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  1. Article: PRE-DONATION SCREENING OF VOLUNTEER PRISONER BLOOD DONORS FOR HEPATITIS B AND C IN PRISONS OF PUNJAB, PAKISTAN.

    Pervaiz, Aslam / Sipra, Fateh Sher / Rana, Tanveer Hussain / Qadeer, Imran

    Journal of Ayub Medical College, Abbottabad : JAMC

    2015  Volume 27, Issue 4, Page(s) 794–797

    Abstract: Background: Prisoners as a high risk group are never recommended for blood donations. In Pakistan, prisoners are legally allowed to donate blood and get thirty days extra remission. Inspectorate of prisons allowed Alizaib Foundation for blood donation ... ...

    Abstract Background: Prisoners as a high risk group are never recommended for blood donations. In Pakistan, prisoners are legally allowed to donate blood and get thirty days extra remission. Inspectorate of prisons allowed Alizaib Foundation for blood donation camps subject to predonation screening of volunteer prisoner blood donor against infectious diseases. This study was conducted to identify the potential benefits of pre-donation screening.
    Methods: This cross sectional study was conducted in October, 2009 in Punjab. Intending volunteer prisoner blood donors from January, 2007 to September, 2009 from prisons of Punjab were included. Physically fit were tested for Hepatitis C Virus (HCV) and B Virus (HBV) by Rapid test kit before bleeding. Data was analysed by Epi-Info.
    Results: A total of 5894 male volunteer prisoner donors were screened and 1038 (17.6%) were rejected. The mean age was 28 years (range: 17-70 years). Of 5894, 857 (14.5%) were HCV positive and 222 (3.8%) were HBV positive. HCV & HBV co-infection was present among 41 (0.7%). Being convicted prisoner blood donor is significantly associated with higher seroprevalence for HCV (OR 1.35, 95% C.I. 1.17-1.57) and being under trial prisoner is significantly associated with higher seroprevalence for HBV (OR 1.40, 95% C.I. 1.06-1.85).
    Conclusion: Hepatitis B & C viruses were responsible for almost 18% prisoner blood donor rejection. Pre-donation screening of blood donors is an effective intervention to improve the safety and limit the cost of blood. Treatment of identified cases may contribute to public health. In the international scenario this study findings necessitate the amendments in the relevant prison rules.
    MeSH term(s) Adolescent ; Adult ; Aged ; Antibodies, Viral/analysis ; Blood Donors ; Cross-Sectional Studies ; Female ; Hepacivirus/immunology ; Hepatitis B/blood ; Hepatitis B/epidemiology ; Hepatitis B virus/immunology ; Hepatitis C/blood ; Hepatitis C/epidemiology ; Humans ; Male ; Mass Screening/methods ; Middle Aged ; Morbidity/trends ; Pakistan/epidemiology ; Prisoners ; Seroepidemiologic Studies ; Volunteers ; Young Adult
    Chemical Substances Antibodies, Viral
    Language English
    Publishing date 2015-10
    Publishing country Pakistan
    Document type Journal Article
    ZDB-ID 2192473-9
    ISSN 1025-9589
    ISSN 1025-9589
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6109: Show issues Location:
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  2. Article ; Online: Fractional-Dose Inactivated Poliovirus Vaccine Campaign - Sindh Province, Pakistan, 2016.

    Pervaiz, Aslam / Mbaeyi, Chukwuma / Baig, Mirza Amir / Burman, Ashley / Ahmed, Jamal A / Akter, Sharifa / Jatoi, Fayaz A / Mahamud, Abdirahman / Asghar, Rana Jawad / Azam, Naila / Shah, Muhammad Nadeem / Laghari, Mumtaz Ali / Soomro, Kamaluddin / Wadood, Mufti Zubair / Ehrhardt, Derek / Safdar, Rana M / Farag, Noha

    MMWR. Morbidity and mortality weekly report

    2017  Volume 66, Issue 47, Page(s) 1295–1299

    Abstract: Following the declaration of eradication of wild poliovirus (WPV) type 2 in September 2015, trivalent oral poliovirus vaccine (tOPV) was withdrawn globally to reduce the risk for type 2 vaccine-derived poliovirus (VDPV2) transmission; all countries ... ...

    Abstract Following the declaration of eradication of wild poliovirus (WPV) type 2 in September 2015, trivalent oral poliovirus vaccine (tOPV) was withdrawn globally to reduce the risk for type 2 vaccine-derived poliovirus (VDPV2) transmission; all countries implemented a synchronized switch to bivalent OPV (type 1 and 3) in April 2016 (1,2). Any isolation of VDPV2 after the switch is to be treated as a potential public health emergency and might indicate the need for supplementary immunization activities (3,4). On August 9, 2016, VDPV2 was isolated from a sewage sample taken from an environmental surveillance site in Hyderabad, Sindh province, Pakistan. Possible vaccination activities in response to VDPV2 isolation include the use of injectable inactivated polio vaccine (IPV), which poses no risk for vaccine-derived poliovirus transmission. Fractional-dose, intradermal IPV (fIPV), one fifth of the standard intramuscular dose, has been developed to more efficiently manage limited IPV supplies. fIPV has been shown in some studies to be noninferior to full-dose IPV (5,6) and was used successfully in response to a similar detection of a single VDPV2 isolate from sewage in India (7). Injectable fIPV was used for response activities in Hyderabad and three neighboring districts. This report describes the findings of an assessment of preparatory activities and subsequent implementation of the fIPV campaign. Despite achieving high coverage (>80%), several operational challenges were noted. The lessons learned from this campaign could help to guide the planning and implementation of future fIPV vaccination activities.
    MeSH term(s) Disease Outbreaks/prevention & control ; Humans ; Immunization Programs/organization & administration ; Infant ; Pakistan/epidemiology ; Poliomyelitis/epidemiology ; Poliomyelitis/prevention & control ; Poliovirus/isolation & purification ; Poliovirus Vaccine, Inactivated/administration & dosage ; Program Evaluation ; Sewage/virology
    Chemical Substances Poliovirus Vaccine, Inactivated ; Sewage
    Language English
    Publishing date 2017-12-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 412775-4
    ISSN 1545-861X ; 0149-2195
    ISSN (online) 1545-861X
    ISSN 0149-2195
    DOI 10.15585/mmwr.mm6647a4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.B 1827: Show issues Location:
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  3. Article ; Online: Health in times of uncertainty in the eastern Mediterranean region, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

