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Browsing by Author "Dong Keon Yon"

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    Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2022) Hmwe Hmwe Kyu; Avina Vongpradith; Sarah Brooke Sirota; Amanda Novotney; Christopher E Troeger; Matthew C Doxey; Rose G Bender; Jorge R Ledesma; Molly H Biehl; Samuel B Albertson; Joseph Jon Frostad; Katrin Burkart; Fiona B Bennitt; Jeff T Zhao; William M Gardner; Hailey Hagins; Dana Bryazka; Regina-Mae Villanueva Dominguez; Semagn Mekonnen Abate; Michael Abdelmasseh; Amir Abdoli; Gholamreza Abdoli; Aidin Abedi; Vida Abedi; Tadesse M Abegaz; Hassan Abidi; Richard Gyan Aboagye; Hassan Abolhassani; Yonas Derso Abtew; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Ahmed Abu-Zaid; Kidist Adamu; Isaac Yeboah Addo; Oyelola A Adegboye; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Muhammad Sohail Afzal; Saira Afzal; Bright Opoku Ahinkorah; Aqeel Ahmad; Araz Ramazan Ahmad; Sajjad Ahmad; Ali Ahmadi; Sepideh Ahmadi; Haroon Ahmed; Jivan Qasim Ahmed; Tarik Ahmed Rashid; Mostafa Akbarzadeh-Khiavi; Hanadi Al Hamad; Luciana Albano; Mamoon A Aldeyab; Bezatu Mengistie Alemu; Kefyalew Addis Alene; Abdelazeem M Algammal; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Beriwan Abdulqadir Ali; Liaqat Ali; Musa Mohammed Ali; Syed Shujait Ali; Yousef Alimohamadi; Vahid Alipour; Adel Al-Jumaily; Syed Mohamed Aljunid; Sami Almustanyir; Rajaa M Al-Raddadi; Rami H Hani Al-Rifai; Saif Aldeen S AlRyalat; Nelson Alvis-Guzman; Nelson J Alvis-Zakzuk; Edward Kwabena Ameyaw; Javad Javad Aminian Dehkordi; John H Amuasi; Dickson A Amugsi; Etsay Woldu Anbesu; Adnan Ansar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Demelash Areda; Ayele Mamo Argaw; Zeleke Gebru Argaw; Judie Arulappan; Raphael Taiwo Aruleba; Mulusew A Asemahagn; Seyyed Shamsadin Athari; Daniel Atlaw; Engi F Attia; Sameh Attia; Avinash Aujayeb; Tewachew Awoke; Tegegn Mulatu Ayana; Martin Amogre Ayanore; Sina Azadnajafabad; Mohammadreza Azangou-Khyavy; Samad Azari; Amirhossein Azari Jafari; Muhammad Badar; Ashish D Badiye; Nayereh Baghcheghi; Sara Bagherieh; Atif Amin Baig; MacIej Banach; Indrajit Banerjee; Mainak Bardhan; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Azadeh Bashiri; Quique Bassat; Abdul-Monim Mohammad Batiha; Abate Bekele Belachew; Melaku Ashagrie Belete; Uzma Iqbal Belgaumi; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Parth Bhatt; Vijayalakshmi S Bhojaraja; Zulfiqar A Bhutta; Soumitra S Bhuyan; Ali Bijani; Saeid Bitaraf; Belay Boda Abule Bodicha; Nikolay Ivanovich Briko; Danilo Buonsenso; Muhammad Hammad Butt; Jiao Cai; Paulo Camargos; Luis Alberto Cámera; Promit Ananyo Chakraborty; Muluken Genetu Chanie; Jaykaran Charan; Vijay Kumar Chattu; Patrick R Ching; Sungchul Choi; Yuen Yu Chong; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Devasahayam J Christopher; Dinh-Toi Chu; Natalie L Cobb; Aaron J Cohen; Natália Cruz-Martins; Omid Dadras; Fentaw Teshome Dagnaw; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; An Thi Minh Dao; Sisay Abebe Debela; Biniyam Demisse; Fitsum Wolde Demisse; Solomon Demissie; Diriba Dereje; Hardik Dineshbhai Desai; Abebaw Alemayehu Desta; Belay Desye; Sameer Dhingra; Nancy Diao; Daniel Diaz; Lankamo Ena Digesa; Linh Phuong Doan; Milad Dodangeh; Deepa Dongarwar; Fariba Dorostkar; Wendel Mombaque Dos Santos; Haneil Larson Dsouza; Eleonora Dubljanin; Oyewole Christopher Durojaiye; Hisham Atan Edinur; Elham Ehsani-Chimeh; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Eman D El Desouky; Iman El Sayed; Maysaa El Sayed Zaki; Muhammed Elhadi; Ahmed Mahmoud Rabie Elkhapery; Amir Emami; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Farshid Etaee; Mohamad Ezati Asar; Adeniyi Francis Fagbamigbe; Shahab Falahi; Aida Fallahzadeh; Anwar Faraj; Emerito Jose A Faraon; Ali Fatehizadeh; Pietro Ferrara; Allegra Allegra Ferrari; Getahun Fetensa; Florian Fischer; Joanne Flavel; Masoud Foroutan; Peter Andras Gaal; Abhay Motiramji Gaidhane; Santosh Gaihre; Nasrin Galehdar; Alberto L Garcia-Basteiro; Tushar Garg; Mesfin Damtew Gebrehiwot; Mathewos Alemu Gebremichael; Yibeltal Yismaw Gela; Belete Negese Belete Gemeda; Bradford D Gessner; Melaku Getachew; Asmare Getie; Seyyed-Hadi Ghamari; Mohammad Ghasemi Nour; Ahmad Ghashghaee; Ali Gholamrezanezhad; Abdolmajid Gholizadeh; Rakesh Ghosh; Sherief Ghozy; Pouya Goleij; Mohamad Golitaleb; Giuseppe Gorini; Alessandra C Goulart; Girma Garedew Goyomsa; Habtamu Alganeh Guadie; Zewdie Gudisa; Rashid Abdi Guled; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Alemu Guta; Parham Habibzadeh; Arvin Haj-Mirzaian; Rabih Halwani; Samer Hamidi; Md Abdul Hannan; Mehdi Harorani; Ahmed I Hasaballah; Hamidreza Hasani; Abbas M Hassan; Shokoufeh Hassani; Hossein Hassanian-Moghaddam; Hadi Hassankhani; Khezar Hayat; Behzad Heibati; Mohammad Heidari; Demisu Zenbaba Heyi; Kamal Hezam; Ramesh Holla; Sung Hwi Hong; Nobuyuki Horita; Mohammad-Salar Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Soodabeh Hoveidamanesh; Junjie Huang; Nawfal R Hussein; Ivo Iavicoli; Segun Emmanuel Ibitoye; Kevin S Ikuta; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mustapha Immurana; Nahlah Elkudssiah Ismail; Masao Iwagami; Jalil Jaafari; Elham Jamshidi; Sung-In Jang; Amirreza Javadi Mamaghani; Tahereh Javaheri; Fatemeh Javanmardi; Javad Javidnia; Sathish Kumar Jayapal; Umesh Jayarajah; Shubha Jayaram; Alelign Tasew Jema; Wonjeong Jeong; Jost B Jonas; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; V. K; Zubair Kabir; Salah Eddine Oussama Kacimi; Vidya Kadashetti; Laleh R Kalankesh; Rohollah Kalhor; Ashwin Kamath; Bhushan Dattatray Kamble; Himal Kandel; Tesfaye K Kanko; Ibraheem M Karaye; André Karch; Samad Karkhah; Bekalu Getnet Kassa; Patrick D M C Katoto; Harkiran Kaur; Rimple Jeet Kaur; Leila Keikavoosi-Arani; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Ejaz Ahmad Khan; Gulfaraz Khan; Imteyaz A Khan; Maseer Khan; Md Nuruzzaman Khan; Moien A B Khan; Yusra H Khan; Moawiah Mohammad Khatatbeh; Mina Khosravifar; Jagdish Khubchandani; Min Seo Kim; Ruth W Kimokoti; Adnan Kisa; Sezer Kisa; Niranjan Kissoon; Luke D Knibbs; Sonali Kochhar; Farzad Kompani; Hamid Reza Koohestani; Vladimir Andreevich Korshunov; Soewarta Kosen; Parvaiz A Koul; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; G Anil Kumar; Om P Kurmi; Ambily Kuttikkattu; Dharmesh Kumar Lal; Judit Lám; Iván Landires; Caterina Ledda; Sang-Woong Lee; Miriam Levi; Sonia Lewycka; Gang Liu; Wei Liu; Rakesh Lodha; László Lorenzovici; Mojgan Lotfi; Joana A Loureiro; Farzan Madadizadeh; Ata Mahmoodpoor; Razzagh Mahmoudi; Marzieh Mahmoudimanesh; Jamal Majidpoor; Alaa Makki; Elaheh Malakan Rad; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Yosef Manla; Clara N Matei; Alexander G Mathioudakis; Richard James Maude; Entezar Mehrabi Nasab; Addisu Melese; Ziad A Memish; Oliver