Browsing by Author "Kalpana Balakrishnan"

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Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1923–1994), (S0140673618322256), (10.1016/S0140-6736(18)32225-6))
(Lancet Publishing Group, 2019) Jeffrey D. Stanaway; Ashkan Afshin; Emmanuela Gakidou; Stephen S. Lim; Degu Abate; Kalkidan Hassen Abate; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Molla Abebe; Zegeye Abebe; Semaw F. Abera; Olifan Zewdie Abil; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Niveen M.E. Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Pawan Acharya; Abdu A. Adamu; Akilew Awoke Adane; Oladimeji M. Adebayo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Zanfina Ademi; Olatunji O. Adetokunboh; Mina G. Adib; Amha Admasie; Jose C. Adsuar; Kossivi Agbelenko Afanvi; Mohsen Afarideh; Gina Agarwal; Anju Aggarwal; Sargis Aghasi Aghayan; Anurag Agrawal; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Mohammad Esmaeil Akbari; Tomi Akinyemiju; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Hesham M. Al-Mekhlafi; Fares Alahdab; Khurshid Alam; Samiah Alam; Tahiya Alam; Alaa Alashi; Seyed Moayed Alavian; Kefyalew Addis Alene; Komal Ali; Syed Mustafa Ali; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala’a Alkerwi; François Alla; Ubai Alsharif; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Walid Ammar; Nahla Hamed Anber; Jason A. Anderson; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Mustafa Geleto Ansha; Josep M. Antó; Carl Abelardo T. Antonio; Palwasha Anwari; Lambert Tetteh Appiah; Seth Christopher Yaw Appiah; Jalal Arabloo; Olatunde Aremu; Johan Ärnlöv; Al Artaman; Krishna K. Aryal; Hamid Asayesh; Zerihun Ataro; Marcel Ausloos; Euripide F.G.A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Rakesh Ayer; Tambe B. Ayuk; Peter S. Azzopardi; Arefeh Babazadeh; Hamid Badali; Alaa Badawi; Kalpana Balakrishnan; Ayele Geleto Bali; Kylie Ball; Shoshana H. Ballew; Maciej Banach; Joseph Adel Mattar Banoub; Aleksandra Barac; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Sanjay Basu; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Béjot; Bayu Begashaw Bekele; Eyasu Tamru Bekru; Ezra Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Gilles Bergeron; Adugnaw Berhane; Eduardo Bernabe; Robert S. Bernstein; Mircea Beuran; Tina Beyranvand; Neeraj Bhala; Ashish Bhalla; Suraj Bhattarai; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Donal Bisanzio; Tuhin Biswas; Tone Bjørge; Brigette F. Blacker; Archie Bleyer; Rohan Borschmann; Ibrahim R. Bou-Orm; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Michael Brauer; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Andrey Nikolaevich Briko; Gabrielle Britton; Traolach Brugha; Rachelle Buchbinder; Richard T. Burnett; Reinhard Busse; Zahid A. Butt; Leah E. Cahill; Lucero Cahuana-Hurtado; Ismael R. Campos-Nonato; Rosario Cárdenas; Giulia Carreras; Juan J. Carrero; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; Ferrán Catalá-López; Kate Causey; Kelly M. Cercy; Ester Cerin; Yazan Chaiah; Hsing-Yi Chang; Jung-Chen Chang; Kai-Lan Chang; Fiona J. Charlson; Aparajita Chattopadhyay; Vijay Kumar Chattu; Miao Li Chee; Ching-Yu Cheng; Adrienne Chew; Peggy Pei-Chia Chiang; Odgerel Chimed-Ochir; Ken Lee Chin; Abdulaal Chitheer; Jee-Young J. Choi; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Massimo Cirillo; Aaron J. Cohen; Daniel Collado-Mateo; Cyrus Cooper; Owen R. Cooper; Josef Coresh; Leslie Cornaby; Paolo Angelo Cortesi; Monica Cortinovis; Megan Costa; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; David K. Cundiff; Alemneh Kabeta Daba; Berihun Assefa Dachew; Abel Fekadu Dadi; Albertino Antonio Moura Damasceno; Lalit Dandona; Rakhi Dandona; Sarah C. Darby; Paul I. Dargan; Ahmad Daryani; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Dragos Virgil Davitoiu; Kairat Davletov; Vanessa De la Cruz-Góngora; Fernando Pio De La Hoz; Diego De Leo; Jan-Walter De Neve; Louisa Degenhardt; Selina Deiparine; Robert P. Dellavalle; Gebre Teklemariam Demoz; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Aniruddha Deshpande; Don C. Des Jarlais; Getenet Ayalew Dessie; Gabrielle Aline Deveber; Subhojit Dey; Samath Dhamminda Dharmaratne; Meghnath Dhimal; Mesfin Tadese Dinberu; Eric L. Ding; Helen Derara Diro; Shirin Djalalinia; Huyen Phuc Do; Klara Dokova; David Teye Doku; Kerrie E. Doyle; Tim R. Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Natalie Ebert; Hedyeh Ebrahimi; Soheil Ebrahimpour; David Edvardsson; Andem Effiong; Anne Elise Eggen; Charbel El Bcheraoui; Ziad El-Khatib; Iqbal Rf Elyazar; Ahmadali Enayati; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Sharareh Eskandarieh; Alireza Esteghamati; Kara Estep; Hamed Fakhim; Mahbobeh Faramarzi; Mohammad Fareed; Talha A. Farid; Carla Sofia E. Sá Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Mohammad Hosein Farzaei; Batool Fatima; Kairsten A. Fay; Ali Akbar Fazaeli; Valery L. Feigin; Andrea B. Feigl; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Giannina Ferrara; Alize J. Ferrari; Manuela L. Ferreira; Irina Filip; Jonas David Finger; Florian Fischer; Nataliya A. Foigt; Kyle J. Foreman; Takeshi Fukumoto; Nancy Fullman; Thomas Fürst; João M. Furtado; Neal D. Futran; Seana Gall; Silvano Gallus; Amiran Gamkrelidze; Morsaleh Ganji; Alberto L. Garcia-Basteiro; William M. Gardner; Abadi Kahsu Gebre; Amanuel Tesfay Gebremedhin; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Yilma Chisha Dea Geramo; Peter W. Gething; Kebede Embaye Gezae; Reza Ghadimi; Keyghobad Ghadiri; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Mamata Ghimire; Rakesh Ghosh; Aloke Gopal Ghoshal; Simona Giampaoli; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Ibrahim Abdelmageed Ginawi; Giorgia Giussani; Elena V. Gnedovskaya; William W. Godwin; Srinivas Goli; Hector Gómez-Dantés; Philimon N. Gona; Sameer Vali Gopalani; Alessandra C. Goulart; Ayman Grada; Morgan E. Grams; Giuseppe Grosso; Harish Chander Gugnani; Yuming Guo; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Reyna Alma Gutiérrez; Daniela S. Gutiérrez-Torres; Juanita A. Haagsma; Tesfa Dejenie Habtewold; Vladimir Hachinski; Nima Hafezi-Nejad; Tekleberhan B. Hagos; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Yuantao Hao; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Caitlin N. Hawley; Simon I. Hay; Akbar Hedayatizadeh-Omran; Behzad Heibati; Behnam Heidari; Mohsen Heidari; Delia Hendrie; Andualem Henok; Ileana Heredia-Pi; Claudiu Herteliu; Fatemeh Heydarpour; Sousan Heydarpour; Desalegn T. Hibstu; Tarig B. Higazi; Esayas Haregot Hilawe; 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; Damian G. Hoy; Mohamed Hsairi; Thomas Hsiao; Guoqing Hu; Howard Hu; John J. Huang; Mamusha Aman Hussen; Chantal K. Huynh; Kim Moesgaard Iburg; Nayu Ikeda; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Sheikh Mohammed Shariful Islam; Farhad Islami; Maria D. Jackson; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Spencer L. James; Simerjot K. Jassal; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Jost B. Jonas; Jitendra Jonnagaddala; Zahra Jorjoran Shushtari; Ankur Joshi; Jacek Jerzy Jozwiak; Mikk Jürisson; Zubair Kabir; Amaha Kahsay; Rizwan Kalani; Tanuj Kanchan; Surya Kant; Chittaranjan Kar; 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; Anil Kaul; Norito Kawakami; Zhila Kazemi; Ali Kazemi Karyani; Adane Teshome Kefale; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Chandrasekharan Nair Kesavachandran; Yousef Saleh Khader; Behzad Khafaei; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Gulfaraz Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Mona M. Khater; Mohammad Khazaei; Habibolah Khazaie; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Aliasghar A. Kiadaliri; Daniel N. Kiirithio; Cho-Il Kim; Daniel Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimäki; Luke D. Knibbs; Ann Kristin Skrindo Knudsen; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Kristopher J. Krohn; Hans Kromhout; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G. Anil Kumar; Manasi Kumar; Igor Kuzin; Hmwe Hmwe Kyu; Carl Lachat; Deepesh P. Lad; Sheetal D. Lad; Alessandra Lafranconi; Ratilal Lalloo; Tea Lallukka; Faris Hasan Lami; Justin J. Lang; Van C. Lansingh; Samantha Leigh Larson; Arman Latifi; Jeffrey V. Lazarus; Paul H. Lee; James Leigh; Mostafa Leili; Cheru Tesema Leshargie; Janni Leung; Miriam Levi; Sonia Lewycka; Shanshan Li; Yichong Li; Juan Liang; Xiaofeng Liang; Yu Liao; Misgan Legesse Liben; Lee-Ling Lim; Shai Linn; Shiwei Liu; Rakesh Lodha; Giancarlo Logroscino; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Tim C.D. Lucas; Raimundas Lunevicius; Stefan Ma; Erlyn Rachelle King Macarayan; Ísis Eloah Machado; Fabiana Madotto; Hue Thi Mai; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Ana-Laura Manda; Helena Manguerra; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Joemer C. Maravilla; Wagner Marcenes; Ashley Marks; Randall V. Martin; Sheila C.O. Martins; Francisco Rogerlândio Martins-Melo; Winfried März; Melvin B. Marzan; Benjamin Ballard Massenburg; Manu Raj Mathur; Prashant Mathur; Kunihiro Matsushita; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Toni Meier; Fantahun Ayenew Mekonnen; Yohannes A. Melaku; Addisu Melese; Mulugeta Melku; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Desalegn Tadese 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; G.K. Mini; Mojde Mirarefin; Andreea Mirica; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Habtamu Mitiku; Babak Moazen; Bahram Mohajer; Karzan Abdulmuhsin Mohammad; Moslem Mohammadi; Noushin Mohammadifard; Mousa Mohammadnia-Afrouzi; Shafiu Mohammed; Farnam Mohebi; Ali H. Mokdad; Mariam Molokhia; Fatemeh Momeniha; Lorenzo Monasta; Yoshan Moodley; Ghobad Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Joana Morgado-Da-Costa; Shane Douglas Morrison; Marilita M. Moschos; Simin Mouodi; Seyyed Meysam Mousavi; Dariush Mozaffarian; Kalayu Brhane Mruts; Achenef Asmamaw Muche; Kindie Fentahun Muchie; Ulrich Otto Mueller; Oumer Sada Muhammed; Satinath Mukhopadhyay; Kate Muller; Kamarul Imran Musa; Ghulam Mustafa; Ashraf F. Nabhan; Mohsen Naghavi; Aliya Naheed; Azin Nahvijou; Gurudatta Naik; Nitish Naik; Farid Najafi; Vinay Nangia; Jobert Richie Nansseu; Bruno Ramos Nascimento; Bruce Neal; Nahid Neamati; Ionut Negoi; Ruxandra Irina