Browsing by Author "Laura Dwyer-Lindgren"

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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Mohsen Naghavi; Kanyin Liane Ong; Amirali Aali; Hazim S. Ababneh; Yohannes Habtegiorgis Abate; Cristiana Abbafati; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Deldar Morad Abdulah; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Aidin Abedi; Kedir Hussein Abegaz; E.S. Abhilash; Hassan Abidi; Olumide Abiodun; Richard Gyan Aboagye; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimaraes Abreu; Woldu Aberhe Abrha; Dariush Abtahi; Samir Abu Rumeileh; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen Me Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Manfred Mario Kokou Accrombessi; Tadele Girum Adal; Abdu A. Adamu; Isaac Yeboah Addo; Giovanni Addolorato; Akindele Olupelumi Adebiyi; Victor Adekanmbi; Abiola Victor Adepoju; Charles Oluwaseun Adetunji; Juliana Bunmi Adetunji; Temitayo Esther Adeyeoluwa; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Biruk Adie Admass; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Aanuoluwapo Adeyimika Afolabi; Muhammad Sohail Afzal; Saira Afzal; Suneth Buddhika Agampodi; Pradyumna Agasthi; Manik Aggarwal; Shahin Aghamiri; Feleke Doyore Agide; Antonella Agodi; Anurag Agrawal; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M Ahmad; Sajjad Ahmad; Shahzaib Ahmad; Tauseef Ahmad; Keivan Ahmadi; Amir Mahmoud Ahmadzade; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Mehrunnisha Sharif Ahmed; Meqdad Saleh Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Essona Matatom Akara; Hossein Akbarialiabad; Karolina Akinosoglou; Tomi Akinyemiju; Mohammed Ahmed Akkaif; Samuel Akyirem; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Fares Alahdab; Samer O. Alalalmeh; Tariq A. Alalwan; Ziyad Al-Aly; Khurshid Alam; Manjurul Alam; Noore Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Sayer Al-Azzam; Almaza Albakri; Mohammed Albashtawy; Mohammad T. AlBataineh; Jacqueline Elizabeth Alcalde-Rabanal; Khalifah A. Aldawsari; Wafa A. Aldhaleei; Robert W. Aldridge; Haileselasie Berhane Alema; Mulubirhan Assefa Alemayohu; Sharifullah Alemi; Yihun Mulugeta Alemu; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Khaled Al-Hanawi; Abid Ali; Amjad Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Shahid Ali; Syed Shujait Shujait Ali; Gianfranco Alicandro; Sheikh Mohammad Alif; Reyhaneh Alikhani; Yousef Alimohamadi; Ahmednur Adem Aliyi; Mohammad A. M. Aljasir; Syed Mohamed Aljunid; Francois Alla; Peter Allebeck; Sabah Al-Marwani; Sadeq Ali Ali Al-Maweri; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Louay Almidani; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jordi Alonso; Jaber S. Alqahtani; Shehabaldin Alqalyoobi; Ahmed Yaseen Alqutaibi; Salman Khalifah Al-Sabah; Zaid Altaany; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Reza Amani; Azmeraw T. Amare; Prince M. Amegbor; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Sohrab Amiri; Mohammad Hosein Amirzade-Iranaq; Hubert Amu; Dickson A. Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; David B. Anderson; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Colin Angus; Abhishek Anil; Sneha Anil; Amir Anoushiravani; Hossein Ansari; Ansariadi Ansariadi; Alireza Ansari-Moghaddam; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Saeid Anvari; Saleha Anwar; Sumadi Lukman Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Muhammad Aqeel; Juan Pablo Arab; Jalal Arabloo; Mosab Arafat; Aleksandr Y. Aravkin; Demelash Areda; Abdulfatai Aremu; Olatunde Aremu; Hany Ariffin; Mesay Arkew; Benedetta Armocida; Michael Benjamin Arndt; Johan Arnlov; Mahwish Arooj; Anton A. Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Ashokan Arumugam; Malke Asaad; Mohsen Asadi-Lari; Akeza Awealom Asgedom; Mona Asghariahmadabad; Mohammad Asghari-Jafarabadi; Muhammad Ashraf; Armin Aslani; Thomas Astell-Burt; Mohammad Athar; Seyyed Shamsadin Athari; Bantalem Tilaye Tilaye Atinafu; Habtamu Wondmagegn Atlaw; Prince Atorkey; Maha Moh'D Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Atalel Fentahun Awedew; Amlaku Mulat Aweke; Beatriz Paulina Ayala Quintanilla; Haleh Ayatollahi; Jose L. Ayuso-Mateos; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Rui M. S. Azevedo; Ahmed Y. Azzam; B.B. Darshan; Abraham Samuel Babu; Muhammad Badar; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Sulaiman Bah; Saeed Bahadorikhalili; Najmeh Bahmanziari; Ruhai Bai; Atif Amin Baig; Jennifer L. Baker; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Senthilkumar Balakrishnan; Madhan Balasubramanian; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Palash Chandra Banik; Hansi Bansal; Kannu Bansal; Franca Barbic; Martina Barchitta; Mainak Bardhan; Erfan Bardideh; Suzanne Lyn Barker-Collo; Till Winfried Barnighausen; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Lope H. Barrero; Amadou Barrow; Sandra Barteit; Lingkan Barua; Zarrin Basharat; Azadeh Bashiri; Afisu Basiru; Pritish Baskaran; Buddha Basnyat; Quique Bassat; João Diogo Basso; Ann V. L. Basting; Sanjay Basu; Kavita Batra; Bernhard T. Baune; Mohsen Bayati; Nebiyou Simegnew Bayileyegn; Thomas Beaney; Neeraj Bedi; Massimiliano Beghi; Emad Behboudi; Priyamadhaba Behera; Amir Hossein Behnoush; Masoud Behzadifar; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Yannick Béjot; Sefealem Assefa Belay; Chalie Mulu Belete; Michelle L. Bell; Muhammad Bashir Bello; Olorunjuwon Omolaja Bello; Luis Belo; Apostolos Beloukas; Rose Grace Bender; Isabela M. Bensenor; Azizullah Beran; Zombor Berezvai; Alemshet Yirga Berhie; Betyna N. Berice; Robert S. Bernstein; Gregory J. Bertolacci; Paulo J. G. Bettencourt; Kebede A. Beyene; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Dinesh Bhandari; Kayleigh Bhangdia; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Ashish Bhargava; Sonu Bhaskar; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Manpreet S. Bhatti; Rajbir Bhatti; Zulfiqar A. Bhutta; Boris Bikbov; Jessica Devin Bishai; Catherine Bisignano; Francesca Bisulli; Atanu Biswas; Bijit Biswas; Saeid Bitaraf; Bikes Destaw Bitew; Veera R. Bitra; Tone Bjørge; Micheal Kofi Boachie; Mary Sefa Boampong; Anca Vasilica Bobirca; Virginia Bodolica; Aadam Olalekan Bodunrin; Eyob Ketema Bogale; Kassawmar Angaw Bogale; Somayeh Bohlouli; Obasanjo Afolabi Bolarinwa; Archith Boloor; Milad Bonakdar Hashemi; Aime Bonny; Kaustubh Bora; Berrak Bora Basara; Hamed Borhany; Arturo Borzutzky; Souad Bouaoud; Antoine Boustany; Christopher Boxe; Edward J. Boyko; Oliver J. Brady; Dejana Braithwaite; Luisa C. Brant; Michael Brauer; Alexandra Brazinova; Javier Brazo-Sayavera; Nicholas J. K. Breitborde; Susanne Breitner; Hermann Brenner; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Gabrielle Britton; Julie Brown; Traolach Brugha; Norma B. Bulamu; Lemma N. Bulto; Danilo Buonsenso; Richard A. Burns; Reinhard Busse; Yasser Bustanji; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Daniela Calina; Luis Alberto Camera; Luciana Aparecida Campos; Ismael R. Campos-Nonato; Chao Cao; Yin Cao; Angelo Capodici; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Juan J. Carrero; Andrea Carugno; Cristina G. Carvalheiro; Felix Carvalho; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Ferrán Catalá-López; Alberico L. Catapano; Maria Sofia Cattaruzza; Christopher R. Cederroth; Luca Cegolon; Francieli Cembranel; Muthia Cenderadewi; Kelly M. Cercy; Ester Cerin; Muge Cevik; Joshua Chadwick; Yaacoub Chahine; Chiranjib Chakraborty; Promit Ananyo Chakraborty; Jeffrey Shi Kai Chan; Raymond N. C. Chan; Rama Mohan Chandika; Eeshwar K. Chandrasekar; Chin-Kuo Chang; Jung-Chen Chang; Gashaw Sisay Chanie; Periklis Charalampous; Vijay