Mendoza-Cano; Alexios-Fotios A Mentis; Tuomo J Meretoja; Mehari Woldemariam Merid; Tomislav Mestrovic; Ana Carolina Micheletti Gomide Nogueira De Sá; Gelana Fekadu Worku Mijena; Le Huu Nhat Minh; Shabir Ahmad Mir; Reza Mirfakhraie; Seyyedmohammadsadeq Mirmoeeni; Agha Zeeshan Mirza; Moonis Mirza; Mohammad Mirza-Aghazadeh-Attari; Abay Sisay Misganaw; Awoke Temesgen Misganaw; Esmaeil Mohammadi; Mokhtar Mohammadi; Arif Mohammed; Shafiu Mohammed; Syam Mohan; Mohammad Mohseni; Nagabhishek Moka; Ali H Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Md Moniruzzaman; Fateme Montazeri; Catrin E Moore; Abdolvahab Moradi; Lidia Morawska; Jonathan F Mosser; Ebrahim Mostafavi; Majid Motaghinejad; Haleh Mousavi Isfahani; Seyed Ali Mousavi-Aghdas; Sumaira Mubarik; Efrén Murillo-Zamora; Ghulam Mustafa; Sanjeev Nair; Tapas Sadasivan Nair; Houshang Najafi; Atta Abbas Naqvi; Sreenivas Narasimha Swamy; Zuhair S Natto; Biswa Prakash Nayak; Seyed Aria Nejadghaderi; Huy Van Nguyen Nguyen; Robina Khan Niazi; Antonio Tolentino Nogueira De Sá; Hasti Nouraei; Ali Nowroozi; Virginia Nuñez-Samudio; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Chimedsuren Ochir; Oluwakemi Ololade Odukoya; Hassan Okati-Aliabad; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Isaac Iyinoluwa Olufadewa; Ahmed Omar Bali; Emad Omer; Eyal Oren; Erika Ota; Nikita Otstavnov; Abderrahim Oulhaj; P.A. Mahesh; Jagadish Rao Padubidri; Keyvan Pakshir; Reza Pakzad; Tamás Palicz; Anamika Pandey; Suman Pant; Shahina Pardhan; Eun-Cheol Park; Eun-Kee Park; Fatemeh Pashazadeh Kan; Rajan Paudel; Shrikant Pawar; Minjin Peng; Gavin Pereira; Simone Perna; Navaraj Perumalsamy; Ionela-Roxana Petcu; David M Pigott; Zahra Zahid Piracha; Vivek Podder; Roman V Polibin; Maarten J Postma; Hamid Pourasghari; Naeimeh Pourtaheri; Mirza Muhammad Fahd Qadir; Mathieu Raad; Mohammad Rabiee; Navid Rabiee; Saber Raeghi; Alireza Rafiei; Fakher Rahim; Mehran Rahimi; Vafa Rahimi-Movaghar; Azizur Rahman; Md Obaidur Rahman; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Pradhum Ram; Kiana Ramezanzadeh; Juwel Rana; Priyanga Ranasinghe; Usha Rani; Sowmya J Rao; Sina Rashedi; Mohammad-Mahdi Rashidi; Azad Rasul; Zubair Ahmed Ratan; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Marissa B Reitsma; Andre M N Renzaho; Mohsen Rezaeian; Abanoub Riad; Reza Rikhtegar; Jefferson Antonio Buendia Rodriguez; Emma L B Rogowski; Luca Ronfani; Kristina E Rudd; Basema Saddik; Erfan Sadeghi; Umar Saeed; Azam Safary; Sher Zaman Safi; Maryam Sahebazzamani; Amirhossein Sahebkar; Sateesh Sakhamuri; Sana Salehi; Muhammad Salman; Hossein Samadi Kafil; Abdallah M Samy; Milena M Santric-Milicevic; Bruno Piassi Sao Jose; Maryam Sarkhosh; Brijesh Sathian; Monika Sawhney; Ganesh Kumar Saya; Abdul-Aziz Seidu; Allen Seylani; Amira A Shaheen; Masood Ali Shaikh; Elaheh Shaker; Hina Shamshad; Mequannent Melaku Sharew; Asaad Sharhani; Azam Sharifi; Purva Sharma; Ali Sheidaei; Suchitra M Shenoy; Jeevan K Shetty; Damtew Solomon Shiferaw; Mika Shigematsu; Jae Il Shin; Hesamaddin Shirzad-Aski; K.M. Shivakumar; Siddharudha Shivalli; Parnian Shobeiri; Wudneh Simegn; Colin R Simpson; Harpreet Singh; Jasvinder A Singh; Paramdeep Singh; Samarjeet Singh Siwal; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Mohammad Sadegh Soltani-Zangbar; Suhang Song; Yimeng Song; Prashant Sood; Chandrashekhar T Sreeramareddy; Paschalis Steiropoulos; Muhammad Suleman; Seyed-Amir Tabatabaeizadeh; Alireza Tahamtan; Majid Taheri; Moslem Taheri Soodejani; Elahe Taki; Iman M Talaat; Mircea Tampa; Sarmila Tandukar; Nathan Y Tat; Vivian Y Tat; Yibekal Manaye Tefera; Gebremaryam Temesgen; Mohamad-Hani Temsah; Azene Tesfaye; Degefa Gomora Tesfaye; Belay Tessema; Rekha Thapar; Jansje Henny Vera Ticoalu; Amir Tiyuri; Imad I Tleyjeh; Munkhsaikhan Togtmol; Marcos Roberto Tovani-Palone; Derara Girma Tufa; Irfan Ullah; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R Valdez; Rohollah Valizadeh; Constantine Vardavas; Tommi Juhani Vasankari; Bay Vo; Linh Gia Vu; Birhanu Wagaye; Yasir Waheed; Yu Wang; Abdul Waris; T Eoin West; Nuwan Darshana Wickramasinghe; Xiaoyue Xu; Sajad Yaghoubi; Gahin Abdulraheem Tayib Yahya; Seyed Hossein Yahyazadeh Jabbari; Dong Keon Yon; Naohiro Yonemoto; Burhan Abdullah Zaman; Alireza Zandifar; Moein Zangiabadian; Heather J Zar; Iman Zare; Zahra Zareshahrabadi; Armin Zarrintan; Mikhail Sergeevich Zastrozhin; Wu Zeng; Mengxi Zhang; Zhi-Jiang Zhang; Chenwen Zhong; Mohammad Zoladl; Alimuddin Zumla; Stephen S Lim; Theo Vos; Mohsen Naghavi; Michael Brauer; Simon I Hay; Christopher J L Murray
    Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–482.8, 483.0–483.9, 484.1–484.2, 484.6–484.7, and 487–489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4–B97.6, J09–J15.8, J16–J16.9, J20–J21.9, J91.0, P23.0–P23.4, and U04–U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age–sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age–sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. Findings: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240–275) LRI incident episodes in males and 232 million (217–248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18–1·42) male deaths and 1·20 million (1·07–1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16–1·18) and 1·31 times (95% UI 1·23–1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4–131·1]) and deaths (100·0% [83·4–115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (–70·7% [–77·2 to –61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7–61·8] in males and 56·4% [40·7–65·1] in females), and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6–35·5] for males and PAF 25·8% [16·3–35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4–25·2) in those aged 15–49 years, 30·5% (24·1–36·9) in those aged 50–69 years, and 21·9% (16·8–27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5–27·9) in those aged 15–49 years and 18·2% (12·5–24·5) in those aged 50–69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2–15·8) of LRI deaths. Interpretation: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. 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
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    Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019