Negoi; Subas Neupane; Charles Richard James Newton; Josephine W. Ngunjiri; Anh Quynh Nguyen; Grant Nguyen; Ha Thu Nguyen; Huong Lan Thi Nguyen; Huong Thanh Nguyen; Minh Nguyen; Nam Ba Nguyen; Emma Nichols; Jing Nie; Dina Nur Anggraini Ningrum; Yirga Legesse Nirayo; Nobuo Nishi; Molly R. Nixon; Marzieh Nojomi; 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; Carla M. Obermeyer; 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; Jacob Olusegun Olusanya; Kanyin L. Ong; Sok King Ong; Eyal Oren; Heather M. Orpana; Alberto Ortiz; Erika Ota; Stanislav S. Otstavnov; Simon Øverland; Mayowa Ojo Owolabi; P.A. Mahesh; Rosana Pacella; Abhijit P. Pakhare; Amir H. Pakpour; Adrian Pana; Songhomitra Panda-Jonas; Eun-Kee Park; Charles D.H. Parry; Hadi Parsian; Shanti Patel; Sanghamitra Pati; Snehal T. Patil; Ajay Patle; George C. Patton; Deepak Paudel; Katherine R. Paulson; Wayra Citlali Paz Ballesteros; Neil Pearce; Alexandre Pereira; David M. Pereira; Norberto Perico; Konrad Pesudovs; Max Petzold; Hai Quang Pham; Michael R. Phillips; Julian David Pillay; Michael A. Piradov; Meghdad Pirsaheb; Tobias Pischon; Farhad Pishgar; Oleguer Plana-Ripoll; Dietrich Plass; Suzanne Polinder; Kevan R. Polkinghorne; Maarten J. Postma; Richie Poulton; Akram Pourshams; Hossein Poustchi; Dorairaj Prabhakaran; Swayam Prakash; Narayan Prasad; Caroline A. Purcell; Manorama B. Purwar; Mostafa Qorbani; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Zohreh Rahimi; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Rajesh Kumar Rai; Fatemeh Rajati; Sasa Rajsic; Sree Bhushan Raju; Usha Ram; Chhabi Lal Ranabhat; Prabhat Ranjan; Goura Kishor Rath; David Laith Rawaf; Salman Rawaf; K. Srinath Reddy; Colin D. Rehm; Jürgen Rehm; Robert C. Reiner; Marissa B. Reitsma; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Luz Myriam Reynales-Shigematsu; Satar Rezaei; Antonio Luiz P. Ribeiro; Juan A. Rivera; Kedir Teji Roba; Sonia Rodríguez-Ramírez; Leonardo Roever; Yesenia Román; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Gregory A. Roth; Dietrich Rothenbacher; Ambuj Roy; Enrico Rubagotti; Lesley Rushton; Charumathi Sabanayagam; Perminder S. Sachdev; Basema Saddik; Ehsan Sadeghi; Sahar Saeedi Moghaddam; Hosein Safari; Yahya Safari; Roya Safari-Faramani; Mahdi Safdarian; Sare Safi; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; Haniye Sadat Sajadi; Nasir Salam; Payman Salamati; Zikria Saleem; Yahya Salimi; Hamideh Salimzadeh; Joshua A. Salomon; Devashri Digvijay Salvi; Inbal Salz; Abdallah M. Samy; Juan Sanabria; Maria Dolores Sanchez-Niño; Tania G. Sánchez-Pimienta; Taren Sanders; Yingying Sang; Damian Francesco Santomauro; Itamar S. Santos; João Vasco Santos; Milena M. Santric Milicevic; Bruno Piassi Sao Jose; Mayank Sardana; Abdur Razzaque Sarker; Rodrigo Sarmiento-Suárez; Nizal Sarrafzadegan; Benn Sartorius; Shahabeddin Sarvi; Brijesh Sathian; Maheswar Satpathy; Arundhati R. Sawant; Monika Sawhney; Mete Saylan; Mehdi Sayyah; Elke Schaeffner; Maria Inês Schmidt; Ione J.C. Schneider; Ben Schöttker; Aletta Elisabeth Schutte; David C. Schwebel; Falk Schwendicke; James G. Scott; Soraya Seedat; Mario Sekerija; Sadaf G. Sepanlou; Marc L. Serre; Edson Serván-Mori; Seyedmojtaba Seyedmousavi; Hosein Shabaninejad; Gavin Shaddick; Azadeh Shafieesabet; Mehdi Shahbazi; Amira A. Shaheen; Masood Ali Shaikh; Teresa Shamah Levy; Mehran Shams-Beyranvand; Mohammadbagher Shamsi; Heidar Sharafi; Kiomars Sharafi; Mehdi Sharif; Mahdi Sharif-Alhoseini; Hamid Sharifi; Jayendra Sharma; Meenakshi Sharma; Rajesh Sharma; Jun She; Aziz Sheikh; Peilin Shi; Kenji Shibuya; Mekonnen Sisay Shiferaw; Mika Shigematsu; Min-Jeong Shin; Rahman Shiri; Reza Shirkoohi; Ivy Shiue; Farhad Shokraneh; Haitham Shoman; Mark G. Shrime; Matthew S. Shupler; Si Si; Soraya Siabani; Abla Mehio Sibai; Tariq J. Siddiqi; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; Diego Augusto Santos Silva; João Pedro Silva; Dayane Gabriele Alves Silveira; Jasvinder A. Singh; Narinder Pal Singh; Virendra Singh; Dhirendra Narain Sinha; Eirini Skiadaresi; Vegard Skirbekk; David L. Smith; Mari Smith; Badr Hasan Sobaih; Soheila Sobhani; Ranjani Somayaji; Moslem Soofi; Reed J.D. Sorensen; Joan B. Soriano; Ireneous N. Soyiri; Angela Spinelli; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Vladimir I. Starodubov; Nadine Steckling; Dan J. Stein; Murray B. Stein; Goran Stevanovic; Leo Stockfelt; Mark A. Stokes; Lela Sturua; Michelle L. Subart; Agus Sudaryanto; Mu’awiyyah Babale Sufiyan; Gerhard Sulo; Bruno F. Sunguya; Patrick John Sur; Bryan L. Sykes; Cassandra E.I. Szoeke; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Santosh Kumar Tadakamadla; Ken Takahashi; Nikhil Tandon; Segen Gebremeskel Tassew; Mohammad Tavakkoli; Nuno Taveira; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Shishay Wahdey Tekelemedhin; Merhawi Gebremedhin Tekle; Habtamu Temesgen; Mohamad-Hani Temsah; Omar Temsah; Abdullah Sulieman Terkawi; Belay Tessema; Mebrahtu Teweldemedhin; Kavumpurathu Raman Thankappan; Andrew Theis; Sathish Thirunavukkarasu; Hannah J. Thomas; Matthew Lloyd Thomas; Nihal Thomas; George D. Thurston; Binyam Tilahun; Taavi Tillmann; Quyen G. To; Myriam Tobollik; Marcello Tonelli; Roman Topor-Madry; Anna E. Torre; Miguel Tortajada-Girbés; Mathilde Touvier; Marcos Roberto Tovani-Palone; Jeffrey A. Towbin; Bach Xuan Tran; Khanh Bao Tran; Thomas Clement Truelsen; Nu Thi Truong; Afewerki Gebremeskel Tsadik; Lorainne Tudor Car; E. Murat Tuzcu; Hayley D. Tymeson; Stefanos Tyrovolas; Kingsley N. Ukwaja; Irfan Ullah; Rachel L. Updike; Muhammad Shariq Usman; Olalekan A. Uthman; Muthiah Vaduganathan; Afsane Vaezi; Pascual R. Valdez; Aaron Van Donkelaar; Elena Varavikova; Santosh Varughese; Tommi Juhani Vasankari; Vidhya Venkateswaran; Narayanaswamy Venketasubramanian; Santos Villafaina; Francesco S. Violante
Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Erratum: Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015 (The Lancet (2016) 388(10053) (1725–1774)(S0140673616315756)(10.1016/S0140-6736(16)31575-6))
(Lancet Publishing Group, 2017) Haidong Wang; Zulfiqar A Bhutta; Matthew M Coates; Megan Coggeshall; Lalit Dandona; Khassoum Diallo; Elisabeth Barboza Franca; Maya Fraser; Nancy Fullman; Peter W Gething; Simon I Hay; Yohannes Kinfu; Maaya Kita; Xie Rachel Kulikoff; Heidi J Larson; Juan Liang; Xiaofeng Liang; Stephen S Lim; Margaret Lind; Alan D Lopez; Rafael Lozano; George A Mensah; Joseph B Mikesell; Ali H Mokdad; Meghan D Mooney; Mohsen Naghavi; Grant Nguyen; Ivo Rakovac; Joshua A Salomon; Naris Silpakit; Amber Sligar; Reed J D Sorensen; Theo Vos; Jun Zhu; Amanuel Alemu Abajobir; Kalkidan Hassen Abate; Kaja M Abbas; Foad Abd-Allah; Abdishakur M Abdulle; Semaw Ferede Abera; Victor Aboyans; Biju Abraham; Ibrahim Abubakar; Laith J Abu-Raddad; Niveen M E Abu-Rmeileh; Gebre Yitayih Abyu; Tom Achoki; Akindele Olupelumi Adebiyi; Isaac Akinkunmi Adedeji; Ademola Lukman Adelekan; Arsène Kouablan Adou; Arnav Agarwal; Oluremi N Ajala; Tomi F Akinyemiju; Nadia Akseer; Khurshid Alam; Noore K M Alam; Deena Alasfoor; Robert William Aldridge; Miguel Angel Alegretti; Zewdie Aderaw Alemu; Raghib Ali; Ala’a Alkerwi; François Alla; Rajaa Al-Raddadi; Ubai Alsharif; Khalid A Altirkawi; Elena Alvarez Martin; Nelson Alvis-Guzman; Azmeraw T Amare; Alemayehu Amberbir; Adeladza Kofi Amegah; Emmanuel A Ameh; Walid Ammar; Stephen Marc Amrock; Hjalte H Andersen; Gregory M Anderson; Carl Abelardo T Antonio; Johan Ärnlöv; Al Artaman; Hamid Asayesh; Rana Jawad Asghar; Reza Assadi; Suleman Atique; Euripide Frinel G Arthur Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Umar Bacha; Alaa Badawi; Kalpana Balakrishnan; Amitava Banerjee; Bolanle F Banigbe; Aleksandra Barac; Ryan M Barber; Suzanne L Barker-Collo; Till Bärnighausen; Lope H Barrero; Tigist Assefa Bayou; Yibeltal Tebekaw Bayou; Shahrzad Bazargan-Hejazi; Justin Beardsley; Neeraj Bedi; Tolesa Bekele; Michelle L Bell; Aminu K Bello; Derrick A Bennett; Isabela M Bensenor; Adugnaw Berhane; Eduardo Bernabé; Balem Demtsu Betsu; Addisu Shunu Beyene; Samir Bhatt; Sibhatu Biadgilign; Boris Bikbov; Sait Mentes Birlik; Donal Bisanzio; Espen Bjertness; Jed D Blore; Rupert R A Bourne; Michael Brainin; Alexandra Brazinova; Nicholas J K Breitborde; Alexandria Brown; Geoffrey Colin Buckle; Michael Burch; Zahid A Butt; Ismael Ricardo Campos-Nonato; Julio Cesar Campuzano; Rosario Cárdenas; David O Carpenter; Juan Jesus Carrero; Austin Carter; Daniel C Casey; Carlos A Castañeda-Orjuela; Jacqueline Castillo Rivas; Ruben Estanislao Castro; Ferrán Catalá-López; Kelly Cercy; Hsing-Yi Chang; Jung-Chen Chang; Chioma Ezinne Chibueze; Vesper Hichilombwe Chisumpa; Jee-Young Jasmine Choi; Rajiv Chowdhury; Devasahayam Jesudas Christopher; Liliana G Ciobanu; Samantha M Colquhoun; Cyrus Cooper; Leslie Cornaby; Solomon Abrha Damtew; Hadi Danawi; Rakhi Dandona; José Das Neves; Adrian C Davis; Pieter de Jager; Diego De Leo; Louisa Degenhardt; Kebede Deribe; Amare Deribew; Don C Des Jarlais; Gabrielle A Deveber; Samath D Dharmaratne; Preet K Dhillon; Eric L Ding; Pratik Pinal Doshi; Kerrie E Doyle; Leilei Duan; Manisha Dubey; Hedyeh Ebrahimi; Christian Lycke Ellingsen; Iqbal Elyazar; Aman Yesuf Endries; Sergey Petrovich Ermakov; Babak Eshrati; Alireza Esteghamati; Emerito Jose Aquino Faraon; Talha A Farid; Carla Sofia E Sa Farinha; André Faro; Maryam S Farvid; Farshad Farzadfar; Seyed-Mohammad Fereshtehnejad; Joao C Fernandes; Florian Fischer; Joseph R A Fitchett; Nataliya Foigt; Richard C Franklin; Joseph Friedman; Thomas Fürst; Ketevan Gambashidze; Amiran Gamkrelidze; Parthasarathi Ganguly; Teshome Gebre; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Alemseged Aregay Gebru; Johanna M Geleijnse; Bradford D Gessner; Ibrahim Abdelmageem Mohamed Ginawi; Ababi Zergaw Giref; Melkamu Dedefo Gishu; Hector Gomez-Dantes; Philimon Gona; Amador Goodridge; Sameer Vali Gopalani; Atsushi Goto; Hebe N Gouda; Harish Chander Gugnani; Yuming Guo; Rahul Gupta; Rajeev Gupta; Vipin Gupta; Bishal Gyawali; Juanita A Haagsma; Nima Hafezi-Nejad; Demewoz Haile; Alemayehu Desalegne Hailu; Gessessew Bugssa Hailu; Randah Ribhi Hamadeh; Samer Hamidi; Jamie Hancock; Alexis J Handal; Graeme J Hankey; Hilda L Harb; Sivadasanpillai Harikrishnan; Kimani M Harun; Rasmus Havmoeller; Roderick J Hay; Ileana Beatriz Heredia-Pi; Hans W Hoek; Masako Horino; Nobuyuki Horita; H. Dean