Browsing by Author "Jorge R. Ledesma"

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Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2020) Cristiana Abbafati; Kaja M. Abbas; Mohammad Abbasi; Mitra Abbasifard; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Foad Abd-Allah; Ahmed Abdelalim; Mohammad Abdollahi; Ibrahim Abdollahpour; Aidin Abedi; Parisa Abedi; Kedir Hussein Abegaz; Hassan Abolhassani; Akine Eshete Abosetugn; Victor Aboyans; Elissa M. Abrams; Lucas Guimarães Abreu; Michael R.M. Abrigo; Abdulaziz Khalid Abu Haimed; Ahmed Abualhasan; Eman Abu-Gharbieh; Laith Jamal Abu-Raddad; Abdelrahman I. Abushouk; Alyssa Acebedo; Ilana N. Ackerman; Maryam Adabi; Tim Adair; Abdu A. Adamu; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Jaimie D. Adelson; Abiodun Moshood Adeoye; Olatunji O. Adetokunboh; Davoud Adham; Shailesh M. Advani; Mohsen Afarideh; Mahdi Afshari; Ashkan Afshin; Emilie E. Agardh; Gina Agarwal; Pradyumna Agasthi; Kareha M. Agesa; Mohammad Aghaali; Seyed Mohammad Kazem Aghamir; Anurag Agrawal; Tauseef Ahmad; Alireza Ahmadi; Keivan Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Ehsan Ahmadpour; Muktar Beshir Ahmed; Budi Aji; Temesgen Yihunie Akalu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Blessing Akombi; Chisom Joyqueenet Akunna; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Noore Alam; Samiah Alam; Tahiya Alam; Fahad Mashhour Alanezi; Turki M. Alanzi; Samuel B. Albertson; Jacqueline Elizabeth Alcalde-Rabanal; Niguse Meles Alema; Biresaw Wassihun Alemu; Yihun Mulugeta Alemu; Khalid F. Alhabib; Robert Kaba Alhassan; Muhammad Ali; Saqib Ali; Gianfranco Alicandro; Mehran Alijanzadeh; Cyrus Alinia; Vahid Alipour; Hesam Alizade; Syed Mohamed Aljunid; François Alla; Peter Allebeck; Majid Abdulrahman Hamad Almadi; Ali Almasi; Amir Almasi-Hashiani; Nihad A. Almasri; Hesham M. Al-Mekhlafi; Abdulaziz M. Almulhim; Jordi Alonso; Rajaa M. Al-Raddadi; Khalid A. Altirkawi; Arwa Khalid Alumran; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Azmeraw T. Amare; Bekalu Amare; Saeed Amini; Mostafa Amini-Rarani; Arya Aminorroaya; Fatemeh Amiri; Arianna Maever L. Amit; Dickson A. Amugsi; Gianna Gayle Herrera Amul; Etsay Woldu Anbesu; Robert Ancuceanu; Deanna Anderlini; Jason A. Anderson; Catalina Liliana Andrei; Tudorel Andrei; Sofia Androudi; Colin Angus; Mina Anjomshoa; Fereshteh Ansari; Iman Ansari; Alireza Ansari-Moghaddam; Ippazio Cosimo Antonazzo; Carl Abelardo T. Antonio; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Seth Christopher Yaw Appiah; Jalal Arabloo; Morteza Arab-Zozani; Aleksandr Y. Aravkin; Aseb Arba Kinfe Arba; Olatunde Aremu; Filippo Ariani; Timur Aripov; Bahram Armoon; Johan Ärnlöv; Oluwaseyi Olalekan Arowosegbe; Krishna K. Aryal; Afsaneh Arzani; Malke Asaad; Mehran Asadi-Aliabadi; Ali A. Asadi-Pooya; Samaneh Asgari; Babak Asghari; Mohammad Asghari Jafarabadi; Charlie Ashbaugh; Michael Assmus; Zahra Atafar; Seyyed Shamsadin Athari; Desta Debalkie Atnafu; Maha Moh'd Wahbi Atout; Sachin R. Atre; Madhu Sudhan Atteraya; Floriane Ausloos; Marcel Ausloos; Leticia Avila-Burgos; Euripide Frinel Gbenato Arthur Avokpaho; Beatriz Paulina Ayala Quintanilla; Getinet Ayano; Martin Amogre Ayanore; Getie Lake Aynalem; Yared Asmare Aynalem; Muluken Altaye Ayza; Samad Azari; Ghasem Azarian; Zelalem Nigussie Azene; Gulrez Azhar; Peter S. Azzopardi; B.B. Darshan; Ebrahim Babaee; Alaa Badawi; Ashish D. Badiye; Mojtaba Bagherzadeh; Eleni Bagli; Mohammad Amin Bahrami; Atif Amin Baig; Mohan Bairwa; Mohammad Hossein Bakhshaei; Ahad Bakhtiari; Shankar M. Bakkannavar; Arun Balachandran; Senthilkumar Balakrishnan; Shivanthi Balalla; Shelly Balassyano; Alberto Baldasseroni; Kylie Ball; Shoshana H. Ballew; Daniela Balzi; Maciej Banach; Srikanta K. Banerjee; Palash Chandra Banik; Marlena S. Bannick; Agegnehu Bante Bante; Simachew Animen Bante; Adhanom Gebreegziabher Baraki; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Celine M. Barthelemy; Lingkan Barua; Akbar Barzegar; Huda Basaleem; Quique Bassat; Sanjay Basu; Bernhard T. Baune; Mohsen Bayati; Bayisa Abdissa Baye; Gholamreza Bazmandegan; Jacob S. Becker; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Yannick Béjot; Tariku Tesfaye Tesfaye Bekuma; Michelle L. Bell; Aminu K. Bello; Rose G. Bender; Derrick A. Bennett; Fiona B. Bennitt; Isabela M. Bensenor; Catherine P. Benziger; Kidanemaryam Berhe; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Akshaya Srikanth Bhagavathula; Reshmi Bhageerathy; Neeraj Bhala; Dinesh Bhandari; Pankaj Bhardwaj; Anusha Ganapati Bhat; Krittika Bhattacharyya; Suraj Bhattarai; Zulfiqar A. Bhutta; Sadia Bibi; Molly H. Biehl; Ali Bijani; Boris Bikbov; Ver Bilano; Muhammad Shahdaat Bin Sayeed; Antonio Biondi; Binyam Minuye Birihane; Donal Bisanzio; Catherine Bisignano; Raaj Kishore Biswas; Helen Bitew; Tone Bjørge; Moses John Bockarie; Somayeh Bohlouli; Mehdi Bohluli; Hunduma Amensisa Bojia; Srinivasa Rao Bolla; Archith Boloor; Alexandra S. Boon-Dooley; Guilherme Borges; Antonio Maria Borzì; Shiva Borzouei; Dipan Bose; Cristina Bosetti; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Dejana Braithwaite; Michael Brauer; Carol Brayne; Nicholas J.K. Breitborde; Susanne Breitner; Hermann Brenner; Alexey V. Breusov; Paul Svitil Briant; Andrew M. Briggs; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Gabrielle B. Britton; Traolach Brugha; Dana Bryazka; Rachelle Buchbinder; Blair R. Bumgarner; Katrin Burkart; Richard Thomas Burnett; Sharath Burugina Nagaraja; Reinhard Busse; Zahid A. Butt; Florentino Luciano Caetano dos Santos; Leah