    (Nature Research, 2025) Yves Miel H. Zuñiga; Alimudin I. Zumla; Liesl Joanna Zühlke; Mohammad Zoladl; Boback Ziaeian; Claire Chenwen Zhong; Xiu Ju George Zhao; Zhijiang Zhang; Jianrong Zhang; Nejimu Biza Zepro; Getachew Assefa; Jean David Zeitoun; Zelalem Banjaw Zegeye; Michael Sergeevich Zastrozhin; Zahra Zareshahrabadi; Kourosh Zarea; Ali Zare Dehnavi; Iman Zare; Moein Zangiabadian; Alireza Zangeneh; Nelson Zamora; Sojib Bin Zaman; Nazar Zaki; Farima Zakaryaei; Mazyar Zahir; Farbod Zahedi Tajrishi; Vesna Zadnik; Siddhesh Zadey; Hossein Yusefi; Taraneh Yousefinezhadi; Zabihollah Allah Yousefi; Mustafa Zeedan Younis; Yuyi You; Naohiro Yonemoto; Dong Keon Yon; Eshetu Yisihak Ukumo; Paul Siu Fai Yip; Vahit Yigit; Arzu Yigit; Siyan Yi; Pengpeng Ye; Fereshteh Yazdanpanah; Sanni Yaya; Tetsuhiro Yokonishi; Lin Yang; Kazumasa Yamagishi; Tomohide Yamada; Seyed Hossein Yahyazadeh Jabbari; Gahin Abdulraheem Tayib Yahya; Sajad Yaghoubi; Xiaoyue Xu; Suowen Xu; Hanzhang Xu; Yang Xie; Hong Xiao; Ratna Dwi Wulandari; Gedif Ashebir Wubetie; Aimin Wu; Anthony D. Woolf; Charles David Alexander Wolfe; Melat K. Woldemariam; Daniel Sisay Wolde Tsadik; Abay Woday Woday Tadesse; Nuwan Darshana Wickramasinghe; Taweewat Wiangkham; Ronny Westerman; Yifeng Wen; Melissa Y.Wei Wei; Abdul Waris; Paul R. Ward; Ziyue Wang; Yuan Pang Wang; Yu Wang; Yanzhong Wang; Linh Gia Vu; Victor Volovici; Bay Vo; Vasiliy V. Vlassov; Prashant M. Vishwanath; Francesco Saverio Violante; Jorge Hugo Villafañe; Dominique Vervoort; Massimiliano Veroux; Madhur Verma; Narayanaswamy Venketasubramanian; Siavash Vaziri; Milena Vasić; Tommi Juhani Vasankari; Santosh Varughese; Priya Vart; Ravi Prasad Varma; Constantine Ilias Vardavas; Jef Van den Eynde; Rohollah Valizadeh; Pascual Rubén Valdez; Sahel Valadan Tahbaz; Alireza Vakilian; Marco Vacante; Era Upadhyay; Unnikrishnan Bhaskaran
    Chronic care manages long-term, progressive conditions, while acute care addresses short-term conditions. Chronic conditions increasingly strain health systems, which are often unprepared for these demands. This study examines the burden of conditions requiring acute versus chronic care, including sequelae. Conditions and sequelae from the Global Burden of Diseases Study 2019 were classified into acute or chronic care categories. Data were analysed by age, sex, and socio-demographic index, presenting total numbers and contributions to burden metrics such as Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLD), and Years of Life Lost (YLL). Approximately 68% of DALYs were attributed to chronic care, while 27% were due to acute care. Chronic care needs increased with age, representing 86% of YLDs and 71% of YLLs, and accounting for 93% of YLDs from sequelae. These findings highlight that chronic care needs far exceed acute care needs globally, necessitating health systems to adapt accordingly. © The Author(s) 2025.
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    Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2023) Sara Momtazmanesh; Sahar Saeedi Moghaddam; Seyyed-Hadi Ghamari; Elaheh Malakan Rad; Negar Rezaei; Parnian Shobeiri; Amirali Aali; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Michael Abdelmasseh; Meriem Abdoun; Deldar Morad Abdulah; Abu Yousuf Md Abdullah; Aidin Abedi; Hassan Abolhassani; Zahra Abrehdari-Tafreshi; Basavaprabhu Achappa; Denberu Eshetie Adane Adane; Tigist Demssew Adane; Isaac Yeboah Addo; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Sajjad Ahmad; Ali Ahmadi; Keivan Ahmadi; Ali Ahmed; Ayman Ahmed; Tarik Ahmed Rashid; Hanadi Al Hamad; Fares Alahdab; Astawus Alemayehu; Sheikh Mohammad Alif; Syed Mohamed Aljunid; Sami Almustanyir; Khalid A Altirkawi; Nelson Alvis-Guzman; Javad Aminian Dehkordi; Mehrdad Amir-Behghadami; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Catherine M Antony; Anayochukwu Edward Anyasodor; Jalal Arabloo; Judie Arulappan; Tahira Ashraf; Seyyed Shamsadin Athari; Engi F Attia; Meshesha Tsegazeab Ayele; Sina Azadnajafabad; Abraham Samuel Babu; Sara Bagherieh; Ovidiu Constantin Baltatu; MacIej Banach; Mainak Bardhan; Francesco Barone-Adesi; Amadou Barrow; Saurav Basu; Nebiyou Simegnew Bayileyegn; Isabela M Bensenor; Nikha Bhardwaj; Pankaj Bhardwaj; Ajay Nagesh Bhat; Krittika Bhattacharyya; Souad Bouaoud; Dejana Braithwaite; Michael Brauer; Muhammad Hammad Butt; Zahid A Butt; Daniela Calina; Luis Alberto Cámera; Gashaw Sisay Chanie; Periklis Charalampous; Vijay Kumar Chattu; Odgerel Chimed-Ochir; Dinh-Toi Chu; Aaron J Cohen; Natália Cruz-Martins; Omid Dadras; Aso Mohammad Darwesh; Saswati Das; Sisay Abebe Debela; Laura Delgado-Ortiz; Diriba Dereje; Mostafa Dianatinasab; Nancy Diao; Daniel Diaz; Lankamo Ena Digesa; Gebisa Dirirsa; Paul Narh Doku; Deepa Dongarwar; Abdel Douiri; Haneil Larson Dsouza; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Ahmed Elabbas Mustafa Elagali; Muhammed Elhadi; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Farshid Etaee; Adeniyi Francis Fagbamigbe; Andre Faro; Ali Fatehizadeh; Ginenus Fekadu; Irina Filip; Florian Fischer; Masoud Foroutan; Richard Charles Franklin; Peter Andras Gaal; Santosh Gaihre; Abduzhappar Gaipov; Mesfin Gebrehiwot; Urge Gerema; Motuma Erena Getachew; Tamiru Getachew; Mansour Ghafourifard; Reza Ghanbari; Ahmad Ghashghaee; Ali Gholami; Artyom Urievich Gil; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Habtamu Alganeh Guadie; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Mostafa Hadei; Rabih Halwani; Asif Hanif; Arief Hargono; Mehdi Harorani; Risky Kusuma Hartono; Hamidreza Hasani; Abdiwahab Hashi; Simon I Hay; Mohammad Heidari; Merel E Hellemons; Claudiu Herteliu; Ramesh Holla; Nobuyuki Horita; Mohammad Hoseini; Mehdi Hosseinzadeh; Junjie Huang; Salman Hussain; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Sufyan Ibrahim; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mustapha Immurana; Nahlah Elkudssiah Ismail; Linda Merin J; Mihajlo Jakovljevic; Elham Jamshidi; Manthan Dilipkumar Janodia; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Ravi Prakash Jha; Olatunji Johnson; Tamas Joo; Nitin Joseph; Jacek Jerzy Jozwiak; Vaishali Kraghuabr; Billingsley Kaambwa; Zubair Kabir; Laleh R Kalankesh; Rohollah Kalhor; Himal Kandel; Shama D Karanth; Ibraheem M Karaye; Bekalu Getnet Kassa; Gizat M Kassie; Leila Keikavoosi-Arani; Mohammad Keykhaei; Himanshu Khajuria; Imteyaz A Khan; Moien A B Khan; Yusra H Khan; Haneen Khreis; Min Seo Kim; Adnan Kisa; Sezer Kisa; Luke D Knibbs; Pavel Kolkhir; Somayeh Komaki; Farzad Kompani; Hamid Reza Koohestani; Ali Koolivand; Oleksii Korzh; Ai Koyanagi; Kewal Krishan; Kris J Krohn; Naveen Kumar; Nithin Kumar; Om P Kurmi; Ambily Kuttikkattu; Carlo La Vecchia; Judit Lám; Qing Lan; Savita Lasrado; Kamaluddin Latief; Paolo Lauriola; Sang-Woong Lee; Yo Han Lee; Samson Mideksa Legesse; Jacopo Lenzi; Ming-Chieh Li; Ro-Ting Lin; Gang Liu; Wei Liu; Chun-Han Lo; László Lorenzovici; Yifei Lu; Soundarya Mahalingam; Elham Mahmoudi; Narayan B Mahotra; Mohammad-Reza Malekpour; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Borhan Mansouri; Elezebeth Mathews; Sazan Qadir Maulud; Enkeleint A Mechili; Entezar Mehrabi Nasab; Ritesh G Menezes; Dechasa Adare Mengistu; Alexios-Fotios A Mentis; Mahboobeh Meshkat; Tomislav Mestrovic; Ana Carolina Micheletti Gomide Nogueira De Sá; Erkin M Mirrakhimov; Awoke Misganaw; Prasanna Mithra; Javad Moghadasi; Esmaeil Mohammadi; Mokhtar Mohammadi; Marita Mohammadshahi; Shafiu Mohammed; Syam Mohan; Nagabhishek Moka; Lorenzo Monasta; Mohammad