Hosgood; Peter J Hotez; Damian G Hoy; Mohamed Hsairi; Guoqing Hu; Cheng Huang; John J Huang; Hsiang Huang; Laetitia Huiart; Chantal Huynh; Kim Moesgaard Iburg; Bulat T Idrisov; Kaire Innos; Kathryn H Jacobsen; Nader Jahanmehr; Mehdi Javanbakht; Achala Upendra Jayatilleke; Sun Ha Jee; Panniyammakal Jeemon; Vivekanand Jha; Guohong Jiang; Ying Jiang; Tariku Jibat; Ye Jin; Jost B Jonas; Zubair Kabir; Yogeshwar Kalkonde; Ritul Kamal; Haidong Kan; Gagandeep Kang; André Karch; Corine Kakizi Karema; Amir Kasaeian; Anil Kaul; Norito Kawakami; Jeanne Françoise Kayibanda; Konstantin Kazanjan; Peter Njenga Keiyoro; Andrew Haddon Kemp; Andre Pascal Kengne; Andre Keren; Maia Kereselidze; Chandrasekharan Nair Kesavachandran; Yousef Saleh Khader; Ibrahim A Khalil; Abdur Rahman Khan; Ejaz Ahmad Khan; Young-Ho Khang; Irma Khonelidze; Jagdish Khubchandani; Cho-Il Kim; Daniel Kim; Yun Jin Kim; Niranjan Kissoon; Miia Kivipelto; Luke D Knibbs; Yoshihiro Kokubo; Soewarta Kosen; Parvaiz A Koul; Ai Koyanagi; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Andreas A Kudom; G. Anil Kumar; Michael J Kutz; Hmwe H Kyu; Dharmesh Kumar Lal; Ratilal Lalloo; Hilton Lam; Jennifer O Lam; Van C Lansingh; Anders Larsson; James Leigh; Ricky Leung; Yichong Li; Yongmei Li; M Patrice Lindsay; Patrick Y Liu; Shiwei Liu; Belinda K Lloyd; Warren D Lo; Giancarlo Logroscino; Nicola Low; Raimundas Lunevicius; Ronan A Lyons; Stefan Ma; Hassan Magdy Abd El Razek; Mohammed Magdy Abd El Razek; Mahdi Mahdavi; Marek Majdan; Azeem Majeed; Reza Malekzadeh; Chabila C Mapoma; Wagner Marcenes; Jose Martinez-Raga; Melvin Barrientos Marzan; Felix Masiye; John J McGrath; Peter A Meaney; Alem Mehari; Man Mohan Mehndiratta; Alemayehu B Mekonnen; Yohannes Adama Melaku; Peter Memiah; Ziad A Memish; Walter Mendoza; Atte Meretoja; Tuomo J Meretoja; Francis Apolinary Mhimbira; Ted R Miller; Edward J Mills; Mojde Mirarefin; Awoke Misganaw; Charles N Mock; Karzan Abdulmuhsin Mohammad; Alireza Mohammadi; Shafiu Mohammed; Lorenzo Monasta; Julio Cesar Montañez Hernandez; Marcella Montico; Ami R Moore; Maziar Moradi-Lakeh; Lidia Morawska; Rintaro Mori; Ulrich O Mueller; Georgina A V Murphy; Srinivas Murthy; Jean B Nachega; Aliya Naheed; Kovin S Naidoo; Luigi Naldi; Devina Nand; Vinay Nangia; Subas Neupane; Charles R Newton; John N Newton; Marie Ng; Frida Namnyak Ngalesoni; Peter Nguhiu; Quyen Le Nguyen; Muhammad Imran Nisar; Patrick Martial Nkamedjie Pete; Ole F Norheim; Rosana E Norman; Felix Akpojene Ogbo; In-Hwan Oh; Foluke Adetola Ojelabi; Pedro R Olivares; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Eyal Oren; Erika Ota; P.A. Mahesh; Eun-Kee Park; Hye-Youn Park; Mahboubeh Parsaeian; Angel J Paternina Caicedo; Scott B Patten; João Mário Pedro; David M Pereira; Norberto Perico; Konrad Pesudovs; Max Petzold; Michael Robert Phillips; Julian David Pillay; Farhad Pishgar; Suzanne Polinder; Daniel Pope; Svetlana Popova; Farshad Pourmalek; Mostafa Qorbani; Rynaz H S Rabiee; Anwar Rafay; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Sajjad Ur Rahman; Rajesh Kumar Rai; Murugesan Raju; Usha Ram; Saleem M Rana; Chhabi Lal Ranabhat; Puja Rao; Amany H Refaat; Giuseppe Remuzzi; Serge Resnikoff; Alex Reynolds; David Rojas-Rueda; Luca Ronfani; Gholamreza Roshandel; Gregory A Roth; Ambuj Roy; George Mugambage Ruhago; Rajesh Sagar; Muhammad Muhammad Saleh; Juan R Sanabria; Maria Dolores Sanchez-Niño; Itamar S Santos; João Vasco Santos; Rodrigo Sarmiento-Suarez; Benn Sartorius; Maheswar Satpathy; Miloje Savic; Monika Sawhney; Ione J C Schneider; Ben Schöttker; David C Schwebel; Soraya Seedat; Sadaf G Sepanlou; Edson E Servan-Mori; Tesfaye Setegn; Saeid Shahraz; Masood Ali Shaikh; Marina Shakh-Nazarova; Rajesh Sharma; Jun She; Sara Sheikhbahaei; Jiabin Shen; Kevin N Sheth; Kenji Shibuya; Hwashin Hyun Shin; Min-Jeong Shin; Rahman Shiri; Ivy Shuie; Inga Dora Sigfusdottir; Diego Augusto Santos Silva; Jonathan Silverberg; Edgar P Simard; Shireen Sindi; Abhishek Singh; Jasvinder A Singh; Om Prakash Singh; Prashant Kumar Singh; Virendra Singh; Joan B Soriano; Sergey Soshnikov; Luciano A Sposato; Chandrashekhar T Sreeramareddy; Vasiliki Stathopoulou; Nicholas Steel; Konstantinos Stroumpoulis; Lela Sturua; Bruno F Sunguya; Soumya Swaminathan; Bryan L Sykes; Cassandra E I Szoeke; Rafael Tabarés-Seisdedos; Mohammad Tavakkoli; Bineyam Taye; Bemnet Amare Tedla; Worku Mekonnen Tefera; Tesfaye Tekle; Girma Temam Shifa; Abdullah Sulieman Terkawi; Fisaha Haile Tesfay; Gizachew Assefa Tessema; Kiran Thapa; Alan J Thomson; Andrew L Thorne-Lyman; Ruoyan Tobe-Gai; Marcello Tonelli; Roman Topor-Madry; Fotis Topouzis; Bach Xuan Tran; Christopher Troeger; Thomas Truelsen; Zacharie Tsala Dimbuene; Abera Kenay Tura; Stefanos Tyrovolas; Kingsley N Ukwaja; Chigozie Jesse Uneke; Olalekan A Uthman; Masoud Vaezghasemi; Tommi Vasankari; Ana Maria Nogales Vasconcelos; Narayanaswamy Venketasubramanian; Raj Kumar Verma; Francesco S Violante; Sergey K Vladimirov; Vasiliy Victorovich Vlassov; Stein Emil Vollset; Linhong Wang; Yanping Wang; Scott Weichenthal; Elisabete Weiderpass; Robert G Weintraub; Daniel J Weiss; Andrea Werdecker; Ronny Westerman; Marc-Alain Widdowson; Tissa Wijeratne; Thomas Neil Williams; Charles Shey Wiysonge; Charles D A Wolfe; Ingrid Wolfe; Sungho Won; Mamo Wubshet; Qingyang Xiao; Gelin Xu; Ajit Kumar Yadav; Bereket Yakob; Yuichiro Yano; Mehdi Yaseri; Pengpeng Ye; Henock Gebremedhin Yebyo; Paul Yip; Naohiro Yonemoto; Seok-Jun Yoon; Mustafa Z Younis; Chuanhua Yu; Zoubida Zaidi; Maysaa El Sayed Zaki; Hajo Zeeb; Hao Zhang; Yong Zhao; Yingfeng Zheng; Maigeng Zhou; Sanjay Zodpey; Christopher J L Murray
GBD 2015 Child Mortality Collaborators. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388: 1725–74—In this Article, Mohsen Naghavi, Michael J Kutz, Chantal Huynh, Samer Hamidi, Addisu Shunu Beyene, and Stephen S Lim should have been listed as authors. The affiliation details for Simon I Hay have been updated. The funding statement for Simon I Hay has been added. These corrections have been made to the online version as of Jan 5, 2017. © 2017 Elsevier Ltd
Excess Mortality Risk Due to Heat Stress in Different Climatic Zones of India
(American Chemical Society, 2024) Rohit Kumar Choudhary; Pallavi Joshi; Santu Ghosh; Dilip Ganguly; Kalpana Balakrishnan; Nidhi Singh; Rajesh Kumar Mall; Alok Kumar; Sagnik Dey
India is at a high risk of heat stress-induced health impacts and economic losses owing to its tropical climate, high population density, and inadequate adaptive planning. The health impacts of heat stress across climate zones in India have not been adequately explored. Here, we examine and report the vulnerability to heat stress in India using 42 years (1979-2020) of meteorological data from ERA-5 and developed climate-zone-specific percentile-based human comfort class thresholds. We found that the heat stress is usually 1-4 °C higher on heatwave (HW) days than on nonheatwave (NHW) days. However, the stress on NHW days remains considerable and cannot be neglected. We then showed the association of a newly formulated India heat index (IHI) with daily all-cause mortality in three cities - Delhi (semiarid), Varanasi (humid subtropical), and Chennai (tropical wet and dry), using a semiparametric quasi-Poisson regression model, adjusted for nonlinear confounding effects of time and PM2.5. The all-cause mortality risk was enhanced by 8.1% (95% confidence interval, CI: 6.0-10.3), 5.9% (4.6-7.2), and 8.0% (1.7-14.2) during “sweltering” days in Varanasi, Delhi, and Chennai, respectively, relative to “comfortable” days. Across four age groups, the impact was more severe in Varanasi (ranging from a 3.2 to 7.5% increase in mortality risk for a unit rise in IHI) than in Delhi (2.6-4.2% higher risk) and Chennai (0.9-5.7% higher risk). We observed a 3-6 days lag effect of heat stress on mortality in these cities. Our results reveal heterogeneity in heat stress impact across diverse climate zones in India and call for developing an early warning system keeping in mind these regional variations. © 2023 American Chemical Society
Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Daniel Dicker; Grant Nguyen; Degu Abate; Kalkidan Hassen 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; Ahmed Abdulahi Abdurahman; Haftom Temesgen Abebe; Molla Abebe; Zegeye Abebe; Teshome Abuka Abebo; Victor Aboyans; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Niveen ME Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Pawan Acharya; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Rufus Adesoji Adedoyin; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Tara Ballav Adhikari; Mina G. Adib; ArsÃ¨ne Kouablan Adou; Jose C. Adsuar; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Rakesh Aggarwal; Sargis Aghasi Aghayan; Sutapa Agrawal; Anurag Agrawal; Mehdi Ahmadi; Alireza Ahmadi; Hamid Ahmadieh; Mohamed Lemine Cheikh Brahim Ahmed; Sayem Ahmed; Muktar Beshir Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Ali S. Akanda; Mohammad Esmaeil Akbari; Mohammed Akibu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Nadia Akseer; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Animut Alebel; Alicia V. Aleman; Kefyalew Addis Alene; Ayman Al-Eyadhy; Raghib Ali; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Alaâ€™A Alkerwi; FranÃ§ois Alla; Peter Allebeck; Christine A. Allen; Jordi Alonso; Rajaa M. Al-Raddadi; Ubai Alsharif; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Erfan Amini; Walid Ammar; Yaw Ampem Amoako; Nahla Hamed Anber; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Degefaye Zelalem Anlay; Hossein Ansari; Ansariadi Ansariadi; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Seth Christopher Yaw Appiah; Olatunde Aremu; Habtamu Abera Areri; Johan Ã„rnlÃ¶v; Megha Arora; Al Artaman; Krishna K. Aryal; Mohsen Asadi-Lari; Hamid Asayesh; Ephrem Tsegay Asfaw; Solomon Weldegebreal Asgedom; Reza Assadi; Zerihun Ataro; Tesfay Mehari Mehari Atey; Seyyed Shamsadin Athari; Suleman Atique; Sachin R. Atre; Madhu Sudhan Atteraya; Engi F. Attia; Marcel Ausloos; Leticia Avila-Burgos; Euripide F G A. Avokpaho; Ashish Awasthi; Baffour Awuah; Beatriz Paulina Ayala Quintanilla; Henok Tadesse Ayele; Yohanes Ayele; Rakesh Ayer; Tambe B. Ayuk; Peter S. Azzopardi; Natasha Azzopardi-Muscat; Hamid Badali; Alaa Badawi; Kalpana Balakrishnan; Ayele Geleto Bali; Maciej