E. Cahill; Lucero Cahuana-Hurtado; Tianji Cai; Charlton S.K.H. Callender; Luis Alberto Cámera; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jackie Cao; Josip Car; Rosario Cárdenas; Giulia Carreras; Juan J. Carrero; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Chris D. Castle; Emma Castro; Franz Castro; Ferrán Catalá-López; Kate Causey; Christopher R. Cederroth; Kelly M. Cercy; Ester Cerin; Julian Chalek; Joht Singh Chandan; Alex R. Chang; Angela Y. Chang; Jung-Chen Chang; Kai-Lan Chang; Jaykaran Charan; Fiona J. Charlson; Vijay Kumar Chattu; Sarika Chaturvedi; Nicolas Cherbuin; Odgerel Chimed-Ochir; Ken Lee Chin; Jesus Lorenzo Chirinos-Caceres; Daniel Youngwhan Cho; Jee-Young Jasmine Choi; Hanne Christensen; Dinh-Toi Chu; Michael T. Chung; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Beniamino Cislaghi; Thomas Khaled Dwayne Classen; Aaron J. Cohen; Emma L. Collins; Haley Comfort; Kelly Compton; Sara Conti; Owen R. Cooper; Barbara Corso; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Richard G. Cowden; Benjamin C. Cowie; Elizabeth A. Cromwell; Andrew J. Croneberger; Di H. Cross; Marita Cross; Christopher Stephen Crowe; Jessica A. Cruz; Steven Cummins; Matthew Cunningham; Saad M.A. Dahlawi; Haijiang Dai; Hancheng Dai; Albertino Antonio Moura Damasceno; Giovanni Damiani; Emanuele D'Amico; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; William James Dangel; Anna-Karin Danielsson; Jiregna Darega Gela; Paul I. Dargan; Aso Mohammad Darwesh; Ahmad Daryani; Jai K. Das; Rajat Das Gupta; José das Neves; Aditya Prasad Dash; Gail Davey; Claudio Alberto Dávila-Cervantes; Adrian C. Davis; Dragos Virgil Davitoiu; Kairat Davletov; Diego De Leo; Jan-Walter De Neve; Frances E. Dean; Nicole K. DeCleene; Amanda Deen; Louisa Degenhardt; Marissa DeLang; Robert Paul Dellavalle; Feleke Mekonnen Demeke; Gebre Teklemariam Demoz; Desalegn Getnet Demsie; Edgar Denova-Gutiérrez; Nebiyu Dereje Dereje; Kebede Deribe; Nikolaos Dervenis; Rupak Desai; Assefa Desalew; Getenet Ayalew Dessie; Keshab Deuba; Samath Dhamminda Dharmaratne; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias da Silva; Daniel Diaz; Zahra Sadat Dibaji Forooshani; Martin Dichgans; Alireza Didarloo; Zachary V. Dingels; Ilse N. Dippenaar; M. Ashworth Dirac; Shirin Djalalinia; Hoa Thi Do; Klara Dokova; David Teye Doku; Christiane Dolecek; Andrew J. Dolgert; Fariba Dorostkar; Chirag P. Doshi; Pratik P. Doshi; Leila Doshmangir; Abdel Douiri; Matthew C. Doxey; Kerrie E. Doyle; Tim Robert Driscoll; Eleonora Dubljanin; Susanna J. Dunachie; Bruce B. Duncan; Andre Rodrigues Duraes; Arielle Wilder Eagan; Hedyeh Ebrahimi; Mohammad Ebrahimi Kalan; David Edvardsson; Andem Effiong; Joshua R. Ehrlich; Nevine El Nahas; Iman El Sayed; Maysaa El Sayed Zaki; Maha El Tantawi; Iffat Elbarazi; Islam Y. Elgendy; Hala Rashad Elhabashy; Shaimaa I. El-Jaafary; Aisha Elsharkawy; Iqbal R.F. Elyazar; Mohammad Hassan Emamian; Sophia Emmons-Bell; Holly E. Erskine; Babak Eshrati; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Firooz Esmaeilzadeh; Alireza Esteghamati; Sadaf Esteghamati; Kara Estep; Arash Etemadi; Atkilt Esaiyas Etisso; Oluchi Ezekannagha; Jessica Fanzo; Tamer Farag; Mohammad Farahmand; Anwar Faraj; Emerito Jose A. Faraon; Mohammad Fareed; Roghiyeh Faridnia; Carla Sofia e Sá Farinha; Andrea Farioli; Pawan Sirwan Faris; Andre Faro; Mithila Faruque; Farshad Farzadfar; Nazir Fattahi; Ali Akbar Fazaeli; Mehdi Fazlzadeh; Valery L. Feigin; Rachel Feldman; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Giannina Ferrara; Pietro Ferrara; Alize J. Ferrari; Manuela L. Ferreira; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; James L. Fisher; Ryan Fitzgerald; Carsten Flohr; Luisa Sorio Flor; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Lisa M. Force; Carla Fornari; Masoud Foroutan; Jack T. Fox; Joel Msafiri Francis; Tahvi D. Frank; Richard Charles Franklin; Marisa Freitas; Weijia Fu; Takeshi Fukumoto; Kai Fukutaki; John E. Fuller; Nancy Fullman; João M. Furtado; Mohamed M. Gad; Abhay Motiramji Gaidhane; Emmanuela Gakidou; Natalie C. Galles; Silvano Gallus; Amiran Gamkrelidze; Alberto L. Garcia-Basteiro; William M. Gardner; Biniyam Sahiledengle Geberemariyam; Abiyu Mekonnen Gebrehiwot; Ketema Bizuwork Gebremedhin; Gebreamlak Gebremedhn Gebremeskel; Leake G. Gebremeskel; Begashaw Melaku Gebresillassie; Assefa Ayalew Ayalew Ayalew Gebreslassie; Yilma Chisha Dea Geramo; Abraham Geremew; Anna Gershberg Hayoon; Hailay Abrha Gesesew; Peter W. Gething; Kebede Embaye Gezae; Maryam Ghadimi; Keyghobad Ghadiri; Fatemeh Ghaffarifar; Mansour Ghafourifard; Alireza Ghajar; Farhad Ghamari; Ahmad Ghashghaee; Hesam Ghiasvand; Nermin Ghith; Asadollah Gholamian; Rakesh Ghosh; Simona Giampaoli; Syed Amir Gilani; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Ibrahim Abdelmageed Ginawi; Themba G. Ginindza; Mojgan Gitimoghaddam; Giorgia Giussani; Mustefa Glagn; Ekaterina Vladimirovna Glushkova; Elena V. Gnedovskaya; Myron Anthony Godinho; Salime Goharinezhad; Mahaveer Golechha; Srinivas Goli; Ricardo Santiago Gomez; Philimon N. Gona; Sameer Vali Gopalani; Emily Goren; Giuseppe Gorini; Taren M. Gorman; Harrison Chase Gottlich; Houman Goudarzi; Amir Hossein Goudarzian; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Felix Greaves; Michal Grivna; Giuseppe Grosso; Mohammed Ibrahim Mohialdeen Gubari; Nachiket Gudi; Harish Chander Gugnani; Andre Luiz Sena Guimaraes; Rafael Alves Guimarães; Rashid Abdi Guled; Teklemariam Gultie; Gaorui Guo; Yuming Guo; Rahul Gupta; Rajeev Gupta; Subodh Sharan Gupta; Tarun