    Mokdad, Ali H / Forouzanfar, Mohammad Hossein / Daoud, Farah / El Bcheraoui, Charbel / Moradi-Lakeh, Maziar / Khalil, Ibrahim / Afshin, Ashkan / Tuffaha, Marwa / Charara, Raghid / Barber, Ryan M / Wagner, Joseph / Cercy, Kelly / Kravitz, Hannah / Coates, Matthew M / Robinson, Margaret / Estep, Kara / Steiner, Caitlyn / Jaber, Sara / Mokdad, Ali A /
    O'Rourke, Kevin F / Chew, Adrienne / Kim, Pauline / El Razek, Mohamed Magdy Abd / Abdalla, Safa / Abd-Allah, Foad / Abraham, Jerry P / Abu-Raddad, Laith J / Abu-Rmeileh, Niveen M E / Al-Nehmi, Abdulwahab A / Akanda, Ali S / Al Ahmadi, Hanan / Al Khabouri, Mazin J / Al Lami, Faris H / Al Rayess, Zulfa A / Alasfoor, Deena / AlBuhairan, Fadia S / Aldhahri, Saleh F / Alghnam, Suliman / Alhabib, Samia / Al-Hamad, Nawal / Ali, Raghib / Ali, Syed Danish / Alkhateeb, Mohammad / AlMazroa, Mohammad A / Alomari, Mahmoud A / Al-Raddadi, Rajaa / Alsharif, Ubai / Al-Sheyab, Nihaya / Alsowaidi, Shirina / Al-Thani, Mohamed / Altirkawi, Khalid A / Amare, Azmeraw T / Amini, Heresh / Ammar, Walid / Anwari, Palwasha / Asayesh, Hamid / Asghar, Rana / Assabri, Ali M / Assadi, Reza / Bacha, Umar / Badawi, Alaa / Bakfalouni, Talal / Basulaiman, Mohammed O / Bazargan-Hejazi, Shahrzad / Bedi, Neeraj / Bhakta, Amit R / Bhutta, Zulfiqar A / Bin Abdulhak, Aref A / Boufous, Soufiane / Bourne, Rupert R A / Danawi, Hadi / Das, Jai / Deribew, Amare / Ding, Eric L / Durrani, Adnan M / Elshrek, Yousef / Ibrahim, Mohamed E / Eshrati, Babak / Esteghamati, Alireza / Faghmous, Imad A D / Farzadfar, Farshad / Feigl, Andrea B / Fereshtehnejad, Seyed-Mohammad / Filip, Irina / Fischer, Florian / Gankpé, Fortuné G / Ginawi, Ibrahim / Gishu, Melkamu Dedefo / Gupta, Rahul / Habash, Rami M / Hafezi-Nejad, Nima / Hamadeh, Randah R / Hamdouni, Hayet / Hamidi, Samer / Harb, Hilda L / Hassanvand, Mohammad Sadegh / Hedayati, Mohammad T / Heydarpour, Pouria / Hsairi, Mohamed / Husseini, Abdullatif / Jahanmehr, Nader / Jha, Vivekanand / Jonas, Jost B / Karam, Nadim E / Kasaeian, Amir / Kassa, Nega Assefa / Kaul, Anil / Khader, Yousef / Khalifa, Shams Eldin A / Khan, Ejaz A / Khan, Gulfaraz / Khoja, Tawfik / Khosravi, Ardeshir / Kinfu, Yohannes / Defo, Barthelemy Kuate / Balaji, Arjun Lakshmana / Lunevicius, Raimundas / Obermeyer, Carla Makhlouf / Malekzadeh, Reza / Mansourian, Morteza / Marcenes, Wagner / Farid, Habibolah Masoudi / Mehari, Alem / Mehio-Sibai, Abla / Memish, Ziad A / Mensah, George A / Mohammad, Karzan A / Nahas, Ziad / Nasher, Jamal T / Nawaz, Haseeb / Nejjari, Chakib / Nisar, Muhammad Imran / Omer, Saad B / Parsaeian, Mahboubeh / Peprah, Emmanuel K / Pervaiz, Aslam / Pourmalek, Farshad / Qato, Dima M / Qorbani, Mostafa / Radfar, Amir / Rafay, Anwar / Rahimi, Kazem / Rahimi-Movaghar, Vafa / Rahman, Sajjad Ur / Rai, Rajesh K / Rana, Saleem M / Rao, Sowmya R / Refaat, Amany H / Resnikoff, Serge / Roshandel, Gholamreza / Saade, Georges / Saeedi, Mohammad Y / Sahraian, Mohammad Ali / Saleh, Shadi / Sanchez-Riera, Lidia / Satpathy, Maheswar / Sepanlou, Sadaf G / Setegn, Tesfaye / Shaheen, Amira / Shahraz, Saeid / Sheikhbahaei, Sara / Shishani, Kawkab / Sliwa, Karen / Tavakkoli, Mohammad / Terkawi, Abdullah S / Uthman, Olalekan A / Westerman, Ronny / Younis, Mustafa Z / El Sayed Zaki, Maysaa / Zannad, Faiez / Roth, Gregory A / Wang, Haidong / Naghavi, Mohsen / Vos, Theo / Al Rabeeah, Abdullah A / Lopez, Alan D / Murray, Christopher J L

    The Lancet. Global health

    2016  Volume 4, Issue 10, Page(s) e704–13

    Abstract: Background: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the ... ...

    Abstract Background: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013.
    Methods: GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically.
    Findings: The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60-80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred.
    Interpretation: Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts.
    Funding: Bill & Melinda Gates Foundation.
    MeSH term(s) Adult ; Africa/epidemiology ; Aged ; Aged, 80 and over ; Aging ; Cardiovascular Diseases/epidemiology ; Child ; Child, Preschool ; Diarrhea/epidemiology ; Global Burden of Disease/trends ; Humans ; Infant ; Infant, Newborn ; Infection/epidemiology ; Life Expectancy ; Middle Aged ; Middle East/epidemiology ; Noncommunicable Diseases/epidemiology ; Obesity/complications ; Obesity/epidemiology ; Quality-Adjusted Life Years ; Risk Factors ; Social Problems ; Wounds and Injuries/epidemiology
    Keywords covid19
    Language English
    Publishing date 2016-08-25
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2723488-5
    ISSN 2214-109X ; 2214-109X
    ISSN (online) 2214-109X
    ISSN 2214-109X
    DOI 10.1016/S2214-109X(16)30168-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

