Browsing by Author "Ashish Bhalla"

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Authors’ response
(Wolters Kluwer Medknow Publications, 2023) Manickam Ponnaiah; Tarun Bhatnagar; Rizwan Suliankachi Abdulkader; Rajalakshmi Elumalai; Janani Surya; Kathiresan Jeyashree; Muthusamy Santhosh Kumar; Ranjithkumar Govindaraju; Jeromie Wesley Vivian Thangaraj; Hari Krishan Aggarwal; Suresh Balan; Tridip Dutta Baruah; Ayan Basu; Yogita Bavaskar; Ajeet Singh Bhadoria; Ashish Bhalla; Pankaj Bhardwaj; Rachana Bhat; Jaya Chakravarty; Gina Maryann Chandy; Bal Kishan Gupta; Rakesh Kakkar; Ali Hasan Faiz Karnam; Sushila Kataria; Janakkumar Khambholja; Dewesh Kumar; Nithin Kumar; Monaliza Lyngdoh; M. Selva Meena; Kedar Mehta; M.P. Sheethal; Subhasis Mukherjee; Anuj Mundra; Arun Murugan; Seetharaman Narayanan; Balamurugan Nathan; Jutika Ojah; Pushpa Patil; Sunita Pawar; A. Charles Pon Ruban; R. Vadivelu; Rishabh Kumar Rana; S. Nagendra Boopathy; S. Priya; Saroj Kumar Sahoo; Arti Shah; Mohammad Shameem; Karthikeyan Shanmugam; Sachin K. Shivnitwar; Abhishek Singhai; Saurabh Srivastava; Sudheera Sulgante; Arunansu Talukdar; Alka Verma; Rajaat Vohra; Rabbanie Tariq Wani; Bhargavi Bathula; Gayathri Kumari; Divya Saravana Kumar; Aishwariya Narasimhan; N.C. Krupa; Thirumaran Senguttuvan; Parvathi Surendran; Dharsikaa Tamilmani; Alka Turuk; Gunjan Kumar; Aparna Murkherjee; Rakesh Aggarwal; Manoj Vasant Murhekar
[No abstract available]
Authors’ response
(Wolters Kluwer Medknow Publications, 2024) Manickam Ponnaiah; Tarun Bhatnagar; Rizwan Suliankachi Abdulkader; Rajalakshmi Elumalai; Janani Surya; Kathiresan Jeyashree; Muthusamy Santhosh Kumar; Ranjithkumar Govindaraju; Jeromie Wesley Vivian Thangaraj; Hari Krishan Aggarwal; Suresh Balan; Tridip Dutta Baruah; Ayan Basu; Yogita Bavaskar; Ajeet Singh Bhadoria; Ashish Bhalla; Pankaj Bhardwaj; Rachana Bhat; Jaya Chakravarty; Gina Maryann Chandy; Bal Kishan Gupta; Rakesh Kakkar; Ali Hasan Faiz Karnam; Sushila Kataria; Janakkumar Khambholja; Dewesh Kumar; Nithin Kumar; Monaliza Lyngdoh; M. Selva Meena; Kedar Mehta; M.P. Sheethal; Subhasis Mukherjee; Anuj Mundra; Arun Murugan; Seetharaman Narayanan; Balamurugan Nathan; Jutika Ojah; Pushpa Patil; Sunita Pawar; A. Charles Pon Ruban; R. Vadivelu; Rishabh Kumar Rana; S. Nagendra Boopathy; S. Priya; Saroj Kumar Sahoo; Arti Shah; Mohammad Shameem; Karthikeyan Shanmugam; Sachin K. Shivnitwar; Abhishek Singhai; Saurabh Srivastava; Sudheera Sulgante; Arunansu Talukdar; Alka Verma; Rajaat Vohra; Rabbanie Tariq Wani; Bhargavi Bathula; Gayathri Kumari; Divya Saravana Kumar; Aishwariya Narasimhan; N.C. Krupa; Thirumaran Senguttuvan; Parvathi Surendran; Dharsikaa Tamilmani; Alka Turuk; Gunjan Kumar; Aparna Murkherjee; Rakesh Aggarwal; Manoj Vasant Murhekar
[No abstract available]
Clinical profile of hospitalized COVID-19 patients in first & second wave of the pandemic: Insights from an Indian registry based observational study
(Wolters Kluwer Medknow Publications, 2021) Gunjan Kumar; Aparna Mukherjee; Ravendra K. Sharma; Geetha R. Menon; Damodar Sahu; Naveet Wig; Samiran Panda; Vishnu Vardhan Rao; Sujeet Singh; Randeep Guleria; Balram Bhargava; Abhijit Pakhare; Rajnish Joshi; Sourin Bhuniya; Manoj Kumar Panigrahi; Pankaj Bhardwaj; Sanjeev Misra; Manoj Gupta; Akhil D. Goel; Netto George Mundadan; Adil Rashid Khan; Manish Soneja; Tridip Dutta Baruah; Pankaj Kumar Kannauje; Ajit Kumar; Kala M.L. Yadhav; Manoj Kumar; Mary John; Sangeetha Mohan; Amit Patel; Surabhi Madan; Subhasis Mukherjee; Amitava Pal; Saikat Banerjee; Arti D. Shah; Yash Rana; Arun Madharia; Ankit Madharia; Rajiv Kumar Bandaru; Archana Mavoori; Simmi Dube; Nitin Nahar; Thrilok Chander Bingi; Rajarao Mesipogu; Vinaya Sekhar Aedula; Manisha Panchal; Mansuri Amirsohil Mohammedrafiq; Rashmi Upadhyay; Saurabh Srivastava; Veeresh B. Salgar; Rizwan Desai; Nyanthung Kikon; Rhondemo Kikon; Lisa Sarangi; Mahesh Rath; Anup Agarwal; Alka Turuk; Lokesh Kumar Sharma; Tanu Anand; Tarun Bhatnagar; Saumitra Ghosh; Avijit Hazra; Yogiraj Ray; Rammohan Ray; Lipilekha Patnaik; Jagdish Prasad Sahoo; Jaya Chakravarty; Sangeeta Kansal; Mohammad Shameem; Nazish Fatima; M. Pavan Kumar; Bikshapathi Rao; D. Himanshu; Amit Kumar; Naveen Dulhani; Amar Deepak Toppo; Nikita Sharma; Rajat Vohra; Sushila Kataria; Pooja Sharma; Arunansu Talukdar; Gargi Dasgupta; Anita Desai; S.N. Nityasri; Yashmin Panchal; K. Manohar; Y.S. Raju; Star Pala; Md. Jamil; V.K. Katyal; Sandeep Goyal; U.K. Ojha; Ravi Ranjan Jha; Ashish Bhalla; G.D. Puri; S. Samita; Vikas Suri; Ritin Mohindra; Ashish Pathak; Ashish Sharma; Janakkumar R. Khambholja; Nehal M. Shah; Paltial N. Palat; Kruti Rajvansh; Sudhir Bhandari; Abhishek Agrawal; Bal Kishan Gupta; Jigyasa Gupta; Ratnamala Choudhury; Mangala Rao; Soumyadip Chatterji; Sudipta Mukherjee
Background & objectives: India witnessed a massive second surge of COVID-19 cases since March 2021 after a period of decline from September 2020. Data collected under the National Clinical Registry for COVID-19 (NCRC) were analysed to describe the differences in demographic and clinical features of COVID-19 patients recruited during these two successive waves. Methods: The NCRC, launched in September 2020, is an ongoing multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized, confirmed COVID-19 patients were captured in an electronic data portal from 41 hospitals across India. Patients enrolled during September 1, 2020 to January 31, 2021 and February 1 to May 11, 2021 constituted participants of the two successive waves, respectively. Results: As on May 11, 2021, 18961 individuals were recruited in the registry, 12059 and 6903 reflecting in-patients from the first and second waves, respectively. Mean age of the patients was significantly lower in the second wave [48.7 (18.1) yr vs. 50.7 (18.0) yr, P<0.001] with higher proportion of patients in the younger age group intervals of <20, and 20-39 yr. Approximately 70 per cent of the admitted patients were ≥ 40 yr of age in both waves of the pandemic. The proportion of males were slightly lower in second wave as compared to the first [4400 (63.7%) vs. 7886 (65.4%), P=0.02]. Commonest presenting symptom was fever in both waves. In the second wave, a significantly higher proportion [2625 (48.6%) vs. 4420 (42.8%), P<0.003] complained of shortness of breath, developed ARDS [422(13%) vs. 880 (7.9%), P<0.001], required supplemental oxygen [1637 (50.3%) vs. 4771 (42.7%), P<0.001], and mechanical ventilation [260 (15.9%) vs. 530 (11.1%), P<0.001]. Mortality also significantly increased in the second wave [OR: 1.35 (95% CI: 1.19, 1.52)] in all age groups except in <20 yr. Interpretation & conclusions: The second wave of COVID-19 in India was slightly different in presentation than the first wave, with a younger demography, lesser comorbidities, and presentation with breathlessness in greater frequency. © 2021 BioMed Central Ltd.. All rights reserved.
Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1736–1788)(S0140673618322037)(10.1016/S0140-6736(18)32203-7))
(Lancet Publishing Group, 2018) Gregory A. Roth; Degu Abate; Kalkidan Hassen Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Haftom Temesgen Abebe; Molla Abebe; Zegeye Abebe; Ayenew Negesse Abejie; Semaw F. Abera; Olifan Zewdie Abil; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Abdu A. Adamu; Oladimeji M. Adebayo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Mina G. Adib; Amha Admasie; Ashkan Afshin; Gina Agarwal; Kareha M. Agesa; Anurag Agrawal; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Muktar Beshir Ahmed; Sayem Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Mohammad Esmaeil Akbari; Rufus Olusola Akinyemi; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Rajaa M. Al-Raddadi; Fares Alahdab; Khurshid Alam; Tahiya Alam; Animut Alebel; Kefyalew Addis Alene; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala'a Alkerwi; Francois Alla; Peter Allebeck; Jordi Alonso; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Leopold N. Aminde; Erfan Amini; Walid Ammar; Yaw Ampem Amoako; Nahla Hamed Anber; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Hossein Ansari; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Palwasha Anwari; Olatunde Aremu; Johan Arnlov; Amit Arora; Monika Arora; Al Artaman; Krishna K. Aryal; Hamid Asayesh; Ephrem Tsegay Asfaw; Zerihun Ataro; Suleman Atique; Sachin R. Atre; Marcel Ausloos; Euripide F.G.A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Yohanes Ayele; Rakesh Ayer; Peter S. Azzopardi; Arefeh Babazadeh; Umar Bacha; Hamid Badali; Alaa Badawi; Ayele Geleto Bali; Katherine E. Ballesteros; Maciej Banach; Kajori Banerjee; Marlena S. Bannick; Joseph Adel Mattar Banoub; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Barnighausen; Simon Barquera; Lope H. Barrero; Quique Bassat; Sanjay Basu; Bernhard T. Baune; Habtamu Wondifraw Baynes; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Bejot; Bayu Begashaw Bekele; Abate Bekele Belachew; Ezra Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Mircea Beuran; Tina Beyranvand; Ashish Bhalla; Suraj Bhattarai; Soumyadeeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Molly H. Biehl; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Donal Bisanzio; Tuhin Biswas; Brigette F. Blacker; Berrak Bora Basara; Rohan Borschmann; Cristina Bosetti; Kayvan Bozorgmehr; Oliver J. Brady; Luisa C. Brant; Carol Brayne; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Paul Svitil Briant; Gabrielle Britton; Traolach Brugha; Reinhard Busse; Zahid A. Butt; Charlton S.K.H. Callender; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jorge Cano; Mate Car; Rosario Cardenas; Giulia Carreras; Juan J. Carrero; Austin Carter; Felix Carvalho; Carlos A. Castaneda-Orjuela; Jacqueline Castillo Rivas; Chris D. Castle; Clara Castro; Franz Castro; Ferran Catala-Lopez; Ester Cerin; Yazan Chaiah; Jung-Chen Chang; Fiona J. Charlson; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Odgerel Chimed-Ochir; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Aaron J. Cohen; Leslie Trumbull Cooper; Paolo Angelo Cortesi; Monica Cortinovis; Ewerton Cousin; Benjamin C. Cowie; Michael H. Criqui; Elizabeth A. Cromwell; Christopher Stephen Crowe; John A. Crump; Matthew Cunningham; Alemneh Kabeta Daba; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Anh Kim Dang; Paul I. Dargan; Ahmad Daryani; Siddharth K. Das; Rajat Das Gupta; Jose Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Adrian C. Davis; Nicole Davis Weaver; Dragos Virgil Davitoiu; Kairat Davletov; Fernando Pio De La Hoz; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Tizta T. Degfie; Selina Deiparine; Gebre Teklemariam Demoz; Balem Betsu Demtsu; Edgar Denova-Gutierrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Subhojit Dey; Samath D. Dharmaratne; Daniel Dicker; Mesfin Tadese Dinberu; Eric L. Ding; M. Ashworth Dirac; Shirin Djalalinia; Klara Dokova; David Teye Doku; Christl A. Donnelly; E. Ray Dorsey; Pratik P. Doshi; Dirk Douwes-Schultz; Kerrie E. Doyle; Tim R. Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Dumessa Edessa; David Edvardsson; Anne Elise Eggen; Charbel El Bcheraoui; Maysaa El Sayed Zaki; Ziad El-Khatib; Hajer Elkout; Christian Lycke Ellingsen; Matthias Endres; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Babak Eshrati; Sharareh Eskandarieh; Reza Esmaeili; Alireza Esteghamati; Mahdi Fakhar; Hamed Fakhim; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Carla Sofia Esá Farinha; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Valery L. Feigin; Andrea B. Feigl; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Alize J. Ferrari; Garumma Tolu Feyissa; Irina Filip; Samuel Finegold; Florian Fischer; Christina Fitzmaurice; Nataliya A. Foigt; Kyle J. Foreman; Carla Fornari; Tahvi D. Frank; Takeshi Fukumoto; John E. Fuller; Nancy Fullman; Thomas Furst; Joao M. Furtado; Neal D. Futran; Silvano Gallus; Alberto L. Garcia-Basteiro; Miguel A. Garcia-Gordillo; William M. Gardner; Abadi Kahsu Gebre; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Bereket Gebremichael; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Ricard Genova-Maleras; Yilma Chisha Dea Geramo; Peter W. Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Mamata Ghimire; Katherine B. Gibney; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Ibrahim Abdelmageed Ginawi; Maurice Giroud; Giorgia Giussani; Shifalika Goenka; Ellen M. Goldberg; Srinivas Goli; Hector Gomez-Dantes; Philimon N. Gona; Sameer Vali Gopalani; Taren M. Gorman; Atsushi Goto; Alessandra C. Goulart; Elena V. Gnedovskaya; Ayman Grada; Giuseppe Grosso; Harish Chander Gugnani; Andre Luiz Sena Guimaraes; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Reyna Alma Gutierrez; Bishal Gyawali; Juanita A. Haagsma; Nima Hafezi-Nejad; Tekleberhan B. Hagos; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Roderick J. Hay; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Mohsen Heidari; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Claudiu Herteliu; Fatemeh Heydarpour; Pouria Heydarpour; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Hans W. Hoek; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; H. Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Peter J. Hotez; Damian G. Hoy; Thomas Hsiao; Guoqing Hu; John J. Huang; Abdullatif Husseini; Mohammedaman Mama Hussen; Susan Hutfless; Bulat Idrisov; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Nazrul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Moti Tolera Jalu; Spencer L. James; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Kathy J. Jenkins; Ravi Prakash Jha; Vivekanand Jha; Catherine O. Johnson; Sarah C. Johnson; Jost B. Jonas; Ankur Joshi; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jurisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Manoochehr Karami; Behzad Karami Matin; Andre Karch; Corine Karema; Hamidreza Karimi-Sari; Amir Kasaeian; Dessalegn H. Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Anil Kaul; Zhila Kazemi; Ali Kazemi Karyani; Dhruv Satish Kazi; Adane Teshome Kefale; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Chandrasekharan Nair Kesavachandran; Yousef Saleh Khader; Behzad Khafaei; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Ejaz Ahmad Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Mona M. Khater; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Jagdish Khubchandani; Aliasghar A. Kiadaliri; Getiye D. Kibret; Zelalem Teklemariam Kidanemariam; Daniel N. Kiirithio; Daniel Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimaki; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G. Anil Kumar; Manasi Kumar; Pushpendra Kumar; Michael J. Kutz; Igor Kuzin; Hmwe Hmwe Kyu; Deepesh P. Lad; Sheetal D. Lad; Alessandra Lafranconi; Dharmesh Kumar Lal; Ratilal Lalloo; Tea Lallukka; Jennifer O. Lam; Faris Hasan Lami; Van C. Lansingh; Sonia Lansky; Heidi J. Larson; Arman Latifi; Kathryn Mei-Ming Lau; Jeffrey V. Lazarus; Georgy Lebedev; Paul H. Lee; James Leigh; Mostafa Leili; Cheru Tesema Leshargie; Shanshan Li; Yichong Li; Juan Liang; Lee-Ling Lim; Stephen S. Lim; Miteku Andualem Limenih; Shai Linn; Shiwei Liu; Yang Liu; Rakesh Lodha; Chris Lonsdale; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Raimundas Lunevicius; Stefan Ma; Erlyn Rachelle King Macarayan; Mark T. Mackay; Jennifer H. MacLachlan; Emilie R. Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Ana-Laura Manda; Luiz Garcia Mandarano-Filho; Helena Manguerra; Mohammad Ali Mansournia; Chabila Christopher Mapoma; Dadi Marami; Joemer C. Maravilla; Wagner Marcenes; Laurie Marczak; Ashley Marks; Guy B. Marks; Gabriel Martinez; Francisco Rogerlandio Martins-Melo; Ira Martopullo; Winfried Marz; Melvin B. Marzan; Joseph R. Masci; Benjamin Ballard Massenburg; Manu Raj Mathur; Prashant Mathur; Richard Matzopoulos; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Brian J. McMahon; Suresh Mehata; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Tefera C. Mekonnen; Addisu Melese; Mulugeta Melku; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Desalegn Tadese Mengistu; Getnet Mengistu; George A. Mensah; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Haftay Berhane Mezgebe; Bartosz Miazgowski; Tomasz Miazgowski; Anoushka I. Millear; Ted R. Miller; Molly Katherine Miller-Petrie; G.K. Mini; Parvaneh Mirabi; Mojde Mirarefin; Andreea Mirica; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Habtamu Mitiku; Babak Moazen; Karzan Abdulmuhsin Mohammad; Moslem Mohammadi; Noushin Mohammadifard; Mohammed A. Mohammed; Shafiu Mohammed; Viswanathan Mohan; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Ghobad Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Ilais Moreno Velasquez; Joana Morgado-Da-Costa; Shane Douglas Morrison; Marilita M. Moschos; Simin Mouodi; Seyyed Meysam Mousavi; Kindie Fentahun Muchie; Ulrich Otto Mueller; Satinath Mukhopadhyay; Kate Muller; John Everett Mumford; Jonah Musa; Kamarul Imran Musa; Ghulam Mustafa; Saravanan Muthupandian; Jean B. Nachega; Gabriele Nagel; Aliya Naheed; Azin Nahvijou; Gurudatta Naik; Sanjeev Nair; Farid Najafi; Luigi Naldi; Hae Sung Nam; Vinay Nangia; Jobert Richie Nansseu; Bruno Ramos Nascimento; Gopalakrishnan Natarajan; Nahid Neamati; Ionut Negoi; Ruxandra Irina Negoi; Subas Neupane; Charles R.J. Newton; Frida N. Ngalesoni; Josephine W. Ngunjiri; Anh Quynh Nguyen; Grant Nguyen; Ha Thu Nguyen; Huong Thanh Nguyen; Long Hoang Nguyen; Minh Nguyen; Trang Huyen Nguyen; Emma Nichols; Dina Nur Anggraini Ningrum; Yirga Legesse Nirayo; Molly R. Nixon; Nomonde Nolutshungu; Shuhei Nomura; Ole F. Norheim; Mehdi Noroozi; Bo Norrving; Jean Jacques Noubiap; Hamid Reza Nouri; Malihe Nourollahpour Shiadeh; Mohammad Reza Nowroozi; Peter S. Nyasulu; Christopher M. Odell; Richard Ofori-Asenso; Felix Akpojene Ogbo; In-Hwan Oh; Olanrewaju Oladimeji; Andrew T. Olagunju; Pedro R. Olivares; Helen Elizabeth Olsen; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Kanyin L. Ong; Sok King Sk Ong; Eyal Oren; Heather M. Orpana; Alberto Ortiz; Justin R. Ortiz; Stanislav S. Otstavnov; Simon Overland; Mayowa Ojo Owolabi; Raziye Ozdemir; P.A. Mahesh; Rosana Pacella; Smita Pakhale; Abhijit P. Pakhare; Amir H. Pakpour; Adrian Pana; Songhomitra Panda-Jonas; Jeyaraj Durai Pandian; Andrea Parisi; Eun-Kee Park; Charles D.H. Parry; Hadi Parsian; Shanti Patel; Sanghamitra Pati; George C. Patton; Vishnupriya Rao Paturi; Katherine R. Paulson; Alexandre Pereira; David M. Pereira; Norberto Perico; Konrad Pesudovs; Max Petzold; Michael R. Phillips; Frederic B. Piel; David M. Pigott; Julian David Pillay; Meghdad Pirsaheb; Farhad Pishgar; Suzanne Polinder; Maarten J. Postma; Akram Pourshams; Hossein Poustchi; Ashwini Pujar; Swayam Prakash; Narayan Prasad; Caroline A. Purcell; Mostafa Qorbani; Hedley Quintana; D.Alex Quistberg; Kirankumar Waman Rade; Amir Radfar Anwar Rafay; Fakher Rahim; Kazem Rahimi; Afarin Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Rajesh Kumar Rai; Sasa Rajsic; Usha Ram; Chhabi Lal Ranabhat; Prabhat Ranjan; Puja C. Rao; David Laith Rawaf; Salman Rawaf; Christian Razo-Garcia; K. Srinath Reddy; Robert C. Reiner; Marissa B. Reitsma; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Satar Rezaei; Shahab Rezaeian; Mohammad Sadegh Rezai; Seyed Mohammad Riahi; Antonio Luiz P. Ribeiro; Maria Jesus Rios-Blancas; Kedir Teji Roba; Nicholas L.S. Roberts; Stephen R. Robinson; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Dietrich Rothenbacher; Ambuj Roy; Enrico Rubagotti; Perminder S. Sachdev; Basema Saddik; Ehsan Sadeghi; Hosein Safari; Mahdi Safdarian; Sare Safi; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; Nasir Salam; Joseph S. 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GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1736–88—The bottom row in figure 7 was cut off. This correction has been made to the online version as of Nov 9, 2018, and has been made to the printed Article. © 2018 Elsevier Ltd
Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1923–1994), (S0140673618322256), (10.1016/S0140-6736(18)32225-6))
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Purwar; Mostafa Qorbani; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Zohreh Rahimi; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Rajesh Kumar Rai; Fatemeh Rajati; Sasa Rajsic; Sree Bhushan Raju; Usha Ram; Chhabi Lal Ranabhat; Prabhat Ranjan; Goura Kishor Rath; David Laith Rawaf; Salman Rawaf; K. Srinath Reddy; Colin D. Rehm; Jürgen Rehm; Robert C. Reiner; Marissa B. Reitsma; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Luz Myriam Reynales-Shigematsu; Satar Rezaei; Antonio Luiz P. Ribeiro; Juan A. Rivera; Kedir Teji Roba; Sonia Rodríguez-Ramírez; Leonardo Roever; Yesenia Román; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Gregory A. Roth; Dietrich Rothenbacher; Ambuj Roy; Enrico Rubagotti; Lesley Rushton; Charumathi Sabanayagam; Perminder S. Sachdev; Basema Saddik; Ehsan Sadeghi; Sahar Saeedi Moghaddam; Hosein Safari; Yahya Safari; Roya Safari-Faramani; Mahdi Safdarian; Sare Safi; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; Haniye Sadat Sajadi; Nasir Salam; Payman Salamati; Zikria Saleem; Yahya Salimi; Hamideh Salimzadeh; Joshua A. Salomon; Devashri Digvijay Salvi; Inbal Salz; Abdallah M. Samy; Juan Sanabria; Maria Dolores Sanchez-Niño; Tania G. Sánchez-Pimienta; Taren Sanders; Yingying Sang; Damian Francesco Santomauro; Itamar S. Santos; João Vasco Santos; Milena M. Santric Milicevic; Bruno Piassi Sao Jose; Mayank Sardana; Abdur Razzaque Sarker; Rodrigo Sarmiento-Suárez; Nizal Sarrafzadegan; Benn Sartorius; Shahabeddin Sarvi; Brijesh Sathian; Maheswar Satpathy; Arundhati R. Sawant; Monika Sawhney; Mete Saylan; Mehdi Sayyah; Elke Schaeffner; Maria Inês Schmidt; Ione J.C. Schneider; Ben Schöttker; Aletta Elisabeth Schutte; David C. Schwebel; Falk Schwendicke; James G. Scott; Soraya Seedat; Mario Sekerija; Sadaf G. Sepanlou; Marc L. Serre; Edson Serván-Mori; Seyedmojtaba Seyedmousavi; Hosein Shabaninejad; Gavin Shaddick; Azadeh Shafieesabet; Mehdi Shahbazi; Amira A. Shaheen; Masood Ali Shaikh; Teresa Shamah Levy; Mehran Shams-Beyranvand; Mohammadbagher Shamsi; Heidar Sharafi; Kiomars Sharafi; Mehdi Sharif; Mahdi Sharif-Alhoseini; Hamid Sharifi; Jayendra Sharma; Meenakshi Sharma; Rajesh Sharma; Jun She; Aziz Sheikh; Peilin Shi; Kenji Shibuya; Mekonnen Sisay Shiferaw; Mika Shigematsu; Min-Jeong Shin; Rahman Shiri; Reza Shirkoohi; Ivy Shiue; Farhad Shokraneh; Haitham Shoman; Mark G. Shrime; Matthew S. Shupler; Si Si; Soraya Siabani; Abla Mehio Sibai; Tariq J. Siddiqi; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; Diego Augusto Santos Silva; João Pedro Silva; Dayane Gabriele Alves Silveira; Jasvinder A. Singh; Narinder Pal Singh; Virendra Singh; Dhirendra Narain Sinha; Eirini Skiadaresi; Vegard Skirbekk; David L. Smith; Mari Smith; Badr Hasan Sobaih; Soheila Sobhani; Ranjani Somayaji; Moslem Soofi; Reed J.D. Sorensen; Joan B. Soriano; Ireneous N. Soyiri; Angela Spinelli; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Vladimir I. Starodubov; Nadine Steckling; Dan J. Stein; Murray B. Stein; Goran Stevanovic; Leo Stockfelt; Mark A. Stokes; Lela Sturua; Michelle L. Subart; Agus Sudaryanto; Mu’awiyyah Babale Sufiyan; Gerhard Sulo; Bruno F. Sunguya; Patrick John Sur; Bryan L. Sykes; Cassandra E.I. Szoeke; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Santosh Kumar Tadakamadla; Ken Takahashi; Nikhil Tandon; Segen Gebremeskel Tassew; Mohammad Tavakkoli; Nuno Taveira; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Shishay Wahdey Tekelemedhin; Merhawi Gebremedhin Tekle; Habtamu Temesgen; Mohamad-Hani Temsah; Omar Temsah; Abdullah Sulieman Terkawi; Belay Tessema; Mebrahtu Teweldemedhin; Kavumpurathu Raman Thankappan; Andrew Theis; Sathish Thirunavukkarasu; Hannah J. Thomas; Matthew Lloyd Thomas; Nihal Thomas; George D. Thurston; Binyam Tilahun; Taavi Tillmann; Quyen G. To; Myriam Tobollik; Marcello Tonelli; Roman Topor-Madry; Anna E. Torre; Miguel Tortajada-Girbés; Mathilde Touvier; Marcos Roberto Tovani-Palone; Jeffrey A. Towbin; Bach Xuan Tran; Khanh Bao Tran; Thomas Clement Truelsen; Nu Thi Truong; Afewerki Gebremeskel Tsadik; Lorainne Tudor Car; E. Murat Tuzcu; Hayley D. Tymeson; Stefanos Tyrovolas; Kingsley N. Ukwaja; Irfan Ullah; Rachel L. Updike; Muhammad Shariq Usman; Olalekan A. Uthman; Muthiah Vaduganathan; Afsane Vaezi; Pascual R. Valdez; Aaron Van Donkelaar; Elena Varavikova; Santosh Varughese; Tommi Juhani Vasankari; Vidhya Venkateswaran; Narayanaswamy Venketasubramanian; Santos Villafaina; Francesco S. Violante
Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Factors associated with unexplained sudden deaths among adults aged 18-45 years in India – A multicentric matched case–control study
(Wolters Kluwer Medknow Publications, 2023) Manickam Ponnaiah; Tarun Bhatnagar; Rizwan Suliankachi Abdulkader; Rajalakshmi Elumalai; Janani Surya; Kathiresan Jeyashree; Muthusamy Santhosh Kumar; Ranjithkumar Govindaraju; Jeromie Wesley Vivian Thangaraj; Hari Krishan Aggarwal; Suresh Balan; Tridip Dutta Baruah; Ayan Basu; Yogita Bavaskar; Ajeet Singh Bhadoria; Ashish Bhalla; Pankaj Bhardwaj; Rachana Bhat; Jaya Chakravarty; Gina Maryann Chandy; Bal Kishan Gupta; Rakesh Kakkar; Ali Hasan Faiz Karnam; Sushila Kataria; Janakkumar Khambholja; Dewesh Kumar; Nithin Kumar; Monaliza Lyngdoh; M. Selva Meena; Kedar Mehta; M.P. Sheethal; Subhasis Mukherjee; Anuj Mundra; Arun Murugan; Seetharaman Narayanan; Balamurugan Nathan; Jutika Ojah; Pushpa Patil; Sunita Pawar; A. Charles Pon Ruban; R. Vadivelu; Rishabh Kumar Rana; S. Nagendra Boopathy; S. Priya; Saroj Kumar Sahoo; Arti Shah; Mohammad Shameem; Karthikeyan Shanmugam; Sachin K. Shivnitwar; Abhishek Singhai; Saurabh Srivastava; Sudheera Sulgante; Arunansu Talukdar; Alka Verma; Rajaat Vohra; Rabbanie Tariq Wani; Bhargavi Bathula; Gayathri Kumari; Divya Saravana Kumar; Aishwariya Narasimhan; N.C. Krupa; Thirumaran Senguttuvan; Parvathi Surendran; Dharsikaa Tamilmani; Alka Turuk; Gunjan Kumar; Aparna Murkherjee; Rakesh Aggarwal; Manoj Vasant Murhekar; Anjan Jyoti Talukdhar; Raj Prathim Das; Pranab Jyoti Bhattacharyya; Pankaj Jyoti Barman; Partha Pratim Das; P.V.M. Lakshmi; Naveen Panday; Ashok Kumar Pannu; Debaprasad Dhibar; Pankaj Kumar Kanauje; Satyajit Singh; Sabah Siddiqui; Nitin Bhajandas Borkar; Mayur Adalja; Sandip Shah Varsha Godbole; Rikin Raj; Nehal Shah; Nilay Suthar; Hemang Purohit; Bhargav Patel; Rutika Pathkjee; Niraj Pandit; Siddharth Shah; Bhavesh Patel; Anuja Agrawal; Deepak Jain; Manish Bansal; Vikas Deswal; Pooja Sharma; Farhana Siraj; Aamir Rashid; Anjum Bashir Fazili; Pradip Kumar Bhattacharya; Hirendra Birua; Manoj Kumar Prasad; Shashi Bhushan Singh; Umendra Kumar Ojha; Ravi Ranjan Jha; L.M. Manuja; S.K. Raghavendra; Vijay Hugar; R. Radha; Pallavi Kesari; Sunil Tapse; Ambrish Avate; Prasanna Kumar; Bhaskaran Unnikrishnan; T. Rekha; A. Basavaprabhu; Mithun Rao; Prithvishree Ravindra; Chythra R. Rao; Jayaraj Mymbilly Balakrishnan; Vikram Palimar; S. Ashwini; Bhavana Hiremath; Rajnikanth Malapur; Ankur Joshi; Manoj Nagar; Atul S. Keche; Arjun Lal Kakrani; Shubhangi Kanitkar; Srikanth Tripathy; Savita Mahajan; Akshada Shinde; Sunil Patil; Vijay Gaikwad; Ganesh Lokhande; Astha Ganeriwal; Ramesh Wasnik; Ashwini Kalantri; Dhiraj Bhandari; Preetam Salunkhe; Abhishek Raut; Star Pala; K.G. Lynrah; Nari Lyngdoh; Rajani Thabah; Manish Kapoor; Sadananda Barik; Chitta Ranjan Mohanty; Sonu Hangma Subba; Satyabrata Guru; Manu Ayyan; Sitanshu Sekhar Kar; Nanda Kishore Maroju; Naveen Kumar; Roselin Mohandas; Charulatha Tamilselvan; Saranya Rajaram; Ankita Kankaria; Moonis Mirza; Preeti Singh Dhoat; Jaspreet Shergill; Manoj Kumar Gupta; Akhil Dhanesh Goel; Amit Kumar Rohila; Durga Shankar Meena; Archana Paliwal; Niti Gahlot; Nikita Sharma; Harkesh Kumar; Dinesh Choudhary; Shyam Lal Meena; Dinesh Bhambhu; Jigyasa Gupta; G. Priya; Sonia Samuel; S. Bagyalakshmi; Sathish Kumar T; Aazmi Mohamed; G. Rathna Kumar; A. Rajesh; V. Rajendran; M. Soorya; P.N. Sridevi; A. Karthika; K. Santha Sheela Kumari; K. Sathish Kumar; Pavithra Gnanavel; Dasarathan Ramesh; Aravind Gunasekaran; R. Kaverikannan; Madhumitha Manohar; P. Sofia; R. Abishek; Jeevithan Shanmugam; Mohan Kumar; Aparnavi Periyasamy; Dhilipan Kumar; G. Selvarani; Thirukumaran Ramasamy; N. Suresh; Kannan Muthuraman Alagappan; Mathavasami Vijayageetha; Sudha Ramalingam; Petchiappan Velammal; Yamini Subramani; Lakshmi Marappa; Viswanathan Pandurangan; T.R. Muralidharan; M. Rajkumar; Senthil Murugan Ramasamy; Bodhare Trupti; Bharath Rajh; Duvuru Amareswar Reddy; Rashmi Upadhyay; Anurag Srivastava; Rakesh Gupta; Ranjan Bhattnagar; Manaswi Chaubey; Soumik Ghosh; Nilesh Kumar; Mohammad Azharuddin; Nafees A. Khan; Mohammad Aslam; Asad Mahmood; R.K. Singh; Priyank Yadav; Aditya Kapoor; Om Prakash Sanjeev; Shyam Sundar; Prasan Kumar Panda; Mukesh Bairwa; Mahendera Singh Gehlot; Pooja Bhadoria; Arup Chakravorty; Sarmistha Chakravorty; Arindam Ray; Aparup Dhua; Amitava Pal; Priyanka Ghosh; Yogiraj Roy; Sinjita Dutta; Subhro Samujjal Basu
Background & objectives: In view of anecdotal reports of sudden unexplained deaths in India’s apparently healthy young adults, linking to coronavirus disease 2019 (COVID-19) infection or vaccination, we determined the factors associated with such deaths in individuals aged 18-45 years through a multicentric matched case–control study. Methods: This study was conducted through participation of 47 tertiary care hospitals across India. Cases were apparently healthy individuals aged 18-45 years without any known co-morbidity, who suddenly (<24 h of hospitalization or seen apparently healthy 24 h before death) died of unexplained causes during 1st October 2021-31st March 2023. Four controls were included per case matched for age, gender and neighborhood. We interviewed/perused records to collect data on COVID-19 vaccination/infection and post-COVID-19 conditions, family history of sudden death, smoking, recreational drug use, alcohol frequency and binge drinking and vigorous-intensity physical activity two days before death/interviews. We developed regression models considering COVID-19 vaccination ≤42 days before outcome, any vaccine received anytime and vaccine doses to compute an adjusted matched odds ratio (aOR) with 95 per cent confidence interval (CI). Results: Seven hundred twenty nine cases and 2916 controls were included in the analysis. Receipt of at least one dose of COVID-19 vaccine lowered the odds [aOR (95% CI)] for unexplained sudden death [0.58 (0.37, 0.92)], whereas past COVID-19 hospitalization [3.8 (1.36, 10.61)], family history of sudden death [2.53 (1.52, 4.21)], binge drinking 48 h before death/interview [5.29 (2.57, 10.89)], use of recreational drug/substance [2.92 (1.1, 7.71)] and performing vigorous-intensity physical activity 48 h before death/interview [3.7 (1.36, 10.05)] were positively associated. Two doses lowered the odds of unexplained sudden death [0.51 (0.28, 0.91)], whereas single dose did not. Interpretation & conclusions: COVID-19 vaccination did not increase the risk of unexplained sudden death among young adults in India. Past COVID-19 hospitalization, family history of sudden death and certain lifestyle behaviors increased the likelihood of unexplained sudden death. © 2023 Indian Journal of Medical Research, published by Wolters Kluwer - Medknow for Director-General, Indian Council of Medical Research.
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Austin E. Schumacher; Hmwe Hmwe Kyu; Amirali Aali; Cristiana Abbafati; Jaffar Abbas; Rouzbeh Abbasgholizadeh; Madineh Akram Abbasi; Mohammadreza Abbasian; Samar Abd ElHafeez; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab; Mohammad Abdollahi; Meriem Abdoun; Auwal Abdullahi; Ame Mehadi Abdurehman; Mesfin Abebe; Aidin Abedi; Armita Abedi; Tadesse M. Abegaz; Roberto Ariel Abeldaño Zuñiga; E.S. Abhilash; Olugbenga Olusola Abiodun; Richard Gyan Aboagye; Hassan Abolhassani; Mohamed Abouzid; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Michael R.M. Abrigo; Dariush Abtahi; Samir Abu Rumeileh; Niveen M.E. Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Juan Manuel Acuna; Tim Adair; Isaac Yeboah Addo; Oladimeji M. Adebayo; Oyelola A. Adegboye; Victor Adekanmbi; Bashir Aden; Abiola Victor Adepoju; Charles Oluwaseun Adetunji; Temitayo Esther Adeyeoluwa; Olorunsola Israel Adeyomoye; Rishan Adha; Amin Adibi; Wirawan Adikusuma; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Abel Afework; Aanuoluwapo Adeyimika Afolabi; Ali Afraz; Shadi Afyouni; Saira Afzal; Pradyumna Agasthi; Shahin Aghamiri; Antonella Agodi; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Tauseef Ahmad; Keivan Ahmadi; Amir Mahmoud Ahmadzade; Mohadese Ahmadzade; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Olufemi Ajumobi; Gizachew Taddesse Akalu; Essona Matatom Akara; Karolina Akinosoglou; Sreelatha Akkala; Samuel Akyirem; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Ammar Al Homsi; Mohammad Al Qadire; Moein Ala; Timothy Olukunle Aladelusi; Tareq Mohammed Ali Al-Ahdal; Samer O. Alalalmeh; Ziyad Al-Aly; Khurshid Alam; Manjurul Alam; Zufishan Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Mohammed Albashtawy; Mohammad T. AlBataineh; Robert W. Aldridge; Sharifullah Alemi; Ayman Al-Eyadhy; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Khaled Al-Hanawi; Abid Ali; Akhtar Ali; Beriwan Abdulqadir Ali; Hassam Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Zahid Ali; Shohreh Alian Samakkhah; Gianfranco Alicandro; Sheikh Mohammad Alif; Mohammad Aligol; Rasoul Alimi; Ahmednur Adem Aliyi; Adel Al-Jumaily; Syed Mohamed Aljunid; Wael Almahmeed; Sabah Al-Marwani; Sadeq Ali Ali Al-Maweri; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Omar Almidani; Mahmoud A. Alomari; Nivaldo Alonso; Jaber S. Alqahtani; Ahmed Yaseen Alqutaibi; Salman Khalifah Al-Sabah; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Farrukh Jawad Alvi; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Karem H. Alzoubi; Azmeraw T. Amare; Edward Kwabena Ameyaw; Abebe Feyissa Amhare; Tarek Tawfik Amin; Alireza Amindarolzarbi; Javad Aminian Dehkordi; Sohrab Amiri; Hubert Amu; Dickson A. Amugsi; Jimoh Amzat; Robert Ancuceanu; Deanna Anderlini; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Dhanalakshmi Angappan; Abhishek Anil; Afifa Anjum; Catherine M. Antony; Ernoiz Antriyandarti; Iyadunni Adesola Anuoluwa; Sumadi Lukman Anwar; Anayochukwu Edward Anyasodor; Seth Christopher Yaw Appiah; Muhammad Aqeel; Jalal Arabloo; Razman Arabzadeh Bahri; Morteza Arab-Zozani; Mosab Arafat; Ana Margarida Araújo; Aleksandr Y. Aravkin; Abdulfatai Aremu; Hany Ariffin; Timur Aripov; Benedetta Armocida; Mahwish Arooj; Anton A. Artamonov; Kurnia Dwi Artanti; Judie Arulappan; Idowu Thomas Aruleba; Raphael Taiwo Aruleba; Ashokan Arumugam; Malke Asaad; Saeed Asgary; Mubarek Yesse Ashemo; Muhammad Ashraf; Marvellous O. Asika; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Alok Atreya; Sameh Attia; Avinash Aujayeb; Abolfazl Avan; Adedapo Wasiu Awotidebe; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Getnet Melaku Ayele; Jose L. Ayuso-Mateos; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Gulrez Shah Azhar; Shahkaar Aziz; Ahmed Y. Azzam; Mina Babashahi; Abraham Samuel Babu; Muhammad Badar; Alaa Badawi; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Sulaiman Bah; Saeed Bahadorikhalili; Jianjun Bai; Ruhai Bai; Jennifer L. Baker; Shankar M. Bakkannavar; Abdulaziz T. Bako; Senthilkumar Balakrishnan; Saliu A. Balogun; Ovidiu Constantin Baltatu; Kiran Bam; Maciej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Hansi Bansal; Shirin Barati; Martina Barchitta; Mainak Bardhan; Suzanne Lyn Barker-Collo; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Ronald D. Barr; Lope H. Barrero; Zarrin Basharat; Asma'u I.J. Bashir; Hameed Akande Bashiru; Pritish Baskaran; Buddha Basnyat; Quique Bassat; João Diogo Basso; Saurav Basu; Kavita Batra; Ravi Batra; Bernhard T. Baune; Mohsen Bayati; Nebiyou Simegnew Bayileyegn; Thomas Beaney; Neeraj Bedi; Tahmina Begum; Emad Behboudi; Amir Hossein Behnoush; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Uzma Iqbal Belgaumi; Michelle L. Bell; Aminu K. Bello; Muhammad Bashir Bello; Olorunjuwon Omolaja Bello; Luis Belo; Apostolos Beloukas; Salaheddine Bendak; Derrick A. Bennett; Isabela M. Bensenor; Habib Benzian; Zombor Berezvai; Adam E. Berman; Amiel Nazer C. Bermudez; Paulo J.G. Bettencourt; Habtamu B. Beyene; Kebede A. Beyene; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Dinesh Bhandari; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Ashish Bhargava; Sonu Bhaskar; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Manpreet S. Bhatti; Rajbir Bhatti; Zulfiqar A. Bhutta; Boris Bikbov; Nada Binmadi; Bagas Suryo Bintoro; Antonio Biondi; Catherine Bisignano; Francesca Bisulli; Atanu Biswas; Raaj Kishore Biswas; Saeid Bitaraf; Tone