Gupta; Juanita A. Haagsma; Vladimir Hachinski; Beatrix Haddock; Nima Hafezi-Nejad; Abdul Hafiz; Hailey Hagins; Lydia M. Haile; Teklehaimanot Gereziher Haile; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Brian J. Hall; Iman Halvaei; Randah R. Hamadeh; Kanaan Hamagharib Abdullah; Sajid Hameed; Samer Hamidi; Erin B. Hamilton; Melanie S. Hammer; Chieh Han; Hannah Han; Demelash Woldeyohannes Handiso; Asif Hanif; Graeme J. Hankey; Hamidreza Haririan; Josep Maria Haro; James D. Harvey; Ahmed I. Hasaballah; Md Mehedi Hasan; Edris Hasanpoor; Amir Hasanzadeh; Maryam Hashemian; Abdiwahab Hashi; Amr Hassan; Shoaib Hassan; Soheil Hassanipour; Hadi Hassankhani; Rasmus J. Havmoeller; Roderick J. Hay; Simon I. Hay; Khezar Hayat; Behzad Heibati; Behnam Heidari; Golnaz Heidari; Reza Heidari-Soureshjani; Delia Hendrie; Kiana Henny; Andualem Henok; Hannah J. Henrikson; Nathaniel J. Henry; Molly E. Herbert; Claudiu Herteliu; Fatemeh Heydarpour; Thomas R. Hird; Hung Chak Ho; Hans W. Hoek; Michael K. Hole; Ramesh Holla; Bruce Hollingsworth; Praveen Hoogar; Kathleen Pillsbury Hopf; Nobuyuki Horita; H. Dean Hosgood; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Damian G. Hoy; Mohamed Hsairi; Thomas Hsiao; Vivian Chia-Rong Hsieh; Guoqing Hu; Kejia Hu; Tanvir M. Huda; Fernando N. Hugo; Ayesha Humayun; Rabia Hussain; Chantal K. Huynh; Bing-Fang Hwang; Vincent C. Iannucci; Ivo Iavicoli; Charles Ugochukwu Ibeneme; Segun Emmanuel Ibitoye; Nayu Ikeda; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mohammad Hasan Imani-Nasab; Leeberk Raja Inbaraj; Helen Ippolito; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; M. Mofizul Islam; Md. Mohaimenul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Hiroyasu Iso; Rebecca Q. Ivers; Chidozie C.D. Iwu; Chinwe Juliana Iwu; Ihoghosa Osamuyi Iyamu; Jalil Jaafari; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Hussain Jafari; Morteza Jafarinia; Deepa Jahagirdar; Mohammad Ali Jahani; Nader Jahanmehr; Mihajlo Jakovljevic; Amir Jalali; Farzad Jalilian; Spencer L. James; Hosna Janjani; Manthan Dilipkumar Janodia; Tahereh Javaheri; Javad Javidnia; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Peng Jia; Lars Johansson; Oommen John; Yetunde O. John-Akinola; Catherine Owens Johnson; Sarah Charlotte Johnson; Jost B. Jonas; Tamas Joo; Ankur Joshi; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Zubair Kabir; Hamed Kalani; Rizwan Kalani; Leila R. Kalankesh; Rohollah Kalhor; Aruna M. Kamath; Zahra Kamiab; Tanuj Kanchan; Neeti Kapoor; Behzad Karami Matin; Marina Karanikolos; André Karch; Mohd Anisul Karim; Salah Eddin Karimi; Seyed Asaad Karimi; Seyed M. Karimi; Ayele Semachew Kasa; Getachew Mullu Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Norito Kawakami; Gbenga A. Kayode; Ali Kazemi Karyani; Suzanne H. Keddie; Peter Njenga Keiyoro; Cathleen Keller; Laura Kemmer; Parkes J. Kendrick; Maia Kereselidze; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Nauman Khalid; Mohammad Khammarnia; Ejaz Ahmad Khan; Gulfaraz Khan; Maseer Khan; Young-Ho Khang; Khaled Khatab; Amir M. Khater; Mona M. Khater; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Salman Khazaei; Habibolah Khazaie; Mohammad Taghi Khodayari; Abdullah T. Khoja; Jagdish Khubchandani; Roba Khundkar; Neda Kianipour; Christian Kieling; Cho-Il Kim; Daniel Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Sezer Kisa; Katarzyna Kissimova-Skarbek; Niranjan Kissoon; Mika Kivimäki; Cameron J. Kneib; Luke D. Knibbs; Megan Knight; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; David S.Q. Koh; Stefan Kohler; Tufa Kolola; Hamidreza Komaki; Jacek A. Kopec; Anna V. Korotkova; Vladimir Andreevich Korshunov; Soewarta Kosen; Anirudh Kotlo; Parvaiz A. Koul; Ai Koyanagi; Moritz U.G. Kraemer; Michael A. Kravchenko; Kewal Krishan; Kris J. Krohn; Hans Kromhout; K.S. Shaji; Barthelemy Kuate Defo; Burcu Bicer Kucuk; Nuworza Kugbey; Vaman Kulkarni; G. Anil Kumar; Manasi Kumar; Nithin Kumar; Pushpendra Kumar; Vivek Kumar; Girikumar Kumaresh; Om P. Kurmi; Dian Kusuma; Hmwe Hmwe Kyu; Carlo La Vecchia; Ben Lacey; Dharmesh Kumar Lal; Ratilal Lalloo; Tea Lallukka; Jennifer O. Lam; Faris Hasan Lami; Qing Lan; Iván Landires; Justin J. Lang; Sinéad M. Langan; Van Charles Lansingh; Sonia Lansky; Heidi Jane Larson; Samantha Leigh Larson; Anders O. Larsson; Savita Lasrado; Zohra S. Lassi; Kathryn Mei-Ming Lau; Paolo Lauriola; Pablo M. Lavados; Jeffrey V. Lazarus; Lisiane F. Leal; Janet L. Leasher; Jorge R. Ledesma; Paul H. Lee; Shaun Wen Huey Lee; Andrew T. Leever; Kate E. LeGrand; James Leigh; Matilde Leonardi; Haley Lescinsky; Janni Leung; Miriam Levi; Sarah Lewington; Bingyu Li; Shanshan Li; Lee-Ling Lim; Christine Lin; Ro-Ting Lin; Christine Linehan; Shai Linn; Stefan Listl; Hung-Chun Liu; Shiwei Liu; Simin Liu; Xuefeng Liu; Yang Liu; Zichen Liu; Justin Lo; Rakesh Lodha; Giancarlo Logroscino; Katharine J. Looker; Alan D. Lopez; Jaifred Christian F. Lopez; Platon D. Lopukhov; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Alton Lu; Tim C.D. Lucas; Alessandra Lugo; Raimundas Lunevicius; Ronan A. Lyons; Jianing Ma; Daiane Borges Machado; Jennifer H. MacLachlan; Mohammed Madadin; Emilie R. Maddison; Ralph Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Phetole Walter Mahasha; Mokhtar Mahdavi Mahdavi; Morteza Mahmoudi; Hue Thi Mai; Azeem Majeed; Jeadran N. Malagón-Rojas; Venkatesh Maled; Afshin Maleki; Shokofeh Maleki; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Amir Manafi; Navid Manafi; Ana Laura Manda; Helena Manguerra; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Ana