Ali Moni; Md Moniruzzaman; Fateme Montazeri; Maryam Moradi; Ebrahim Mostafavi; Christine Mpundu-Kaambwa; Efrén Murillo-Zamora; Christopher J L Murray; Tapas Sadasivan Nair; Vinay Nangia; Sreenivas Narasimha Swamy; Aparna Ichalangod Narayana; Zuhair S Natto; Biswa Prakash Nayak; Wogene Wogene Negash; Evangelia Nena; Sandhya Neupane Kandel; Robina Khan Niazi; Antonio Tolentino Nogueira De Sá; Ali Nowroozi; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Rahman Md Obaidur; Oluwakemi Ololade Odukoya; Hassan Okati-Aliabad; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Ahmed Omar Bali; Sergej M Ostojic; P.A. Mahesh; Alicia Padron-Monedero; Jagadish Rao Padubidri; Mohammad Taha Pahlevan Fallahy; Tamás Palicz; Adrian Pana; Eun-Kee Park; Jay Patel; Rajan Paudel; Uttam Paudel; Paolo Pedersini; Marcos Pereira; Renato B Pereira; Ionela-Roxana Petcu; Majid Pirestani; Maarten J Postma; Akila Prashant; Mohammad Rabiee; Amir Radfar; Sima Rafiei; Fakher Rahim; Mohammad Hifz Ur Rahman; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Shayan Rahmani; Vahid Rahmanian; Prashant Rajput; Juwel Rana; Chythra R Rao; Sowmya J Rao; Sina Rashedi; Mohammad-Mahdi Rashidi; Zubair Ahmed Ratan; David Laith Rawaf; Salman Rawaf; Lal Rawal; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Maryam Rezaei; Nazila Rezaei; Nima Rezaei; Mohsen Rezaeian; Mónica Rodrigues; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; David Rojas-Rueda; Kristina E Rudd; Aly M A Saad; Siamak Sabour; Basema Saddik; Erfan Sadeghi; Masoumeh Sadeghi; Umar Saeed; Maryam Sahebazzamani; Amirhossein Sahebkar; Harihar Sahoo; Mirza Rizwan Sajid; Sateesh Sakhamuri; Sana Salehi; Abdallah M Samy; Milena M Santric-Milicevic; Bruno Piassi Sao Jose; Brijesh Sathian; Maheswar Satpathy; Ganesh Kumar Saya; Subramanian Senthilkumaran; Allen Seylani; Saeed Shahabi; Masood Ali Shaikh; Mohd Shanawaz; Mohammed Shannawaz; Rahim Ali Sheikhi; Shashank Shekhar; Migbar Mekonnen Sibhat; Colin R Simpson; Jasvinder A Singh; Paramdeep Singh; Surjit Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Mohammad Sadegh Soltani-Zangbar; Suhang Song; Ireneous N Soyiri; Paschalis Steiropoulos; Leo Stockfelt; Jing Sun; Ken Takahashi; Iman M Talaat; Ker-Kan Tan; Nathan Y Tat; Vivian Y Tat; Birhan Tsegaw Taye; Pugazhenthan Thangaraju; Rekha Thapar; Friedrich Thienemann; Amir Tiyuri; Mai Thi Ngoc Tran; Jaya Prasad Tripathy; Lorainne Tudor Car; Biruk Shalmeno Tusa; Irfan Ullah; Sana Ullah; Marco Vacante; Pascual R Valdez; Rohollah Valizadeh; Job F M Van Boven; Tommi Juhani Vasankari; Siavash Vaziri; Francesco S Violante; Bay Vo; Ning Wang; Melissa Y Wei; Ronny Westerman; Nuwan Darshana Wickramasinghe; Suowen Xu; Xiaoyue Xu; Lalit Yadav; Yazachew Yismaw; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Yong Yu; Ismaeel Yunusa; Mazyar Zahir; Moein Zangiabadian; Zahra Zareshahrabadi; Armin Zarrintan; Mikhail Sergeevich Zastrozhin; Zelalem Banjaw Zegeye; Yunquan Zhang; Mohsen Naghavi; Bagher Larijani; Farshad Farzadfar
    Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries. Funding: Bill & Melinda Gates Foundation. © 2023 The Authors
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    Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019
    (Elsevier B.V., 2022) Kevin S Ikuta; Lucien R Swetschinski; Gisela Robles Aguilar; Fablina Sharara; Tomislav Mestrovic; Authia P Gray; Nicole Davis Weaver; Eve E Wool; Chieh Han; Anna Gershberg Hayoon; Amirali Aali; Semagn Mekonnen Abate; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Sherief Abd-Elsalam; Getachew Abebe; Aidin Abedi; Amir Parsa Abhari; Hassan Abidi; Richard Gyan Aboagye; Abdorrahim Absalan; Hiwa Abubaker Ali; Juan Manuel Acuna; Tigist Demssew Adane; Isaac Yeboah Addo; Oyelola A Adegboye; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Muhammad Sohail Afzal; Saira Afzal; Zahra Babaei Aghdam; Bright Opoku Ahinkorah; Aqeel Ahmad; Araz Ramazan Ahmad; Rizwan Ahmad; Sajjad Ahmad; Sohail Ahmad; Sepideh Ahmadi; Ali Ahmed; Haroon Ahmed; Jivan Qasim Ahmed; Tarik Ahmed Rashid; Marjan Ajami; Budi Aji; Mostafa Akbarzadeh-Khiavi; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Ziyad Al-Aly; Mamoon A Aldeyab; Alicia V Aleman; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Beriwan Abdulqadir Ali; Liaqat Ali; Syed Shujait Ali; Yousef Alimohamadi; Vahid Alipour; Atiyeh Alizadeh; Syed Mohamed Aljunid; Kasim Allel; Sami Almustanyir; Edward Kwabena Ameyaw; Arianna Maever L Amit; Nivedita Anandavelane; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Dewi Anggraini; Adnan Ansar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Aleksandr Y Aravkin; Demelash Areda; Timur Aripov; Anton A Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Muhammad Asaduzzaman; Tahira Ashraf; Seyyed Shamsadin Athari; Daniel Atlaw; Sameh Attia; Marcel Ausloos; Tewachew Awoke; Beatriz Paulina Ayala Quintanilla; Tegegn Mulatu Ayana; Sina Azadnajafabad; Amirhossein Azari Jafari; B. Darshan; Muhammad Badar; Ashish D Badiye; Nayereh Baghcheghi; Sara Bagherieh; Atif Amin Baig; Indrajit Banerjee; Aleksandra Barac; Mainak Bardhan; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Pritish Baskaran; Saurav Basu; Abdul-Monim Mohammad Batiha; Neeraj Bedi; Melaku Ashagrie Belete; Uzma Iqbal Belgaumi; Rose G Bender; Bharti Bhandari; Dinesh Bhandari; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Suraj Bhattarai; Saeid Bitaraf; Danilo Buonsenso; Zahid A Butt; Florentino Luciano Caetano Dos Santos; Jiao Cai; Daniela Calina; Paulo Camargos; Luis Alberto Cámera; Rosario Cárdenas; Muge Cevik; Joshua Chadwick; Jaykaran Charan; Akhilanand Chaurasia; Patrick R Ching; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Fazle Rabbi Chowdhury; Dinh-Toi Chu; Isaac Sunday Chukwu; Omid Dadras; Fentaw Teshome Dagnaw; Xiaochen Dai; Saswati Das; Anna Dastiridou; Sisay Abebe Debela; Fitsum Wolde Demisse; Solomon Demissie; Diriba Dereje; Msganaw Derese; Hardik Dineshbhai Desai; Fikadu Nugusu Dessalegn; Samuel Abebe A Dessalegni; Belay Desye; Kartik Dhaduk; Meghnath Dhimal; Sameer Dhingra; Nancy Diao; Daniel Diaz; Shirin Djalalinia; Milad Dodangeh; Deepa Dongarwar; Bezabih Terefe Dora; Fariba Dorostkar; Haneil Larson Dsouza; Eleonora Dubljanin; Susanna J Dunachie; Oyewole Christopher Durojaiye; Hisham Atan Edinur; Habtamu Bekele Ejigu; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Hassan El-Abid; Muhammed Elhadi; Mohamed A Elmonem; Amir Emami; Luchuo Engelbert Bain; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Babak Eshrati; Farshid Etaee; Adeniyi Francis Fagbamigbe; Shahab Falahi; Aida Fallahzadeh; Emerito Jose A Faraon; Ali Fatehizadeh; Ginenus Fekadu; João C Fernandes; Allegra Ferrari; Getahun Fetensa; Irina Filip; Florian Fischer; Masoud Foroutan; Peter Andras Gaal; Muktar A Gadanya; Abhay Motiramji Gaidhane; Balasankar Ganesan; Mesfin Gebrehiwot; Reza Ghanbari; Mohammad Ghasemi Nour; Ahmad Ghashghaee; Ali Gholamrezanezhad; Abdolmajid Gholizadeh; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Amador Goodridge; Damitha Asanga Gunawardane; Yuming Guo; Rajat Das Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Alemu Guta; Parham Habibzadeh; Atlas Haddadi Avval; Rabih Halwani; Asif Hanif; Md Abdul Hannan; Harapan Harapan; Shoaib Hassan; Hadi Hassankhani; Khezar Hayat; Behzad Heibati; Golnaz Heidari; Mohammad Heidari; Reza Heidari-Soureshjani; Claudiu Herteliu; Demisu Zenbaba Heyi; Kamal Hezam; Praveen Hoogar; Nobuyuki Horita; Md Mahbub Hossain; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Soodabeh Hoveidamanesh; Junjie Huang; Salman Hussain; Nawfal R Hussein; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mohammad Tarique Imam; Mustapha Immurana; Leeberk Raja Inbaraj; Arnaud Iradukunda; Nahlah Elkudssiah Ismail; Chidozie C D Iwu; Chinwe Juliana Iwu; Merin J. 