    Murray, Christopher J L / Ortblad, Katrina F / Guinovart, Caterina / Lim, Stephen S / Wolock, Timothy M / Roberts, D Allen / Dansereau, Emily A / Graetz, Nicholas / Barber, Ryan M / Brown, Jonathan C / Wang, Haidong / Duber, Herbert C / Naghavi, Mohsen / Dicker, Daniel / Dandona, Lalit / Salomon, Joshua A / Heuton, Kyle R / Foreman, Kyle / Phillips, David E /
    Fleming, Thomas D / Flaxman, Abraham D / Phillips, Bryan K / Johnson, Elizabeth K / Coggeshall, Megan S / Abd-Allah, Foad / Abera, Semaw Ferede / Abraham, Jerry P / Abubakar, Ibrahim / Abu-Raddad, Laith J / Abu-Rmeileh, Niveen Me / Achoki, Tom / Adeyemo, Austine Olufemi / Adou, Arsène Kouablan / Adsuar, José C / Agardh, Emilie Elisabet / Akena, Dickens / Al Kahbouri, Mazin J / Alasfoor, Deena / Albittar, Mohammed I / Alcalá-Cerra, Gabriel / Alegretti, Miguel Angel / Alemu, Zewdie Aderaw / Alfonso-Cristancho, Rafael / Alhabib, Samia / Ali, Raghib / Alla, Francois / Allen, Peter J / Alsharif, Ubai / Alvarez, Elena / Alvis-Guzman, Nelson / Amankwaa, Adansi A / Amare, Azmeraw T / Amini, Hassan / Ammar, Walid / Anderson, Benjamin O / Antonio, Carl Abelardo T / Anwari, Palwasha / Arnlöv, Johan / Arsenijevic, Valentina S Arsic / Artaman, Ali / Asghar, Rana J / Assadi, Reza / Atkins, Lydia S / Badawi, Alaa / Balakrishnan, Kalpana / Banerjee, Amitava / Basu, Sanjay / Beardsley, Justin / Bekele, Tolesa / Bell, Michelle L / Bernabe, Eduardo / Beyene, Tariku Jibat / Bhala, Neeraj / Bhalla, Ashish / Bhutta, Zulfiqar A / Abdulhak, Aref Bin / Binagwaho, Agnes / Blore, Jed D / Basara, Berrak Bora / Bose, Dipan / Brainin, Michael / Breitborde, Nicholas / Castañeda-Orjuela, Carlos A / Catalá-López, Ferrán / Chadha, Vineet K / Chang, Jung-Chen / Chiang, Peggy Pei-Chia / Chuang, Ting-Wu / Colomar, Mercedes / Cooper, Leslie Trumbull / Cooper, Cyrus / Courville, Karen J / Cowie, Benjamin C / Criqui, Michael H / Dandona, Rakhi / Dayama, Anand / De Leo, Diego / Degenhardt, Louisa / Del Pozo-Cruz, Borja / Deribe, Kebede / Des Jarlais, Don C / Dessalegn, Muluken / Dharmaratne, Samath D / Dilmen, Uğur / Ding, Eric L / Driscoll, Tim R / Durrani, Adnan M / Ellenbogen, Richard G / Ermakov, Sergey Petrovich / Esteghamati, Alireza / Faraon, Emerito Jose A / Farzadfar, Farshad / Fereshtehnejad, Seyed-Mohammad / Fijabi, Daniel Obadare / Forouzanfar, Mohammad H / Fra Paleo, Urbano / Gaffikin, Lynne / Gamkrelidze, Amiran / Gankpé, Fortuné Gbètoho / Geleijnse, Johanna M / Gessner, Bradford D / Gibney, Katherine B / Ginawi, Ibrahim Abdelmageem Mohamed / Glaser, Elizabeth L / Gona, Philimon / Goto, Atsushi / Gouda, Hebe N / Gugnani, Harish Chander / Gupta, Rajeev / Gupta, Rahul / Hafezi-Nejad, Nima / Hamadeh, Randah Ribhi / Hammami, Mouhanad / Hankey, Graeme J / Harb, Hilda L / Haro, Josep Maria / Havmoeller, Rasmus / Hay, Simon I / Hedayati, Mohammad T / Pi, Ileana B Heredia / Hoek, Hans W / Hornberger, John C / Hosgood, H Dean / Hotez, Peter J / Hoy, Damian G / Huang, John J / Iburg, Kim M / Idrisov, Bulat T / Innos, Kaire / Jacobsen, Kathryn H / Jeemon, Panniyammakal / Jensen, Paul N / Jha, Vivekanand / Jiang, Guohong / Jonas, Jost B / Juel, Knud / Kan, Haidong / Kankindi, Ida / Karam, Nadim E / Karch, André / Karema, Corine Kakizi / Kaul, Anil / Kawakami, Norito / Kazi, Dhruv S / Kemp, Andrew H / Kengne, Andre Pascal / Keren, Andre / Kereselidze, Maia / Khader, Yousef Saleh / Khalifa, Shams Eldin Ali Hassan / Khan, Ejaz Ahmed / Khang, Young-Ho / Khonelidze, Irma / Kinfu, Yohannes / Kinge, Jonas M / Knibbs, Luke / Kokubo, Yoshihiro / Kosen, S / Defo, Barthelemy Kuate / Kulkarni, Veena S / Kulkarni, Chanda / Kumar, Kaushalendra / Kumar, Ravi B / Kumar, G Anil / Kwan, Gene F / Lai, Taavi / Balaji, Arjun Lakshmana / Lam, Hilton / Lan, Qing / Lansingh, Van C / Larson, Heidi J / Larsson, Anders / Lee, Jong-Tae / Leigh, James / Leinsalu, Mall / Leung, Ricky / Li, Yichong / Li, Yongmei / De Lima, Graça Maria Ferreira / Lin, Hsien-Ho / Lipshultz, Steven E / Liu, Shiwei / Liu, Yang / Lloyd, Belinda K / Lotufo, Paulo A / Machado, Vasco Manuel Pedro / Maclachlan, Jennifer H / Magis-Rodriguez, Carlos / Majdan, Marek / Mapoma, Christopher Chabila / Marcenes, Wagner / Marzan, Melvin Barrientos / Masci, Joseph R / Mashal, Mohammad Taufiq / Mason-Jones, Amanda J / Mayosi, Bongani M / Mazorodze, Tasara T / Mckay, Abigail Cecilia / Meaney, Peter A / Mehndiratta, Man Mohan / Mejia-Rodriguez, Fabiola / Melaku, Yohannes Adama / Memish, Ziad A / Mendoza, Walter / Miller, Ted R / Mills, Edward J / Mohammad, Karzan Abdulmuhsin / Mokdad, Ali H / Mola, Glen Liddell / Monasta, Lorenzo / Montico, Marcella / Moore, Ami R / Mori, Rintaro / Moturi, Wilkister Nyaora / Mukaigawara, Mitsuru / Murthy, Kinnari S / Naheed, Aliya / Naidoo, Kovin S / Naldi, Luigi / Nangia, Vinay / Narayan, K M Venkat / Nash, Denis / Nejjari, Chakib / Nelson, Robert G / Neupane, Sudan Prasad / Newton, Charles R / Ng, Marie / Nisar, Muhammad Imran / Nolte, Sandra / Norheim, Ole F / Nowaseb, Vincent / Nyakarahuka, Luke / Oh, In-Hwan / Ohkubo, Takayoshi / Olusanya, Bolajoko O / Omer, Saad B / Opio, John Nelson / Orisakwe, Orish Ebere / Pandian, Jeyaraj D / Papachristou, Christina / Caicedo, Angel J Paternina / Patten, Scott B / Paul, Vinod K / Pavlin, Boris Igor / Pearce, Neil / Pereira, David M / Pervaiz, Aslam / Pesudovs, Konrad / Petzold, Max / Pourmalek, Farshad / Qato, Dima / Quezada, Amado D / Quistberg, D Alex / Rafay, Anwar / Rahimi, Kazem / Rahimi-Movaghar, Vafa / Ur Rahman, Sajjad / Raju, Murugesan / Rana, Saleem M / Razavi, Homie / Reilly, Robert Quentin / Remuzzi, Giuseppe / Richardus, Jan Hendrik / Ronfani, Luca / Roy, Nobhojit / Sabin, Nsanzimana / Saeedi, Mohammad Yahya / Sahraian, Mohammad Ali / Samonte, Genesis May J / Sawhney, Monika / Schneider, Ione J C / Schwebel, David C / Seedat, Soraya / Sepanlou, Sadaf G / Servan-Mori, Edson E / Sheikhbahaei, Sara / Shibuya, Kenji / Shin, Hwashin Hyun / Shiue, Ivy / Shivakoti, Rupak / Sigfusdottir, Inga Dora / Silberberg, Donald H / Silva, Andrea P / Simard, Edgar P / Singh, Jasvinder A / Skirbekk, Vegard / Sliwa, Karen / Soneji, Samir / Soshnikov, Sergey S / Sreeramareddy, Chandrashekhar T / Stathopoulou, Vasiliki Kalliopi / Stroumpoulis, Konstantinos / Swaminathan, Soumya / Sykes, Bryan L / Tabb, Karen M / Talongwa, Roberto Tchio / Tenkorang, Eric Yeboah / Terkawi, Abdullah Sulieman / Thomson, Alan J / Thorne-Lyman, Andrew L / Towbin, Jeffrey A / Traebert, Jefferson / Tran, Bach X / Dimbuene, Zacharie Tsala / Tsilimbaris, Miltiadis / Uchendu, Uche S / Ukwaja, Kingsley N / Uzun, Selen Begüm / Vallely, Andrew J / Vasankari, Tommi J / Venketasubramanian, N / Violante, Francesco S / Vlassov, Vasiliy Victorovich / Vollset, Stein Emil / Waller, Stephen / Wallin, Mitchell T / Wang, Linhong / Wang, XiaoRong / Wang, Yanping / Weichenthal, Scott / Weiderpass, Elisabete / Weintraub, Robert G / Westerman, Ronny / White, Richard A / Wilkinson, James D / Williams, Thomas Neil / Woldeyohannes, Solomon Meseret / Wong, John Q / Xu, Gelin / Yang, Yang C / Yano, Yuichiro / Yentur, Gokalp Kadri / Yip, Paul / Yonemoto, Naohiro / Yoon, Seok-Jun / Younis, Mustafa / Yu, Chuanhua / Jin, Kim Yun / El Sayed Zaki, Maysaa / Zhao, Yong / Zheng, Yingfeng / Zhou, Maigeng / Zhu, Jun / Zou, Xiao Nong / Lopez, Alan D / Vos, Theo

    Lancet (London, England)

    2014  Volume 384, Issue 9947, Page(s) 1005–1070

    Abstract: Background: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and ... ...