M. Mantilla Herrera; Chabila Christopher Mapoma; Joemer C. Maravilla; Ashley Marks; Randall V. Martin; Santi Martini; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Anthony Masaka; Seyedeh Zahra Masoumi; João Massano; Benjamin Ballard Massenburg; Claudia I. Mastrogiacomo; Manu Raj Mathur; Kunihiro Matsushita; Pallab K. Maulik; Erin A. May; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Carlo Eduardo Medina-Solís; Birhanu Geta Meharie; Man Mohan Mehndiratta; Entezar Mehrabi Nasab; Fereshteh Mehri; Ravi Mehrotra; Kala M. Mehta; Wahengbam Bigyananda Meitei; Teferi Mekonnen; Addisu Melese; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; Meresa Berwo Mengesha; George A. Mensah; Alibek Mereke; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Kebadnew Mulatu Mihretie; Ted R. Miller; Edward J. Mills; George J. Milne; G.K. Mini; Mohammad Miri; Andreea Mirica; Erkin M. Mirrakhimov; Hamed Mirzaei; Maryam Mirzaei; Roya Mirzaei; Mehdi Mirzaei-Alavijeh; Awoke Temesgen Misganaw; Philip B. Mitchell; Prasanna Mithra; Babak Moazen; Masoud Moghadaszadeh; Bahram Mohajer; Osama Mohamad; Efat Mohamadi; Dara K. Mohammad; Yousef Mohammad
Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 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-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
Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Hmwe Hmwe Kyu; 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; Molla Abebe; Zegeye Abebe; Olifan Zewdie Abil; Victor Aboyans; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Niveen M.E. Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Pawan Acharya; Ilana N. Ackerman; Abdu A. Adamu; Oladimeji M. Adebayo; Victor Adekanmbi; Zanfina Ademi; Olatunji O. Adetokunboh; Mina G. Adib; Jose C. Adsuar; Kossivi Agbelenko Afanvi; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Kareha M. Agesa; Rakesh Aggarwal; Sargis Aghasi Aghayan; Anurag Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Sayem Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Tomi Akinyemiju; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Hesham M. Al-Mekhlafi; Rajaa M. Al-Raddadi; Fares Alahdab; Khurshid Alam; Tahiya Alam; Alaa Alashi; Seyed Moayed Alavian; Kefyalew Addis Alene; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala'A Alkerwi; François Alla; Peter Allebeck; Jordi Alonso; Ubai Alsharif; Khalid Altirkawi; Nelson Alvis-Guzman; Leopold N. Aminde; Erfan Amini; Mohammadreza Amiresmaili; Walid Ammar; Yaw Ampem Amoako; Nahla Hamed Anber; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Palwasha Anwari; Jalal Arabloo; Olatunde Aremu; Johan Ärnlöv; Amit Arora; Megha Arora; Al Artaman; Krishna K. Aryal; Hamid Asayesh; Zerihun Ataro; Marcel Ausloos; Leticia Avila-Burgos; Euripide F.G.A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Rakesh Ayer; Peter S. Azzopardi; Arefeh Babazadeh; Hamid Badali; Kalpana Balakrishnan; Ayele Geleto Bali; Maciej Banach; Joseph Adel Mattar Banoub; Aleksandra Barac; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Simon Barquera; Lope H. Barrero; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Bayu Begashaw Bekele; Eyasu Tamru Bekru; Abate Bekele Belachew; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Adugnaw Berhane; Eduardo Bernabe; Robert S. Bernstein; Mircea Beuran; Tina Beyranvand; Neeraj Bhala; Samir Bhatt; Soumyadeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Molly H. Biehl; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Donal Bisanzio; Tone Bjorge; Archie Bleyer; Eshetu Mulisa Bobasa; Ibrahim R. Bou-Orm; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Luisa C. Brant; Carol Brayne; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Paul Svitil Briant; Andrey Nikolaevich Briko; Gabrielle Britton; Traolach Brugha; Rachelle Buchbinder; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Julio Cesar Campuzano Rincon; Jorge Cano; Rosario Cárdenas; Juan J. Carrero; Austin Carter; Félix Carvalho; Carlos A. Castaneda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; Ferrán Catalá-López; Kelly M. Cercy; Ester Cerin; Yazan Chaiah; Jung-Chen Chang; Fiona J. Charlson; Vijay Kumar Chattu; Peggy Pei-Chia Chiang; Abdulaal Chitheer; Jee-Young J. Choi; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Massimo Cirillo; Daniel Collado-Mateo; Cyrus Cooper; Paolo Angelo Cortesi; Monica Cortinovis; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; Marita Cross; John A. Crump; Alemneh Kabeta Daba; Berihun Assefa Dachew; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Paul I. Dargan; Ahmad Daryani; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Dragos Virgil Davitoiu; Fernando Pio De La Hoz; Diego De Leo; Jan-Walter De Neve; Hans De Steur; Meaza Girma Degefa; Louisa Degenhardt; Selina Deiparine; Gebre Teklemariam Demoz; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Subhojit Dey; Samath D. Dharmaratne; Meghnath Dhimal; Mesfin Tadese Dinberu; M. Ashworth Dirac; Shirin Djalalinia; Linh Doan; Klara Dokova; David Teye Doku; E. Ray Dorsey; Kerrie E. Doyle; Tim Robert Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Michelle M. Echko; Dumessa Edessa; David Edvardsson; Andem Effiong; Anne Elise Eggen; Joshua R. Ehrlich; Charbel El Bcheraoui; Ziad El-Khatib; Iqbal R.F. Elyazar; Ahmadali Enayati; Melese Linger Endalifer; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Sharareh Eskandarieh; Alireza Esteghamati; Sadaf Esteghamati; Hamed Fakhim; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Talha A. Farid; Carla Sofia E. Sá Farinha; Andrea