Banach; Amrit Banstola; Aleksandra Barac; Miguel A. Barboza; Simon Barquera; Lope H. Barrero; Huda Basaleem; Quique Bassat; Arindam Basu; Sanjay Basu; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick BÃ©jot; Bayu Begashaw Bekele; Abate Bekele Belachew; Aregawi Gebreyesus Belay; Ezra Belay; Saba Abraham Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Adugnaw Berhane; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Mircea Beuran; Tina Beyranvand; Neeraj Bhala; Eesh Bhatia; Samir Bhatt; Suraj Bhattarai; Soumyadeeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Boris Bikbov; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Sait Mentes Birlik; Charles Birungi; Donal Bisanzio; Tuhin Biswas; Tone BjÃ¸rge; Archie Bleyer; Berrak Bora Basara; Dipan Bose; Cristina Bosetti; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Nicola Luigi Bragazzi; Luisa C. Brant; Alexandra Brazinova; Nicholas J K. Breitborde; Hermann Brenner; Gabrielle Britton; Traolach Brugha; Kristin E. Burke; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Charlton S K H. Callender; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jorge Cano; Mate Car; Rosario CÃ¡rdenas; Giulia Carreras; Juan J. Carrero; Austin Carter; FÃ©lix Carvalho; Carlos A. CastaÃ±eda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; FerrÃ¡n CatalÃ¡-LÃ³pez; Alanur Ã‡avlin; Ester Cerin; Yazan Chaiah; Ana Paula Champs; Hsing-Yi Chang; Jung-Chen Chang; Aparajita Chattopadhyay; Pankaj Chaturvedi; Wanqing Chen; Peggy Pei-Chia Chiang; Odgerel Chimed-Ochir; Ken Lee Chin; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Jee-Young J. Choi; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Aaron J. Cohen; Daniel Collado-Mateo; Maria-Magdalena Constantin; Sara Conti; Cyrus Cooper; Leslie Trumbull Cooper; Paolo Angelo Cortesi; Monica Cortinovis; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; Christopher Stephen Crowe; John A. Crump; Alexandra Cucu; Matthew Cunningham; Alemneh Kabeta Daba; Berihun Assefa Dachew; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Anh Kim Dang; Paul I. Dargan; Ahmad Daryani; Siddharth K. Das; Rajat Das Gupta; JosÃ© Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Nicole Davis Weaver; Dragos Virgil Davitoiu; Kairat Davletov; Anand Dayama; Barbora de Courten; Fernando Pio De la Hoz; Diego De leo; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Tizta T. Degfie; Selina Deiparine; Robert P. Dellavalle; Gebre Teklemariam Demoz; Balem Betsu Demtsu; Edgar Denova-GutiÃ©rrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Subhojit Dey; Samath Dhamminda Dharmaratne; Meghnath Dhimal; Eric L. Ding; Shirin Djalalinia; David Teye Doku; Kate A. Dolan; Christl A. Donnelly; E Ray Dorsey; Dirk Douwes-Schultz; Kerrie E. Doyle; Thomas M. Drake; Tim Robert Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Dumessa Edessa; David Edvardsson; Anne Elise Eggen; Charbel El Bcheraoui; Maysaa El Sayed Zaki; Mohammed Elfaramawi; Ziad El-Khatib; Christian Lycke Ellingsen; Iqbal R F. Elyazar; Ahmadali Enayati; Aman Yesuf Yesuf Endries; Benjamin Er; Sergey Petrovich Ermakov; Babak Eshrati; Sharareh Eskandarieh; Reza Esmaeili; Alireza Esteghamati; Sadaf Esteghamati; Mahdi Fakhar; Hamed Fakhim; Tamer Farag; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Talha A. Farid; Carla Sofia E SÃ¡ Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Mir Sohail Fazeli; Valery L. Feigin; Andrea B. Feigl; Fariba Feizy; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Garumma Tolu Feyissa; Daniel Obadare Fijabi; Irina Filip; Samuel Finegold; Florian Fischer; Luisa Sorio Flor; Nataliya A. Foigt; John A. Ford; Kyle J. Foreman; Carla Fornari; Tahvi D. Frank; Richard Charles Franklin; Takeshi Fukumoto; John E. Fuller; Nancy Fullman; Thomas FÃ¼rst; JoÃ£o M. Furtado; Neal D. Futran; Adriana Galan; Silvano Gallus; Ketevan Gambashidze; Amiran Gamkrelidze; Fortune Gbetoho Gankpe; Alberto L. Garcia-Basteiro; Miguel A. Garcia-Gordillo; Teshome Gebre; Abadi Kahsu Gebre; Gebremedhin Berhe Gebregergs; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Tilayie Feto Gelano; Yalemzewod Assefa Gelaw; Johanna M. Geleijnse; Ricard Genova-Maleras; Bradford D. Gessner; Sefonias Getachew; Peter W. Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Hesam Ghiasvand; Mamata Ghimire; Aloke Gopal Ghoshal; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Giorgia Giussani; Shifalika Goenka; Srinivas Goli; Ricardo Santiago Gomez; Mari Carmen Gomez-Cabrera; Hector GÃ³mez-DantÃ©s; Philimon N. Gona; Amador Goodridge; Sameer Vali Gopalani; Atsushi Goto; Alessandra C. Goulart; BÃ¡rbara Niegia Garcia Goulart; Ayman Grada; Giuseppe Grosso; Harish Chander Gugnani; Andre Luiz Sena Guimaraes; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Bishal Gyawali; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Tekleberhan B. Hagos; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arya Haj-Mirzaian; Arvin Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Hamidreza Haririan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Roderick J. Hay; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Mohsen Heidari; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Ileana Heredia-Pi; Claudiu Herteliu; Fatemeh Heydarpour; Pouria Heydarpour; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Hans W. Hoek; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; Masako Horino; H Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Sorin Hostiuc; Mihaela Hostiuc; Peter J. Hotez; Damian G. Hoy; Mohamed Hsairi; Aung Soe Htet; Guoqing Hu; John J. Huang; Abdullatif Husseini; Mohammedaman Mama Hussen; Susan Hutfless; Kim Moesgaard Iburg; Ehimario U. Igumbor; Chad Thomas Ikeda; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Oluwaseyi Oluwakemi Isehunwa; Sheikh Mohammed Shariful Islam; Farhad Islami; Leila Jahangiry; Nader Jahanmehr; Rajesh Jain; Sudhir Kumar Jain; Mihajlo Jakovljevic; Spencer L. James; Mehdi Javanbakht; Sudha Jayaraman; Achala Upendra Jayatilleke; Sun Ha Jee; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Sarah Charlotte Johnson; Jost B. Jonas; Ankur Joshi; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk JÃ¼risson; K. Madhanraj; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Molla Kahssay; Rizwan Kalani; Umesh Kapil; Manoochehr Karami; Behzad Karami Matin; AndrÃ© Karch; Corine Karema; Narges Karimi; Seyed M. Karimi; Hamidreza Karimi-Sari; Amir Kasaeian; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Zemenu Yohannes Kassa; Nicholas J. Kassebaum; Marzieh Katibeh; Srinivasa Vittal Katikireddi; Anil Kaul; Norito Kawakami; Hossein Kazemeini; Zhila Kazemi; Ali Kazemi Karyani; K.C. Prakash; Seifu Kebede; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Maia Kereselidze; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Ejaz Ahmad Khan; Gulfaraz Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Tripti Khanna; Mona M. Khater; Alireza Khatony; Habibolah Khazaie; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Jagdish Khubchandani; Aliasghar A. Kiadaliri; Getiye D Dejenu Kibret; Cho-Il Kim; Daniel Kim; Jun Y. Kim; Young-Eun Kim; Ruth W. Kimokoti; Yohannes Kinfu; Sanjay Kinra; Adnan Kisa; Katarzyna Kissimova-Skarbek; Niranjan Kissoon; Mika KivimÃ¤ki; Marcus E. Kleber; Luke D. Knibbs; Ann Kristin Skrindo Knudsen; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Margaret N. Kosek; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Sanjay Krishnaswami; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Andreas A. Kudom; Ernst J. Kuipers; Xie Rachel Kulikoff; G Anil Kumar; Manasi Kumar; Pushpendra Kumar; Fekede Asefa Kumsa; Michael J. Kutz; Sheetal D. Lad; Alessandra Lafranconi; Dharmesh Kumar Lal; Ratilal Lalloo; Hilton Lam; Faris Hasan Lami; Qing Lan; SinÃ©ad M. Langan; Van C. Lansingh; Sonia Lansky; Heidi Jane Larson; Dennis Odai Laryea; Zohra S. Lassi; Arman Latifi; Pablo M. Lavados; Avula Laxmaiah; Jeffrey V. Lazarus; Georgy Lebedev; Paul H. Lee; James Leigh; Cheru Tesema Leshargie; Samson Leta; Miriam Levi; Shanshan Li; Yichong Li; Xiaohong Li; Juan Liang; Xiaofeng Liang; Misgan Legesse Liben; Lee-Ling Lim; Stephen S. Lim; Miteku Andualem Limenih; Shai Linn; Shiwei Liu; Yang Liu; Rakesh Lodha; Giancarlo Logroscino; Chris Lonsdale; Scott A. Lorch; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Tim C D. Lucas; Raimundas Lunevicius; Ronan A. Lyons; Stefan Ma; Crispin Mabika; Erlyn Rachelle King Macarayan; Mark T. Mackay; Emilie R. Maddison; Ralph Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Manzoor Ahmad Malik; Deborah Carvalho Malta; Abdullah A. Mamun; Wondimu Ayele Manamo; Ana-Laura Manda; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Chabila Christopher Mapoma; Dadi Marami; Joemer C. Maravilla; Wagner Marcenes; Shakhnazarova Marina; Jose Martinez-Raga; Sheila C O. Martins; Francisco RogerlÃ¢ndio Martins-Melo; Winfried MÃ¤rz; Melvin B. Marzan; Tivani Phosa Mashamba-Thompson; Felix Masiye; Benjamin Ballard Massenburg; Pallab K. Maulik; Mohsen Mazidi; John J. McGrath; Martin McKee; Suresh Mehata; Sanjay Madhav Mehendale; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Tesfa Mekonen; Tefera Chane Mekonnen; Hagazi Gebre Meles; Kidanu Gebremariam Meles; Addisu Melese; Mulugeta Melku; Peter T N. Memiah; Ziad A. Memish; Walter Mendoza; Desalegn Tadese Mengistu; Getnet Mengistu; George A. Mensah; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Haftay Berhane Mezgebe; Yode Miangotar; Bartosz Miazgowski; Tomasz Miazgowski; Ted R. Miller; G.K. Mini; Andreea Mirica; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Babak Moazen; Nurilign Abebe Moges; Karzan Abdulmuhsin Mohammad; Moslem Mohammadi; Noushin Mohammadifard; Maryam Mohammadi-Khanaposhtani; Mousa Mohammadnia-Afrouzi; Shafiu Mohammed; Mohammed A. Mohammed; Viswanathan Mohan; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Ghobad Moradi; Mahmoudreza Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Ilais Moreno VelÃ¡squez; Joana Morgado-Da-costa; Shane Douglas Morrison; Abbas Mosapour; Marilita M. Moschos; Seyyed Meysam Mousavi; Achenef Asmamaw Muche; Kindie Fentahun Muchie; Ulrich Otto Mueller; Satinath Mukhopadhyay; Erin C. Mullany; Kate Muller; Manoj Murhekar; Tasha B. Murphy; G.V.S. 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Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. © 2018 The Author(s).
Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016
(Lancet Publishing Group, 2017) Simon I. Hay; Amanuel Alemu Abajobir; Kalkidan Hassen Abate; Cristiana Abbafati; Kaja M. Abbas; Foad Abd-Allah; Abdishakur M. Abdulle; Teshome Abuka Abebo; Semaw Ferede Abera; Victor Aboyans; Laith J. Abu-Raddad; Ilana N. Ackerman; Isaac A. Adedeji; Olatunji Adetokunboh; Ashkan Afshin; Rakesh Aggarwal; Sutapa Agrawal; Anurag Agrawal; Aliasghar Ahmad Kiadaliri; Muktar Beshir Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Sneha Aiyar; Tomi F. Akinyemiju; Nadia Akseer; Faris Hasan Al Lami; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Noore Alam; Tahiya Alam; Deena Alasfoor; Kefyalew Addis Alene; Raghib Ali; Reza Alizadeh-Navaei; Juma M. Alkaabi; Ala'a Alkerwi; François Alla; Peter Allebeck; Christine Allen; Fatma Al-Maskari; Mohammad Abdulaziz Almazroa; Rajaa Al-Raddadi; Ubai Alsharif; Shirina Alsowaidi; Benjamin M. Althouse; Khalid A. Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Erfan Amini; Walid Ammar; Yaw Ampem Amoako; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Palwasha Anwari; Johan Ärnlöv; Megha Arora; Al Artaman; Krishna Kumar Aryal; Solomon W. Asgedom; Tesfay Mehari Atey; Niguse Tadele Atnafu; Leticia Avila-Burgos; Euripide Frinel G. Arthur Avokpaho; Ashish Awasthi; Shally Awasthi; Beatriz Paulina Ayala Quintanilla; Mahmoud Reza Azarpazhooh; Peter Azzopardi; Tesleem Kayode Babalola; Umar Bacha; Alaa Badawi; Kalpana Balakrishnan; Marlena S. Bannick; Aleksandra Barac; Suzanne L. Barker-Collo; Till Bärnighausen; Simon Barquera; Lope H. Barrero; Sanjay Basu; Robert Battista; Katherine E. Battle; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Justin Beardsley; Neeraj Bedi; Yannick Béjot; Bayu Begashaw Bekele; Michelle L. Bell; Derrick A. Bennett; James R. Bennett; Isabela M. Bensenor; Jennifer Benson; Adugnaw Berhane; Derbew Fikadu Berhe; Eduardo Bernabé; Balem Demtsu Betsu; Mircea Beuran; Addisu Shunu Beyene; Anil Bhansali; Samir Bhatt; Zulfqar A. Bhutta; Sibhatu Biadgilign; Kelly Bienhof; Boris Bikbov; Charles Birungi; Stan Biryukov; Donal Bisanzio; Habtamu Mellie Bizuayehu; Fiona M. Blyth; Dube Jara Boneya; Dipan Bose; Ibrahim R. Bou-Orm; Rupert R. A. Bourne; Michael Brainin; Carol E. G. Brayne; Alexandra Brazinova; Nicholas J. K. Breitborde; Paul S. Briant; Gabrielle Britton; Traolach S. Brugha; Rachelle Buchbinder; Lemma Negesa Bulto Bulto; Blair Bumgarner; Zahid A. Butt; Lucero Cahuana-Hurtado; Ewan Cameron; Ismael Ricardo Campos-Nonato; Hélène Carabin; Rosario Cárdenas; David O. Carpenter; Juan Jesus Carrero; Austin Carter; Felix Carvalho; Daniel Casey; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Chris D. Castle; Ferrán Catalá-López; Jung-Chen Chang; Fiona J. Charlson; Pankaj Chaturvedi; Honglei Chen; Mirriam Chibalabala; Chioma Ezinne Chibueze; Vesper Hichilombwe Chisumpa; Abdulaal A. Chitheer; Rajiv Chowdhury; Devasahayam Jesudas Christopher; Liliana G. Ciobanu; Massimo Cirillo; Danny Colombara; Leslie Trumbull Cooper; Cyrus Cooper; Paolo Angelo Cortesi; Monica Cortinovis; Michael H. Criqui; Elizabeth A. Cromwell; Marita Cross; John A. Crump; Abel Fekadu Dadi; Koustuv Dalal; Albertino Damasceno; Lalit Dandona; Rakhi Dandona; José Das Neves; Dragos V. Davitoiu; Kairat Davletov; Barbora De Courten; Diego De Leo; Hans De Steur; Louisa Degenhardt; Selina Deiparine; Robert P. Dellavalle; Kebede Deribe; Amare Deribew; Don C. Das Jarlais; Subhojit Dey; Samath D. Dharmaratne; Preet K. Dhillon; Daniel Dicker; Shirin Djalalinia; Huyen Phuc Do; Klara Dokova; David Teye Doku; E. Ray Dorsey; Kadine Priscila Bender Dos Santos; Tim R. Driscoll; Manisha Dubey; Bruce Bartholow Duncan; Beth E. 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Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE difered from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs ofset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the fve lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs ofset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention eforts, and development assistance for health, including fnancial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. © 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
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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, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015
(Lancet Publishing Group, 2016) Haidong Wang; Zulfiqar A Bhutta; Matthew M Coates; Megan Coggeshall; Lalit Dandona; Khassoum Diallo; Elisabeth Barboza Franca; Maya Fraser; Nancy Fullman; Peter W Gething; Simon I Hay; Yohannes Kinfu; Maaya Kita; Xie Rachel Kulikoff; Heidi J Larson; Juan Liang; Xiaofeng Liang; Stephen S Lim; Margaret Lind; Alan D Lopez; Rafael Lozano; George A Mensah; Joseph B Mikesell; Ali H Mokdad; Meghan D Mooney; Mohsen Naghavi; Grant Nguyen; Ivo Rakovac; Joshua A Salomon; Naris Silpakit; Amber Sligar; Reed J D Sorensen; Theo Vos; Jun Zhu; Amanuel Alemu Abajobir; Kalkidan Hassen Abate; Kaja M Abbas; Foad Abd-Allah; Abdishakur M Abdulle; Semaw Ferede Abera; Victor Aboyans; Biju Abraham; Ibrahim Abubakar; Laith J Abu-Raddad; Niveen M E Abu-Rmeileh; Gebre Yitayih Abyu; Tom Achoki; Akindele Olupelumi Adebiyi; Isaac Akinkunmi Adedeji; Ademola Lukman Adelekan; Arsène Kouablan Adou; Arnav Agarwal; Oluremi N Ajala; Tomi F Akinyemiju; Nadia Akseer; Khurshid Alam; Noore K M Alam; Deena Alasfoor; Robert William Aldridge; Miguel Angel Alegretti; Zewdie Aderaw Alemu; Raghib Ali; Ala’a Alkerwi; François Alla; Rajaa Al-Raddadi; Ubai Alsharif; Khalid A Altirkawi; Elena Alvarez Martin; Nelson Alvis-Guzman; Azmeraw T Amare; Alemayehu Amberbir; Adeladza Kofi Amegah; Emmanuel A Ameh; Walid Ammar; Stephen Marc Amrock; Hjalte H Andersen; Gregory M Anderson; Carl Abelardo T Antonio; Johan Ärnlöv; Al Artaman; Hamid Asayesh; Rana Jawad Asghar; Reza Assadi; Suleman Atique; Euripide Frinel G Arthur Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Umar Bacha; Alaa Badawi; Kalpana Balakrishnan; Amitava Banerjee; Bolanle F Banigbe; Aleksandra Barac; Ryan M Barber; Suzanne L Barker-Collo; Till Bärnighausen; Lope H Barrero; Tigist Assefa Bayou; Yibeltal Tebekaw Bayou; Shahrzad Bazargan-Hejazi; Justin Beardsley; Neeraj Bedi; Tolesa Bekele; Michelle L Bell; Aminu K Bello; Derrick A Bennett; Isabela M Bensenor; Adugnaw Berhane; Eduardo Bernabé; Balem Demtsu Betsu; Addisu Shunu Beyene; Samir Bhatt; Sibhatu Biadgilign; Boris Bikbov; Sait Mentes Birlik; Donal Bisanzio; Espen Bjertness; Jed D Blore; Rupert R A Bourne; Michael Brainin; Alexandra Brazinova; Nicholas J K Breitborde; Alexandria Brown; Geoffrey Colin Buckle; Michael Burch; Zahid A Butt; Ismael Ricardo Campos-Nonato; Julio Cesar Campuzano; Rosario Cárdenas; David O Carpenter; Juan Jesus Carrero; Austin Carter; Daniel C Casey; Carlos A Castañeda-Orjuela; Jacqueline Castillo Rivas; Ruben Estanislao Castro; Ferrán Catalá-López; Kelly Cercy; Hsing-Yi Chang; Jung-Chen Chang; Chioma Ezinne Chibueze; Vesper Hichilombwe Chisumpa; Jee-Young Jasmine Choi; Rajiv Chowdhury; Devasahayam Jesudas Christopher; Liliana G Ciobanu; Samantha M Colquhoun; Cyrus Cooper; Leslie Cornaby; Solomon Abrha Damtew; Hadi Danawi; Rakhi Dandona; José Das Neves; Adrian C Davis; Pieter de Jager; Diego De Leo; Louisa Degenhardt; Kebede Deribe; Amare Deribew; Don C Des Jarlais; Gabrielle A Deveber; Samath D Dharmaratne; Preet K Dhillon; Eric L Ding; Pratik Pinal Doshi; Kerrie E Doyle; Leilei Duan; Manisha Dubey; Hedyeh Ebrahimi; Christian Lycke Ellingsen; Iqbal Elyazar; Aman Yesuf Endries; Sergey Petrovich Ermakov; Babak Eshrati; Alireza Esteghamati; Emerito Jose Aquino Faraon; Talha A Farid; Carla Sofia E Sa Farinha; André Faro; Maryam S Farvid; Farshad Farzadfar; Seyed-Mohammad Fereshtehnejad; Joao C Fernandes; Florian Fischer; Joseph R A Fitchett; Nataliya Foigt; Richard C Franklin; Joseph Friedman; Thomas Fürst; Ketevan Gambashidze; Amiran Gamkrelidze; Parthasarathi Ganguly; Teshome Gebre; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Alemseged Aregay Gebru; Johanna M Geleijnse; Bradford D Gessner; Ibrahim Abdelmageem Mohamed Ginawi; Ababi Zergaw Giref; Melkamu Dedefo Gishu; Hector Gomez-Dantes; Philimon Gona; Amador Goodridge; Sameer Vali Gopalani; Atsushi Goto; Hebe N Gouda; Harish Chander Gugnani; Yuming Guo; Rahul Gupta; Rajeev Gupta; Vipin Gupta; Bishal Gyawali; Juanita A Haagsma; Nima Hafezi-Nejad; Demewoz Haile; Alemayehu Desalegne Hailu; Gessessew Bugssa Hailu; Randah Ribhi Hamadeh; Samer Hamidi; Jamie Hancock; Alexis J Handal; Graeme J Hankey; Hilda L Harb; Sivadasanpillai Harikrishnan; Kimani M Harun; Rasmus Havmoeller; Roderick J Hay; Ileana Beatriz Heredia-Pi; Hans W Hoek; Masako Horino; Nobuyuki Horita; H. 