    Abstract Background: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration.
    Methods: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets.
    Findings: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990.
    Interpretation: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action.
    Funding: Bill & Melinda Gates Foundation.
    MeSH term(s) Age Distribution ; Epidemics/statistics & numerical data ; Female ; Global Health/trends ; HIV Infections/epidemiology ; Humans ; Incidence ; Malaria/epidemiology ; Male ; Mortality/trends ; Organizational Objectives ; Sex Distribution ; Tuberculosis/epidemiology
    Language English
    Publishing date 2014-07-22
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(14)60844-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

    Forouzanfar, Mohammad H / Alexander, Lily / Anderson, H Ross / Bachman, Victoria F / Biryukov, Stan / Brauer, Michael / Burnett, Richard / Casey, Daniel / Coates, Matthew M / Cohen, Aaron / Delwiche, Kristen / Estep, Kara / Frostad, Joseph J / Astha, K C / Kyu, Hmwe H / Moradi-Lakeh, Maziar / Ng, Marie / Slepak, Erica Leigh / Thomas, Bernadette A /
    Wagner, Joseph / Aasvang, Gunn Marit / Abbafati, Cristiana / Abbasoglu Ozgoren, Ayse / Abd-Allah, Foad / Abera, Semaw F / Aboyans, Victor / Abraham, Biju / Abraham, Jerry Puthenpurakal / Abubakar, Ibrahim / Abu-Rmeileh, Niveen M E / Aburto, Tania C / Achoki, Tom / Adelekan, Ademola / Adofo, Koranteng / Adou, Arsène K / Adsuar, José C / Afshin, Ashkan / Agardh, Emilie E / Al Khabouri, Mazin J / Al Lami, Faris H / Alam, Sayed Saidul / Alasfoor, Deena / Albittar, Mohammed I / Alegretti, Miguel A / Aleman, Alicia V / Alemu, Zewdie A / Alfonso-Cristancho, Rafael / Alhabib, Samia / Ali, Raghib / Ali, Mohammed K / Alla, François / Allebeck, Peter / Allen, Peter J / Alsharif, Ubai / Alvarez, Elena / Alvis-Guzman, Nelson / Amankwaa, Adansi A / Amare, Azmeraw T / Ameh, Emmanuel A / Ameli, Omid / Amini, Heresh / Ammar, Walid / Anderson, Benjamin O / Antonio, Carl Abelardo T / Anwari, Palwasha / Argeseanu Cunningham, Solveig / Arnlöv, Johan / Arsenijevic, Valentina S Arsic / Artaman, Al / Asghar, Rana J / Assadi, Reza / Atkins, Lydia S / Atkinson, Charles / Avila, Marco A / Awuah, Baffour / Badawi, Alaa / Bahit, Maria C / Bakfalouni, Talal / Balakrishnan, Kalpana / Balalla, Shivanthi / Balu, Ravi Kumar / Banerjee, Amitava / Barber, Ryan M / Barker-Collo, Suzanne L / Barquera, Simon / Barregard, Lars / Barrero, Lope H / Barrientos-Gutierrez, Tonatiuh / Basto-Abreu, Ana C / Basu, Arindam / Basu, Sanjay / Basulaiman, Mohammed O / Batis Ruvalcaba, Carolina / Beardsley, Justin / Bedi, Neeraj / Bekele, Tolesa / Bell, Michelle L / Benjet, Corina / Bennett, Derrick A / Benzian, Habib / Bernabé, Eduardo / Beyene, Tariku J / Bhala, Neeraj / Bhalla, Ashish / Bhutta, Zulfiqar A / Bikbov, Boris / Bin Abdulhak, Aref A / Blore, Jed D / Blyth, Fiona M / Bohensky, Megan A / Bora Başara, Berrak / Borges, Guilherme / Bornstein, Natan M / Bose, Dipan / Boufous, Soufiane / Bourne, Rupert R / Brainin, Michael / Brazinova, Alexandra / Breitborde, Nicholas J / Brenner, Hermann / Briggs, Adam D M / Broday, David M / Brooks, Peter M / Bruce, Nigel G / Brugha, Traolach S / Brunekreef, Bert / Buchbinder, Rachelle / Bui, Linh N / Bukhman, Gene / Bulloch, Andrew G / Burch, Michael / Burney, Peter G J / Campos-Nonato, Ismael R / Campuzano, Julio C / Cantoral, Alejandra J / Caravanos, Jack / Cárdenas, Rosario / Cardis, Elisabeth / Carpenter, David O / Caso, Valeria / Castañeda-Orjuela, Carlos A / Castro, Ruben E / Catalá-López, Ferrán / Cavalleri, Fiorella / Çavlin, Alanur / Chadha, Vineet K / Chang, Jung-Chen / Charlson, Fiona J / Chen, Honglei / Chen, Wanqing / Chen, Zhengming / Chiang, Peggy P / Chimed-Ochir, Odgerel / Chowdhury, Rajiv / Christophi, Costas A / Chuang, Ting-Wu / Chugh, Sumeet S / Cirillo, Massimo / Claßen, Thomas K D / Colistro, Valentina / Colomar, Mercedes / Colquhoun, Samantha M / Contreras, Alejandra G / Cooper, Cyrus / Cooperrider, Kimberly / Cooper, Leslie T / Coresh, Josef / Courville, Karen J / Criqui, Michael H / Cuevas-Nasu, Lucia / Damsere-Derry, James / Danawi, Hadi / Dandona, Lalit / Dandona, Rakhi / Dargan, Paul I / Davis, Adrian / Davitoiu, Dragos V / Dayama, Anand / de Castro, E Filipa / De la Cruz-Góngora, Vanessa / De Leo, Diego / de Lima, Graça / Degenhardt, Louisa / del Pozo-Cruz, Borja / Dellavalle, Robert P / Deribe, Kebede / Derrett, Sarah / Des Jarlais, Don C / Dessalegn, Muluken / deVeber, Gabrielle A / Devries, Karen M / Dharmaratne, Samath D / Dherani, Mukesh K / Dicker, Daniel / Ding, Eric L / Dokova, Klara / Dorsey, E Ray / Driscoll, Tim R / Duan, Leilei / Durrani, Adnan M / Ebel, Beth E / Ellenbogen, Richard G / Elshrek, Yousef M / Endres, Matthias / Ermakov, Sergey P / Erskine, Holly E / Eshrati, Babak / Esteghamati, Alireza / Fahimi, Saman / Faraon, Emerito