Farioli; Andre Faro; Farshad Farzadfar; Ali Akbar Fazaeli; Valery L. Feigin; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Alize J. Ferrari; Manuela L. Ferreira; Irina Filip; Florian Fischer; Christina Fitzmaurice; Nataliya A. Foigt; Kyle J. Foreman; Tahvi D. Frank; Takeshi Fukumoto; Nancy Fullman; Thomas Fürst; Joao M. Furtado; Emmanuela Gakidou; Seana Gall; Silvano Gallus; Morsaleh Ganji; Alberto L. Garcia-Basteiro; William M. Gardner; Abadi Kahsu Gebre; Amanuel Tesfay Gebremedhin; 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; Keyghobad Ghadiri; Maryam Ghasemi-Kasman; Mamata Ghimire; Aloke Gopal Ghoshal; Paramjit Singh Gill; Tiffany K. Gill; Ibrahim Abdelmageed Ginawi; Giorgia Giussani; Elena V. Gnedovskaya; Ellen M. Goldberg; Srinivas Goli; Hector Gómez-Dantés; Philimon N. Gona; Sameer Vali Gopalani; Taren M. Gorman; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Giuseppe Grosso; Harish Chander Gugnani; Francis Guillemin; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Reyna Alma Gutiérrez; Bishal Gyawali; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Hassan Haghparast Bidgoli; Tekleberhan B. Hagos; Tewodros Tesfa Hailegiyorgis; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Yuantao Hao; Hilda L. Harb; Sivadasanpillai Harikrishnan; Hamidreza Haririan; Josep Maria Haro; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Roderick J. 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Background: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted lifeyears (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severityof ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-speci?c mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the ?ve leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health. Copyright © 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 incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Spencer L. James; 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; Zegeye Abebe; Semaw F. Abera; Olifan Zewdie Abil; Haftom Niguse Abraha; Laith Jamal Abu-Raddad; Niveen M.E. Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Pawan Acharya; Ilana N. Ackerman; Abdu A. Adamu; Oladimeji M. Adebayo; Victor Adekanmbi; Olatunji O. Adetokunboh; Mina G. Adib; Jose C. Adsuar; Kossivi Agbelenko Afanvi; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Kareha M. Agesa; Rakesh Aggarwal; Sargis Aghasi Aghayan; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Tomi Akinyemiju; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Hesham M. Al-Mekhlafi; Rajaa M. 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Ballew; Maciej Banach; Joseph Adel Mattar Banoub; Amrit Banstola; Aleksandra Barac; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Béjot; Abate Bekele Belachew; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Isabela M. Bensenor; Eduardo Bernabe; Robert S. Bernstein; Mircea Beuran; Tina Beyranvand; Neeraj Bhala; Suraj Bhattarai; Soumyadeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Donal Bisanzio; Brigette F. Blacker; Fiona M. Blyth; Ibrahim R. Bou-Orm; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Michael Brainin; Luisa C. Brant; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Paul Svitil Briant; Andrew M. Briggs; Andrey Nikolaevich Briko; Gabrielle Britton; Traolach Brugha; Rachelle Buchbinder; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Jorge Cano; Rosario Cárdenas; Juan J. Carrero; Austin Carter; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; Ferrán Catalá-López; Kelly M. Cercy; Ester Cerin; Yazan Chaiah; Alex R. Chang; Hsing-Yi Chang; Jung-Chen Chang; Fiona J. Charlson; Aparajita Chattopadhyay; Vijay Kumar Chattu; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Ken Lee Chin; Abdulaal Chitheer; Jee-Young J. Choi; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Daniel Collado-Mateo; Cyrus Cooper; Josef Coresh; Paolo Angelo Cortesi; Monica Cortinovis; Megan Costa; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; Marita Cross; John A. Crump; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Paul I. Dargan; Ahmad Daryani; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Gail Davey; Adrian C. Davis; Dragos Virgil Davitoiu; Barbora De Courten; Fernando Pio De La Hoz; Diego De Leo; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Selina Deiparine; Robert P. Dellavalle; Gebre Teklemariam Demoz; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Subhojit Dey; Samath Dhamminda Dharmaratne; Mesfin Tadese Dinberu; M. Ashworth Dirac; Shirin Djalalinia; Linh Doan; Klara Dokova; David Teye Doku; E. Ray Dorsey; Kerrie E. Doyle; Tim Robert Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Michelle Marie Echko; David Edvardsson; Andem Effiong; Joshua R. Ehrlich; Charbel El Bcheraoui; Maysaa El Sayed Zaki; Ziad El-Khatib; Hajer Elkout; Iqbal R.F. Elyazar; Ahmadali Enayati; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Babak Eshrati; Sharareh Eskandarieh; Alireza Esteghamati; Sadaf Esteghamati; Hamed Fakhim; Vahid Fallah Omrani; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Talha A. Farid; Carla Sofia Esá Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Valery L. Feigin; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Alize J. Ferrari; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; Christina Fitzmaurice; Nataliya A. Foigt; Kyle J. Foreman; Jack Fox; Tahvi D. Frank; Takeshi Fukumoto; Nancy Fullman; Thomas Fürst; João M. Furtado; Neal D. Futran; Seana Gall; Morsaleh Ganji; Fortune Gbetoho Gankpe; Alberto