Kumar Chattu; Pankaj Chaturvedi; Victoria Chatzimavridou-Grigoriadou; Akhilanand Chaurasia; Angela W. Chen; An-Tian Chen; Catherine S. Chen; Haowei Chen; Meng Xuan Chen; Simiao Chen; Ching-Yu Cheng; Esther T. W. Cheng; Nicolas Cherbuin; Wondimye Ashenafi Cheru; Ju-Huei Chien; Odgerel Chimed-Ochir; Ritesh Chimoriya; Patrick R. Ching; Jesus Lorenzo Chirinos-Caceres; Abdulaal Chitheer; William C. S. Cho; Bryan Chong; Hitesh Chopra; Sonali Gajanan Choudhari; Rajiv Chowdhury; Devasahayam J. Christopher; Isaac Sunday Chukwu; Eric Chung; Erin Chung; Eunice Chung; Sheng-Chia Chung; Muhammad Chutiyami; Zinhle Cindi; Iolanda Cioffi; Mareli M. Claassens; Rafael M. Claro; Kaleb Coberly; Rebecca M. Cogen; Alyssa Columbus; Haley Comfort; Joao Conde; Samuele Cortese; Paolo Angelo Cortesi; Vera Marisa Costa; Simona Costanzo; Ewerton Cousin; Rosa A. S. Couto; Richard G. Cowden; Kenneth Michael Cramer; Michael H. Criqui; Natalia Cruz-Martins; Silvia Magali Cuadra-Hernandez; Garland T. Culbreth; Patricia Cullen; Matthew Cunningham; Maria Paula Curado; Sriharsha Dadana; Omid Dadras; Siyu Dai; Xiaochen Dai; Zhaoli Dai; Lachlan L. Dalli; Giovanni Damiani; Jiregna Darega Gela; Jai K. Das; Saswati Das; Subasish Das; Ana Maria Dascalu; Nihar Ranjan Dash; Mohsen Dashti; Anna Dastiridou; Gail Davey; Claudio Alberto Davila-Cervantes; Nicole Davis Weaver; Kairat Davletov; Diego De Leo; Katie De Luca; Aklilu Tamire Debele; Shayom Debopadhaya; Louisa Degenhardt; Azizallah Dehghan; Lee Deitesfeld; Cristian Del Bo; Ivan Delgado-Enciso; Berecha Hundessa Demessa; Andreas K. Demetriades; Ke Deng; Xinlei Deng; Edgar Denova-Gutierrez; Niloofar Deravi; Nebiyu Dereje; Nikolaos Dervenis; Emina Dervišević; Don C. Des Jarlais; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Syed Masudur Rahman Dewan; Arkadeep Dhali; Kuldeep Dhama; Meghnath Dhimal; Sameer Dhingra; Vishal R. Dhulipala; Diana Dias Da Silva; Daniel Diaz; Michael J. Diaz; Adriana Dima; Delaney D. Ding; Huanghe Ding; Ricardo Jorge Dinis-Oliveira; M. Ashworth Dirac; Shirin Djalalinia; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Saeid Doaei; Masoud Dodangeh; Milad Dodangeh; Sushil Dohare; Klara Georgieva Dokova; Christiane Dolecek; Regina-Mae Villanueva Dominguez; Wanyue Dong; Deepa Dongarwar; Mario D'Oria; Fariba Dorostkar; E. Ray Dorsey; Wendel Mombaque Dos Santos; Rajkumar Doshi; Leila Doshmangir; Robert Kokou Dowou; Tim Robert Driscoll; Haneil Larson Dsouza; Viola Dsouza; Mi Du; John Dube; Bruce B. Duncan; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Laura Dwyer-Lindgren; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Abdel Rahman E'Mar; Ejemai Eboreime; Alireza Ebrahimi; Chidiebere Peter Echieh; Hisham Atan Edinur; David Edvardsson; Kristina Edvardsson; Defi Efendi; Ferry Efendi; Diyan Ermawan Effendi; Terje Andreas Eikemo; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Iffat Elbarazi; Teshome Bekele Elema; Noha Mousaad Elemam; Frank J. Elgar; Islam Y. Elgendy; Ghada Metwally Tawfik ElGohary; Hala Rashad Elhabashy; Muhammed Elhadi; Waseem El-Huneidi; Legesse Tesfaye Elilo; Omar Abdelsadek Abdou Elmeligy; Mohamed A. Elmonem; Mohammed Elshaer; Ibrahim Elsohaby; Theophilus I. Emeto; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Christopher Imokhuede Esezobor; Babak Eshrati; Sharareh Eskandarieh; Juan Espinosa-Montero; Habtamu Esubalew; Farshid Etaee; Natalia Fabin; Adewale Oluwaseun Fadaka; Adeniyi Francis Fagbamigbe; Ayesha Fahim; Saman Fahimi; Aliasghar Fakhri-Demeshghieh; Luca Falzone; Mohammad Fareed; Carla Sofia E Sa Farinha; Moezalislam Ezzat Mahmoud Faris; Pawan Sirwan Faris; Andre Faro; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Hamed Fattahi; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Alireza Feizkhah; Ginenus Fekadu; Xiaoru Feng; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Daniela Ferrante; Alize