Jose A / Farzadfar, Farshad / Fay, Derek F J / Feigin, Valery L / Feigl, Andrea B / Fereshtehnejad, Seyed-Mohammad / Ferrari, Alize J / Ferri, Cleusa P / Flaxman, Abraham D / Fleming, Thomas D / Foigt, Nataliya / Foreman, Kyle J / Paleo, Urbano Fra / Franklin, Richard C / Gabbe, Belinda / Gaffikin, Lynne / Gakidou, Emmanuela / Gamkrelidze, Amiran / Gankpé, Fortuné G / Gansevoort, Ron T / García-Guerra, Francisco A / Gasana, Evariste / Geleijnse, Johanna M / Gessner, Bradford D / Gething, Pete / Gibney, Katherine B / Gillum, Richard F / Ginawi, Ibrahim A M / Giroud, Maurice / Giussani, Giorgia / Goenka, Shifalika / Goginashvili, Ketevan / Gomez Dantes, Hector / Gona, Philimon / Gonzalez de Cosio, Teresita / González-Castell, Dinorah / Gotay, Carolyn C / Goto, Atsushi / Gouda, Hebe N / Guerrant, Richard L / Gugnani, Harish C / Guillemin, Francis / Gunnell, David / Gupta, Rahul / Gupta, Rajeev / Gutiérrez, Reyna A / Hafezi-Nejad, Nima / Hagan, Holly / Hagstromer, Maria / Halasa, Yara A / Hamadeh, Randah R / Hammami, Mouhanad / Hankey, Graeme J / Hao, Yuantao / Harb, Hilda L / Haregu, Tilahun Nigatu / Haro, Josep Maria / Havmoeller, Rasmus / Hay, Simon I / Hedayati, Mohammad T / Heredia-Pi, Ileana B / Hernandez, Lucia / Heuton, Kyle R / Heydarpour, Pouria / Hijar, Martha / Hoek, Hans W / Hoffman, Howard J / Hornberger, John C / Hosgood, H Dean / Hoy, Damian G / Hsairi, Mohamed / Hu, Guoqing / Hu, Howard / Huang, Cheng / Huang, John J / Hubbell, Bryan J / Huiart, Laetitia / Husseini, Abdullatif / Iannarone, Marissa L / Iburg, Kim M / Idrisov, Bulat T / Ikeda, Nayu / Innos, Kaire / Inoue, Manami / Islami, Farhad / Ismayilova, Samaya / Jacobsen, Kathryn H / Jansen, Henrica A / Jarvis, Deborah L / Jassal, Simerjot K / Jauregui, Alejandra / Jayaraman, Sudha / Jeemon, Panniyammakal / Jensen, Paul N / Jha, Vivekanand / Jiang, Fan / Jiang, Guohong / Jiang, Ying / Jonas, Jost B / Juel, Knud / Kan, Haidong / Kany Roseline, Sidibe S / Karam, Nadim E / Karch, André / Karema, Corine K / Karthikeyan, Ganesan / Kaul, Anil / Kawakami, Norito / Kazi, Dhruv S / Kemp, Andrew H / Kengne, Andre P / Keren, Andre / Khader, Yousef S / Khalifa, Shams Eldin Ali Hassan / Khan, Ejaz A / Khang, Young-Ho / Khatibzadeh, Shahab / Khonelidze, Irma / Kieling, Christian / Kim, Daniel / Kim, Sungroul / Kim, Yunjin / Kimokoti, Ruth W / Kinfu, Yohannes / Kinge, Jonas M / Kissela, Brett M / Kivipelto, Miia / Knibbs, Luke D / Knudsen, Ann Kristin / Kokubo, Yoshihiro / Kose, M Rifat / Kosen, Soewarta / Kraemer, Alexander / Kravchenko, Michael / Krishnaswami, Sanjay / Kromhout, Hans / Ku, Tiffany / Kuate Defo, Barthelemy / Kucuk Bicer, Burcu / Kuipers, Ernst J / Kulkarni, Chanda / Kulkarni, Veena S / Kumar, G Anil / Kwan, Gene F / Lai, Taavi / Lakshmana Balaji, Arjun / Lalloo, Ratilal / Lallukka, Tea / Lam, Hilton / Lan, Qing / Lansingh, Van C / Larson, Heidi J / Larsson, Anders / Laryea, Dennis O / Lavados, Pablo M / Lawrynowicz, Alicia E / Leasher, Janet L / Lee, Jong-Tae / Leigh, James / Leung, Ricky / Levi, Miriam / Li, Yichong / Li, Yongmei / Liang, Juan / Liang, Xiaofeng / Lim, Stephen S / Lindsay, M Patrice / Lipshultz, Steven E / Liu, Shiwei / Liu, Yang / Lloyd, Belinda K / Logroscino, Giancarlo / London, Stephanie J / Lopez, Nancy / Lortet-Tieulent, Joannie / Lotufo, Paulo A / Lozano, Rafael / Lunevicius, Raimundas / Ma, Jixiang / Ma, Stefan / Machado, Vasco M P / MacIntyre, Michael F / Magis-Rodriguez, Carlos / Mahdi, Abbas A / Majdan, Marek / Malekzadeh, Reza / Mangalam, Srikanth / Mapoma, Christopher C / Marape, Marape / Marcenes, Wagner / Margolis, David J / Margono, Christopher / Marks, Guy B / Martin, Randall V / Marzan, Melvin B / Mashal, Mohammad T / Masiye, Felix / Mason-Jones, Amanda J / Matsushita, Kunihiro / Matzopoulos, Richard / Mayosi, Bongani M / Mazorodze, Tasara T / McKay, Abigail C / McKee, Martin / McLain, Abigail / Meaney, Peter A / Medina, Catalina / Mehndiratta, Man Mohan / Mejia-Rodriguez, Fabiola / Mekonnen, Wubegzier / Melaku, Yohannes A / Meltzer, Michele / Memish, Ziad A / Mendoza, Walter / Mensah, George A / Meretoja, Atte / Mhimbira, Francis Apolinary / Micha, Renata / Miller, Ted R / Mills, Edward J / Misganaw, Awoke / Mishra, Santosh / Mohamed Ibrahim, Norlinah / Mohammad, Karzan A / Mokdad, Ali H / Mola, Glen L / Monasta, Lorenzo / Montañez Hernandez, Julio C / Montico, Marcella / Moore, Ami R / Morawska, Lidia / Mori, Rintaro / Moschandreas, Joanna / Moturi, Wilkister N / Mozaffarian, Dariush / Mueller, Ulrich O / Mukaigawara, Mitsuru / Mullany, Erin C / Murthy, Kinnari S / Naghavi, Mohsen / Nahas, Ziad / Naheed, Aliya / Naidoo, Kovin S / Naldi, Luigi / Nand, Devina / Nangia, Vinay / Narayan, K M Venkat / Nash, Denis / Neal, Bruce / Nejjari, Chakib / Neupane, Sudan P / Newton, Charles R / Ngalesoni, Frida N / Ngirabega, Jean de Dieu / Nguyen, Grant / Nguyen, Nhung T / Nieuwenhuijsen, Mark J / Nisar, Muhammad