L. Garcia-Basteiro; William M. Gardner; Abadi Kahsu Gebre; Amanuel Tesfay Gebremedhin; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Ricard Genova-Maleras; Yilma Chisha Dea Geramo; Peter W. Gething; Kebede Embaye Gezae; Keyghobad Ghadiri; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Mamata Ghimire; Rakesh Ghosh; Aloke Gopal Ghoshal; Simona Giampaoli; Paramjit Singh Gill; Tiffany K. Gill; Ibrahim Abdelmageed Ginawi; Giorgia Giussani; Elena V. Gnedovskaya; Ellen M. Goldberg; Srinivas Goli; Hector Gómez-Dantés; Philimon N. Gona; Sameer Vali Gopalani; Taren M. Gorman; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Morgan E. Grams; Giuseppe Grosso; Harish Chander Gugnani; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Bishal Gyawali; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Hassan Haghparast Bidgoli; Tekleberhan B. Hagos; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Yuantao Hao; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Caitlin N. Hawley; Roderick J. Hay; Simon I. Hay; Akbar Hedayatizadeh-Omran; Behzad Heibati; Delia Hendrie; Andualem Henok; Claudiu Herteliu; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Huong Thanh Hoang; Hans W. Hoek; Howard J. Hoffman; 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; Mohamed Hsairi; Aung Soe Htet; Guoqing Hu; John J. Huang; Chantal K. Huynh; Kim Moesgaard Iburg; Chad Thomas Ikeda; Bogdan Ileanu; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Sheikh Mohammed; Shariful Islam; Farhad Islami; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Catherine O. Johnson; Jost B. Jonas; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jürisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Tanuj Kanchan; Manoochehr Karami; Behzad Karami Matin; André Karch; Corine Karema; Narges Karimi; Seyed M. Karimi; Amir Kasaeian; Dessalegn H. Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Norito Kawakami; Ali Kazemi Karyani; Masoud Masoud Keighobadi; Peter Njenga Keiyoro; Laura Kemmer; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Yousef Saleh Khader; Behzad Khafaei; Morteza Abdullatif Khafaie; Alireza Khajavi; Ibrahim A. Khalil; Ejaz Ahmad Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Mohammad Khazaei; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Aliasghar A. Kiadaliri; Daniel N. Kiirithio; Cho-Il Kim; Daniel Kim; Pauline Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimäki; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Soewarta Kosen; Georgios A. Kotsakis; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Kristopher J. Krohn; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G. Anil Kumar; Manasi Kumar; Hmwe Hmwe Kyu; Deepesh P. Lad; Sheetal D. Lad; Alessandra Lafranconi; Ratilal Lalloo; Tea Lallukka; Faris Hasan Lami; Van C. Lansingh; Arman Latifi; Kathryn Mei-Ming Lau; Jeffrey V. Lazarus; Janet L. Leasher; Jorge R. Ledesma; Paul H. Lee; James Leigh; Janni Leung; Miriam Levi; Sonia Lewycka; Shanshan Li; Yichong Li; Yu Liao; Misgan Legesse Liben; Lee-Ling Lim; Stephen S. Lim; Shiwei Liu; Rakesh Lodha; Katharine J. Looker; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Nicola Low; Rafael Lozano; Tim C.D. Lucas; Lydia R. Lucchesi; Raimundas Lunevicius; Ronan A. Lyons; Stefan Ma; Erlyn Rachelle King Macarayan; Mark T. Mackay; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Narayan Bahadur Mahotra; Hue Thi Mai; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Ana-Laura Manda; Helena Manguerra; Treh Manhertz; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Chabila Christopher Mapoma; Joemer C. Maravilla; Wagner Marcenes; Ashley Marks; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Winfried März; Melvin B. Marzan; Tivani Phosa Mashamba-Thompson; Benjamin Ballard Massenburg; Manu Raj Mathur; Kunihiro Matsushita; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Fabiola Mejia-Rodriguez; Tesfa Mekonen; Addisu Melese; Mulugeta Melku; Michele Meltzer; 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; Naser Mohammad Gholi Mezerji; Bartosz Miazgowski; Tomasz Miazgowski; Anoushka I. Millear; Ted R. Miller; Benjamin Miltz; G.K. Mini; Mojde Mirarefin; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Philip B. Mitchell; Habtamu Mitiku; Babak Moazen; Bahram Mohajer; Karzan Abdulmuhsin Mohammad; Noushin Mohammadifard; Mousa Mohammadnia-Afrouzi; Mohammed A. Mohammed; Shafiu Mohammed; Farnam Mohebi; Modhurima Moitra; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Yoshan Moodley; Mahmood Moosazadeh; Ghobad Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Ilais Moreno Velásquez; Joana Morgado-Da-Costa; Shane Douglas Morrison; Marilita M. Moschos; Seyyed Meysam Mousavi; Kalayu Brhane Mruts; Achenef Asmamaw Muche; Kindie Fentahun Muchie; Ulrich Otto Mueller; Oumer Sada Muhammed; Satinath Mukhopadhyay; Kate Muller; John Everett Mumford; Manoj Murhekar; Jonah Musa; Kamarul Imran Musa; Ghulam Mustafa; Ashraf F. Nabhan; Chie Nagata; Mohsen Naghavi; Aliya Naheed; Azin Nahvijou; Gurudatta Naik; Nitish Naik; 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 Richard James Newton; Josephine W. Ngunjiri; Anh Quynh Nguyen; Ha Thu Nguyen; Huong Lan Thi Nguyen; Huong Thanh Nguyen; Long Hoang Nguyen; Minh Nguyen; Nam Ba Nguyen; Son Hoang Nguyen; Emma Nichols; Dina Nur Anggraini Ningrum; 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; Elaine O. Nsoesie; Peter S. Nyasulu; Christopher M. Odell; Richard Ofori-Asenso; Felix Akpojene Ogbo; In-Hwan Oh; Olanrewaju Oladimeji; Andrew T. Olagunju; Tinuke O. Olagunju; Pedro R. Olivares; Helen