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Khan; Moawiah Mohammad Khatatbeh; Mona M Khater; Hamid Reza Khayat Kashani; Jagdish Khubchandani; Hanna Kim; Min Seo Kim; Ruth W Kimokoti; Niranjan Kissoon; Sonali Kochhar; Farzad Kompani; Soewarta Kosen; Parvaiz A Koul; Sindhura Lakshmi Koulmane Laxminarayana; Fiorella Krapp Lopez; Kewal Krishan; Vijay Krishnamoorthy; Vishnutheertha Kulkarni; Naveen Kumar; Om P Kurmi; Ambily Kuttikkattu; Hmwe Hmwe Kyu; Dharmesh Kumar Lal; Judit Lám; Iván Landires; Savita Lasrado; Sang-Woong Lee; Jacopo Lenzi; Sonia Lewycka; Shanshan Li; Stephen S Lim; Wei Liu; Rakesh Lodha; Michael J Loftus; Ayush Lohiya; Lászl Lorenzovici; Mojgan Lotfi; Ata Mahmoodpoor; Mansour Adam Mahmoud; Razzagh Mahmoudi; Azeem Majeed; Jamal Majidpoor; Alaa Makki; Galana Ayana Mamo; Yosef Manla; Miquel Martorell; Clara N Matei; Barney Mcmanigal; Entezar Mehrabi Nasab; Ravi Mehrotra; Addisu Melese; Oliver Mendoza-Cano; Ritesh G Menezes; Alexios-Fotios A Mentis; Georgia Micha; Irmina Maria Michalek; Ana Carolina Micheletti Gomide Nogueira Des; Neda Milevska Kostova; Shabir Ahmad Mir; Mojgan Mirghafourvand; Seyyedmohammadsadeq Mirmoeeni; Erkin M Mirrakhimov; Mohammad Mirza-Aghazadeh-attari; Abay Sisay Misganaw; Awoke Misganaw; Sanjeev Misra; Esmaeil Mohammadi; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Syam Mohan; Mohammad Mohseni; Ali H Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Catrin E Moore; Maryam Moradi; Mostafa Moradi Sarabi; Shane Douglas Morrison; Majid Motaghinejad; Haleh Mousavi Isfahani; Amin Mousavi Khaneghah; Seyed Ali Mousavi-Aghdas; Sumaira Mubarik; Francesk Mulita; Getaneh Baye B Mulu; Sandra B Munro; Saravanan Muthupandian; Tapas Sadasivan Nair; Atta Abbas Naqvi; Himanshi Narang; Zuhair S Natto; Muhammad Naveed; Biswa Prakash Nayak; Shumaila Naz; Ionut Negoi; Seyed Aria Nejadghaderi; Sandhya Neupane Kandel; Che Henry Ngwa; Robina Khan Niazi; Antonio Tolentino Nogueira Des; Nafise Noroozi; Hasti Nouraei; Ali Nowroozi; Virginia Nuñez-Samudio; Jerry John Nutor; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Rahman Md Obaidur; Vivek Anand Ojha; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Bolajoko Olubukunola Olusanya; Ahmed Omar Bali; Emad Omer; Nikita Otstavnov; Bilcha Oumer; Jagadish Rao Padubidri; Keyvan Pakshir; Tamás Palicz; Adrian Pana; Shahina Pardhan; Jose L Paredes; Utsav Parekh; Eun-Cheol Park; Seoyeon Park; Ashish Pathak; Rajan Paudel; Uttam Paudel; Shrikant Pawar; Hamidreza Pazoki Toroudi; Minjin Peng; Umberto Pensato; Veincent Christian Filipino Pepito; Marcos Pereira; Mario F P Peres; Norberto Perico; Ionela-Roxana Petcu; Zahra Zahid Piracha; Indrashis Podder; Nayanum Pokhrel; Ramesh Poluru; Maarten J Postma; Naeimeh Pourtaheri; Akila Prashant; Ibrahim Qattea; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Saber Raeghi; Sima Rafiei; Pankaja Raghav Raghav; Leila Rahbarnia; Vafa Rahimi-Movaghar; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Pradhum Ram; Muhammad Modassar Ali Nawaz Ranjha; Sowmya J Rao; Mohammad-Mahdi Rashidi; Azad Rasul; Zubair Ahmed Ratan; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Misganu Teshoma Regasa; Giuseppe Remuzzi; Melese Abate Reta; Nazila Rezaei; Aziz Rezapour; Abanoub Riad; Rezaul Karim Ripon; Kristina E Rudd; Basema Saddik; Saeid Sadeghian; Umar Saeed; Mohsen Safaei; Azam Safary; Sher Zaman Safi; Maryam Sahebazzamani; Amirhossein Sahebkar; Harihar Sahoo; Saina Salahi; Sarvenaz Salahi; Hedayat Salari; Sana Salehi; Hossein Samadi Kafil; Abdallah M Samy; Nima Sanadgol; Senthilkumar Sankararaman; Francesco Sanmarchi; Brijesh Sathian; Monika Sawhney; Ganesh Kumar Saya; Subramanian Senthilkumaran; Allen Seylani; Pritik A Shah; Masood Ali Shaikh; Elaheh Shaker; Murad Ziyaudinovich Shakhmardanov; Mequannent Melaku Sharew; Athena Sharifi-Razavi; Purva Sharma; Rahim Ali Sheikhi; Ali Sheikhy; Pavanchand H Shetty; Mika Shigematsu; Jae Il Shin; Hesamaddin Shirzad-Aski; K.M. Shivakumar; Parnian Shobeiri; Seyed Afshin Shorofi; Sunil Shrestha; Migbar Mekonnen Sibhat; Negussie Boti Sidemo; Mustafa Kamal Sikder; Luís Manuel Lopes Rodrigues Silva; Jasvinder A Singh; Paramdeep Singh; Surjit Singh; Md Shahjahan Siraj; Samarjeet Singh Siwal; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Bogdan Socea; Damtew Damtew Solomon; Yimeng Song; Chandrashekhar T Sreeramareddy; Muhammad Suleman; Rizwan Suliankatchi Abdulkader; Saima Sultana; Miklós Szócska; Seyed-Amir Tabatabaeizadeh; Mohammad Tabish; Majid Taheri; Elahe Taki; Ker-Kan Tan; Sarmila Tandukar; Nathan Y Tat; Vivian Y Tat; Belay Negash Tefera; Yibekal Manaye Tefera; Gebremaryam Temesgen; Mohamad-Hani Temsah; Samar Tharwat; Arulmani Thiyagarajan; Imad I Tleyjeh; Christopher E Troeger; Krishna Kishore Umapathi; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R Valdez; Jef Van Den Eynde; H Rogier Van Doorn; Siavash Vaziri; Georgios-Ioannis Verras; Harimadhav Viswanathan; Bay Vo; Abdul Waris; Gizachew Tadesse Wassie; Nuwan Darshana Wickramasinghe; Sajad Yaghoubi; Gahin Abdulraheem Tayib Yahya Yahya; Seyed Hossein Yahyazadeh Jabbari; Arzu Yigit; Vahit Yigit; Dong Keon Yon; Naohiro Yonemoto; Mazyar Zahir; Burhan Abdullah Zaman; Sojib Bin Zaman; Moein Zangiabadian; Iman Zare; Mikhail Sergeevich Zastrozhin; Zhi-Jiang Zhang; Peng Zheng; Chenwen Zhong; Mohammad Zoladl; Alimuddin Zumla; Simon I Hay; Christiane Dolecek; Benn Sartorius; Christopher J L Murray; Mohsen Naghavi
    Background: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. Findings: From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Global, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021