Bjørge; Archie Bleyer; Mary Sefa Boampong; Virginia Bodolica; Aadam Olalekan Bodunrin; Obasanjo Afolabi Bolarinwa; Milad Bonakdar Hashemi; Aime Bonny; Kaustubh Bora; Berrak Bora Basara; Safiya Bala Borodo; Rohan Borschmann; Alejandro Botero Carvajal; Souad Bouaoud; Sofiane Boudalia; Edward J. Boyko; Nicola Luigi Bragazzi; Dejana Braithwaite; Hermann Brenner; Gabrielle Britton; Annie J. Browne; Andre R. Brunoni; Norma B. Bulamu; Lemma N. Bulto; Danilo Buonsenso; Katrin Burkart; Richard A. Burns; Sharath Burugina Nagaraja; Reinhard Busse; Yasser Bustanji; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Tianji Cai; Daniela Calina; Luis Alberto Cámera; Luciana Aparecida Campos; Ismael R. Campos-Nonato; Chao Cao; Carlos Alberto Cardenas; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Juan J. Carrero; Andrea Carugno; Felix Carvalho; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Ferrán Catalá-López; Alberico L. Catapano; Maria Sofia Cattaruzza; Arthur Caye; Christopher R. Cederroth; Francieli Cembranel; Muthia Cenderadewi; Kelly M. Cercy; Ester Cerin; Muge Cevik; Pamela R. Chacón-Uscamaita; Yaacoub Chahine; Chiranjib Chakraborty; Jeffrey Shi Kai Chan; Chin-Kuo Chang; Periklis Charalampous; Jaykaran Charan; Vijay Kumar Chattu; Victoria Chatzimavridou-Grigoriadou; Malizgani Paul Chavula; Huzaifa Ahmad Cheema; An-Tian Chen; Haowei Chen; Lingxiao Chen; Meng Xuan Chen; Simiao Chen; Nicolas Cherbuin; Derek S. Chew; Gerald Chi; Jesus Lorenzo Chirinos-Caceres; Abdulaal Chitheer; So Mi Jemma Cho; William C.S. Cho; Bryan Chong; Hitesh Chopra; Rahul Choudhary; Rajiv Chowdhury; Dinh-Toi Chu; Isaac Sunday Chukwu; Eric Chung; Eunice Chung; Sheng-Chia Chung; Karly I. Cini; Cain C.T. Clark; Kaleb Coberly; Alyssa Columbus; Haley Comfort; Joao Conde; Sara Conti; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Richard G. Cowden; Michael H. Criqui; Natália Cruz-Martins; Garland T. Culbreth; Patricia Cullen; Matthew Cunningham; Daniel da Silva E Silva; Sriharsha Dadana; Omid Dadras; Zhaoli Dai; Koustuv Dalal; Lachlan L. Dalli; Giovanni Damiani; Emanuele D'Amico; Sara Daneshvar; Aso Mohammad Darwesh; Jai K. Das; Saswati Das; Nihar Ranjan Dash; Mohsen Dashti; Claudio Alberto Dávila-Cervantes; Nicole Davis Weaver; Kairat Davletov; Diego De Leo; Aklilu Tamire Debele; Louisa Degenhardt; Reza Dehbandi; Lee Deitesfeld; Ivan Delgado-Enciso; Laura Delgado-Ortiz; Daniel Demant; Berecha Hundessa Demessa; Andreas K. Demetriades; Xinlei Deng; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Hardik Dineshbhai Desai; Rupak Desai; Keshab Deuba; Vinoth Gnana Chellaiyan Devanbu; Sourav Dey; Arkadeep Dhali; Kuldeep Dhama; Mandira Lamichhane Dhimal; Meghnath Dhimal; Sameer Dhingra; Diana Dias Da Silva; Daniel Diaz; Adriana Dima; Delaney D. Ding; M. Ashworth Dirac; Abhinav Dixit; Shilpi Gupta Dixit; Thanh Chi Do; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Masoud Dodangeh; Klara Georgieva Dokova; Christiane Dolecek; E Ray Dorsey; Wendel Mombaque dos Santos; Rajkumar Doshi; Leila Doshmangir; Abdel Douiri; Robert Kokou Dowou; Tim Robert Driscoll; Haneil Larson Dsouza; John Dube; Samuel C. Dumith; Susanna J. Dunachie; Bruce B. Duncan; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Sulagna Dutta; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Oluwakemi Ebenezer; Ejemai Eboreime; Alireza Ebrahimi; Chidiebere Peter Echieh; Abdelaziz Ed-Dra; Hisham Atan Edinur; David Edvardsson; Kristina Edvardsson; Defi Efendi; Ferry Efendi; Shayan Eghdami; Terje Andreas Eikemo; Ebrahim Eini; Michael Ekholuenetale; Emmanuel Ekpor; Temitope Cyrus Ekundayo; Rabie Adel El Arab; Doaa Abdel Wahab El Morsi; Maysaa El Sayed Zaki; Maha El Tantawi; Iffat Elbarazi; Noha Mousaad Elemam; Frank J. Elgar; Islam Y. Elgendy; Ghada Metwally Tawfik ElGohary; Hala Rashad Elhabashy; Muhammed Elhadi; Omar Abdelsadek Abdou Elmeligy; Mohammed Elshaer; Ibrahim Elsohaby; Amir Emami Zeydi; Mehdi Emamverdi; Theophilus I. Emeto; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Tesfahun C. Eshetie; Sharareh Eskandarieh; Juan Espinosa-Montero; Kara Estep; Farshid Etaee; Ugochukwu Anthony Eze; Natalia Fabin; Adewale Oluwaseun Fadaka; Adeniyi Francis Fagbamigbe; Saman Fahimi; Luca Falzone; Carla Sofia E Sá Farinha; MoezAlIslam Ezzat Mahmoud Faris; Mohsen Farjoud Kouhanjani; Andre Faro; Hossein Farrokhpour; Ali Fatehizadeh; Hamed Fattahi; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Ginenus Fekadu; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Daniela Ferrante; Pietro Ferrara; Nuno Ferreira; Getahun Fetensa; Irina Filip; Florian Fischer; Joanne Flavel; Abraham D. Flaxman; Luisa S. Flor; Bobirca Teodor Florin; Morenike Oluwatoyin Folayan; Kristen Marie Foley; Artem Alekseevich Fomenkov; Lisa M. Force; Carla Fornari; Behzad Foroutan; Matteo Foschi; Kate Louise Francis; Richard Charles Franklin; Alberto Freitas; Joseph Friedman; Sara D. Friedman; Takeshi Fukumoto; John E. Fuller; Peter Andras Gaal; Muktar A. Gadanya; Santosh Gaihre; Abduzhappar Gaipov; Emmanuela Gakidou; Yaseen Galali; Nasrin Galehdar; Silvano Gallus; Quan Gan; Aravind P. Gandhi; Balasankar Ganesan; Jalaj Garg; Shuo-Yan Gau; Prem Gautam; Rupesh K. Gautam; Federica Gazzelloni; Miglas W. Gebregergis; Mesfin Gebrehiwot; Tesfay Brhane Gebremariam; Urge Gerema; Motuma Erena Getachew; Tamirat Getachew; Peter W. Gething; Mansour Ghafourifard; Sulmaz Ghahramani; Khalid Yaser Ghailan; Alireza Ghajar; Mohammad Javad Ghanbarnia; MohammadReza Ghasemi; Afsaneh Ghasemzadeh; Fariba Ghassemi; Ramy Mohamed Ghazy; Sailaja Ghimire; Asadollah Gholamian; Ali Gholamrezanezhad; Pooyan Ghorbani Vajargah; Ghozali Ghozali; Sherief Ghozy; Arun Digambarrao Ghuge; Alessandro Gialluisi; Ruth Margaret Gibson; Artyom Urievich Gil; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Themba G. Ginindza; Alem Girmay; James C. Glasbey; Elena V. Gnedovskaya; Laszlo Göbölös; Amit Goel; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Arefeh Golestanfar; Davide Golinelli; Philimon N. Gona; Houman Goudarzi; Amir Hossein Goudarzian; Anmol Goyal; Scott Greenhalgh; Michal Grivna; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Avirup Guha; Stefano Guicciardi; Damitha Asanga Gunawardane; Sasidhar Gunturu; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Indarchand Ratanlal Gupta; Rajat Das Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Reyna Alma Gutiérrez; Farrokh Habibzadeh; Parham Habibzadeh; Vladimir Hachinski; Mohammad Haddadi; Rasool Haddadi; Nils Haep; Adel Hajj Ali; Esam S. Halboub; Sobia Ahsan Halim; Brian J. Hall; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Kanaan Hamagharib Abdullah; Samer Hamidi; Mohammad Hamiduzzaman; Ahmad Hammoud; Nasrin Hanifi; Graeme J. Hankey; Md Abdul Hannan; Md Nuruzzaman Haque; Harapan Harapan; Josep Maria Haro; Ahmed I. Hasaballah; Faizul Hasan; Ikramul Hasan; M Tasdik Hasan; Hamidreza Hasani; Mohammad Hasanian; Ali Hasanpour-Dehkordi; Abbas M. Hassan; Amr Hassan; Hossein Hassanian-Moghaddam; Soheil Hassanipour; Johannes Haubold; Rasmus J. Havmoeller; Simon I. Hay; Youssef Hbid; Jeffrey J. Hebert; Omar E. Hegazi; Golnaz Heidari; Mohammad Heidari; Mahsa Heidari-Foroozan; Reza Heidari-Soureshjani; Bartosz Helfer; Claudiu Herteliu; Hamed Hesami; Dineshani Hettiarachchi; Demisu Zenbaba Heyi; Kamal Hezam; Yuta Hiraike; Howard J. Hoffman; Ramesh Holla; Nobuyuki Horita; Md Belal Hossain; Md Mahbub Hossain; Sahadat Hossain; Mohammad-Salar Hosseini; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Vivian Chia-Rong Hsieh; Chengxi Hu; Junjie Huang; Md Nazmul Huda; Fernando N. Hugo; Michael Hultström; Javid Hussain; Salman Hussain; Nawfal R. Hussein; Le Duc Huy; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Oluwatope Olaniyi Idowu; Desta Ijo; Kevin S. Ikuta; Mehran Ilaghi; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Leeberk Raja Inbaraj; Arnaud Iradukunda; Farideh Iravanpour; Kenneth Chukwuemeka Iregbu; Md Rabiul Islam; Mohammad Mainul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Nahlah Elkudssiah Ismail; Gaetano Isola; Masao Iwagami; Chidozie C.D. Iwu; Chinwe Juliana Iwu-Jaja; Mahalaxmi Iyer; Linda Merin; Jalil Jaafari; Louis Jacob; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Morteza Jafarinia; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Mihajlo Jakovljevic; Reza Jalilzadeh Yengejeh; Elham Jamshidi; Chinmay T. Jani; Mark M. Janko; Abubakar Ibrahim Jatau; Sathish Kumar Jayapal; Shubha Jayaram; Jayakumar Jeganathan; Alelign Tasew Jema; Digisie Mequanint Jemere; Wonjeong Jeong; Anil K. Jha; Ravi Prakash Jha; John S. 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Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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
(Elsevier B.V., 2024) Mohsen Naghavi; Kanyin Liane Ong; Amirali Aali; Hazim S. Ababneh; Yohannes Habtegiorgis Abate; Cristiana Abbafati; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Deldar Morad Abdulah; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Aidin Abedi; Kedir Hussein Abegaz; E.S. Abhilash; Hassan Abidi; Olumide Abiodun; Richard Gyan Aboagye; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimaraes Abreu; Woldu Aberhe Abrha; Dariush Abtahi; Samir Abu Rumeileh; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen Me Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Manfred Mario Kokou Accrombessi; Tadele Girum Adal; Abdu A. Adamu; Isaac Yeboah Addo; Giovanni Addolorato; Akindele Olupelumi Adebiyi; Victor Adekanmbi; Abiola Victor Adepoju; Charles Oluwaseun Adetunji; Juliana Bunmi Adetunji; Temitayo Esther Adeyeoluwa; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Biruk Adie Admass; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Aanuoluwapo Adeyimika Afolabi; Muhammad Sohail Afzal; Saira Afzal; Suneth Buddhika Agampodi; Pradyumna Agasthi; Manik Aggarwal; Shahin Aghamiri; Feleke Doyore Agide; Antonella Agodi; Anurag Agrawal; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M Ahmad; Sajjad Ahmad; Shahzaib Ahmad; Tauseef Ahmad; Keivan Ahmadi; Amir Mahmoud Ahmadzade; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Mehrunnisha Sharif Ahmed; Meqdad Saleh Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Essona Matatom Akara; Hossein Akbarialiabad; Karolina Akinosoglou; Tomi Akinyemiju; Mohammed Ahmed Akkaif; Samuel Akyirem; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Fares Alahdab; Samer O. Alalalmeh; Tariq A. Alalwan; Ziyad Al-Aly; Khurshid Alam; Manjurul Alam; Noore Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Sayer Al-Azzam; Almaza Albakri; Mohammed Albashtawy; Mohammad T. AlBataineh; Jacqueline Elizabeth Alcalde-Rabanal; Khalifah A. Aldawsari; Wafa A. Aldhaleei; Robert W. Aldridge; Haileselasie Berhane Alema; Mulubirhan Assefa Alemayohu; Sharifullah Alemi; Yihun Mulugeta Alemu; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Khaled Al-Hanawi; Abid Ali; Amjad Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Shahid Ali; Syed Shujait Shujait Ali; Gianfranco Alicandro; Sheikh Mohammad Alif; Reyhaneh Alikhani; Yousef Alimohamadi; Ahmednur Adem Aliyi; Mohammad A. M. Aljasir; Syed Mohamed Aljunid; Francois Alla; Peter Allebeck; Sabah Al-Marwani; Sadeq Ali Ali Al-Maweri; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Louay Almidani; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jordi Alonso; Jaber S. Alqahtani; Shehabaldin Alqalyoobi; Ahmed Yaseen Alqutaibi; Salman Khalifah Al-Sabah; Zaid Altaany; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Reza Amani; Azmeraw T. Amare; Prince M. Amegbor; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Sohrab Amiri; Mohammad Hosein Amirzade-Iranaq; Hubert Amu; Dickson A. Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; David B. Anderson; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Colin Angus; Abhishek Anil; Sneha Anil; Amir Anoushiravani; Hossein Ansari; Ansariadi Ansariadi; Alireza Ansari-Moghaddam; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Saeid Anvari; Saleha Anwar; Sumadi Lukman Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Muhammad Aqeel; Juan Pablo Arab; Jalal Arabloo; Mosab Arafat; Aleksandr Y. Aravkin; Demelash Areda; Abdulfatai Aremu; Olatunde Aremu; Hany Ariffin; Mesay Arkew; Benedetta Armocida; Michael Benjamin Arndt; Johan Arnlov; Mahwish Arooj; Anton A. Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Ashokan Arumugam; Malke Asaad; Mohsen Asadi-Lari; Akeza Awealom Asgedom; Mona Asghariahmadabad; Mohammad Asghari-Jafarabadi; Muhammad Ashraf; Armin Aslani; Thomas Astell-Burt; Mohammad Athar; Seyyed Shamsadin Athari; Bantalem Tilaye Tilaye Atinafu; Habtamu Wondmagegn Atlaw; Prince Atorkey; Maha Moh'D Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Atalel Fentahun Awedew; Amlaku Mulat Aweke; Beatriz Paulina Ayala Quintanilla; Haleh Ayatollahi; Jose L. Ayuso-Mateos; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Rui M. S. Azevedo; Ahmed Y. Azzam; B.B. Darshan; Abraham Samuel Babu; Muhammad Badar; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Sulaiman Bah; Saeed Bahadorikhalili; Najmeh Bahmanziari; Ruhai Bai; Atif Amin Baig; Jennifer L. Baker; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Senthilkumar Balakrishnan; Madhan Balasubramanian; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Palash Chandra Banik; Hansi Bansal; Kannu Bansal; Franca Barbic; Martina Barchitta; Mainak Bardhan; Erfan Bardideh; Suzanne Lyn Barker-Collo; Till Winfried Barnighausen; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Lope H. Barrero; Amadou Barrow; Sandra Barteit; Lingkan Barua; Zarrin Basharat; Azadeh Bashiri; Afisu Basiru; Pritish Baskaran; Buddha Basnyat; Quique Bassat; João Diogo Basso; Ann V. L. Basting; Sanjay Basu; Kavita Batra; Bernhard T. Baune; Mohsen Bayati; Nebiyou Simegnew Bayileyegn; Thomas Beaney; Neeraj Bedi; Massimiliano Beghi; Emad Behboudi; Priyamadhaba Behera; Amir Hossein Behnoush; Masoud Behzadifar; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Yannick Béjot; Sefealem Assefa Belay; Chalie Mulu Belete; Michelle L. Bell; Muhammad Bashir Bello; Olorunjuwon Omolaja Bello; Luis Belo; Apostolos Beloukas; Rose Grace Bender; Isabela M. Bensenor; Azizullah Beran; Zombor Berezvai; Alemshet Yirga Berhie; Betyna N. Berice; Robert S. Bernstein; Gregory J. Bertolacci; Paulo J. G. Bettencourt; Kebede A. Beyene; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Dinesh Bhandari; Kayleigh Bhangdia; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Ashish Bhargava; Sonu Bhaskar; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Manpreet S. Bhatti; Rajbir Bhatti; Zulfiqar A. Bhutta; Boris Bikbov; Jessica Devin Bishai; Catherine Bisignano; Francesca Bisulli; Atanu Biswas; Bijit Biswas; Saeid Bitaraf; Bikes Destaw Bitew; Veera R. Bitra; Tone Bjørge; Micheal Kofi Boachie; Mary Sefa Boampong; Anca Vasilica Bobirca; Virginia Bodolica; Aadam Olalekan Bodunrin; Eyob Ketema Bogale; Kassawmar Angaw Bogale; Somayeh Bohlouli; Obasanjo Afolabi Bolarinwa; Archith Boloor; Milad Bonakdar Hashemi; Aime Bonny; Kaustubh Bora; Berrak Bora Basara; Hamed Borhany; Arturo Borzutzky; Souad Bouaoud; Antoine Boustany; Christopher Boxe; Edward J. Boyko; Oliver J. Brady; Dejana Braithwaite; Luisa C. Brant; Michael Brauer; Alexandra Brazinova; Javier Brazo-Sayavera; Nicholas J. K. Breitborde; Susanne Breitner; Hermann Brenner; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Gabrielle Britton; Julie Brown; Traolach Brugha; Norma B. Bulamu; Lemma N. Bulto; Danilo Buonsenso; Richard A. Burns; Reinhard Busse; Yasser Bustanji; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Daniela Calina; Luis Alberto Camera; Luciana Aparecida Campos; Ismael R. Campos-Nonato; Chao Cao; Yin Cao; Angelo Capodici; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Juan J. Carrero; Andrea Carugno; Cristina G. Carvalheiro; Felix Carvalho; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Ferrán Catalá-López; Alberico L. Catapano; Maria Sofia Cattaruzza; Christopher R. Cederroth; Luca Cegolon; Francieli Cembranel; Muthia Cenderadewi; Kelly M. Cercy; Ester Cerin; Muge Cevik; Joshua Chadwick; Yaacoub Chahine; Chiranjib Chakraborty; Promit Ananyo Chakraborty; Jeffrey Shi Kai Chan; Raymond N. C. Chan; Rama Mohan Chandika; Eeshwar K. Chandrasekar; Chin-Kuo Chang; Jung-Chen Chang; Gashaw Sisay Chanie; Periklis Charalampous; Vijay Kumar Chattu; Pankaj Chaturvedi; Victoria Chatzimavridou-Grigoriadou; Akhilanand Chaurasia; Angela W. Chen; An-Tian Chen; Catherine S. Chen; Haowei Chen; Meng Xuan Chen; Simiao Chen; Ching-Yu Cheng; Esther T. W. Cheng; Nicolas Cherbuin; Wondimye Ashenafi Cheru; Ju-Huei Chien; Odgerel Chimed-Ochir; Ritesh Chimoriya; Patrick R. Ching; Jesus Lorenzo Chirinos-Caceres; Abdulaal Chitheer; William C. S. Cho; Bryan Chong; Hitesh Chopra; Sonali Gajanan Choudhari; Rajiv Chowdhury; Devasahayam J. Christopher; Isaac Sunday Chukwu; Eric Chung; Erin Chung; Eunice Chung; Sheng-Chia Chung; Muhammad Chutiyami; Zinhle Cindi; Iolanda Cioffi; Mareli M. Claassens; Rafael M. Claro; Kaleb Coberly; Rebecca M. Cogen; Alyssa Columbus; Haley Comfort; Joao Conde; Samuele Cortese; Paolo Angelo Cortesi; Vera Marisa Costa; Simona Costanzo; Ewerton Cousin; Rosa A. S. Couto; Richard G. Cowden; Kenneth Michael Cramer; Michael H. Criqui; Natalia Cruz-Martins; Silvia Magali Cuadra-Hernandez; Garland T. Culbreth; Patricia Cullen; Matthew Cunningham; Maria Paula Curado; Sriharsha Dadana; Omid Dadras; Siyu Dai; Xiaochen Dai; Zhaoli Dai; Lachlan L. Dalli; Giovanni Damiani; Jiregna Darega Gela; Jai K. Das; Saswati Das; Subasish Das; Ana Maria Dascalu; Nihar Ranjan Dash; Mohsen Dashti; Anna Dastiridou; Gail Davey; Claudio Alberto Davila-Cervantes; Nicole Davis Weaver; Kairat Davletov; Diego De Leo; Katie De Luca; Aklilu Tamire Debele; Shayom Debopadhaya; Louisa Degenhardt; Azizallah Dehghan; Lee Deitesfeld; Cristian Del Bo; Ivan Delgado-Enciso; Berecha Hundessa Demessa; Andreas K. Demetriades; Ke Deng; Xinlei Deng; Edgar Denova-Gutierrez; Niloofar Deravi; Nebiyu Dereje; Nikolaos Dervenis; Emina Dervišević; Don C. Des Jarlais; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Syed Masudur Rahman Dewan; Arkadeep Dhali; Kuldeep Dhama; Meghnath Dhimal; Sameer Dhingra; Vishal R. Dhulipala; Diana Dias Da Silva; Daniel Diaz; Michael J. Diaz; Adriana Dima; Delaney D. Ding; Huanghe Ding; Ricardo Jorge Dinis-Oliveira; M. Ashworth Dirac; Shirin Djalalinia; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Saeid Doaei; Masoud Dodangeh; Milad Dodangeh; Sushil Dohare; Klara Georgieva Dokova; Christiane Dolecek; Regina-Mae Villanueva Dominguez; Wanyue Dong; Deepa Dongarwar; Mario D'Oria; Fariba Dorostkar; E. Ray Dorsey; Wendel Mombaque Dos Santos; Rajkumar Doshi; Leila Doshmangir; Robert Kokou Dowou; Tim Robert Driscoll; Haneil Larson Dsouza; Viola Dsouza; Mi Du; John Dube; Bruce B. Duncan; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Laura Dwyer-Lindgren; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Abdel Rahman E'Mar; Ejemai Eboreime; Alireza Ebrahimi; Chidiebere Peter Echieh; Hisham Atan Edinur; David Edvardsson; Kristina Edvardsson; Defi Efendi; Ferry Efendi; Diyan Ermawan Effendi; Terje Andreas Eikemo; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Iffat Elbarazi; Teshome Bekele Elema; Noha Mousaad Elemam; Frank J. Elgar; Islam Y. 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Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Gregory A. Roth; Degu Abate; Kalkidan Hassen Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Haftom Temesgen Abebe; Molla Abebe; Zegeye Abebe; Ayenew Negesse Abejie; Semaw F. Abera; Olifan Zewdie Abil; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Abdu A. Adamu; Oladimeji M. Adebayo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Mina G. Adib; Amha Admasie; Ashkan Afshin; Gina Agarwal; Kareha M. Agesa; Anurag Agrawal; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Muktar Beshir Ahmed; Sayem Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Mohammad Esmaeil Akbari; Rufus Olusola Akinyemi; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Rajaa M. Al-Raddadi; Fares Alahdab; Khurshid Alam; Tahiya Alam; Animut Alebel; Kefyalew Addis Alene; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala'a Alkerwi; Francois Alla; Peter Allebeck; Jordi Alonso; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Leopold N. Aminde; Erfan Amini; Walid Ammar; Yaw Ampem Amoako; Nahla Hamed Anber; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Hossein Ansari; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Palwasha Anwari; Olatunde Aremu; Johan Arnlov; Amit Arora; Monika Arora; Al Artaman; Krishna K. Aryal; Hamid Asayesh; Ephrem Tsegay Asfaw; Zerihun Ataro; Suleman Atique; Sachin R. Atre; Marcel Ausloos; Euripide F.G.A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Yohanes Ayele; Rakesh Ayer; Peter S. Azzopardi; Arefeh Babazadeh; Umar Bacha; Hamid Badali; Alaa Badawi; Ayele Geleto Bali; Katherine E. Ballesteros; Maciej Banach; Kajori Banerjee; Marlena S. Bannick; Joseph Adel Mattar Banoub; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Barnighausen; Simon Barquera; Lope H. Barrero; Quique Bassat; Sanjay Basu; Bernhard T. Baune; Habtamu Wondifraw Baynes; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Bejot; Bayu Begashaw Bekele; Abate Bekele Belachew; Ezra Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Mircea Beuran; Tina Beyranvand; Ashish Bhalla; Suraj Bhattarai; Soumyadeeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Molly H. Biehl; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Donal Bisanzio; Tuhin Biswas; Brigette F. Blacker; Berrak Bora Basara; Rohan Borschmann; Cristina Bosetti; Kayvan Bozorgmehr; Oliver J. Brady; Luisa C. Brant; Carol Brayne; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Paul Svitil Briant; Gabrielle Britton; Traolach Brugha; Reinhard Busse; Zahid A. Butt; Charlton S.K.H. Callender; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jorge Cano; Mate Car; Rosario Cardenas; Giulia Carreras; Juan J. Carrero; Austin Carter; Felix Carvalho; Carlos A. Castaneda-Orjuela; Jacqueline Castillo Rivas; Chris D. Castle; Clara Castro; Franz Castro; Ferran Catala-Lopez; Ester Cerin; Yazan Chaiah; Jung-Chen Chang; Fiona J. Charlson; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Odgerel Chimed-Ochir; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Aaron J. Cohen; Leslie Trumbull Cooper; Paolo Angelo Cortesi; Monica Cortinovis; Ewerton Cousin; Benjamin C. Cowie; Michael H. Criqui; Elizabeth A. Cromwell; Christopher Stephen Crowe; John A. Crump; Matthew Cunningham; Alemneh Kabeta Daba; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Anh Kim Dang; Paul I. Dargan; Ahmad Daryani; Siddharth K. Das; Rajat Das Gupta; Jose Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Adrian C. Davis; Nicole Davis Weaver; Dragos Virgil Davitoiu; Kairat Davletov; Fernando Pio De La Hoz; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Tizta T. Degfie; Selina Deiparine; Gebre Teklemariam Demoz; Balem Betsu Demtsu; Edgar Denova-Gutierrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Subhojit Dey; Samath D. Dharmaratne; Daniel Dicker; Mesfin Tadese Dinberu; Eric L. Ding; M. Ashworth Dirac; Shirin Djalalinia; Klara Dokova; David Teye Doku; Christl A. Donnelly; E. Ray Dorsey; Pratik P. Doshi; Dirk Douwes-Schultz; Kerrie E. Doyle; Tim R. Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Dumessa Edessa; David Edvardsson; Anne Elise Eggen; Charbel El Bcheraoui; Maysaa El Sayed Zaki; Ziad El-Khatib; Hajer Elkout; Christian Lycke Ellingsen; Matthias Endres; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Babak Eshrati; Sharareh Eskandarieh; Reza Esmaeili; Alireza Esteghamati; Mahdi Fakhar; Hamed Fakhim; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Carla Sofia Esá Farinha; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Valery L. Feigin; Andrea B. Feigl; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Alize J. Ferrari; Garumma Tolu Feyissa; Irina Filip; Samuel Finegold; Florian Fischer; Christina Fitzmaurice; Nataliya A. Foigt; Kyle J. Foreman; Carla Fornari; Tahvi D. Frank; Takeshi Fukumoto; John E. Fuller; Nancy Fullman; Thomas Furst; Joao M. Furtado; Neal D. Futran; Silvano Gallus; Alberto L. Garcia-Basteiro; Miguel A. Garcia-Gordillo; William M. Gardner; Abadi Kahsu Gebre; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Bereket Gebremichael; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Ricard Genova-Maleras; Yilma Chisha Dea Geramo; Peter W. Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Mamata Ghimire; Katherine B. Gibney; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Ibrahim Abdelmageed Ginawi; Maurice Giroud; Giorgia Giussani; Shifalika Goenka; Ellen M. Goldberg; Srinivas Goli; Hector Gomez-Dantes; Philimon N. Gona; Sameer Vali Gopalani; Taren M. Gorman; Atsushi Goto; Alessandra C. Goulart; Elena V. Gnedovskaya; Ayman Grada; Giuseppe Grosso; Harish Chander Gugnani; Andre Luiz Sena Guimaraes; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Reyna Alma Gutierrez; Bishal Gyawali; Juanita A. Haagsma; Nima Hafezi-Nejad; Tekleberhan B. Hagos; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Roderick J. Hay; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Mohsen Heidari; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Claudiu Herteliu; Fatemeh Heydarpour; Pouria Heydarpour; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Hans W. Hoek; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; H. Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Peter J. Hotez; Damian G. Hoy; Thomas Hsiao; Guoqing Hu; John J. Huang; Abdullatif Husseini; Mohammedaman Mama Hussen; Susan Hutfless; Bulat Idrisov; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Nazrul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Moti Tolera Jalu; Spencer L. James; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Kathy J. Jenkins; Ravi Prakash Jha; Vivekanand Jha; Catherine O. Johnson; Sarah C. Johnson; Jost B. Jonas; Ankur Joshi; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jurisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Manoochehr Karami; Behzad Karami Matin; Andre Karch; Corine Karema; Hamidreza Karimi-Sari; Amir Kasaeian; Dessalegn H. Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Anil Kaul; Zhila Kazemi; Ali Kazemi Karyani; Dhruv Satish Kazi; Adane Teshome Kefale; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Chandrasekharan Nair Kesavachandran; Yousef Saleh Khader; Behzad Khafaei; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Ejaz Ahmad Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Mona M. Khater; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Jagdish Khubchandani; Aliasghar A. Kiadaliri; Getiye D. Kibret; Zelalem Teklemariam Kidanemariam; Daniel N. Kiirithio; Daniel Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimaki; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G. Anil Kumar; Manasi Kumar; Pushpendra Kumar; Michael J. Kutz; Igor Kuzin; Hmwe Hmwe Kyu; Deepesh P. Lad; Sheetal D. Lad; Alessandra Lafranconi; Dharmesh Kumar Lal; Ratilal Lalloo; Tea Lallukka; Jennifer O. Lam; Faris Hasan Lami; Van C. Lansingh; Sonia Lansky; Heidi J. Larson; Arman Latifi; Kathryn Mei-Ming Lau; Jeffrey V. Lazarus; Georgy Lebedev; Paul H. Lee; James Leigh; Mostafa Leili; Cheru Tesema Leshargie; Shanshan Li; Yichong Li; Juan Liang; Lee-Ling Lim; Stephen S. Lim; Miteku Andualem Limenih; Shai Linn; Shiwei Liu; Yang Liu; Rakesh Lodha; Chris Lonsdale; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Raimundas Lunevicius; Stefan Ma; Erlyn Rachelle King Macarayan; Mark T. Mackay; Jennifer H. MacLachlan; Emilie R. Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Ana-Laura Manda; Luiz Garcia Mandarano-Filho; Helena Manguerra; Mohammad Ali Mansournia; Chabila Christopher Mapoma; Dadi Marami; Joemer C. Maravilla; Wagner Marcenes; Laurie Marczak; Ashley Marks; Guy B. Marks; Gabriel Martinez; Francisco Rogerlandio Martins-Melo; Ira Martopullo; Winfried Marz; Melvin B. Marzan; Joseph R. Masci; Benjamin Ballard Massenburg; Manu Raj Mathur; Prashant Mathur; Richard Matzopoulos; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Brian J. McMahon; Suresh Mehata; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Tefera C. Mekonnen; Addisu Melese; Mulugeta Melku; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Desalegn Tadese Mengistu; Getnet Mengistu; George A. Mensah; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Haftay Berhane Mezgebe; Bartosz Miazgowski; Tomasz Miazgowski; Anoushka I. Millear; Ted R. Miller; Molly Katherine Miller-Petrie; G.K. Mini; Parvaneh Mirabi; Mojde Mirarefin; Andreea Mirica; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Habtamu Mitiku; Babak Moazen; Karzan Abdulmuhsin Mohammad; Moslem Mohammadi; Noushin Mohammadifard; Mohammed A. Mohammed; Shafiu Mohammed; Viswanathan Mohan; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Ghobad Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Ilais Moreno Velasquez; Joana Morgado-Da-Costa; Shane Douglas Morrison; Marilita M. Moschos; Simin Mouodi; Seyyed Meysam Mousavi; Kindie Fentahun Muchie; Ulrich Otto Mueller; Satinath Mukhopadhyay; Kate Muller; John Everett Mumford; Jonah Musa; Kamarul Imran Musa; Ghulam Mustafa; Saravanan Muthupandian; Jean B. 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Ong; Sok King Sk Ong; Eyal Oren; Heather M. Orpana; Alberto Ortiz; Justin R. Ortiz; Stanislav S. Otstavnov; Simon Overland; Mayowa Ojo Owolabi; Raziye Ozdemir; P.A. Mahesh; Rosana Pacella; Smita Pakhale; Abhijit P. Pakhare; Amir H. Pakpour; Adrian Pana; Songhomitra Panda-Jonas; Jeyaraj Durai Pandian; Andrea Parisi; Eun-Kee Park; Charles D.H. Parry; Hadi Parsian; Shanti Patel; Sanghamitra Pati; George C. Patton; Vishnupriya Rao Paturi; Katherine R. Paulson; Alexandre Pereira; David M. Pereira; Norberto Perico; Konrad Pesudovs; Max Petzold; Michael R. Phillips; Frederic B. Piel; David M. Pigott; Julian David Pillay; Meghdad Pirsaheb; Farhad Pishgar; Suzanne Polinder; Maarten J. Postma; Akram Pourshams; Hossein Poustchi; Ashwini Pujar; Swayam Prakash; Narayan Prasad; Caroline A. Purcell; Mostafa Qorbani; Hedley Quintana; D.Alex Quistberg; Kirankumar Waman Rade; Amir Radfar Anwar Rafay; Fakher Rahim; Kazem Rahimi; Afarin Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Rajesh Kumar Rai; Sasa Rajsic; Usha Ram; Chhabi Lal Ranabhat; Prabhat Ranjan; Puja C. Rao; David Laith Rawaf; Salman Rawaf; Christian Razo-Garcia; K. Srinath Reddy; Robert C. Reiner; Marissa B. Reitsma; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Satar Rezaei; Shahab Rezaeian; Mohammad Sadegh Rezai; Seyed Mohammad Riahi; Antonio Luiz P. Ribeiro; Maria Jesus Rios-Blancas; Kedir Teji Roba; Nicholas L.S. Roberts; Stephen R. Robinson; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Dietrich Rothenbacher; Ambuj Roy; Enrico Rubagotti; Perminder S. Sachdev; Basema Saddik; Ehsan Sadeghi; Hosein Safari; Mahdi Safdarian; Sare Safi; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; Nasir Salam; Joseph S. 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Stokes; Michelle L. Subart; Agus Sudaryanto; Mu'Awiyyah Babale Sufiyan; Patrick John Sur; Ipsita Sutradhar; Bryan L. Sykes; P.N. Sylaja; Dillon O. Sylte; Cassandra E.I. Szoeke; Rafael Tabares-Seisdedos; Takahiro Tabuchi; Santosh Kumar Tadakamadla; Ken Takahashi; Nikhil Tandon; Segen Gebremeskel Tassew; Nuno Taveira; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Merhawi Gebremedhin Tekle; Mohamad-Hani Temsah; Omar Temsah; Abdullah Sulieman Terkawi; Manaye Yihune Teshale; Belay Tessema; Gizachew Assefa Tessema; Kavumpurathu Raman Thankappan; Sathish Thirunavukkarasu; Nihal Thomas; Amanda G. Thrift; George D. Thurston; Binyam Tilahun; Quyen G. To; Ruoyan Tobe-Gai; Marcello Tonelli; Roman Topor-Madry; Anna E. Torre; Miguel Tortajada-Girbes; Mathilde Touvier; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Khanh Bao Tran; Suryakant Tripathi; Christopher E. Troeger; Thomas Clement Truelsen; Nu Thi Truong; Afewerki Gebremeskel Tsadik; Derrick Tsoi; Lorainne Tudor Car; E. Murat Tuzcu; Stefanos Tyrovolas; Kingsley N. Ukwaja; Irfan Ullah; Eduardo A. Undurraga; Rachel L. Updike; Muhammad Shariq Usman; Olalekan A. Uthman; Selen Begum Uzun; Muthiah Vaduganathan; Afsane Vaezi; Gaurang Vaidya; Pascual R. Valdez; Elena Varavikova; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Santos Villafaina; Francesco S. Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Stein Emil Vollset; Theo Vos; Gregory R. Wagner; Fasil Shiferaw Wagnew; Yasir Waheed; Mitchell Taylor Wallin; Judd L. Walson; Yanping Wang; Yuan-Pang Wang; Molla Mesele Wassie; Elisabete Weiderpass; Robert G. Weintraub; Fitsum Weldegebreal; Kidu Gidey Weldegwergs; Andrea Werdecker; Adhena Ayaliew Werkneh; T. Eoin West; Ronny Westerman; Harvey A. Whiteford; Justyna Widecka
Background: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings: At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation: Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
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Background: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016
(Lancet Publishing Group, 2018) Nancy Fullman; Jamal Yearwood; Solomon M. Abay; Cristiana Abbafati; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Zegeye Abebe; Teshome Abuka Abebo; Victor Aboyans; Haftom Niguse Abraha; Daisy M.X. Abreu; Laith J. Abu-Raddad; Akilew Awoke Adane; Rufus Adesoji Adedoyin; Olatunji Adetokunboh; Tara Ballav Adhikari; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Dominic Agius; Anurag Agrawal; Sutapa Agrawal; Aliasghar Ahmad Kiadaliri; Miloud Taki Eddine Aichour; Mohammed Akibu; Rufus Olusola Akinyemi; Tomi F. Akinyemiju; Nadia Akseer; Faris Hasan Al Lami; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Tahiya Alam; Deena Alasfoor; Mohammed I. Albittar; Kefyalew Addis Alene; Ayman Al-Eyadhy; Syed Danish Ali; Mehran Alijanzadeh; Syed M. Aljunid; Ala'a Alkerwi; François Alla; Peter Allebeck; Christine Allen; Mahmoud A. Alomari; Rajaa Al-Raddadi; Ubai Alsharif; Khalid A. Altirkawi; Nelson Alvis-Guzman; Azmeraw T. 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Singh; Lavanya Singh; Narinder Pal Singh; Virendra Singh; Dhirendra Narain Sinha; Abiy Hiruye Sinke; Mekonnen Sisay; Vegard Skirbekk; Karen Sliwa; Alison Smith; Adauto Martins Soares Filho; Badr H.A. Sobaih; Melek Somai; Samir Soneji; Moslem Soofi; Reed J.D. Sorensen; Joan B. Soriano; Ireneous N. Soyiri; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Jeffrey D. Stanaway; Vasiliki Stathopoulou; Nicholas Steel; Dan J. Stein; Mark Andrew Stokes; Lela Sturua; Muawiyyah Babale Sufiyan; Rizwan Abdulkader Suliankatchi; Bruno F. Sunguya; Patrick J. Sur; Bryan L. Sykes; P.N. Sylaja; Cassandra E.I. Szoeke; Rafael Tabarés-Seisdedos; Santosh Kumar Tadakamadla; Andualem Henok Tadesse; Getachew Redae Taffere; Nikhil Tandon; Amare Tariku Tariku; Nuno Taveira; Arash Tehrani-Banihashemi; Girma Temam Shifa; Mohamad-Hani Temsah; Abdullah Sulieman Terkawi; Azeb Gebresilassie Tesema; Dawit Jember Tesfaye; Belay Tessema; J.S. Thakur; Nihal Thomas; Matthew J. Thompson; Taavi Tillmann; Quyen G. To; Ruoyan Tobe-Gai; Marcello Tonelli; Roman Topor-Madry; Fotis Topouzis; Anna Torre; Miguel Tortajada; Bach Xuan Tran; Khanh Bao Tran; Avnish Tripathi; Srikanth Prasad Tripathy; Christopher Troeger; Thomas Truelsen; Derrick Tsoi; Lorainne Tudor Car; Kald Beshir Tuem; Stefanos Tyrovolas; Uche S. Uchendu; Kingsley Nnanna Ukwaja; Irfan Ullah; Rachel Updike; Olalekan A. Uthman; Benjamin S. Chudi Uzochukwu; Pascual Rubén Valdez; Job F.M. Van Boven; Santosh Varughese; Tommi Vasankari; Narayanaswamy Venketasubramanian; Francesco S. Violante; Sergey K. Vladimirov; Vasiliy Victorovich Vlassov; Stein Emil Vollset; Theo Vos; Fasil Wagnew; Yasir Waheed; Mitchell T. Wallin; Judd L. Walson; Yafeng Wang; Yuan-Pang Wang; Molla Mesele Wassie; Marcia R. Weaver; Elisabete Weiderpass; Robert G. Weintraub; Jordan Weiss; Kidu Gidey Weldegwergs; Andrea Werdecker; T. Eoin West; Ronny Westerman; Richard G. White; Harvey A. Whiteford; Justyna Widecka; Andrea Sylvia Winkler; Charles Shey Wiysonge; Charles D.A. Wolfe; Yohanes Ayele Wondimkun; Abdulhalik Workicho; Grant M.A. Wyper; Denis Xavier; Gelin Xu; Lijing L. Yan; Yuichiro Yano; Mehdi Yaseri; Nigus Bililign Yimer; Peng Yin; Paul Yip; Biruck Desalegn Yirsaw; Naohiro Yonemoto; Gerald Yonga; Seok-Jun Yoon; Marcel Yotebieng; Mustafa Z. Younis; Chuanhua Yu; Vesna Zadnik; Zoubida Zaidi; Maysaa El Sayed Zaki; Sojib Bin Zaman; Mohammad Zamani; Zerihun Menlkalew Zenebe; Maigeng Zhou; Jun Zhu; Stephanie R.M. Zimsen; Ben Zipkin; Sanjay Zodpey; Liesl Joanna Zuhlke; Christopher J.L. Murray; Rafael Lozano
Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view - and subsequent provision - of quality health care for all populations. Copyright © 2018 The Author(s). Published by Elsevier Ltd.
Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Rafael Lozano; Nancy Fullman; Degu Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Omar Abdel-Rahman; Alireza Abdi; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Nebiyu Dereje Abebe; Zegeye Abebe; Ayenew Negesse Abejie; Semaw F. Abera; Olifan Zewdie Abil; Victor Aboyans; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Niveen Me Abu-Rmeileh; Gebre Y. Abyu; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Pawan Acharya; Abdu A. Adamu; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Rufus Adesoji Adedoyin; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Tara Ballav Adhikari; Mina G. Adib; Arsène Kouablan Adou; Jose C. Adsuar; Mohsen Afarideh; Mahdi Afshari; Ashkan Afshin; Gina Agarwal; Sargis Aghasi Aghayan; Dominic Agius; Anurag Agrawal; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Sayem Ahmed; Temesgen Yihunie Akalu; Ali S. Akanda; Mohammad Esmaeil Akbari; Mohammed Akibu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Nadia Akseer; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Tahiya Alam; Ammar Albujeer; Animut Alebel; Kefyalew Addis Alene; Ayman Al-Eyadhy; Samia Alhabib; Raghib Ali; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala'a Alkerwi; François Alla; Peter Allebeck; Christine A. Allen; Ali Almasi; Fatma Al-Maskari; Hesham M. Al-Mekhlafi; Jordi Alonso; Rajaa M. Al-Raddadi; Ubai Alsharif; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Kebede Amenu; Erfan Amini; Walid Ammar; Nahla Hamed Anber; Jason A. Anderson; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Hossein Ansari; Ansariadi Ansariadi; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Palwasha Anwari; Lambert Tetteh Appiah; Olatunde Aremu; Habtamu Abera Areri; Johan Ärnlöv; Monika Arora; Krishna K. Aryal; Hamid Asayesh; Ephrem Tsegay Asfaw; Solomon Weldegebreal Asgedom; Rana Jawad Asghar; Reza Assadi; Zerihun Ataro; Suleman Atique; Sachin R. Atre; Madhu Sudhan Atteraya; Marcel Ausloos; Leticia Avila-Burgos; Euripide F. G. A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Henok Tadesse Ayele; Yohanes Ayele; Rakesh Ayer; Mahmoud Reza Azarpazhooh; Peter S. Azzopardi; Natasha Azzopardi-Muscat; Tesleem Kayode Babalola; Arefeh Babazadeh; Hamid Badali; Alaa Badawi; Kalpana Balakrishnan; Ayele Geleto Bali; Maciej Banach; Amitava Banerjee; Joseph Adel Mattar Banoub; Amrit Banstola; Aleksandra Barac; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Celine M. Barthelemy; Quique Bassat; Arindam Basu; Sanjay Basu; Robert J. Battista; Bernhard T. Baune; Habtamu Wondifraw Baynes; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Béjot; Bayu Begashaw Bekele; Abate Bekele Belachew; Aregawi Gebreyesus Belay; Saba Abraham Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Habib Benzian; Adugnaw Berhane; Abadi Kidanemariam Berhe; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Mircea Beuran; Tina Beyranvand; Neeraj Bhala; Ashish Bhalla; Anil Bhansali; Suraj Bhattarai; Soumyadeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Molly H. Biehl; Ali Bijani; Boris Bikbov; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Sait Mentes Birlik; Charles Birungi; Donal Bisanzio; Tuhin Biswas; Helen Bitew; Hailemichael Bizuneh; Espen Bjertness; Eshetu Mulisa Bobasa; Soufiane Boufous; Rupert Bourne; Kayvan Bozorgmehr; Nicola Luigi Bragazzi; Michael Brainin; Luisa C. Brant; Michael Brauer; Alexandra Brazinova; Nicholas J. K. Breitborde; Paul Svitil Briant; Gabrielle Britton; Traolach Brugha; Gene Bukhman; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Charlton S.K.H. Callender; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jorge Cano; Josip Car; Mate Car; Rosario Cárdenas; Juan J. Carrero; Austin Carter; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; Kate Causey; Alanur Çavlin; Kelly M. Cercy; Ester Cerin; Yazan Chaiah; Julian Chalek; Hsing-Yi Chang; Jung-Chen Chang; Aparajita Chattopadhyay; Vijay Kumar Chattu; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Ken Lee Chin; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Jee-Young J. Choi; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Thomas Khaled Dwayne Claßen; Aaron J. Cohen; Daniel Collado-Mateo; Cyrus Cooper; Leslie Trumbull Cooper; Leslie Cornaby; Monica Cortinovis; Megan Costa; Ewerton Cousin; Elizabeth A. Cromwell; Christopher Stephen Crowe; Matthew Cunningham; Alemneh Kabeta Daba; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Anh Kim Dang; Paul I. Dargan; Ahmad Daryani; Siddharth K. Das; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Adrian C. Davis; Dragos Virgil Davitoiu; Kairat Davletov; Anand Dayama; Barbora De Courten; Diego De Leo; Jan-Walter De Neve; Hans De Steur; Meaza Girma Degefa; Louisa Degenhardt; Tizta Tilahun Degfie; Selina Deiparine; Robert P. Dellavalle; Gebre Teklemariam Demoz; Balem Demtsu; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Getenet Ayalew Dessie; Subhojit Dey; Samath D. Dharmaratne; Meghnath Dhimal; Daniel Dicker; Mesfin Tadese Dinberu; Eric L. Ding; Shirin Djalalinia; Huyen Phuc Do; Klara Dokova; David Teye Doku; Dirk Douwes-Schultz; Tim Robert Driscoll; Leilei Duan; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Soheil Ebrahimpour; David Edvardsson; Charbel El Bcheraoui; Erika Eldrenkamp; Ziad El-Khatib; Iqbal R.F. Elyazar; Ahmadali Enayati; Aman Yesuf Endries; Babak Eshrati; Sharareh Eskandarieh; Alireza Esteghamati; Sadaf Esteghamati; Kara Estep; Mahdi Fakhar; Hamed Fakhim; Jessica Fanzo; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Talha A. Farid; Carla Sofia E. Sá Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Hossein Farzam; Ali Akbar Fazaeli; Mir Sohail Fazeli; Valery L. Feigin; Andrea B. Feigl; Wubalem Fekadu; Rachel Feldman; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Garumma Tolu Feyissa; Daniel Obadare Fijabi; Irina Filip; Samuel Finegold; Jonas David Finger; Florian Fischer; Christina Fitzmaurice; Luisa Sorio Flor; Nataliya A. Foigt; Kyle J. Foreman; Tahvi D. Frank; Richard Charles Franklin; Takeshi Fukumoto; Kai Fukutaki; John E. Fuller; Thomas Fürst; João M. Furtado; Emmanuela Gakidou; Silvano Gallus; Fortune Gbetoho Gankpe; Ron T. Gansevoort; Ana Cristina Garcia; Alberto L. Garcia-Basteiro; Miguel A. Garcia-Gordillo; William M. Gardner; Abadi Kahsu Gebre; Teshome Gebre; Gebremedhin Berhe Gebregergs; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Bereket Gebremichael; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Yilma Chisha Dea Geramo; Sefonias Getachew; Peter W. Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Keyghobad Ghadiri; Maryam Ghasemi-Kasman; Hesam Ghiasvand; Mamata Ghimire; Aloke Gopal Ghoshal; Simona Giampaoli; Paramjit Singh Gill; Tiffany K. Gill; Giorgia Giussani; Elena V. Gnedovskaya; Ellen M. Goldberg; Srinivas Goli; Philimon N. Gona; Amador Goodridge; Sameer Vali Gopalani; Taren M. Gorman; Atsushi Goto; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Max G. Griswold; Giuseppe Grosso; Harish Chander C. Gugnani; Francis Guillemin; Andre Luiz Sena Guimaraes; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Giang Hai Ha; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Hassan Haghparast Bidgoli; Tekleberhan B. Hagos; Michael Tamene Haile; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Hamidreza Haririan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Caitlin N. Hawley; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Behnam Heidari; Mohsen Heidari; Delia Hendrie; Andualem Henok; Ileana Heredia-Pi; Claudiu Herteliu; Behzad Heydarpour; Fatemeh Heydarpour; Sousan Heydarpour; Desalegn T. Hibstu; Martha Híjar; Hans W. Hoek; Daniel J. Hoffman; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; Nobuyuki Horita; H. Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Peter J. Hotez; Damian G. Hoy; Mohamed Hsairi; Thomas Hsiao; Guoqing Hu; John J. Huang; Caitlyn Hughes; Chantal K. Huynh; Ehimario U. Igumbor; Chad Thomas Ikeda; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Sheikh Mohammed Shariful Islam; Farhad Islami; Rebecca Q. Ivers; Neda Izadi; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Moti Tolera Jalu; Amr A. Jamal; Spencer L. James; Simerjot K. Jassal; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Catherine O. Johnson; Sarah C. Johnson; Jost B. Jonas; Jitendra Jonnagaddala; Zahra Jorjoran Shushtari; Ankur Joshi; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jürisson; K. Madhanraj; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Molla Kahssay; Rizwan Kalani; Umesh Kapil; Manoochehr Karami; Behzad Karami Matin; Marina Karanikolos; Narges Karimi; Seyed M. Karimi; Hamidreza Karimi-Sari; Amir Kasaeian; Dessalegn H. Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Zemenu Yohannes Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Anil Kaul; Norito Kawakami; Zhila Kazemi; Ali Kazemi Karyani; Dhruv Satish Kazi; K.C. Prakash; Seifu Kebede; Peter Njenga Keiyoro; Laura Kemmer; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Chandrasekharan Nair Kesavachandran; Yousef Saleh Khader; Behzad Khafaei; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Ejaz Ahmad Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Tripti Khanna; Mona M. Khater; Alireza Khatony; Zahra Khazaeipour; Habibolah Khazaie; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Jagdish Khubchandani; Aliasghar A. Kiadaliri; Helen W. Kiarie; Getiye D. Kibret; Daniel N. Kiirithio; Daniel Kim; Jun Y. Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Sanjay Kinra; Adnan Kisa; Katarzyna Kissimova-Skarbek; Niranjan Kissoon; Mika Kivimäki; Jonathan M. Kocarnik; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Margaret N. Kosek; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Kristopher J. Krohn; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Andreas A. Kudom; Xie Rachel Kulikoff; G. Anil Kumar; Manasi Kumar; Pushpendra Kumar; Michael J. Kutz; Hmwe Hmwe Kyu; Carl Lachat; Deepesh P. Lad; Sheetal D. Lad; Alessandra Lafranconi; Abraham K. Lagat; Dharmesh Kumar Lal; Ratilal Lalloo; Hilton Lam; Faris Hasan Lami; Prabhat Lamichhane; Qing Lan; Justin J. Lang; Van C. Lansingh; Sonia Lansky; Heidi J. Larson; Anders O. Larsson; Dennis Odai Laryea; Zohra S. Lassi; Arman Latifi; Kathryn Mei-Ming Lau; Avula Laxmaiah; Jeffrey V. Lazarus; Janet L. Leasher; Georgy Lebedev; Jorge R. Ledesma; James B. Lee; Paul H. Lee; Andrew T. Leever; James Leigh; Mall Leinsalu; Cheru Tesema Leshargie; Janni Leung; Sonia Lewycka; Shanshan Li; Xiaohong Li; Yichong Li; Juan Liang; Xiaofeng Liang; Misgan Legesse Liben; Lee-Ling Lim; Miteku Andualem Limenih; Shai Linn; Shiwei Liu; Yang Liu; Rakesh Lodha; Giancarlo Logroscino; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Lydia R. Lucchesi; Ronan A. Lyons; Erlyn Rachelle King Macarayan; Mark T. Mackay; Emilie R. Maddison; Fabiana Madotto; Dhaval P. Maghavani; Carlos Magis-Rodriguez; Narayan Bahadur Mahotra; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Ana-Laura Manda; Luiz Garcia Mandarano-Filho; Srikanth Mangalam; Helena Manguerra; Mohammad Ali Mansournia; Chabila Christopher Mapoma; Joemer C. Maravilla; Wagner Marcenes; Ashley Marks; Randall V. Martin; Sheila C. O. Martins; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Tivani Phosa Mashamba-Thompson; Benjamin Ballard Massenburg; Manu Raj Mathur; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Brian J. McMahon; Suresh Mehata; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Fabiola Mejia-Rodriguez; Tesfa Mekonen; Tefera C. Chane Mekonnen; Hagazi Gebre Meles; Addisu Melese; Mulugeta Melku; Peter T. N. Memiah; Ziad A. Memish; Walter Mendoza; Desalegn Tadese Mengistu; Getnet Mengistu; George A. Mensah; Gert B. M. Mensink; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Haftay Berhane Mezgebe; Bartosz Miazgowski; Tomasz Miazgowski; Anoushka I. Millear; Ted R. Miller; Molly Katherine Miller-Petrie; George J. Milne; G.K. Mini; Shawn P. Minnig; Parvaneh Mirabi; Mojde Mirarefin; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Philip B. Mitchell; Babak Moazen; Ali Akbar Moghadamnia; Bahram Mohajer; Karzan Abdulmuhsin Mohammad; Moslem Mohammadi; Noushin Mohammadifard; Mousa Mohammadnia-Afrouzi; Mohammed A. Mohammed; Shafiu Mohammed; Murali B. V. Mohan; Viswanathan Mohan; Farnam Mohebi; Modhurima Moitra; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Julio Cesar Montañez; Mahmood Moosazadeh; Ghobad Moradi; Mahmoudreza Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Joana Morgado-da-Costa; Naho Morisaki; Shane Douglas Morrison; Abbas Mosapour; Marilita M. Moschos; W Cliff Mountjoy-Venning; Simin Mouodi; Seyyed Meysam Mousavi; Achenef Asmamaw Muche; Kindie Fentahun Muchie; Ulrich Otto Mueller; Oumer Sada S. Muhammed; Satinath Mukhopadhyay; Erin C. Mullany; Kate Muller; John Everett Mumford; Manoj Murhekar; G.V.S. Murthy; Srinivas Murthy; Jonah Musa; Kamarul Imran Musa; Ghulam Mustafa; Saravanan Muthupandian; Ashraf F. Nabhan; Jean B. Nachega; Ahamarshan Jayaraman Nagarajan; Gabriele Nagel; Mohsen Naghavi; Aliya Naheed; Azin Nahvijou; Kovin Naidoo; Gurudatta Naik; Nitish Naik; Farid Najafi; Luigi Naldi; Hae Sung Nam; Vinay Nangia; Jobert Richie Nansseu; Bruno Ramos Nascimento; Haseeb Nawaz; Nahid Neamati; Ionut Negoi; Ruxandra Irina Negoi; Subas Neupane; Charles Richard James Newton; Frida N. Ngalesoni; Josephine W. Ngunjiri; Anh Nguyen; Grant Nguyen; Ha Nguyen; Huong Lan Thi Nguyen; Huong Thanh Nguyen; Minh Nguyen; Emma Nichols; Solomon Gedlu Nigatu; Dina Nur Anggraini Ningrum; Yirga Legesse Nirayo; Muhammad Imran Nisar; Molly R. Nixon; Nomonde Nolutshungu; Marika Nomura; Ole F. Norheim; Mehdi Noroozi; Bo Norrving; Jean Jacques Noubiap; Hamid Reza Nouri; Malihe Nourollahpour Shiadeh; Mohammad Reza Nowroozi; Peter S. Nyasulu; Carla Makhlouf Obermeyer; Richard Ofori-Asenso; Okechukwu Samuel Ogah; Felix Akpojene Ogbo; In-Hwan Oh; Anselm Okoro; Kelechi E. Oladimeji; Olanrewaju