Elizabeth Olsen; Bolajoko Olubukunola Olusanya; Kanyin L. Ong; Sok King Ong; Eyal Oren; Alberto Ortiz; Erika Ota; Stanislav S. Otstavnov; Simon øverland; Mayowa Ojo Owolabi; P.A. Mahesh; Rosana Pacella; Amir H. Pakpour; Adrian Pana; Songhomitra Panda-Jonas; Andrea Parisi; Eun-Kee Park; Charles D.H. Parry; Shanti Patel; Sanghamitra Pati; Snehal T. Patil; Ajay Patle; George C. Patton; Vishnupriya Rao Paturi; Katherine R. Paulson; Neil Pearce; David M. Pereira; Norberto Perico; Konrad Pesudovs; Hai Quang Pham; Michael R. Phillips; David M. Pigott; Julian David Pillay; Michael A. Piradov; Meghdad Pirsaheb; Farhad Pishgar; Oleguer Plana-Ripoll; Dietrich Plass; Suzanne Polinder; Svetlana Popova; Maarten J. Postma; Akram Pourshams; Hossein Poustchi; Dorairaj Prabhakaran; Swayam Prakash; V. Prakash; Caroline A. Purcell; Manorama B. Purwar; Mostafa Qorbani; D. Alex Quistberg; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Kazem Rahimi; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Sajjad Ur Rahman; Rajesh Kumar Rai; Fatemeh Rajati; Usha Ram; Prabhat Ranjan; Anna Ranta; Puja C. Rao; David Laith Rawaf; Salman Rawaf; K. Srinath Reddy; Robert C. Reiner; Nickolas Reinig; Marissa Bettay Reitsma; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Satar Rezaei; Mohammad Sadegh Rezai; Antonio Luiz P. Ribeiro; Stephen R. Robinson; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Gregory A. Roth; Ambuj Roy; Enrico Rubagotti; Perminder S. 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Soriano; Ireneous N. Soyiri; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Jeffrey D. Stanaway; Dan J. Stein; Caitlyn Steiner; Timothy J. Steiner; Mark A. Stokes; Lars Jacob Stovner; Michelle L. Subart; Agus Sudaryanto; Mu'awiyyah Babale Sufiyan; Bruno F. Sunguya; Patrick John Sur; Ipsita Sutradhar; Bryan L. Sykes; Dillon O. Sylte; Rafael Tabarés-Seisdedos; Santosh Kumar Tadakamadla; Birkneh Tilahun Tadesse; Nikhil Tandon; Segen Gebremeskel Tassew; Mohammad Tavakkoli; Nuno Taveira; Hugh R. Taylor; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Shishay Wahdey Tekelemedhin; Merhawi Gebremedhin Tekle; Habtamu Temesgen; Mohamad-Hani Temsah; Omar Temsah; Abdullah Sulieman Terkawi; Mebrahtu Teweldemedhin; Kavumpurathu Raman Thankappan; Nihal Thomas; Binyam Tilahun; Quyen G. To; Marcello Tonelli; Roman Topor-Madry; Fotis Topouzis; Anna E. Torre; Miguel Tortajada-Girbés; Mathilde Touvier; Marcos Roberto Tovani-Palone; Jeffrey A. Towbin; Bach Xuan Tran; Khanh Bao Tran; Christopher E. Troeger; Thomas Clement Truelsen; Miltiadis K. Tsilimbaris; Derrick Tsoi; Lorainne Tudor Car; E. Murat Tuzcu; Kingsley N. Ukwaja; Irfan Ullah; Eduardo A. Undurraga; Jurgen Unutzer; Rachel L. Updike; Muhammad Shariq Usman; Olalekan A. Uthman; Muthiah Vaduganathan; Afsane Vaezi; Pascual R. Valdez; Santosh Varughese; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Santos Villafaina; Francesco S. Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Stein Emil Vollset; Kia Vosoughi; Isidora S. Vujcic; Fasil Shiferaw Wagnew; Yasir Waheed; Stephen G. Waller; Yafeng Wang; Yuan-Pang Wang; Elisabete Weiderpass; Robert G. Weintraub; Daniel J. Weiss; Fitsum Weldegebreal; Kidu Gidey Weldegwergs; Andrea Werdecker; T. Eoin West; Harvey A. Whiteford; Justyna Widecka; Tissa Wijeratne; Lauren B. Wilner; Shadrach Wilson; Andrea Sylvia Winkler; Alison B. Wiyeh; Charles Shey Wiysonge; Charles D.A. Wolfe; Anthony D. 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Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Copyright © 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 sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Jorge R. Ledesma; Jianing Ma; Avina Vongpradith; Emilie R. Maddison; Amanda Novotney; Molly H. Biehl; Kate E. Legrand; Jennifer M. Ross; Deepa Jahagirdar; Dana Bryazka; Rachel Feldman; Hassan Abolhassani; Akine Eshete Abosetugn; Eman Abu-Gharbieh; Oladimeji M. Adebayo; Qorinah Estiningtyas Sakilah Adnani; Saira Afzal; Bright Opoku Ahinkorah; Sajjad Ahmad Ahmad; Sepideh Ahmadi; Tarik Ahmed Rashid; Yusra Ahmed Salih; Addis Aklilu; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Yosef Alemayehu; Kefyalew Addis Alene; Beriwan Abdulqadir Ali; Liaqat Ali; Vahid Alipour; Hesam Alizade; Rajaa M. Al-Raddadi; Nelson Alvis-Guzman; Saeed Amini; Arianna Maever L. Amit; Jason A. Anderson; Sofa Androudi; Carl Abelardo T. Antonio; Catherine M. Antony; Razique Anwer; Jalal Arabloo; Asrat Arja; Mulusew A. Asemahagn; Sachin R. Atre; Gulrez Shah Azhar; B.B. Darshan; Zaheer-Ud-Din Babar; Atif Amin Baig; Maciej Banach; Hiba Jawdat Barqawi; Fabio Barra; Amadou Barrow; Sanjay Basu; Uzma Iqbal Belgaumi; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Natalia V. Bhattacharjee; Krittika Bhattacharyya; Ali Bijani; Boris Bikbov; Archith Boloor; Nikolay Ivanovich Briko; Danilo Buonsenso; Sharath Burugina Nagaraja; Zahid A. Butt; Austin Carter; Felix Carvalho; Jaykaran Charan; Souranshu Chatterjee; Soosanna Kumary Chattu; Vijay Kumar Chattu; Devasahayam J. Christopher; Dinh-Toi Chu; Mareli M. Claassens; Omid Dadras; Amare Belachew Dagnew; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; Aso Mohammad Darwesh; Deepak Dhamnetiya; Mostafa Dianatinasab; Daniel Diaz; Linh Phuong Doan; Sahar Eftekharzadeh; Muhammed Elhadi; Amir Emami; Shymaa Enany; Emerito Jose A. Faraon; Farshad Farzadfar; Eduarda Fernandes; Lorenzo Ferro Desideri; Irina Filip; Florian Fischer; Masoud Foroutan; Tahvi D. Frank; Alberto L. Garcia-Basteiro; Christian Garcia-Calavaro; Tushar Garg; Biniyam Sahiledengle Geberemariyam; Keyghobad