    (Elsevier Ltd, 2024) Jorge R. Ledesma; Jianing Ma; Meixin Zhang; Ann V. L. Basting; Huong Thi Chu; Avina Vongpradith; Amanda Novotney; Kate E. LeGrand; Yvonne Yiru Xu; Xiaochen Dai; Sneha Ingle Nicholson; Lauryn K. Stafford; Austin Carter; Jennifer M. Ross; Hedayat Abbastabar; Meriem Abdoun; Deldar Morad Abdulah; Richard Gyan Aboagye; Hassan Abolhassani; Woldu Aberhe Abrha; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Salahdein Aburuz; Isaac Yeboah Addo; Abiola Victor Adepoju; Kishor Adhikari; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Abel Afework; Shahin Aghamiri; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Danish Ahmad; Sajjad Ahmad; Amir Mahmoud Ahmadzade; Haroon Ahmed; Mohammed Ahmed; Ayman Ahmed; Karolina Akinosoglou; Tareq Mohammed Ali Al-Ahdal; Nazmul Alam; Mohammed Albashtawy; Mohammad T. AlBataineh; Adel Ali Saeed Al-Gheethi; Abid Ali; Endale Alemayehu Ali; Liaqat Ali; Zahid Ali; Syed Shujait Shujait Ali; Kasim Allel; Awais Altaf; Jaffar A. Al-Tawfiq; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Reza Amani; Ganiyu Adeniyi Amusa; Jimoh Amzat; Jason R. Andrews; Abhishek Anil; Razique Anwer; Aleksandr Y. Aravkin; Damelash Areda; Anton A. Artamonov; Raphael Taiwo Aruleba; Mulusew A. Asemahagn; Sachin R. Atre; Avinash Aujayeb; Davood Azadi; Sina Azadnajafabad; Ahmed Y. Azzam; Muhammad Badar; Ashish D. Badiye; Sara Bagherieh; Saeed Bahadorikhalili; Atif Amin Baig; Maciej Banach; Biswajit Banik; Mainak Bardhan; Hiba Jawdat Barqawi; Zarrin Basharat; Pritish Baskaran; Saurav Basu; Maryam Beiranvand; Melaku Ashagrie Belete; Makda Abate Belew; Uzma Iqbal Belgaumi; Apostolos Beloukas; Paulo J. G. Bettencourt; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Ashish Bhargava; Vivek Bhat; Jasvinder Singh Bhatti; Gurjit Kaur Bhatti; Boris Bikbov; Veera R. Bitra; Vesna Bjegovic-Mikanovic; Danilo Buonsenso; Katrin Burkart; Yasser Bustanji; Zahid A. Butt; Paulo Camargos; Yu Cao; Sinclair Carr; Felix Carvalho; Luca Cegolon; Muthia Cenderadewi; Muge Cevik; Yaacoub Chahine; Vijay Kumar Chattu; Patrick R. Ching; Hitesh Chopra; Eunice Chung; Mareli M. Claassens; Kaleb Coberly; Natália Cruz-Martins; Bashir Dabo; Sriharsha Dadana; Omid Dadras; Isaac Darban; Jiregna Darega Gela; Aso Mohammad Darwesh; Mahmood Dashti; Berecha Hundessa Demessa; Biniyam Demisse; Solomon Demissie; Awoke Masrie Asrat Derese; Kebede Deribe; Hardik Dineshbhai Desai; Vinoth Gnana Chellaiyan Devanbu; Arkadeep Dhali; Kuldeep Dhama; Sameer Dhingra; Thao Huynh Phuong Do; Deepa Dongarwar; Haneil Larson Dsouza; John Dube; Arkadiusz Marian Dziedzic; Abdelaziz Ed-Dra; Ferry Efendi; Diyan Ermawan Effendi; Aziz Eftekharimehrabad; Nopryan Ekadinata; Temitope Cyrus Ekundayo; Muhammed Elhadi; Legesse Tesfaye Elilo; Theophilus I. Emeto; Luchuo Engelbert Bain; Adeniyi Francis Fagbamigbe; Ayesha Fahim; Alireza Feizkhah; Getahun Fetensa; Florian Fischer; Abduzhappar Gaipov; Aravind P. Gandhi; Rupesh K. Gautam; Miglas W. Gebregergis; Mesfin Gebrehiwot; Kahsu Gebrekirstos Gebrekidan; Kazem Ghaffari; Fariba Ghassemi; Ramy Mohamed Ghazy; Amador Goodridge; Anmol Goyal; Shi-Yang Guan; Mesay Dechasa Gudeta; Rashid Abdi Guled; Novianti Br Gultom; Veer Bala Gupta; Vivek Kumar Gupta; Sapna Gupta; Hailey Hagins; Semira Goitom Hailu; Wase Benti Hailu; Samer Hamidi; Asif Hanif; Harapan Harapan; Rumina Syeda Hasan; Shoaib Hassan; Johannes Haubold; Kamal Hezam; Sung Hwi Hong; Nobuyuki Horita; Md Belal Hossain; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Hong-Han Huynh; Segun Emmanuel Ibitoye; Kevin S. Ikuta; Irena M. Ilic; Milena D. Ilic; Md Rabiul Islam; Nahlah Elkudssiah Ismail; Faisal Ismail; Abdollah Jafarzadeh; Mihajlo Jakovljevic; Mahsa Jalili; Manthan Dilipkumar Janodia; Nabi Jomehzadeh; Jost B. Jonas; Nitin Joseph; Charity Ehimwenma Joshua; Zubair Kabir; Bhushan Dattatray Kamble; Tanuj Kanchan; Himal Kandel; Kehinde Kazeem Kanmodi; Rami S. Kantar; Ibraheem M. Karaye; Arman Karimi Behnagh; Gebrehiwot G. Kassa; Rimple Jeet Kaur; Navjot Kaur; Himanshu Khajuria; Faham Khamesipour; Yusra H. Khan; M. Nuruzzaman Khan; Mahammed Ziauddin Khan Suheb; Khaled Khatab; Fatemeh Khatami; Min Seo Kim; Soewarta Kosen; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Kewal Krishan; Burcu Kucuk Bicer; Md Abdul Kuddus; Mukhtar Kulimbet; Nithin Kumar; Dharmesh Kumar Lal; Iván Landires; Kamaluddin Latief; Trang Diep Thanh Le; Thao Thi Thu Le; Caterina Ledda; Munjae Lee; Seung Won Lee; Temesgen L. Lerango; Stephen S. Lim; Chaojie Liu; Xuefeng Liu; Platon D. Lopukhov; Hong Luo; Hengliang Lv; Preetam Bhalchandra Mahajan; Amir Ali Mahboobipour; Azeem Majeed; Elaheh Malakan Rad; Kashish Malhotra; Muhammad Sajeel Ahmed Malik; Lesibana Anthony Malinga; Tauqeer Hussain Mallhi; Aseer Manilal; Bernardo Alfonso Martinez-Guerra; Francisco Rogerlândio Martins-Melo; Roy Rillera Marzo; Hossein Masoumi-Asl; Vasundhara Mathur; Richard James Maude; Ravi Mehrotra; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Muayad Aghali Merza; Tomislav Mestrovic; Laurette Mhlanga; Sanjeev Misra; Arup Kumar Misra; Prasanna Mithra; Babak Moazen; Hussen Mohammed; Ali H. Mokdad; Lorenzo Monasta; Catrin E. Moore; Parsa Mousavi; Francesk Mulita; Fungai Musaigwa; Raman Muthusamy; Ahamarshan Jayaraman Nagarajan; Pirouz Naghavi; Ganesh R. Naik; Gurudatta Naik; Sanjeev Nair; Tapas Sadasivan Nair; Zuhair S. Natto; Biswa Prakash Nayak; Hadush Negash; Dang H. Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Chukwudi A. Nnaji; Lawrence Achilles Nnyanzi; Efaq Ali Noman; Shuhei Nomura; Bogdan Oancea; Kehinde O. Obamiro; Ismail A. Odetokun; Daniel Bogale Odo Odo; Oluwakemi Ololade Odukoya; In-Hwan Oh; Chukwuma O. Okereke; Osaretin Christabel Okonji; Eyal Oren; Edgar Ortiz-Brizuela; Uchechukwu Levi Osuagwu; Amel Ouyahia; P.A. Mahesh Padukudru; Pragyan Paramita Parija; Romil R. Parikh; Seoyeon Park; Ashwaghosha Parthasarathi; Shankargouda Patil; Shrikant Pawar; Minjin Peng; Veincent Christian Filipino Pepito; Prince Peprah; João Perdigão; Norberto Perico; Hoang Tran Pham; Maarten J. Postma; Attur Ravindra Attur Prabhu; Manya Prasad; Akila Prashant; Elton Junio Sady Prates; Fakher Rahim; Mosiur Rahman; Muhammad Aziz Rahman; Masoud Rahmati; Sathish Rajaa; Shakthi Kumaran Ramasamy; Indu Ramachandra Rao; Sowmya J. Rao; Deepthi Rapaka; Ahmed Mustafa Rashid; Zubair Ahmed Ratan; Nakul Ravikumar; Salman Rawaf; Murali Mohan Rama Krishna Reddy; Elrashdy Moustafa Mohamed Redwan; Giuseppe Remuzzi; Luis Felipe Reyes; Nazila Rezaei; Mohsen Rezaeian; Omid Rezahosseini; Mónica Rodrigues; Priyanka Roy; Guilherme de Andrade Ruela; Siamak Sabour; Basema Saddik; Umar Saeed; Sher Zaman Safi; Narjes Saheb Sharif-Askari; Fatemeh Saheb Sharif-Askari; Amirhossein Sahebkar; Biniyam Sahiledengle; Soumya Swaroop Sahoo; Nasir Salam; Afeez Abolarinwa Salami; Samreen Saleem; Mohamed A. Saleh; Hossein Samadi Kafil; Sara Samadzadeh; Yoseph Leonardo Samodra; Rama Krishna Sanjeev; Aswini Saravanan; Susan M. Sawyer; Siddharthan Selvaraj; Sabyasachi Senapati; Subramanian Senthilkumaran; Pritik A. Shah; Samiah Shahid; Masood Ali Shaikh; Sunder Sham; Mohammad Ali Shamshirgaran; Mohd Shanawaz; Medha Sharath; Samendra P. Sherchan; Ranjitha S. Shetty; Hesamaddin Shirzad-Aski; Aminu Shittu; Emmanuel Edwar Siddig; João Pedro Silva; Surjit Singh; Paramdeep