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Anil Kumar; Michael J Kutz; Hmwe H Kyu; Dharmesh Kumar Lal; Ratilal Lalloo; Hilton Lam; Jennifer O Lam; Van C Lansingh; Anders Larsson; James Leigh; Ricky Leung; Yichong Li; Yongmei Li; M Patrice Lindsay; Patrick Y Liu; Shiwei Liu; Belinda K Lloyd; Warren D Lo; Giancarlo Logroscino; Nicola Low; Raimundas Lunevicius; Ronan A Lyons; Stefan Ma; Hassan Magdy Abd El Razek; Mohammed Magdy Abd El Razek; Mahdi Mahdavi; Marek Majdan; Azeem Majeed; Reza Malekzadeh; Chabila C Mapoma; Wagner Marcenes; Jose Martinez-Raga; Melvin Barrientos Marzan; Felix Masiye; John J McGrath; Peter A Meaney; Alem Mehari; Man Mohan Mehndiratta; Alemayehu B Mekonnen; Yohannes Adama Melaku; Peter Memiah; Ziad A Memish; Walter Mendoza; Atte Meretoja; Tuomo J Meretoja; Francis Apolinary Mhimbira; Ted R Miller; Edward J Mills; Mojde Mirarefin; Awoke Misganaw; Charles N Mock; Karzan Abdulmuhsin Mohammad; Alireza Mohammadi; Shafiu Mohammed; Lorenzo Monasta; Julio Cesar Montañez Hernandez; Marcella Montico; Ami R Moore; Maziar Moradi-Lakeh; Lidia Morawska; Rintaro Mori; Ulrich O Mueller; Georgina A V Murphy; Srinivas Murthy; Jean B Nachega; Aliya Naheed; Kovin S Naidoo; Luigi Naldi; Devina Nand; Vinay Nangia; Subas Neupane; Charles R Newton; John N Newton; Marie Ng; Frida Namnyak Ngalesoni; Peter Nguhiu; Quyen Le Nguyen; Muhammad Imran Nisar; Patrick Martial Nkamedjie Pete; Ole F Norheim; Rosana E Norman; Felix Akpojene Ogbo; In-Hwan Oh; Foluke Adetola Ojelabi; Pedro R Olivares; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Eyal Oren; Erika Ota; P.A. Mahesh; Eun-Kee Park; Hye-Youn Park; Mahboubeh Parsaeian; Angel J Paternina Caicedo; Scott B Patten; João Mário Pedro; David M Pereira; Norberto Perico; Konrad Pesudovs; Max Petzold; Michael Robert Phillips; Julian David Pillay; Farhad Pishgar; Suzanne Polinder; Daniel Pope; Svetlana Popova; Farshad Pourmalek; Mostafa Qorbani; Rynaz H S Rabiee; Anwar Rafay; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Sajjad Ur Rahman; Rajesh Kumar Rai; Murugesan Raju; Usha Ram; Saleem M Rana; Chhabi Lal Ranabhat; Puja Rao; Amany H Refaat; Giuseppe Remuzzi; Serge Resnikoff; Alex Reynolds; David Rojas-Rueda; Luca Ronfani; Gholamreza Roshandel; Gregory A Roth; Ambuj Roy; George Mugambage Ruhago; Rajesh Sagar; Muhammad Muhammad Saleh; Juan R Sanabria; Maria Dolores Sanchez-Niño; Itamar S Santos; João Vasco Santos; Rodrigo Sarmiento-Suarez; Benn Sartorius; Maheswar Satpathy; Miloje Savic; Monika Sawhney; Ione J C Schneider; Ben Schöttker; David C Schwebel; Soraya Seedat; Sadaf G Sepanlou; Edson E Servan-Mori; Tesfaye Setegn; Saeid Shahraz; Masood Ali Shaikh; Marina Shakh-Nazarova; Rajesh Sharma; Jun She; Sara Sheikhbahaei; Jiabin Shen; Kevin N Sheth; Kenji Shibuya; Hwashin Hyun Shin; Min-Jeong Shin; Rahman Shiri; Ivy Shuie; Inga Dora Sigfusdottir; Diego Augusto Santos Silva; Jonathan Silverberg; Edgar P Simard; Shireen Sindi; Abhishek Singh; Jasvinder A Singh; Om Prakash Singh; Prashant Kumar Singh; Virendra Singh; Joan B Soriano; Sergey Soshnikov; Luciano A Sposato; Chandrashekhar T Sreeramareddy; Vasiliki Stathopoulou; Nicholas Steel; Konstantinos Stroumpoulis; Lela Sturua; Bruno F Sunguya; Soumya Swaminathan; Bryan L Sykes; Cassandra E I Szoeke; Rafael Tabarés-Seisdedos; Mohammad Tavakkoli; Bineyam Taye; Bemnet Amare Tedla; Worku Mekonnen Tefera; Tesfaye Tekle; Girma Temam Shifa; Abdullah Sulieman Terkawi; Fisaha Haile Tesfay; Gizachew Assefa Tessema; Kiran Thapa; Alan J Thomson; Andrew L Thorne-Lyman; Ruoyan Tobe-Gai; Marcello Tonelli; Roman Topor-Madry; Fotis Topouzis; Bach Xuan Tran; Christopher Troeger; Thomas Truelsen; Zacharie Tsala Dimbuene; Abera Kenay Tura; Stefanos Tyrovolas; Kingsley N Ukwaja; Chigozie Jesse Uneke; Olalekan A Uthman; Masoud Vaezghasemi; Tommi Vasankari; Ana Maria Nogales Vasconcelos; Narayanaswamy Venketasubramanian; Raj Kumar Verma; Francesco S Violante; Sergey K Vladimirov; Vasiliy Victorovich Vlassov; Stein Emil Vollset; Linhong Wang; Yanping Wang; Scott Weichenthal; Elisabete Weiderpass; Robert G Weintraub; Daniel J Weiss; Andrea Werdecker; Ronny Westerman; Marc-Alain Widdowson; Tissa Wijeratne; Thomas Neil Williams; Charles Shey Wiysonge; Charles D A Wolfe; Ingrid Wolfe; Sungho Won; Mamo Wubshet; Qingyang Xiao; Gelin Xu; Ajit Kumar Yadav; Bereket Yakob; Yuichiro Yano; Mehdi Yaseri; Pengpeng Ye; Henock Gebremedhin Yebyo; Paul Yip; Naohiro Yonemoto; Seok-Jun Yoon; Mustafa Z Younis; Chuanhua Yu; Zoubida Zaidi; Maysaa El Sayed Zaki; Hajo Zeeb; Hao Zhang; Yong Zhao; Yingfeng Zheng; Maigeng Zhou; Sanjay Zodpey; Christopher J L Murray
Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1–4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980–2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age–sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, 5·8 million (95% uncertainty interval [UI] 5·7–6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7–53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3–43·6) to 2·6 million (2·6–2·7) neonatal deaths and 47·0% (35·1–57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6–3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Interpretation Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license.
Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000–18: a geospatial modelling study
(Elsevier Ltd, 2022) Joseph Jon Frostad; QuynhAnh P. Nguyen; Mathew M. Baumann; Brigette F. Blacker; Laurie B. Marczak; Aniruddha Deshpande; Kirsten E. Wiens; Kate E. LeGrand; Kimberly B. Johnson; Mohsen Abbasi-Kangevari; Amir Abdoli; Hassan Abolhassani; Lucas Guimarães Abreu; Michael R. M. Abrigo; Niveen M.E. Abu-Rmeileh; Victor Adekanmbi; Anurag Agrawal; Muktar Beshir Ahmed; Ziyad Al-Aly; Fahad Mashhour Alanezi; Jacqueline Elizabeth Alcalde-Rabanal; Vahid Alipour; Khalid A. Altirkawi; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Adeladza Kofi Amegah; Saeed Amini; Fatemeh Amiri; Dickson A. Amugsi; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Ernoiz Antriyandarti; Davood Anvari; Jalal Arabloo; Morteza Arab-Zozani; Seyyed Shamsadin Athari; Marcel Ausloos; Getinet Ayano; Yared Asmare Aynalem; Samad Azari; Ashish D. Badiye; Atif Amin Baig; Kalpana Balakrishnan; Maciej Banach; Sanjay Basu; Neeraj Bedi; Michelle L. Bell; Derrick A. Bennett; Krittika Bhattacharyya; Zulfiqar A. Bhutta; Sadia Bibi; Somayeh Bohlouli; Soufiane Boufous; Nicola Luigi Bragazzi; Dejana Braithwaite; Sharath Burugina Nagaraja; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Josip Car; Rosario Cárdenas; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Ester Cerin; Soosanna Kumary Chattu; Vijay Kumar Chattu; Pankaj Chaturvedi; Sarika Chaturvedi; Simiao Chen; Dinh-Toi Chu; Sheng-Chia Chung; Saad M. A. Dahlawi; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; Aso Mohammad Darwesh; Jai K. Das; Aditya Prasad Dash; Claudio Alberto Dávila-Cervantes; Diego De Leo; Jan-Walter De Neve; Getu Debalkie Demissie; Edgar Denova-Gutiérrez; Sagnik Dey; Samath Dhamminda Dharmaratne; Meghnath Dhimal; Govinda Prasad Dhungana; Daniel Diaz; Isaac Oluwafemi Dipeolu; Fariba Dorostkar; Leila Doshmangir; Andre Rodrigues Duraes; Hisham Atan Edinur; Ferry Efendi; Maha El Tantawi; Sharareh Eskandarieh; Ibtihal Fadhil; Nazir Fattahi; Nelsensius Klau Fauk; Seyed-Mohammad Fereshtehnejad; Morenike Oluwatoyin Folayan; Masoud Foroutan; Takeshi Fukumoto; Abhay Motiramji Gaidhane; Mansour Ghafourifard; Ahmad Ghashghaee; Syed Amir Gilani; Tiffany K. Gill; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Mohammed Ibrahim Mohialdeen Gubari; Davide Guido; Yuming Guo; Rajat Das Gupta; Rajeev Gupta; Reyna Alma Gutiérrez; Nima Hafezi-Nejad; Randah R. Hamadeh; Ahmed I. Hasaballah; Soheil Hassanipour; Khezar Hayat; Behzad Heibati; Reza Heidari-Soureshjani; Nathaniel J. Henry; Claudiu Herteliu; Mehdi Hosseinzadeh; Mohamed Hsairi; Guoqing Hu; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Chidozie C. D. Iwu; Jalil Jaafari; Mihajlo Jakovljevic; Tahereh Javaheri; Ravi Prakash Jha; John S. Ji; Jost B. Jonas; Ali Kabir; Zubair Kabir; Rohollah Kalhor; Naser Kamyari; Tanuj Kanchan; Umesh Kapil; Neeti Kapoor; Gbenga A. Kayode; Peter Njenga Keiyoro; Yousef Saleh Khader; Nauman Khalid; Ejaz Ahmad Khan; Maseer Khan; Md Nuruzzaman Khan; Khaled Khatab; Mona M. Khater; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Jagdish Khubchandani; Gyu Ri Kim; Yun Jin Kim; Ruth W. Kimokoti; Adnan Kisa; Sezer Kisa; Luke D. Knibbs; Parvaiz A. Koul; Ai Koyanagi; Kewal Krishan; G. Anil Kumar; Manasi Kumar; Dian Kusuma; Carlo La Vecchia; Ben Lacey; Faris Hasan Lami; Qing Lan; Savita Lasrado; Paolo Lauriola; Paul H. Lee; Sonia Lewycka; Shanshan Li; Daiane Borges Machado; Phetole Walter Mahasha; Mina Maheri; Azeem Majeed; Afshin Maleki; Reza Malekzadeh; Deborah Carvalho Malta; Borhan Mansouri; Mohammad Ali Mansournia; Natalie Maria Martinez; Santi Martini; Francisco Rogerlândio Martins-Melo; Benjamin K. Mayala; Man Mohan Mehndiratta; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; Tuomo J. Meretoja; Tomislav Mestrovic; Irmina Maria Michalek; Erkin M. Mirrakhimov; Maryam Mirzaei; Roya Mirzaei; Babak Moazen; Yousef Mohammad; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Ali H. Mokdad; Lorenzo Monasta; Maziar Moradi-Lakeh; Paula Moraga; Lidia Morawska; Abbas Mosapour; Simin Mouodi; Amin Mousavi Khaneghah; Satinath Mukhopadhyay; Sandra B. Munro; Christopher J. L. Murray; Ahamarshan Jayaraman Nagarajan; Mohsen Naghavi; Sanjeev Nair; Vinay Nangia; Bruno Ramos Nascimento; Javad Nazari; Ionut Negoi; Henok Biresaw Netsere; Josephine W. Ngunjiri; Huong Lan Thi Nguyen; Jean Jacques Noubiap; Bogdan Oancea; Felix Akpojene Ogbo; In-Hwan Oh; Andrew T. Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Ahmed Omar Bali; Obinna E. Onwujekwe; Nikita Otstavnov; Stanislav S. Otstavnov; Mayowa O. Owolabi; P.A. Mahesh; Anamika Pandey; Eun-Cheol Park; Eun-Kee Park; Sangram Kishor Patel; Hai Quang Pham; Thomas Pilgrim; Meghdad Pirsaheb; Khem Narayan Pokhrel; Maarten J. Postma; Zahiruddin Quazi Syed; Navid Rabiee; Amir Radfar; Fakher Rahim; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Chhabi Lal Ranabhat; Sowmya J. Rao; Davide Rasella; Prateek Rastogi; Goura Kishor Rath; David Laith Rawaf; Salman Rawaf; Lal Rawal; Reza Rawassizadeh; Andre M. N. Renzaho; Bhageerathy Reshmi; Negar Rezaei; Nima Rezaei; Aziz Rezapour; Jennifer Rickard; Leonardo Roever; Luca Ronfani; Morteza Rostamian; Enrico Rubagotti; Godfrey M. Rwegerera; Basema Saddik; Ehsan Sadeghi; Sahar Saeedi Moghaddam; Rajesh Sagar; Amirhossein Sahebkar; Biniyam Sahiledengle; Marwa Rashad Salem; Abdallah M. Samy; Milena M. Santric-Milicevic; Sivan Yegnanarayana Iyer Saraswathy; Brijesh Sathian; Thirunavukkarasu Sathish; David C. Schwebel; Sadaf G. Sepanlou; Saeed Shahabi; Amira A. Shaheen; Izza Shahid; Masood Ali Shaikh; Ali S. Shalash; Mehran Shams-Beyranvand; Mohammed Shannawaz; Kiomars Sharafi; Aziz Sheikh; Sara Sheikhbahaei; Ranjitha S. Shetty; Wondimeneh Shibabaw Shiferaw; Mika Shigematsu; Jae Il Shin; K.M. Shivakumar; Soraya Siabani; Tariq Jamal Siddiqi; Balbir Bagicha Singh; Jasvinder A. Singh; Yitagesu Sintayehu; Muluken Bekele Sorrie; Ireneous N. Soyiri; Emma Elizabeth Spurlock; Chandrashekhar T. Sreeramareddy; Leo Stockfelt; Mu'awiyyah Babale Sufiyan; Rizwan Suliankatchi Abdulkader; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Amir Taherkhani; Mohamad-Hani Temsah; Kavumpurathu Raman Thankappan; Marcos Roberto Tovani-Palone; Eugenio Traini; Saif Ullah; Bhaskaran Unnikrishnan; Era Upadhyay; Sahel Valadan Tahbaz; Santosh Varughese; Francesco S. Violante; Bay Vo; Giang Thu Vu; Yasir Waheed; Yuan-Pang Wang; Catherine A. Welgan; Andrea Werdecker; Seyed Hossein Yahyazadeh Jabbari; Sanni Yaya; Vahid Yazdi-Feyzabadi; Mekdes Tigistu Yilma; Naohiro Yonemoto; Mustafa Z. Younis; Taraneh Yousefinezhadi; Chuanhua Yu; Yong Yu; Sojib Bin Zaman; Yunquan Zhang; Zhi-Jiang Zhang; Michael Brauer; Simon I. Hay; Robert C. Reiner
Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. 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. Adsuar; Mohsen Afarideh; Mahdi Afshari; Ashkan Afshin; Gina Agarwal; Sargis Aghasi Aghayan; Dominic Agius; Anurag Agrawal; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Sayem Ahmed; Temesgen Yihunie Akalu; Ali S. Akanda; Mohammad Esmaeil Akbari; Mohammed Akibu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Nadia Akseer; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Tahiya Alam; Ammar Albujeer; Animut Alebel; Kefyalew Addis Alene; Ayman Al-Eyadhy; Samia Alhabib; Raghib Ali; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala'a Alkerwi; François Alla; Peter Allebeck; Christine A. Allen; Ali Almasi; Fatma Al-Maskari; Hesham M. Al-Mekhlafi; Jordi Alonso; Rajaa M. Al-Raddadi; Ubai Alsharif; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Kebede Amenu; Erfan Amini; Walid Ammar; Nahla Hamed Anber; Jason A. Anderson; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Hossein Ansari; Ansariadi Ansariadi; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Palwasha Anwari; Lambert Tetteh Appiah; Olatunde Aremu; Habtamu Abera Areri; Johan Ärnlöv; Monika Arora; Krishna K. Aryal; Hamid Asayesh; Ephrem Tsegay Asfaw; Solomon Weldegebreal Asgedom; Rana Jawad Asghar; Reza Assadi; Zerihun Ataro; Suleman Atique; Sachin R. Atre; Madhu Sudhan Atteraya; Marcel Ausloos; Leticia Avila-Burgos; Euripide F. G. A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Henok Tadesse Ayele; Yohanes Ayele; Rakesh Ayer; Mahmoud Reza Azarpazhooh; Peter S. Azzopardi; Natasha Azzopardi-Muscat; Tesleem Kayode Babalola; Arefeh Babazadeh; Hamid Badali; Alaa Badawi; Kalpana Balakrishnan; Ayele Geleto Bali; Maciej Banach; Amitava Banerjee; Joseph Adel Mattar Banoub; Amrit Banstola; Aleksandra Barac; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Celine M. Barthelemy; Quique Bassat; Arindam Basu; Sanjay Basu; Robert J. Battista; Bernhard T. Baune; Habtamu Wondifraw Baynes; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Béjot; Bayu Begashaw Bekele; Abate Bekele Belachew; Aregawi Gebreyesus Belay; Saba Abraham Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Habib Benzian; Adugnaw Berhane; Abadi Kidanemariam Berhe; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Mircea Beuran; Tina Beyranvand; Neeraj Bhala; Ashish Bhalla; Anil Bhansali; Suraj Bhattarai; Soumyadeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Molly H. Biehl; Ali Bijani; Boris Bikbov; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Sait Mentes Birlik; Charles Birungi; Donal Bisanzio; Tuhin Biswas; Helen Bitew; Hailemichael Bizuneh; Espen Bjertness; Eshetu Mulisa Bobasa; Soufiane Boufous; Rupert Bourne; Kayvan Bozorgmehr; Nicola Luigi Bragazzi; Michael Brainin; Luisa C. Brant; Michael Brauer; Alexandra Brazinova; Nicholas J. K. Breitborde; Paul Svitil Briant; Gabrielle Britton; Traolach Brugha; Gene Bukhman; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Charlton S.K.H. Callender; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jorge Cano; Josip Car; Mate Car; Rosario Cárdenas; Juan J. Carrero; Austin Carter; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; Kate Causey; Alanur Çavlin; Kelly M. Cercy; Ester Cerin; Yazan Chaiah; Julian Chalek; Hsing-Yi Chang; Jung-Chen Chang; Aparajita Chattopadhyay; Vijay Kumar Chattu; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Ken Lee Chin; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Jee-Young J. Choi; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Thomas Khaled Dwayne Claßen; Aaron J. Cohen; Daniel Collado-Mateo; Cyrus Cooper; Leslie Trumbull Cooper; Leslie Cornaby; Monica Cortinovis; Megan Costa; Ewerton Cousin; Elizabeth A. Cromwell; Christopher Stephen Crowe; Matthew Cunningham; Alemneh Kabeta Daba; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Anh Kim Dang; Paul I. Dargan; Ahmad Daryani; Siddharth K. Das; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Adrian C. Davis; Dragos Virgil Davitoiu; Kairat Davletov; Anand Dayama; Barbora De Courten; Diego De Leo; Jan-Walter De Neve; Hans De Steur; Meaza Girma Degefa; Louisa Degenhardt; Tizta Tilahun Degfie; Selina Deiparine; Robert P. Dellavalle; Gebre Teklemariam Demoz; Balem Demtsu; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Getenet Ayalew Dessie; Subhojit Dey; Samath D. Dharmaratne; Meghnath Dhimal; Daniel Dicker; Mesfin Tadese Dinberu; Eric L. Ding; Shirin Djalalinia; Huyen Phuc Do; Klara Dokova; David Teye Doku; Dirk Douwes-Schultz; Tim Robert Driscoll; Leilei Duan; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Soheil Ebrahimpour; David Edvardsson; Charbel El Bcheraoui; Erika Eldrenkamp; Ziad El-Khatib; Iqbal R.F. Elyazar; Ahmadali Enayati; Aman Yesuf Endries; Babak Eshrati; Sharareh Eskandarieh; Alireza Esteghamati; Sadaf Esteghamati; Kara Estep; Mahdi Fakhar; Hamed Fakhim; Jessica Fanzo; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Talha A. Farid; Carla Sofia E. Sá Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Hossein Farzam; Ali Akbar Fazaeli; Mir Sohail Fazeli; Valery L. Feigin; Andrea B. Feigl; Wubalem Fekadu; Rachel Feldman; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Garumma Tolu Feyissa; Daniel Obadare Fijabi; Irina Filip; Samuel Finegold; Jonas David Finger; Florian Fischer; Christina Fitzmaurice; Luisa Sorio Flor; Nataliya A. Foigt; Kyle J. Foreman; Tahvi D. Frank; Richard Charles Franklin; Takeshi Fukumoto; Kai Fukutaki; John E. Fuller; Thomas Fürst; João M. Furtado; Emmanuela Gakidou; Silvano Gallus; Fortune Gbetoho Gankpe; Ron T. Gansevoort; Ana Cristina Garcia; Alberto L. Garcia-Basteiro; Miguel A. Garcia-Gordillo; William M. Gardner; Abadi Kahsu Gebre; Teshome Gebre; Gebremedhin Berhe Gebregergs; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Bereket Gebremichael; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Yilma Chisha Dea Geramo; Sefonias Getachew; Peter W. Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Keyghobad Ghadiri; Maryam Ghasemi-Kasman; Hesam Ghiasvand; Mamata Ghimire; Aloke Gopal Ghoshal; Simona Giampaoli; Paramjit Singh Gill; Tiffany K. Gill; Giorgia Giussani; Elena V. Gnedovskaya; Ellen M. Goldberg; Srinivas Goli; Philimon N. Gona; Amador Goodridge; Sameer Vali Gopalani; Taren M. Gorman; Atsushi Goto; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Max G. Griswold; Giuseppe Grosso; Harish Chander C. Gugnani; Francis Guillemin; Andre Luiz Sena Guimaraes; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Giang Hai Ha; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Hassan Haghparast Bidgoli; Tekleberhan B. Hagos; Michael Tamene Haile; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Hamidreza Haririan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Caitlin N. Hawley; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Behnam Heidari; Mohsen Heidari; Delia Hendrie; Andualem Henok; Ileana Heredia-Pi; Claudiu Herteliu; Behzad Heydarpour; Fatemeh Heydarpour; Sousan Heydarpour; Desalegn T. Hibstu; Martha Híjar; Hans W. Hoek; Daniel J. Hoffman; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; Nobuyuki Horita; H. Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Peter J. Hotez; Damian G. Hoy; Mohamed Hsairi; Thomas Hsiao; Guoqing Hu; John J. Huang; Caitlyn Hughes; Chantal K. Huynh; Ehimario U. Igumbor; Chad Thomas Ikeda; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Sheikh Mohammed Shariful Islam; Farhad Islami; Rebecca Q. Ivers; Neda Izadi; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Moti Tolera Jalu; Amr A. Jamal; Spencer L. James; Simerjot K. Jassal; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Catherine O. Johnson; Sarah C. Johnson; Jost B. Jonas; Jitendra Jonnagaddala; Zahra Jorjoran Shushtari; Ankur Joshi; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jürisson; K. Madhanraj; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Molla Kahssay; Rizwan Kalani; Umesh Kapil; Manoochehr Karami; Behzad Karami Matin; Marina Karanikolos; Narges Karimi; Seyed M. Karimi; Hamidreza Karimi-Sari; Amir Kasaeian; Dessalegn H. 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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
Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years: an analysis of the Global Burden of Disease Study 2017