Ghadiri; Ahmad Ghashghaee; Mahaveer Golechha; Amador Goodridge; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Mohammad Rifat Haider; Samer Hamidi; Asif Hanif; Shaful Haque; Harapan Harapan; Arief Hargono; Ahmed I. Hasaballah; Abdiwahab Hashi; Shoaib Hassan; Hadi Hassankhani; Khezar Hayat; Kamal Hezam; Ramesh Holla; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Rabia Hussain; Segun Emmanuel Ibitoye; Irena M. Ilic; Milena D. Ilic; Seyed Sina Naghibi Irvani; Nahlah Elkudssiah Ismail; Ramaiah Itumalla; Jalil Jaafari; Kathryn H. Jacobsen; Vardhmaan Jain; Fatemeh Javanmardi; Sathish Kumar Jayapal; Shubha Jayaram; Ravi Prakash Jha; Jost B. Jonas; Nitin Joseph; Farahnaz Joukar; Zubair Kabir; Ashwin Kamath; Tanuj Kanchan; Himal Kandel; Patrick D.M.C. Katoto; Gbenga A. Kayode; Parkes J. Kendrick; Amene Abebe Kerbo; Himanshu Khajuria; Rovshan Khalilov; Khaled Khatab; Abdullah T. Khoja; Jagdish Khubchandani; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Soewarta Kosen; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Burcu Kucuk Bicer; Avinash Kumar; G. Anil Kumar; Narinder Kumar; Nithin Kumar; Alexander Kwarteng; Hassan Mehmood Lak; Dharmesh Kumar Lal; Iván Landires; Savita Lasrado; Shaun Wen Huey Lee; Wei-Chen Lee; Christine Lin; Xuefeng Liu; Platon D. Lopukhov; Rafael Lozano; Daiane Borges Machado; Shilpashree Madhava Kunjathur; Deepak Madi; Preetam Bhalchandra Mahajan; Azeem Majeed; Ahmad Azam Malik; Francisco Rogerlândio Martins-Melo; Saurabh Mehta; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Hayimro Edemealem Merie; Amanual Getnet Mersha; Mohamed Kamal Mesregah; Tomislav Mestrovic; Nour Mheidly Mheidly; Sanjeev Misra; Prasanna Mithra; Masoud Moghadaszadeh; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Shafu Mohammed; Mariam Molokhia; Mohammad Ali Moni; Ahmed Al Montasir; Catrin E. Moore; Ahamarshan Jayaraman Nagarajan; Sanjeev Nair; Suma Nair; Atta Abbas Naqvi; Sreenivas Narasimha Swamy; Biswa Prakash Nayak; Javad Nazari; Sandhya Neupane Kandel; Trang Huyen Nguyen; Molly R. Nixon; Chukwudi A. Nnaji; Mpiko Ntsekhe; Virginia Nuñez-Samudio; Bogdan Oancea; Oluwakemi Ololade Odukoya; Andrew T. Olagunju; Eyal Oren; P.A. Mahesh; Ramakrishnan Parthasarathi; Fatemeh Pashazadeh Kan; Sanjay M. Pattanshetty; Rajan Paudel; Pintu Paul; Shrikant Pawar; Veincent Christian Filipino Pepito; Norberto Perico; Majid Pirestani; Roman V. Polibin; Maarten J. Postma; Akram Pourshams; Akila Prashant; Dimas Ria Angga Pribadi; Amir Radfar; Alireza Rafei; Fakher Rahim; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Mosiur Rahman; Amir Masoud Rahmani; Priyanga Ranasinghe; Chythra R. Rao; David Laith Rawaf; Salman Rawaf; Marissa B. Reitsma; Giuseppe Remuzzi; Andre M. N. Renzaho; Melese Abate Reta; Nima Rezaei; Omid Rezahosseini; Mohammad Sadegh Rezai; Aziz Rezapour; Gholamreza Roshandel; Denis O. Roshchin; Siamak Sabour; K.M. Saif-Ur-rahman; Nasir Salam; Hossein Samadi Kafl; Mehrnoosh Samaei; Abdallah M. Samy; Satish Saroshe; Benn Sartorius; Brijesh Sathian; Susan M. Sawyer; Subramanian Senthilkumaran; Allen Seylani; Omid Shafaat; Masood Ali Shaikh; Kiomars Sharaf; Ranjitha S. Shetty; Mika Shigematsu; Jae Il Shin; João Pedro Silva; Jitendra Kumar Singh; Smriti Sinha; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Emma Elizabeth Spurlock; Chandrashekhar T. Sreeramareddy; Paschalis Steiropoulos; Mu'awiyyah Babale Sufyan; Takahiro Tabuchi; Eyayou Girma Tadesse; Zemenu Tamir; Elvis Enowbeyang Tarkang; Yohannes Tekalegn; Fisaha Haile Tesfay; Belay Tessema; Rekha Thapar; Imad I. Tleyjeh; Ruoyan Tobe-Gai; Bach Xuan Tran; Berhan Tsegaye; Gebiyaw Wudie Tsegaye; Anayat Ullah; Chukwuma David Umeokonkwo; Sahel Valadan Tahbaz; Bay Vo; Giang Thu Vu; Yasir Waheed; Magdalene K. Walters; Joanna L. Whisnant; Mesfn Agachew Woldekidan; Befkadu Legesse Wubishet; Seyed Hossein Yahyazadeh Jabbari; Taklo Simeneh Yazie Yazie; Yigizie Yeshaw; Siyan Yi; Vahit Yigit; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Alimuddin Zumla; Ali H. Mokdad; Joshua A. Salomon; Robert C. Reiner; Stephen S. Lim; Mohsen Naghavi; Theo Vos; Simon I. Hay; Christopher J. L. Murray; Hmwe Hmwe Kyu
Background: Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. Methods: We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. Findings: Globally, in 2019, among HIV-negative individuals, there were 1·18 million (95% uncertainty interval 1·08–1·29) deaths due to tuberculosis and 8·50 million (7·45–9·73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000–279 000) deaths due to tuberculosis and 1·15 million (1·01–1·32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000–425 000) more deaths and 1·01 million (0·82–1·23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820–11 400) more deaths and 81 100 (63 300–100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1·5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4·27 (3·69–5·02), 6·17 (5·48–7·02), and 1·17 (1·07–1·28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2·23 (2·03–2·44) times greater among males than females, whereas the fraction due to unsafe sex was 1·06 (1·05–1·08) times greater among females than males. Interpretation: As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestones. 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
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. 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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. 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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