Oladimeji; Andrew T. Olagunju; Tinuke O. Olagunju; Pedro R. Olivares; Helen Elizabeth Olsen; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Kanyin L. Ong; Sok King Ong; Anu Mary Oommen; John Nelson Opio; Eyal Oren; Andrei Oros; Doris D. V. Ortega-Altamirano; Alberto Ortiz; Justin R. Ortiz; Eduardo Ortiz-Panozo; Erika Ota; Stanislav S. Otstavnov; Mayowa Ojo Owolabi; P.A. Mahesh; Smita Pakhale; Abhijit P. Pakhare; Wen-Harn Pan; Adrian Pana; Basant Kumar Panda; Songhomitra Panda-Jonas; Jeyaraj Durai Pandian; Nikolaos Papantoniou; Eun-Kee Park; Charles D. H. Parry; Hadi Parsian; Shanti Patel; Sanghamitra Pati; Ajay Patle; George C. Patton; Vishnupriya Rao Paturi; Deepak Paudel; Katherine R. Paulson; Neil Pearce; Emmanuel K. Peprah; David M. Pereira; Norberto Perico; Aslam Pervaiz; Konrad Pesudovs; William A. Petri; Max Petzold; Michael R. Phillips; David M. Pigott; Julian David Pillay; Meghdad Pirsaheb; Martin Pletcher; Constance Dimity Pond; Maarten J. Postma; Akram Pourshams; Hossein Poustchi; Dorairaj Prabhakaran; Swayam Prakash; Narayan Prasad; Caroline A. Purcell; Manita Pyakurel; Mostafa Qorbani; Reginald Quansah; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Kazem Rahimi; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Md Shafiur Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Sajjad Ur Rahman; Rajesh Kumar Rai; Fatemeh Rajati; Sasa Rajsic; Usha Ram; Saleem M. Rana; Chhabi Lal Ranabhat; Prabhat Ranjan; Davide Rasella; David Laith Rawaf; Salman Rawaf; Christian Razo-García; K Srinath Reddy; Robert C. Reiner; Cesar Reis; Marissa B. Reitsma; Giuseppe Remuzzi; Andre M. N. Renzaho; Serge Resnikoff; Luz Myriam Reynales-Shigematsu; Satar Rezaei; Shahab Rezaeian; Mohammad Sadegh Rezai; Seyed Mohammad Riahi; Antonio Luiz P. Ribeiro; Maria Jesus Rios-Blancas; Kedir Teji Roba; Nicholas L. S. Roberts; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Gregory A. Roth; Ambuj Roy; Enrico Rubagotti; George Mugambage Ruhago; Yogesh Damodar Sabde; Perminder S. Sachdev; Basema Saddik; Ehsan Sadeghi; Hosein Safari; Yahya Safari; Roya Safari-Faramani; Mahdi Safdarian; Sare Safi; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; Haniye Sadat Sajadi; Nasir Salam; Joseph S. Salama; Payman Salamati; Raphael De Freitas Saldanha; Zikria Saleem; Yahya Salimi; Hamideh Salimzadeh; Joshua A. Salomon; Sundeep Santosh Salvi; Inbal Salz; Evanson Zondani Sambala; Abdallah M. Samy; Juan Sanabria; Maria Dolores Sanchez-Niño; Itamar S. Santos; Milena M. Santric Milicevic; Bruno Piassi Sao Jose; Mayank Sardana; Abdur Razzaque Sarker; Nizal Sarrafzadegan; Benn Sartorius; Shahabeddin Sarvi; Brijesh Sathian; Maheswar Satpathy; Miloje Savic; Arundhati R. Sawant; Monika Sawhney; Sonia Saxena; Mete Saylan; Mehdi Sayyah; Elke Schaeffner; Maria Inês Schmidt; Ione J. C. Schneider; Ben Schöttker; Aletta Elisabeth Schutte; David C. Schwebel; Falk Schwendicke; Soraya Seedat; Mario Sekerija; Sadaf G. Sepanlou; Edson Serván-Mori
Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020
(Elsevier B.V., 2022) Dana Bryazka; Marissa B. Reitsma; Max G. Griswold; Kalkidan Hassen Abate; Cristiana Abbafati; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Amir Abdoli; Mohammad Abdollahi; Abu Yousuf Md. Abdullah; E.S. Abhilash; Eman Abu-Gharbieh; Juan Manuel Acuna; Giovanni Addolorato; Oladimeji M. Adebayo; Victor Adekanmbi; Kishor Adhikari; Sangeet Adhikari; Qorinah Estiningtyas Sakilah Adnani; Saira Afzal; Wubetu Yimam Agegnehu; Manik Aggarwal; Bright Opoku Ahinkorah; Araz Ramazan Ahmad; Sajjad Ahmad; Tauseef Ahmad; Ali Ahmadi; Sepideh Ahmadi; Haroon Ahmed; Tarik Ahmed Rashid; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Md.Zakiul Alam; Dejene Tsegaye Alem; Kefyalew Addis Alene; Yousef Alimohamadi; Atiyeh Alizadeh; Kasim Allel; Jordi Alonso; Saba Alvand; Nelson Alvis-Guzman; Firehiwot Amare; Edward Kwabena Ameyaw; Sohrab Amiri; Robert Ancuceanu; Jason A. Anderson; Catalina Liliana Andrei; Tudorel Andrei; Jalal Arabloo; Muhammad Arshad; Anton A. Artamonov; Zahra Aryan; Malke Asaad; Mulusew A. Asemahagn; Thomas Astell-Burt; Seyyed Shamsadin Athari; Desta Debalkie Atnafu; Prince Atorkey; Alok Atreya; Floriane Ausloos; Marcel Ausloos; Getinet Ayano; Martin Amogre Ayanore; Olatunde O. Ayinde; Jose L. Ayuso-Mateos; Sina Azadnajafabad; Melkalem Mamuye Azanaw; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Ahmed Y. Azzam; Ashish D. Badiye; Nasser Bagheri; Sara Bagherieh; Mohan Bairwa; Shankar M. Bakkannavar; Ravleen Kaur Bakshi; Awraris Hailu Balchut Bilchut; T.W. Bärnighausen; Fabio Barra; Amadou Barrow; Pritish Baskaran; Luis Belo; Derrick A. Bennett; Isabela M. Bensenor; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Nikha Bhardwaj; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Bagas Suryo Bintoro; Elena A. Elena Blokhina; Belay Boda Abule Bodicha; Archith Boloor; Cristina Bosetti; Dejana Braithwaite; Hermann Brenner; Nikolay Ivanovich Briko; Andre R. Brunoni; Zahid A. Butt; Chao Cao; Yin Cao; Rosario Cárdenas; Andre F. Carvalho; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Giulio Castelpietra; Luis F.S. Castro-De-Araujo; Maria Sofia Cattaruzza; Promit Ananyo Chakraborty; Jaykaran Charan; Vijay Kumar Chattu; Akhilanand Chaurasia; Nicolas Cherbuin; Dinh-Toi Chu; Nandita Chudal; Sheng-Chia Chung; Chuchu Churko; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Simona Costanzo; Richard G. Cowden; Michael H. Criqui; Natália Cruz-Martins; Garland T. Culbreth; Berihun Assefa Dachew; Omid Dadras; Xiaochen Dai; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; Beniam Darge Daniel; Anna Danielewicz; Jiregna Darega Gela; Kairat Davletov; Jacyra Azevedo Paiva de Araujo; Antonio Reis De Sá; Sisay Abebe Debela; Azizallah Dehghan; Andreas K. Demetriades; Meseret Derbew Molla; Rupak Desai; Abebaw Alemayehu Desta; Diana Dias da Silva; Daniel Diaz; Lankamo Ena Digesa; Mengistie Diress; Milad Dodangeh; Deepa Dongarwar; Fariba Dorostkar; Haneil Larson Dsouza; Bereket Duko; Bruce B. Duncan; Kristina Edvardsson; Michael Ekholuenetale; Frank J. Elgar; Muhammed Elhadi; Mohamed A. Elmonem; Aman Yesuf Endries; Sharareh Eskandarieh; Azin Etemadimanesh; Adeniyi Francis Fagbamigbe; Ildar Ravisovich Fakhradiyev; Fatemeh Farahmand; Carla Sofia E. Sá Farinha; Andre Faro; Farshad Farzadfar; Ali Fatehizadeh; Nelsensius Klau Fauk; Valery L. Feigin; Rachel Feldman; Xiaoqi Feng; Zinabu Fentaw; Simone Ferrero; Lorenzo Ferro Desideri; Irina Filip; Florian Fischer; Joel Msafiri Francis; Richard Charles Franklin; Peter Andras Gaal; Mohamed M. Gad; Silvano Gallus; Fabio Galvano; Balasankar Ganesan; Tushar Garg; Mesfin Gebrehiwot Damtew Gebrehiwot; Teferi Gebru Gebremeskel; Mathewos Alemu Gebremichael; Tadele Regasa Gemechu; Lemma Getacher; Motuma Erena Getachew; Abera Getachew Obsa; Asmare Getie; Amir Ghaderi; Mansour Ghafourifard; Alireza Ghajar; Seyyed-Hadi Ghamari; Lilian A. Ghandour; Mohammad Ghasemi Nour; Ahmad Ghashghaee; Sherief Ghozy; Franklin N. Glozah; Ekaterina Vladimirovna Glushkova; Justyna Godos; Amit Goel; Salime Goharinezhad; Mahaveer Golechha; Pouya Goleij; Mohamad Golitaleb; Felix Greaves; Michal Grivna; Giuseppe Grosso; Temesgen Worku Gudayu; Bhawna Gupta; Rajeev Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Nima Hafezi-Nejad; Arvin Haj-Mirzaian; Brian J. Hall; Rabih Halwani; Tiilahun Beyene Handiso; Graeme J. Hankey; Sanam Hariri; Josep Maria Haro; Ahmed I. Hasaballah; Hossein Hassanian-Moghaddam; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Mohammad Heidari; Delia Hendrie; Claudiu Herteliu; Demisu Zenbaba Heyi; Kamal Hezam; Mbuzeleni Mbuzeleni Hlongwa; Ramesh Holla; Md. Mahbub Hossain; Sahadat Hossain; Seyed Kianoosh Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Guoqing Hu; Junjie Huang; Salman Hussain; Segun Emmanuel Ibitoye; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Lalu Muhammad Irham; M. Mofizul Islam; Rakibul M. Islam; Sheikh Mohammed Shariful Islam; Hiroyasu Iso; Ramaiah Itumalla; Masao Iwagami; Roxana Jabbarinejad; Louis Jacob; Mihajlo Jakovljevic; Zahra Jamalpoor; Elham Jamshidi; Sathish Kumar Jayapal; Umesh Umesh Jayarajah; Ranil Jayawardena; Rime Jebai; Seyed Ali Jeddi; Alelign Tasew Jema; Ravi Prakash Jha; Har Ashish Jindal; Jost B. Jonas; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Robel Hussen Kabthymer; Bhushan Dattatray Kamble; Himal Kandel; Girum Gebremeskel Kanno; Neeti Kapoor; Ibraheem M. Karaye; Salah Eddin Karimi; Bekalu Getnet Kassa; Rimple Jeet Kaur; Gbenga A. Kayode; Mohammad Keykhaei; Himanshu Khajuria; Rovshan Khalilov; Imteyaz A. Khan; Moien A.B. Khan; Hanna Kim; Jihee Kim; Min Seo Kim; Ruth W. Kimokoti; Mika Kivimäki; Vitalii Klymchuk; Ann Kristin Skrindo Knudsen; Ali-Asghar Kolahi; Vladimir Andreevich Korshunov; Ai Koyanagi; Kewal Krishan; Yuvaraj Krishnamoorthy; G. Anil Kumar; Narinder Kumar; Nithin Kumar; Ben Lacey; Tea Lallukka; Savita Lasrado; Jerrald Lau; Sang-Woong Lee; Wei-Chen Lee; Yo Han Lee; Lee-Ling Lim; Stephen S. Lim; Stany W. Lobo; Platon D. Lopukhov; Stefan Lorkowski; Rafael Lozano; Giancarlo Lucchetti; Farzan Madadizadeh; Áurea M. Madureira-Carvalho; Soleiman Mahjoub; Ata Mahmoodpoor; Rashidul Alam Mahumud; Alaa Makki; Mohammad-Reza Malekpour; Narayana Manjunatha; Borhan Mansouri; Mohammad Ali Mansournia; Jose Martinez-Raga; Francisco A. Martinez-Villa; Richard Matzopoulos; Pallab K. Maulik; Mahsa Mayeli; John J. McGrath; Jitendra Kumar Meena; Entezar Mehrabi Nasab; Ritesh G. Menezes; Gert B.M. Mensink; Alexios-Fotios A. Mentis; Atte Meretoja; Bedasa Taye Merga; Tomislav Mestrovic; Junmei Miao Jonasson; Bartosz Miazgowski; Ana Carolina Micheletti Gomide Nogueira De Sá; Ted R. Miller; G.K. Mini; Andreea Mirica; Antonio Mirijello; Seyyedmohammadsadeq Mirmoeeni; Erkin M. Mirrakhimov; Sanjeev Misra; Babak Moazen; Maryam Mobarakabadi; Marcello Moccia; Yousef Mohammad; Esmaeil Mohammadi; Abdollah Mohammadian-Hafshejani; Teroj Abdulrahman Mohammed; Nagabhishek Moka; Ali H. Mokdad; Sara Momtazmanesh; Yousef Moradi; Ebrahim Mostafavi; Sumaira Mubarik; Erin C. Mullany; Beemnet Tekabe Mulugeta; Efrén Murillo-Zamora; Christopher J.L. Murray; Julius C. Mwita; Mohsen Naghavi; Mukhammad David Naimzada; Vinay Nangia; Biswa Prakash Nayak; Ionut Negoi; Ruxandra Irina Negoi; Seyed Aria Nejadghaderi; Samata Nepal; Sudan Prasad Prasad Neupane; Sandhya Neupane Kandel; Yeshambel T. Nigatu; Ali Nowroozi; Khan M. Nuruzzaman; Chimezie Igwegbe Nzoputam; Kehinde O. Obamiro; Felix Akpojene Ogbo; Ayodipupo Sikiru Oguntade; Hassan Okati-Aliabad; Babayemi Oluwaseun Olakunde; Gláucia Maria Moraes Oliveira; Ahmed Omar Bali; Emad Omer; Doris V. Ortega-Altamirano; Adrian Otoiu; Stanislav S. Otstavnov; Bilcha Oumer; P.A. Mahesh; Alicia Padron-Monedero; Raffaele Palladino; Adrian Pana; Songhomitra Panda-Jonas; Anamika Pandey; Ashok Pandey; Shahina Pardhan; Tarang Parekh; Eun-Kee Park; Charles D.H. Parry; Fatemeh Pashazadeh Kan; Jay Patel; Siddhartha Pati; George C. Patton; Uttam Paudel; Shrikant Pawar; Amy E. Peden; Ionela-Roxana Petcu; Michael R. Phillips; Marina Pinheiro; Evgenii Plotnikov; Pranil Man Singh Pradhan; Akila Prashant; Jianchao Quan; Amir Radfar; Alireza Rafiei; Pankaja Raghav Raghav; Vafa Rahimi-Movaghar; Azizur Rahman; Md.Mosfequr Rahman; Mosiur Rahman; Amir Masoud Rahmani; Shayan Rahmani; Chhabi Lal Ranabhat; Priyanga Ranasinghe; Chythra R. Rao; Drona Prakash Rasali; Mohammad-Mahdi Rashidi; Zubair Ahmed Ratan; David Laith Rawaf; Salman Rawaf; Lal Rawal; Andre M.N. Renzaho; Negar Rezaei; Saeid Rezaei; Mohsen Rezaeian; Seyed Mohammad Riahi; Esperanza Romero-Rodríguez; Gregory A. Roth; Godfrey M. Rwegerera; Basema Saddik; Erfan Sadeghi; Reihaneh Sadeghian; Umar Saeed; Farhad Saeedi; Rajesh Sagar; Amirhossein Sahebkar; Harihar Sahoo; Mohammad Ali Sahraian; K.M. Saif-Ur-Rahman; Sarvenaz Salahi; Hamideh Salimzadeh; Abdallah M. Samy; Francesco Sanmarchi; Milena M. Santric-Milicevic; Yaser Sarikhani; Brijesh Sathian; Ganesh Kumar Saya; Mehdi Sayyah; Maria Inês Schmidt; Aletta Elisabeth Schutte; Michaël Schwarzinger; David C. Schwebel; Abdul-Aziz Seidu; Nachimuthu Senthil Kumar; SeyedAhmad SeyedAlinaghi; Allen Seylani; Feng Sha; Sarvenaz Shahin; Fariba Shahraki-Sanavi; Shayan Shahrokhi; Masood Ali Shaikh; Elaheh Shaker; Murad Ziyaudinovich Shakhmardanov; Mehran Shams-Beyranvand; Sara Sheikhbahaei; Rahim Ali Sheikhi; Adithi Shetty; Jeevan K. Shetty; Damtew Solomon Shiferaw; Mika Shigematsu; Rahman Shiri; Reza Shirkoohi; K.M. Shivakumar; Velizar Shivarov; Parnian Shobeiri; Roman Shrestha; Negussie Boti Sidemo; Inga Dora Sigfusdottir; Diego Augusto Santos Silva; Natacha Torres da Silva; Jasvinder A. Singh; Surjit Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; David A. Sleet; Marco Solmi; Yonatan Solomon; Suhang Song; Yimeng Song; Reed J.D. Sorensen; Sergey Soshnikov; Ireneous N. Soyiri; Dan J. Stein; Sonu Hangma Subba; Miklós Szócska; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Majid Taheri; Ker-Kan Tan; Minale Tareke; Elvis Enowbeyang Tarkang; Gebremaryam Temesgen; Worku Animaw Temesgen; Mohamad-Hani Temsah; Kavumpurathu Raman Thankappan; Rekha Thapar; Nikhil Kenny Thomas; Chalachew Tiruneh; Jovana Todorovic; Marco Torrado; Mathilde Touvier; Marcos Roberto Tovani-Palone; Mai Thi Ngoc Tran; Sergi Trias-Llimós; Jaya Prasad Tripathy; Alireza Vakilian; Rohollah Valizadeh; Mehdi Varmaghani; Shoban Babu Varthya; Tommi Juhani Vasankari; Theo Vos; Birhanu Wagaye; Yasir Waheed; Mandaras Tariku Walde; Cong Wang; Yanzhong Wang; Yuan-Pang Wang; Ronny Westerman; Nuwan Darshana Wickramasinghe; Abate Dargie Wubetu; Suowen Xu; Kazumasa Yamagishi; Lin Yang; Gesila Endashaw E. Yesera; Arzu Yigit; Vahit Yiğit; Ayenew Engida Yimaw; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Siddhesh Zadey; Mazyar Zahir; Iman Zare; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Chenwen Zhong; Mohammad Zmaili; Yves Miel H. Zuniga; Emmanuela Gakidou
Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license