Singh; Harpreet Singh; Jasvinder A. Singh; Md Shahjahan Siraj; Siswanto Siswanto; Ranjan Solanki; Yonatan Solomon; Joan B. Soriano; Chandrashekhar T. Sreeramareddy; Vijay Kumar Srivastava; Paschalis Steiropoulos; Chandan Kumar Swain; Takahiro Tabuchi; Mircea Tampa; Jacques J. L. Lukenze Tamuzi; Nathan Y. Tat; Razieh Tavakoli Oliaee; Gebrehiwot Teklay; Edosa Geta Tesfaye; Belay Tessema; Pugazhenthan Thangaraju; Rekha Thapar; Chern Choong Chern Thum; Jansje Henny Vera Ticoalu; Imad M. Tleyjeh; Ruoyan Tobe-Gai; Temesgen Mohammed Toma; Khai Hoan Tram; Aniefiok John Udoakang; Tungki Pratama Umar; Chukwuma David Umeokonkwo; Seyed Mohammad Vahabi; Asokan Govindaraj Vaithinathan; Job F. M. van Boven; Shoban Babu Varthya; Ziyue Wang; Muktar S. A. Warsame; Ronny Westerman; Tewodros Eshete Wonde; Sajad Yaghoubi; Siyan Yi; Vahit Yigit; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Fathiah Zakham; Moein Zangiabadian; Francis Zeukeng; Haijun Zhang; Yang Zhao; Peng Zheng; Magdalena Zielinska; Joshua A. Salomon; Robert C. Reiner; Mohsen Naghavi; Theo Vos; Simon I. Hay; Christopher J. L. Murray; Hmwe Hmwe Kyu
    Background: Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to 2021, and to report on age-specific progress between 2015 and 2020. Methods: We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021) analytical framework to compute age-specific tuberculosis mortality and incidence estimates for 204 countries and territories (1990–2021 inclusive). We quantified tuberculosis mortality among individuals without HIV co-infection using 22 603 site-years of vital registration data, 1718 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, 680 site-years of mortality surveillance data, and 9 site-years of minimally invasive tissue sample (MITS) diagnoses data as inputs into the Cause of Death Ensemble modelling platform. Age-specific HIV and tuberculosis deaths were established with a population attributable fraction approach. We analysed all available population-based data sources, including prevalence surveys, annual case notifications, tuberculin surveys, and tuberculosis mortality, in DisMod-MR 2.1 to produce internally consistent age-specific estimates of tuberculosis incidence, prevalence, and mortality. We also estimated age-specific tuberculosis mortality without HIV co-infection that is attributable to the independent and combined effects of three risk factors (smoking, alcohol use, and diabetes). As a secondary analysis, we examined the potential impact of the COVID-19 pandemic on tuberculosis mortality without HIV co-infection by comparing expected tuberculosis deaths, modelled with trends in tuberculosis deaths from 2015 to 2019 in vital registration data, with observed tuberculosis deaths in 2020 and 2021 for countries with available cause-specific mortality data. Findings: We estimated 9·40 million (95% uncertainty interval [UI] 8·36 to 10·5) tuberculosis incident cases and 1·35 million (1·23 to 1·52) deaths due to tuberculosis in 2021. At the global level, the all-age tuberculosis incidence rate declined by 6·26% (5·27 to 7·25) between 2015 and 2020 (the WHO End TB strategy evaluation period). 15 of 204 countries achieved a 20% decrease in all-age tuberculosis incidence between 2015 and 2020, eight of which were in western sub-Saharan Africa. When stratified by age, global tuberculosis incidence rates decreased by 16·5% (14·8 to 18·4) in children younger than 5 years, 16·2% (14·2 to 17·9) in those aged 5–14 years, 6·29% (5·05 to 7·70) in those aged 15–49 years, 5·72% (4·02 to 7·39) in those aged 50–69 years, and 8·48% (6·74 to 10·4) in those aged 70 years and older, from 2015 to 2020. Global tuberculosis deaths decreased by 11·9% (5·77 to 17·0) from 2015 to 2020. 17 countries attained a 35% reduction in deaths due to tuberculosis between 2015 and 2020, most of which were in eastern Europe (six countries) and central Europe (four countries). There was variable progress by age: a 35·3% (26·7 to 41·7) decrease in tuberculosis deaths in children younger than 5 years, a 29·5% (25·5 to 34·1) decrease in those aged 5–14 years, a 15·2% (10·0 to 20·2) decrease in those aged 15–49 years, a 7·97% (0·472 to 14·1) decrease in those aged 50–69 years, and a 3·29% (–5·56 to 9·07) decrease in those aged 70 years and older. Removing the combined effects of the three attributable risk factors would have reduced the number of all-age tuberculosis deaths from 1·39 million (1·28 to 1·54) to 1·00 million (0·703 to 1·23) in 2020, representing a 36·5% (21·5 to 54·8) reduction in tuberculosis deaths compared to those observed in 2015. 41 countries were included in our analysis of the impact of the COVID-19 pandemic on tuberculosis deaths without HIV co-infection in 2020, and 20 countries were included in the analysis for 2021. In 2020, 50 900 (95% CI 49 700 to 52 400) deaths were expected across all ages, compared to an observed 45 500 deaths, corresponding to 5340 (4070 to 6920) fewer deaths; in 2021, 39 600 (38 300 to 41 100) deaths were expected across all ages compared to an observed 39 000 deaths, corresponding to 657 (–713 to 2180) fewer deaths. Interpretation: Despite accelerated progress in reducing the global burden of tuberculosis in the past decade, the world did not attain the first interim milestones of the WHO End TB Strategy in 2020. The pace of decline has been unequal with respect to age, with older adults (ie, those aged >50 years) having the slowest progress. As countries refine their national tuberculosis programmes and recalibrate for achieving the 2035 targets, they could consider learning from the strategies of countries that achieved the 2020 milestones, as well as consider targeted interventions to improve outcomes in older age groups. 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
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    Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019
    (John Wiley and Sons Inc, 2023) Youn Ho Shin; Jimin Hwang; Rosie Kwon; Seung Won Lee; Min Seo Kim; Jae Il Shin; Dong Keon Yon; Yohannes Habtegiorgis Abate; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Michael Abdelmasseh; Deldar Morad Abdulah; Richard Gyan Aboagye; Hassan Abolhassani; Elissa M. Abrams; Yonas Derso Abtew; Eman Abu-Gharbieh; Denberu Eshetie Adane Adane; Tigist Demssew Adane; Isaac Yeboah Addo; Rishan Adha; Amin Adibi; Qorinah Estiningtyas Sakilah Adnani; Anurag Agrawal; Sohail Ahmad; Ali Ahmadi; Ali Ahmed; Ayman Ahmed; Sayer Al-Azzam; Fadwa Alhalaiqa Naji Alhalaiqa; Sheikh Mohammad Alif; Vahid Alipour; Zaid Altaany; Khalid A. Altirkawi; Nelson Alvis-Guzman; Hany Aly; Adnan Ansar; Judie Arulappan; Mohammad Asghari-Jafarabadi; Tahira Ashraf; Seyyed Shamsadin Athari; Daniel Atlaw; Avinash Aujayeb; Sina Azadnajafabad; Mahsa Babaei; Hassan Babamohamadi; Alaa Badawi; Nayereh Baghcheghi; Sara Bagherieh; Khuloud Bajbouj; Maciej Banach; Mainak Bardhan; Francesco Barone-Adesi; Amadou Barrow; Azadeh Bashiri; Nebiyou Simegnew Bayileyegn; Isabela M. Bensenor; Alemshet Yirga Berhie; Kebede A. Beyene; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Ajay Nagesh Bhat; Vijayalakshmi S. 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Williams; Dereje Y. Yada; Yazachew Yismaw; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mazyar Zahir; Heather J. Zar; Iman Zare; Mikhail Sergeevich Zastrozhin; Mohammad A. Zeineddine; Getachew Assefa Zenebe; Zhi-Jiang Zhang; Hanqing Zhao; Mohammad Zoladl