I / Nogueira, José R / Nolla, Joan M / Nolte, Sandra / Norheim, Ole F / Norman, Rosana E / Norrving, Bo / Nyakarahuka, Luke / Oh, In-Hwan / Ohkubo, Takayoshi / Olusanya, Bolajoko O / Omer, Saad B / Opio, John Nelson / Orozco, Ricardo / Pagcatipunan, Rodolfo S / Pain, Amanda W / Pandian, Jeyaraj D / Panelo, Carlo Irwin A / Papachristou, Christina / Park, Eun-Kee / Parry, Charles D / Paternina Caicedo, Angel J / Patten, Scott B / Paul, Vinod K / Pavlin, Boris I / Pearce, Neil / Pedraza, Lilia S / Pedroza, Andrea / Pejin Stokic, Ljiljana / Pekericli, Ayfer / Pereira, David M / Perez-Padilla, Rogelio / Perez-Ruiz, Fernando / Perico, Norberto / Perry, Samuel A L / Pervaiz, Aslam / Pesudovs, Konrad / Peterson, Carrie B / Petzold, Max / Phillips, Michael R / Phua, Hwee Pin / Plass, Dietrich / Poenaru, Dan / Polanczyk, Guilherme V / Polinder, Suzanne / Pond, Constance D / Pope, C Arden / Pope, Daniel / Popova, Svetlana / Pourmalek, Farshad / Powles, John / Prabhakaran, Dorairaj / Prasad, Noela M / Qato, Dima M / Quezada, Amado D / Quistberg, D Alex A / Racapé, Lionel / Rafay, Anwar / Rahimi, Kazem / Rahimi-Movaghar, Vafa / Rahman, Sajjad Ur / Raju, Murugesan / Rakovac, Ivo / Rana, Saleem M / Rao, Mayuree / Razavi, Homie / Reddy, K Srinath / Refaat, Amany H / Rehm, Jürgen / Remuzzi, Giuseppe / Ribeiro, Antonio L / Riccio, Patricia M / Richardson, Lee / Riederer, Anne / Robinson, Margaret / Roca, Anna / Rodriguez, Alina / Rojas-Rueda, David / Romieu, Isabelle / Ronfani, Luca / Room, Robin / Roy, Nobhojit / Ruhago, George M / Rushton, Lesley / Sabin, Nsanzimana / Sacco, Ralph L / Saha, Sukanta / Sahathevan, Ramesh / Sahraian, Mohammad Ali / Salomon, Joshua A / Salvo, Deborah / Sampson, Uchechukwu K / Sanabria, Juan R / Sanchez, Luz Maria / Sánchez-Pimienta, Tania G / Sanchez-Riera, Lidia / Sandar, Logan / Santos, Itamar S / Sapkota, Amir / Satpathy, Maheswar / Saunders, James E / Sawhney, Monika / Saylan, Mete I / Scarborough, Peter / Schmidt, Jürgen C / Schneider, Ione J C / Schöttker, Ben / Schwebel, David C / Scott, James G / Seedat, Soraya / Sepanlou, Sadaf G / Serdar, Berrin / Servan-Mori, Edson E / Shaddick, Gavin / Shahraz, Saeid / Levy, Teresa Shamah / Shangguan, Siyi / She, Jun / Sheikhbahaei, Sara / Shibuya, Kenji / Shin, Hwashin H / Shinohara, Yukito / Shiri, Rahman / Shishani, Kawkab / Shiue, Ivy / Sigfusdottir, Inga D / Silberberg, Donald H / Simard, Edgar P / Sindi, Shireen / Singh, Abhishek / Singh, Gitanjali M / Singh, Jasvinder A / Skirbekk, Vegard / Sliwa, Karen / Soljak, Michael / Soneji, Samir / Søreide, Kjetil / Soshnikov, Sergey / Sposato, Luciano A / Sreeramareddy, Chandrashekhar T / Stapelberg, Nicolas J C / Stathopoulou, Vasiliki / Steckling, Nadine / Stein, Dan J / Stein, Murray B / Stephens, Natalie / Stöckl, Heidi / Straif, Kurt / Stroumpoulis, Konstantinos / Sturua, Lela / Sunguya, Bruno F / Swaminathan, Soumya / Swaroop, Mamta / Sykes, Bryan L / Tabb, Karen M / Takahashi, Ken / Talongwa, Roberto T / Tandon, Nikhil / Tanne, David / Tanner, Marcel / Tavakkoli, Mohammad / Te Ao, Braden J / Teixeira, Carolina M / Téllez Rojo, Martha M / Terkawi, Abdullah S / Texcalac-Sangrador, José Luis / Thackway, Sarah V / Thomson, Blake / Thorne-Lyman, Andrew L / Thrift, Amanda G / Thurston, George D / Tillmann, Taavi / Tobollik, Myriam / Tonelli, Marcello / Topouzis, Fotis / Towbin, Jeffrey A / Toyoshima, Hideaki / Traebert, Jefferson / Tran, Bach X / Trasande, Leonardo / Trillini, Matias / Trujillo, Ulises / Dimbuene, Zacharie Tsala / Tsilimbaris, Miltiadis / Tuzcu, Emin Murat / Uchendu, Uche S / Ukwaja, Kingsley N / Uzun, Selen B / van de Vijver, Steven / Van Dingenen, Rita / van Gool, Coen H / van Os, Jim / Varakin, Yuri Y / Vasankari, Tommi J / Vasconcelos, Ana Maria N / Vavilala, Monica S / Veerman, Lennert J / Velasquez-Melendez, Gustavo / Venketasubramanian, N / Vijayakumar, Lakshmi / Villalpando, Salvador / Violante, Francesco S / Vlassov, Vasiliy Victorovich / Vollset, Stein Emil / Wagner, Gregory R / Waller, Stephen G / Wallin, Mitchell T / Wan, Xia / Wang, Haidong / Wang, JianLi / Wang, Linhong / Wang, Wenzhi / Wang, Yanping / Warouw, Tati S / Watts, Charlotte H / Weichenthal, Scott / Weiderpass, Elisabete / Weintraub, Robert G / Werdecker, Andrea / Wessells, K Ryan / Westerman, Ronny / Whiteford, Harvey A / Wilkinson, James D / Williams, Hywel C / Williams, Thomas N / Woldeyohannes, Solomon M / Wolfe, Charles D A / Wong, John Q / Woolf, Anthony D / Wright, Jonathan L / Wurtz, Brittany / Xu, Gelin / Yan, Lijing L / Yang, Gonghuan / Yano, Yuichiro / Ye, Pengpeng / Yenesew, Muluken / Yentür, Gökalp K / Yip, Paul / Yonemoto, Naohiro / Yoon, Seok-Jun / Younis, Mustafa Z / Younoussi, Zourkaleini / Yu, Chuanhua / Zaki, Maysaa E / Zhao, Yong / Zheng, Yingfeng / Zhou, Maigeng / Zhu, Jun / Zhu, Shankuan / Zou, Xiaonong / Zunt, Joseph R / Lopez, Alan D / Vos, Theo / Murray, Christopher J