(Elsevier Ltd, 2020) Christopher E Troeger; Ibrahim A Khalil; Brigette F Blacker; Molly H Biehl; Samuel B Albertson; Stephanie R M Zimsen; Puja C Rao; Degu Abate; Alireza Ahmadi; Mohamed Lemine Cheikh Brahim Ahmed; Chalachew Genet Akal; Fares Alahdab; Noore Alam; Kefyalew Addis Alene; Vahid Alipour; Syed Mohamed Aljunid; Rajaa M Al-Raddadi; Nelson Alvis-Guzman; Saeed Amini; Nahla Hamed Anber; Mina Anjomshoa; Carl Abelardo T Antonio; Jalal Arabloo; Olatunde Aremu; Hagos Tasew Atalay; Suleman Atique; Euripide F G A Avokpaho; Samah Awad; Ashish Awasthi; Alaa Badawi; Kalpana Balakrishnan; Joseph Adel Mattar Banoub; Aleksandra Barac; Quique Bassat; Neeraj Bedi; Derrick A Bennett; Krittika Bhattacharyya; Zulfiqar A Bhutta; Ali Bijani; Josip Car; Félix Carvalho; Carlos A Castañeda-Orjuela; Devasahayam J Christopher; Lalit Dandona; Rakhi Dandona; Ahmad Daryani; Feleke Mekonnen Demeke; Aniruddha Deshpande; Shirin Djalalinia; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Maysaa El Sayed Zaki; Aman Yesuf Endries; Eduarda Fernandes; Florian Fischer; Nancy Fullman; William M Gardner; Birhanu Geta; Keyghobad Ghadiri; Giuseppe Gorini; Alessandra C Goulart; Yuming Guo; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Samer Hamidi; Hamid Yimam Hassen; Chi Linh Hoang; Mihaela Hostiuc; Zakir Hussain; Seyed Sina Naghibi Irvani; Spencer L James; Ravi Prakash Jha; Jost B Jonas; André Karch; Amir Kasaeian; Tesfaye Dessale Kassa; Nicholas J Kassebaum; Adane Teshome Kefale; Yousef Saleh Khader; Ejaz Ahmad Khan; Md Nuruzzaman Khan; Young-Ho Khang; Abdullah T Khoja; Ruth W Kimokoti; Adnan Kisa; Sezer Kisa; Niranjan Kissoon; Sonali Kochhar; Soewarta Kosen; Ai Koyanagi; Barthelemy Kuate Defo; G Anil Kumar; Dharmesh Kumar Lal; Cheru Tesema Leshargie; Shanshan Li; Rakesh Lodha; Erlyn Rachelle King MacArayan; Marek Majdan; Abdullah A Mamun; H. Manguerra; Addisu Melese; Ziad A Memish; Desalegn Tadese Mengistu; Tuomo J Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Erkin M Mirrakhimov; Babak Moazen; Karzan Abdulmuhsin Mohammad; Shafiu Mohammed; Lorenzo Monasta; Catrin E Moore; Jonathan F Mosser; Seyyed Meysam Mousavi; Srinivas Murthy; Ghulam Mustafa; Javad Nazari; Cuong Tat Nguyen; Long Hoang Nguyen; Muhammad Imran Nisar; Molly R Nixon; Felix Akpojene Ogbo; Anselm Okoro; Andrew T Olagunju; Tinuke O Olagunju; P.A. Mahesh; Smita Pakhale; Maarten J Postma; Mostafa Qorbani; Reginald Quansah; Alireza Rafiei; Fakher Rahim; Vafa Rahimi-Movaghar; Rajesh Kumar Rai; Mohammad Sadegh Rezai; Aziz Rezapour; Maria Jesus Rios-Blancas; Luca Ronfani; Katherine Rosettie; Dietrich Rothenbacher; Saeed Safari; Zikria Saleem; Evanson Zondani Sambala; Abdallah M Samy; Milena M Santric Milicevic; Benn Sartorius; Monika Sawhney; Seyedmojtaba Seyedmousavi; Masood Ali Shaikh; Aziz Sheikh; Mika Shigematsu; David L Smith; Joan B Soriano; Chandrashekhar T Sreeramareddy; Jeffrey D Stanaway; Mu'Awiyyah Babale Sufiyan; Teklay G E Teklu; Mohamad-Hani Temsah; Belay Tessema; Bach Xuan Tran; Khanh Bao Tran; Irfan Ullah; Rachel L Updike; Tommi Juhani Vasankari; Yousef Veisani; Fiseha Wadilo Wada; Yasir Waheed; Marcia Weaver; Kirsten E Wiens; Charles Shey Wiysonge; Ebrahim M Yimer; Naohiro Yonemoto; Zoubida Zaidi; Heather J Zar; Afshin Zarghi; Stephen S Lim; Theo Vos; Ali H Mokdad; Christopher J L Murray; Hmwe Hmwe Kyu; Simon I Hay; Robert C Reiner
Background: Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods: This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings: Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162–593 145) among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1–87·1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69·6% (63·1–74·6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2–15·5), childhood wasting (9·9% decrease, 9·6–10·2), and low use of oral rehydration solution (6·9% decrease, 4·8–8·4). Interpretation: Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors—particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution—appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. 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
Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years: an analysis for the Global Burden of Disease Study 2017
(Elsevier Ltd, 2020) Christopher E. Troeger; Ibrahim A. Khalil; Brigette F. Blacker; Molly H. Biehl; Samuel B. Albertson; Stephanie R.M. Zimsen; Puja C. Rao; Degu Abate; Amha Admasie; Alireza Ahmadi; Mohamed Lemine Cheikh Brahim Ahmed; Chalachew Genet Akal; Fares Alahdab; Noore Alam; Kefyalew Addis Alene; Vahid Alipour; Syed Mohamed Aljunid; Rajaa M. Al-Raddadi; Nelson Alvis-Guzman; Saeed Amini; Mina Anjomshoa; Carl Abelardo T. Antonio; Jalal Arabloo; Olatunde Aremu; Hagos Tasew Atalay; Suleman Atique; Euripide F.G.A. Avokpaho; Samah Awad; Ashish Awasthi; Alaa Badawi; Kalpana Balakrishnan; Joseph Adel Mattar Banoub; Aleksandra Barac; Quique Bassat; Neeraj Bedi; Derrick A. Bennett; Krittika Bhattacharyya; Zulfiqar A. Bhutta; Ali Bijani; Corey B. Bills; Josip Car; Félix Carvalho; Carlos A. Castañeda-Orjuela; Kate Causey; Devasahayam J. Christopher; Aaron J. Cohen; Lalit Dandona; Rakhi Dandona; Ahmad Daryani; Feleke Mekonnen Demeke; Shirin Djalalinia; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Maysaa El Sayed Zaki; Aman Yesuf Endries; Eduarda Fernandes; Florian Fischer; Joseph Frostad; Nancy Fullman; William M. Gardner; Birhanu Geta; Keyghobad Ghadiri; Giuseppe Gorini; Alessandra C. Goulart; Yuming Guo; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Samer Hamidi; Hamid Yimam Hassen; Chi Linh Hoang; Nobuyuki Horita; Mihaela Hostiuc; Zakir Hussain; Seyed Sina Naghibi Irvani; Spencer L. James; Ravi Prakash Jha; Jost B. Jonas; André Karch; Amir Kasaeian; Tesfaye Dessale Kassa; Nicholas J. Kassebaum; Adane Teshome Kefale; Yousef Saleh Khader; Ejaz Ahmad Khan; Gulfaraz Khan; Md Nuruzzaman Khan; Young-Ho Khang; Abdullah T. Khoja; Ruth W. Kimokoti; Adnan Kisa; Sezer Kisa; Niranjan Kissoon; Luke D. Knibbs; Sonali Kochhar; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Barthelemy Kuate Defo; G. Anil Kumar; Dharmesh Kumar Lal; Cheru Tesema Leshargie; Sonia Lewycka; Shanshan Li; Rakesh Lodha; Erlyn Rachelle King MacArayan; Marek Majdan; Abdullah A. Mamun; Helena Manguerra; Varshil Mehta; Addisu Melese; Ziad A. Memish; Desalegn Tadese Mengistu; Tuomo J. Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Erkin M. Mirrakhimov; Babak Moazen; Karzan Abdulmuhsin Mohammad; Shafiu Mohammed; Lorenzo Monasta; Catrin E. Moore; Lidia Morawska; Jonathan F. Mosser; Seyyed Meysam Mousavi; Srinivas Murthy; Ghulam Mustafa; Javad Nazari; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Long Hoang Nguyen; Son Hoang Nguyen; Katie R. Nielsen; Muhammad Imran Nisar; Molly R. Nixon; Felix Akpojene Ogbo; Anselm Okoro; Andrew T. Olagunju; Tinuke O. Olagunju; Eyal Oren; Justin R. Ortiz; P.A. Mahesh; Smita Pakhale; Maarten J. Postma; Mostafa Qorbani; Reginald Quansah; Alireza Rafiei; Fakher Rahim; Vafa Rahimi-Movaghar; Rajesh Kumar Rai; Marissa Bettay Reitsma; Mohammad Sadegh Rezai; Aziz Rezapour; Maria Jesus Rios-Blancas; Luca Ronfani; Dietrich Rothenbacher; Salvatore Rubino; Zikria Saleem; Evanson Zondani Sambala; Abdallah M. Samy; Milena M. Santric Milicevic; Rodrigo Sarmiento-Suárez; Benn Sartorius; Miloje Savic; Monika Sawhney; Sonia Saxena; Alyssa Sbarra; Seyedmojtaba Seyedmousavi; Masood Ali Shaikh; Aziz Sheikh; Mika Shigematsu; David L. Smith; Chandrashekhar T. Sreeramareddy; Jeffrey D. Stanaway; Mu awiyyah Babale Sufiyan; Mohamad-Hani Temsah; Belay Tessema; Bach Xuan Tran; Khanh Bao Tran; Afewerki Gebremeskel Tsadik; Irfan Ullah; Rachel L. Updike; Tommi Juhani Vasankari; Yousef Veisani; Fiseha Wadilo Wada; Yasir Waheed; Katie Welgan; Kirsten E. Wiens; Charles Shey Wiysonge; Ebrahim M. Yimer; Naohiro Yonemoto; Zoubida Zaidi; Heather J. Zar; Stephen S. Lim; Theo Vos; Ali H. Mokdad; Christopher J.L. Murray; Hmwe Hmwe Kyu; Simon I. Hay; Robert C. Reiner
Background: Despite large reductions in under-5 lower respiratory infection (LRI) mortality in many locations, the pace of progress for LRIs has generally lagged behind that of other childhood infectious diseases. To better inform programmes and policies focused on preventing and treating LRIs, we assessed the contributions and patterns of risk factor attribution, intervention coverage, and sociodemographic development in 195 countries and territories by drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) LRI estimates. Methods: We used four strategies to model LRI burden: the mortality due to LRIs was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive ensemble modelling tool; the incidence of LRIs was modelled using population representative surveys, health-care utilisation data, and scientific literature in a compartmental meta-regression tool; the attribution of risk factors for LRI mortality was modelled in a counterfactual framework; and trends in LRI mortality were analysed applying changes in exposure to risk factors over time. In GBD, infectious disease mortality, including that due to LRI, is among HIV-negative individuals. We categorised locations based on their burden in 1990 to make comparisons in the changing burden between 1990 and 2017 and evaluate the relative percent change in mortality rate, incidence, and risk factor exposure to explain differences in the health loss associated with LRIs among children younger than 5 years. Findings: In 2017, LRIs caused 808 920 deaths (95% uncertainty interval 747 286–873 591) in children younger than 5 years. Since 1990, there has been a substantial decrease in the number of deaths (from 2 337 538 to 808 920 deaths; 65·4% decrease, 61·5–68·5) and in mortality rate (from 362·7 deaths [330·1–392·0] per 100 000 children to 118·9 deaths [109·8–128·3] per 100 000 children; 67·2% decrease, 63·5–70·1). LRI incidence declined globally (32·4% decrease, 27·2–37·5). The percent change in under-5 mortality rate and incidence has varied across locations. Among the risk factors assessed in this study, those responsible for the greatest decrease in under-5 LRI mortality between 1990 and 2017 were increased coverage of vaccination against Haemophilus influenza type b (11·4% decrease, 0·0–24·5), increased pneumococcal vaccine coverage (6·3% decrease, 6·1–6·3), and reductions in household air pollution (8·4%, 6·8–9·2). Interpretation: Our findings show that there have been substantial but uneven declines in LRI mortality among countries between 1990 and 2017. Although improvements in indicators of sociodemographic development could explain some of these trends, changes in exposure to modifiable risk factors are related to the rates of decline in LRI mortality. No single intervention would universally accelerate reductions in health loss associated with LRIs in all settings, but emphasising the most dominant risk factors, particularly in countries with high case fatality, can contribute to the reduction of preventable deaths. 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