    Background: Asthma and atopic dermatitis (AD) are chronic allergic conditions, along with allergic rhinitis and food allergy and cause high morbidity and mortality both in children and adults. This study aims to evaluate the global, regional, national, and temporal trends of the burden of asthma and AD from 1990 to 2019 and analyze their associations with geographic, demographic, social, and clinical factors. Methods: Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019, we assessed the age-standardized prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of both asthma and AD from 1990 to 2019, stratified by geographic region, age, sex, and socio-demographic index (SDI). DALYs were calculated as the sum of years lived with disability and years of life lost to premature mortality. Additionally, the disease burden of asthma attributable to high body mass index, occupational asthmagens, and smoking was described. Results: In 2019, there were a total of 262 million [95% uncertainty interval (UI): 224–309 million] cases of asthma and 171 million [95% UI: 165–178 million] total cases of AD globally; age-standardized prevalence rates were 3416 [95% UI: 2899–4066] and 2277 [95% UI: 2192–2369] per 100,000 population for asthma and AD, respectively, a 24.1% [95% UI: −27.2 to −20.8] decrease for asthma and a 4.3% [95% UI: 3.8–4.8] decrease for AD compared to baseline in 1990. Both asthma and AD had similar trends according to age, with age-specific prevalence rates peaking at age 5–9 years and rising again in adulthood. The prevalence and incidence of asthma and AD were both higher for individuals with higher SDI; however, mortality and DALYs rates of individuals with asthma had a reverse trend, with higher mortality and DALYs rates in those in the lower SDI quintiles. Of the three risk factors, high body mass index contributed to the highest DALYs and deaths due to asthma, accounting for a total of 3.65 million [95% UI: 2.14–5.60 million] asthma DALYs and 75,377 [95% UI: 40,615–122,841] asthma deaths. Conclusions: Asthma and AD continue to cause significant morbidity worldwide, having increased in total prevalence and incidence cases worldwide, but having decreased in age-standardized prevalence rates from 1990 to 2019. Although both are more frequent at younger ages and more prevalent in high-SDI countries, each condition has distinct temporal and regional characteristics. Understanding the temporospatial trends in the disease burden of asthma and AD could guide future policies and interventions to better manage these diseases worldwide and achieve equity in prevention, diagnosis, and treatment. © 2023 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
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    Measuring routine childhood vaccination coverage in 204 countries and territories, 1980–2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1
    (Elsevier B.V., 2021) Natalie C Galles; Patrick Y Liu; Rachel L Updike; Nancy Fullman; Jason Nguyen; Sam Rolfe; Alyssa N Sbarra; Megan F Schipp; Ashley Marks; Gdiom Gebreheat Abady; Kaja M Abbas; Sumra Wajid Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Amir Abdoli; Hassan Abolhassani; Akine Eshete Abosetugn; Maryam Adabi; Abdu A Adamu; Olatunji O Adetokunboh; Qorinah Estiningtyas Sakilah Adnani; Shailesh M Advani; Saira Afzal; Seyed Mohammad Kazem Aghamir; Bright Opoku Ahinkorah; Sohail Ahmad; Tauseef Ahmad; Sepideh Ahmadi; Haroon Ahmed; Muktar Beshir Ahmed; Tarik Ahmed Rashid; Yusra Ahmed Salih; Yonas Akalu; Addis Aklilu; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Luciana Albano; Yosef Alemayehu; Kefyalew Addis Alene; Ayman Al-Eyadhy; Robert Kaba Alhassan; Liaqat Ali; Syed Mohamed Aljunid; Sami Almustanyir; Khalid A Altirkawi; Nelson Alvis-Guzman; Hubert Amu; Catalina Liliana Andrei; Tudorel Andrei; Adnan Ansar; Alireza Ansari-Moghaddam; Ippazio Cosimo Antonazzo; Benny Antony; 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Enany; A.T. Olagunju; P.S. Faris; B. Tsegaye; I. Filip; F. Fischer; M.R. Francis; M.R. Francis; T. Fukumoto; X. Liu; A.M. Saad; S. Gaidhane; T. Garg; Y. Tekalegn; S. Mohammed; T. Gebre; K. Ghadiri; K. Ghadiri; M. Ghafourifard; M. Moghadaszadeh; S. Gilani; S. Gilani; P.D. Lopukhov; M. Golechha; S.V. Gopalani; H. Goudarzi; M.B. Ahmed; H. Goudarzi; Y. Guo; S. Li; Y. Guo; V. Gupta; V.K. Gupta; R.A. Gutiérrez; A. Hargono Dr; S. Hassan; S. Hassan; G. Heidari; S. Islam; V. Hsieh; J. Huang; C. Zhong; A. Humayun; R. Hussain; A. Makki; J. Noubiap; U. Iqbal; S.N. Irvani; S. Islam; R. Kalhor; R. Kalhor; Z. Kamal; Z. Kamal; A. Karch; J. Khan; G. Kim; M. Kim; M. Kim; Y. Kim; S. Kosen; A. Kumar; A. Kwarteng; C. La Vecchia; I. Landires; V. Nuñez-Samudio; I. Landires; S. Lasrado; M. Levi; M. Levi; C.E. Moore; X. Liu; J. Sanabria; A. Thavamani; P.C. Matthews; J.C. Medina; J.C. Medina; W. Mendoza; R.G. Menezes; M.K. Mesregah; T. Mestrovic; M. Mohammadi; A. Mohammed; S. Mohammed; A. Mohapatra; M. Molokhia; E. Traini; H. Mirzaei; M. Zamanian; S.B. Munro; N. Otstavnov; M. Naveed; I. Negoi; T.H. Nguyen; T.H. Nguyen; B.O. Olakunde; M. Pathak; S. Pawar; M. Pirestani; M. Rabiee; M. Rahman; S. Rahmawaty; A. Rajesh; S. Rawaf; S. Rawaf; M. Saeb; U. Saeed; U. Saeed; M. Samaei; J. Sanabria; F. Sanmarchi; M. Sawhney; A. Seidu; A. Seidu; M.A. Shaikh; M. Shigematsu; A. Soheili; K. Tan; B. Thakur; A. Thavamani; E. Traini; M. Tripathi; S. Ullah; S. Ullah; B. Vo; G.T. Vu; A.S. Winkler; A.S. Winkler; C. Yu; D. Yuce
    Background: Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods: For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings: By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4–82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5–42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4–41·3] in 1980 to 83·6% [82·3–84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4–44·1) in 1980 to 79·8% (78·4–81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6–60·9) to 14·5 million (13·4–15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation: After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Funding: Bill & Melinda Gates Foundation. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    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
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