    Lancet (London, England)

    2015  Volume 386, Issue 10010, Page(s) 2287–2323

    Abstract: Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats ... ...

    Abstract Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.
    Methods: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.
    Findings: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.
    Interpretation: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.
    Funding: Bill & Melinda Gates Foundation.
    MeSH term(s) Environmental Exposure/adverse effects ; Female ; Global Health/statistics & numerical data ; Global Health/trends ; Health Behavior ; Humans ; Male ; Metabolic Diseases/epidemiology ; Nutritional Status ; Occupational Diseases/epidemiology ; Occupational Exposure/adverse effects ; Risk Assessment/methods ; Risk Factors ; Sanitation/trends
    Language English
    Publishing date 2015-09-11
    Publishing country England
    Document type Comparative Study ; Journal Article ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(15)00128-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition.

    Murray, Christopher J L / Barber, Ryan M / Foreman, Kyle J / Abbasoglu Ozgoren, Ayse / Abd-Allah, Foad / Abera, Semaw F / Aboyans, Victor / Abraham, Jerry P / Abubakar, Ibrahim / Abu-Raddad, Laith J / Abu-Rmeileh, Niveen M / Achoki, Tom / Ackerman, Ilana N / Ademi, Zanfina / Adou, Arsène K / Adsuar, José C / Afshin, Ashkan / Agardh, Emilie E / Alam, Sayed Saidul /
    Alasfoor, Deena / Albittar, Mohammed I / Alegretti, Miguel A / Alemu, Zewdie A / Alfonso-Cristancho, Rafael / Alhabib, Samia / Ali, Raghib / Alla, François / Allebeck, Peter / Almazroa, Mohammad A / Alsharif, Ubai / Alvarez, Elena / Alvis-Guzman, Nelson / Amare, Azmeraw T / Ameh, Emmanuel A / Amini, Heresh / Ammar, Walid / Anderson, H Ross / Anderson, Benjamin O / Antonio, Carl Abelardo T / Anwari, Palwasha / Arnlöv, Johan / Arsic Arsenijevic, Valentina S / Artaman, Al / Asghar, Rana J / Assadi, Reza / Atkins, Lydia S / Avila, Marco A / Awuah, Baffour / Bachman, Victoria F / Badawi, Alaa / Bahit, Maria C / Balakrishnan, Kalpana / Banerjee, Amitava / Barker-Collo, Suzanne L / Barquera, Simon / Barregard, Lars / Barrero, Lope H / Basu, Arindam / Basu, Sanjay / Basulaiman, Mohammed O / Beardsley, Justin / Bedi, Neeraj / Beghi, Ettore / Bekele, Tolesa / Bell, Michelle L / Benjet, Corina / Bennett, Derrick A / Bensenor, Isabela M / Benzian, Habib / Bernabé, Eduardo / Bertozzi-Villa, Amelia / Beyene, Tariku J / Bhala, Neeraj / Bhalla, Ashish / Bhutta, Zulfiqar A / Bienhoff, Kelly / Bikbov, Boris / Biryukov, Stan / Blore, Jed D / Blosser, Christopher D / Blyth, Fiona M / Bohensky, Megan A / Bolliger, Ian W / Bora Başara, Berrak / Bornstein, Natan M / Bose, Dipan / Boufous, Soufiane / Bourne, Rupert R A / Boyers, Lindsay N / Brainin, Michael / Brayne, Carol E / Brazinova, Alexandra / Breitborde, Nicholas J K / Brenner, Hermann / Briggs, Adam D / Brooks, Peter M / Brown, Jonathan C / Brugha, Traolach S / Buchbinder, Rachelle / Buckle, Geoffrey C / Budke, Christine M / Bulchis, Anne / Bulloch, Andrew G / Campos-Nonato, Ismael R / Carabin, Hélène / Carapetis, Jonathan R / Cárdenas, Rosario / Carpenter, David O / Caso, Valeria / Castañeda-Orjuela, Carlos A / Castro, Ruben E / Catalá-López, Ferrán / Cavalleri, Fiorella / Çavlin, Alanur / Chadha, Vineet K / Chang, Jung-Chen / Charlson, Fiona J / Chen, Honglei / Chen, Wanqing / Chiang, Peggy P / Chimed-Ochir, Odgerel / Chowdhury, Rajiv / Christensen, Hanne / Christophi, Costas A / Cirillo, Massimo / Coates, Matthew M / Coffeng, Luc E / Coggeshall, Megan S / Colistro, Valentina / Colquhoun, Samantha M / Cooke, Graham S / Cooper, Cyrus / Cooper, Leslie T / Coppola, Luis M / Cortinovis, Monica / Criqui, Michael H / Crump, John A / Cuevas-Nasu, Lucia / Danawi, Hadi / Dandona, Lalit / Dandona, Rakhi / Dansereau, Emily / Dargan, Paul I / Davey, Gail / Davis, Adrian / Davitoiu, Dragos V / Dayama, Anand / De Leo, Diego / Degenhardt, Louisa / Del Pozo-Cruz, Borja / Dellavalle, Robert P / Deribe, Kebede / Derrett, Sarah / Des Jarlais, Don C / Dessalegn, Muluken / Dharmaratne, Samath D / Dherani, Mukesh K / Diaz-Torné, Cesar / Dicker, Daniel / Ding, Eric L / Dokova, Klara / Dorsey, E Ray / Driscoll, Tim R / Duan, Leilei / Duber, Herbert C / Ebel, Beth E / Edmond, Karen M / Elshrek, Yousef M / Endres, Matthias / Ermakov, Sergey P / Erskine, Holly E / Eshrati, Babak / Esteghamati, Alireza / Estep, Kara / Faraon, Emerito Jose A / Farzadfar, Farshad / Fay, Derek F / Feigin, Valery L / Felson, David T / Fereshtehnejad, Seyed-Mohammad / Fernandes, Jefferson G / Ferrari, Alize J / Fitzmaurice, Christina / Flaxman, Abraham D / Fleming, Thomas D / Foigt, Nataliya / Forouzanfar, Mohammad H / Fowkes, F Gerry R / Paleo, Urbano Fra / Franklin, Richard C / Fürst, Thomas / Gabbe, Belinda / Gaffikin, Lynne / Gankpé, Fortuné G / Geleijnse, Johanna M / Gessner, Bradford D / Gething, Peter / Gibney, Katherine B / Giroud, Maurice / Giussani, Giorgia / Gomez Dantes, Hector / Gona, Philimon / González-Medina, Diego / Gosselin, Richard A / Gotay, Carolyn C / Goto, Atsushi / Gouda, Hebe N / Graetz, Nicholas / Gugnani, Harish C / Gupta, Rahul / Gupta, Rajeev / Gutiérrez, Reyna A / Haagsma, Juanita / Hafezi-Nejad, Nima / Hagan, Holly / Halasa, Yara A / Hamadeh, Randah R / Hamavid, Hannah / Hammami, Mouhanad / Hancock, Jamie / Hankey, Graeme J / Hansen, Gillian M / Hao, Yuantao / Harb, Hilda L / Haro, Josep Maria / Havmoeller, Rasmus / Hay, Simon I / Hay, Roderick J / Heredia-Pi, Ileana B / Heuton, Kyle R / Heydarpour, Pouria / Higashi, Hideki / Hijar, Martha / Hoek, Hans W / Hoffman, Howard J / Hosgood, H Dean / Hossain, Mazeda / Hotez, Peter J / Hoy, Damian G / Hsairi, Mohamed / Hu, Guoqing / Huang, Cheng / Huang, John J / Husseini, Abdullatif / Huynh, Chantal / Iannarone, Marissa L / Iburg, Kim M / Innos, Kaire / Inoue, Manami / Islami, Farhad / Jacobsen, Kathryn H / Jarvis, Deborah L / Jassal, Simerjot K / Jee, Sun Ha / Jeemon, Panniyammakal / Jensen, Paul N / Jha, Vivekanand / Jiang, Guohong / Jiang, Ying / Jonas, Jost B / Juel, Knud / Kan, Haidong / Karch, André / Karema, Corine K / Karimkhani, Chante / Karthikeyan, Ganesan / Kassebaum, Nicholas J / Kaul, Anil / Kawakami, Norito / Kazanjan, Konstantin / Kemp, Andrew H / Kengne, Andre P / Keren, Andre / Khader, Yousef S / Khalifa, Shams Eldin A / Khan, Ejaz A / Khan, Gulfaraz / Khang, Young-Ho / Kieling, Christian / Kim, Daniel / Kim, Sungroul / Kim, Yunjin / Kinfu, Yohannes / Kinge, Jonas M / Kivipelto, Miia / Knibbs, Luke D / Knudsen, Ann Kristin / Kokubo, Yoshihiro / Kosen, Soewarta / Krishnaswami, Sanjay / Kuate Defo, Barthelemy / Kucuk Bicer, Burcu / Kuipers, Ernst J / Kulkarni, Chanda / Kulkarni, Veena S / Kumar, G Anil / Kyu, Hmwe H / Lai, Taavi / Lalloo, Ratilal / Lallukka, Tea / Lam, Hilton / Lan, Qing / Lansingh, Van C / Larsson, Anders / Lawrynowicz, Alicia E B / Leasher, Janet L / Leigh, James / Leung, Ricky / Levitz, Carly E / Li, Bin / Li, Yichong / Li, Yongmei / Lim, Stephen S / Lind, Maggie / Lipshultz, Steven E / Liu, Shiwei / Liu, Yang / Lloyd, Belinda K / Lofgren, Katherine T / Logroscino, Giancarlo / Looker, Katharine J / Lortet-Tieulent, Joannie / Lotufo, Paulo A / Lozano, Rafael / Lucas, Robyn M / Lunevicius, Raimundas / Lyons, Ronan A / Ma, Stefan / Macintyre, Michael F / Mackay, Mark T / Majdan, Marek / Malekzadeh, Reza / Marcenes, Wagner / Margolis, David J / Margono, Christopher / Marzan, Melvin B / Masci, Joseph R / Mashal, Mohammad T / Matzopoulos, Richard / Mayosi, Bongani M / Mazorodze, Tasara T / Mcgill, Neil W / Mcgrath, John J / Mckee, Martin / Mclain, Abigail / Meaney, Peter A / Medina, Catalina / Mehndiratta, Man Mohan / Mekonnen, Wubegzier / Melaku, Yohannes A / Meltzer, Michele / Memish, Ziad A / Mensah, George A / Meretoja, Atte / Mhimbira, Francis A / Micha, Renata / Miller, Ted R / Mills, Edward J / Mitchell, Philip B / Mock, Charles N / Mohamed Ibrahim, Norlinah / Mohammad, Karzan A / Mokdad, Ali H / Mola, Glen L D / Monasta, Lorenzo / Montañez Hernandez, Julio C / Montico, Marcella / Montine, Thomas J / Mooney, Meghan D / Moore, Ami R / Moradi-Lakeh, Maziar / Moran, Andrew E / Mori, Rintaro / Moschandreas, Joanna / Moturi, Wilkister N / Moyer, Madeline L / Mozaffarian, Dariush / Msemburi, William T / Mueller, Ulrich O / Mukaigawara, Mitsuru / Mullany, Erin C / Murdoch, Michele E / Murray, Joseph / Murthy, Kinnari S / Naghavi, Mohsen / Naheed, Aliya / Naidoo, Kovin S / Naldi, Luigi / Nand, Devina / Nangia, Vinay / Narayan, K M Venkat / Nejjari, Chakib / Neupane, Sudan P / Newton, Charles R / Ng, Marie / Ngalesoni, Frida N / Nguyen, Grant / Nisar, Muhammad I / Nolte, Sandra / Norheim, Ole F / Norman, Rosana E / Norrving, Bo / Nyakarahuka, Luke / Oh, In-Hwan / Ohkubo, Takayoshi / Ohno, Summer L / Olusanya, Bolajoko O / Opio, John Nelson / Ortblad, Katrina / Ortiz, Alberto / Pain, Amanda W / Pandian, Jeyaraj D / Panelo, Carlo Irwin A / Papachristou, Christina / Park, Eun-Kee / Park, Jae-Hyun / Patten, Scott B / Patton, George C / Paul, Vinod K / Pavlin, Boris I / Pearce, Neil / Pereira, David M / Perez-Padilla, Rogelio / Perez-Ruiz, Fernando / Perico, Norberto / Pervaiz, Aslam / Pesudovs, Konrad / Peterson, Carrie B / Petzold, Max / Phillips, Michael R / Phillips, Bryan K / Phillips, David E / Piel, Frédéric B / Plass, Dietrich / Poenaru, Dan / Polinder, Suzanne / Pope, Daniel / Popova, Svetlana / Poulton, Richie G / Pourmalek, Farshad / Prabhakaran, Dorairaj / Prasad, Noela M / Pullan, Rachel L / Qato, Dima M / Quistberg, D Alex / Rafay, Anwar / Rahimi, Kazem / Rahman, Sajjad U / Raju, Murugesan / Rana, Saleem M / Razavi, Homie / Reddy, K Srinath / Refaat, Amany / Remuzzi, Giuseppe / Resnikoff, Serge / Ribeiro, Antonio L / Richardson, Lee / Richardus, Jan Hendrik / Roberts, D Allen / Rojas-Rueda, David / Ronfani, Luca / Roth, Gregory A / Rothenbacher, Dietrich / Rothstein, David H / Rowley, Jane T / Roy, Nobhojit / Ruhago, George M / Saeedi, Mohammad Y / Saha, Sukanta / Sahraian, Mohammad Ali / Sampson, Uchechukwu K A / Sanabria, Juan R / Sandar, Logan / Santos, Itamar S / Satpathy, Maheswar / Sawhney, Monika / Scarborough, Peter / Schneider, Ione J / Schöttker, Ben / Schumacher, Austin E / Schwebel, David C / Scott, James G / Seedat, Soraya / Sepanlou, Sadaf G / Serina, Peter T / Servan-Mori, Edson E / Shackelford, Katya A / Shaheen, Amira / Shahraz, Saeid / Shamah Levy, Teresa / Shangguan, Siyi / She, Jun / Sheikhbahaei, Sara / Shi, Peilin / Shibuya, Kenji / Shinohara, Yukito / Shiri, Rahman / Shishani, Kawkab / Shiue, Ivy / Shrime, Mark G / Sigfusdottir, Inga D / Silberberg, Donald H / Simard, Edgar P / Sindi, Shireen / Singh, Abhishek / Singh, Jasvinder A / Singh, Lavanya / Skirbekk, Vegard / Slepak, Erica Leigh / Sliwa, Karen / Soneji, Samir / Søreide, Kjetil / Soshnikov, Sergey / Sposato, Luciano A / Sreeramareddy, Chandrashekhar T / Stanaway, Jeffrey D / Stathopoulou, Vasiliki / Stein, Dan J / Stein, Murray B / Steiner, Caitlyn / Steiner, Timothy J / Stevens, Antony / Stewart, Andrea / Stovner, Lars J / Stroumpoulis, Konstantinos / Sunguya, Bruno F / Swaminathan, Soumya / Swaroop, Mamta / Sykes, Bryan L / Tabb, Karen M / Takahashi, Ken / Tandon, Nikhil / Tanne, David / Tanner, Marcel / Tavakkoli, Mohammad / Taylor, Hugh R / Te Ao, Braden J / Tediosi, Fabrizio / Temesgen, Awoke M / Templin, Tara / Ten Have, Margreet / Tenkorang, Eric Y / Terkawi, Abdullah S / Thomson, Blake / Thorne-Lyman, Andrew L / Thrift, Amanda G / Thurston, George D / Tillmann, Taavi / Tonelli, Marcello / Topouzis, Fotis / Toyoshima, Hideaki / Traebert, Jefferson / Tran, Bach X / Trillini, Matias / Truelsen, Thomas / Tsilimbaris, Miltiadis / Tuzcu, Emin M / Uchendu, Uche S / Ukwaja, Kingsley N / Undurraga, Eduardo A / Uzun, Selen B / Van Brakel, Wim H / Van De Vijver, Steven / van Gool, Coen H / Van Os, Jim / Vasankari, Tommi J / Venketasubramanian, N / Violante, Francesco S / Vlassov, Vasiliy V / Vollset, Stein Emil / Wagner, Gregory R / Wagner, Joseph / Waller, Stephen G / Wan, Xia / Wang, Haidong / Wang, Jianli / Wang, Linhong / Warouw, Tati S / Weichenthal, Scott / Weiderpass, Elisabete / Weintraub, Robert G / Wenzhi, Wang / Werdecker, Andrea / Westerman, Ronny / Whiteford, Harvey A / Wilkinson, James D / Williams, Thomas N / Wolfe, Charles D / Wolock, Timothy M / Woolf, Anthony D / Wulf, Sarah / Wurtz, Brittany / Xu, Gelin / Yan, Lijing L / Yano, Yuichiro / Ye, Pengpeng / Yentür, 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    Lancet (London, England)

    2015  Volume 386, Issue 10009, Page(s) 2145–2191

    Abstract: Background: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of ... ...

    Abstract Background: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development.
    Methods: We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time.
    Findings: Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6-6·6), from 65·3 years (65·0-65·6) in 1990 to 71·5 years (71·0-71·9) in 2013, HALE at birth rose by 5·4 years (4·9-5·8), from 56·9 years (54·5-59·1) to 62·3 years (59·7-64·8), total DALYs fell by 3·6% (0·3-7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6-29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non-communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries.
    Interpretation: Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition--in which increasing sociodemographic status brings structured change in disease burden--is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions.
    Funding: Bill & Melinda Gates Foundation.
    MeSH term(s) Aged ; Chronic Disease/epidemiology ; Communicable Diseases/epidemiology ; Female ; Global Health/statistics & numerical data ; Health Transition ; Humans ; Life Expectancy ; Male ; Middle Aged ; Mortality, Premature ; Quality-Adjusted Life Years ; Socioeconomic Factors ; Wounds and Injuries/epidemiology
    Language English
    Publishing date 2015-08-28
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(15)61340-X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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