J. Ferrari; Nuno Ferreira; Getahun Fetensa; Bikila Regassa Feyisa; Irina Filip; Florian Fischer; Joanne Flavel; David Flood; Bobirca Teodor Florin; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Behzad Foroutan; Masoud Foroutan; Ingeborg Forthun; Daniela Fortuna; Matteo Foschi; Kayode Raphael Fowobaje; Kate Louise Francis; Richard Charles Franklin; Alberto Freitas; Joseph Friedman; Sara D. Friedman; Takeshi Fukumoto; John E. Fuller; Blima Fux; Peter Andras Gaal; Muktar A. Gadanya; Abhay Motiramji Gaidhane; Santosh Gaihre; Emmanuela Gakidou; Yaseen Galali; Natalie C. Galles; Silvano Gallus; Mandukhai Ganbat; Aravind P. Gandhi; Balasankar Ganesan; Mohammad Arfat Ganiyani; Ma Garcia-Gordillo; William M. Gardner; Jalaj Garg; Naval Garg; Rupesh K. Gautam; Semiu Olatunde Gbadamosi; Tilaye Gebru Gebi; Miglas W. Gebregergis; Mesfin Gebrehiwot; Teferi Gebru Gebremeskel; Simona Roxana Georgescu; Tamirat Getachew; Peter W. Gething; Molla Getie; Keyghobad Ghadiri; Sulmaz Ghahramani; Khalid Yaser Ghailan; Mohammad-Reza Ghasemi; Ghazal Ghasempour Dabaghi; Afsaneh Ghasemzadeh; Ahmad Ghashghaee; Fariba Ghassemi; Ramy Mohamed Ghazy; Ajnish Ghimire; Sama Ghoba; Maryam Gholamalizadeh; Asadollah Gholamian; Ali Gholamrezanezhad; Nasim Gholizadeh; Mahsa Ghorbani; Pooyan Ghorbani Vajargah; Aloke Gopal Ghoshal; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Themba G. Ginindza; Alem Girmay; James C. Glasbey; Elena V. Gnedovskaya; Laszlo Gobolos; Myron Anthony Godinho; Amit Goel; Ali Golchin; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Nelson G. M. Gomes; Philimon N. Gona; Sameer Vali Gopalani; Giuseppe Gorini; Houman Goudarzi; Alessandra C. Goulart; Barbara Niegia Garcia Goulart; Anmol Goyal; Ayman Grada; Simon Matthew Graham; Michal Grivna; Giuseppe Grosso; Shi-Yang Guan; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Avirup Guha; Stefano Guicciardi; Rafael Alves Guimaraes; Snigdha Gulati; Damitha Asanga Gunawardane; Sasidhar Gunturu; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Manoj Kumar Gupta; Mohak Gupta; Rajat Das Gupta; Rajeev Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Lami Gurmessa; Reyna Alma Gutierrez; Farrokh Habibzadeh; Parham Habibzadeh; Rasool Haddadi; Mostafa Hadei; Najah R. Hadi; Nils Haep; Nima Hafezi-Nejad; Demewoz Haile; Alemayehu Hailu; Arvin Haj-Mirzaian; Esam S. Halboub; Brian J. Hall; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Sajid Hameed; Samer Hamidi; Erin B. Hamilton; Chieh Han; Qiuxia Han; Asif Hanif; Nasrin Hanifi; Graeme J. Hankey; Fahad Hanna; Md Abdul Hannan; Md Nuruzzaman Haque; Harapan Harapan; Arief Hargono; Josep Maria Haro; Ahmed I. Hasaballah; Ikramul Hasan; M. Tasdik Hasan; Hamidreza Hasani; Mohammad Hasanian; Abdiwahab Hashi; Md Saquib Hasnain; Ikrama Hassan; Soheil Hassanipour; Hadi Hassankhani; Johannes Haubold; Rasmus J. Havmoeller; Simon I. Hay; Jiawei He; Jeffrey J. Hebert; Omar E. Hegazi; Golnaz Heidari; Mohammad Heidari; Mahsa Heidari-Foroozan; Bartosz Helfer; Delia Hendrie; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Hamed Hesami; Kamal Hezam; Catherine L. Hill; Yuta Hiraike; Ramesh Holla; Nobuyuki Horita; Md Mahbub Hossain; Sahadat Hossain; Mohammad-Salar Hosseini; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Ahmad Hosseinzadeh Adli; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Vivian Chiarong Hsieh; Rebecca L. Hsu; Chengxi Hu; Junjie Huang; Michael Hultstrom; Ayesha Humayun; Tsegaye Gebreyes Hundie; Javid Hussain; M. Azhar Hussain; Nawfal R. Hussein; Foziya Mohammed Hussien; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Khalid S. Ibrahim; Pulwasha Maria Iftikhar; Desta Ijo; Adalia I. Ikiroma; Kevin S. Ikuta; Paul Chukwudi Ikwegbue; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mohammad Tarique Imam; Mustapha Immurana; Sumant Inamdar; Endang Indriasih; Muhammad Iqhrammullah; Arnaud Iradukunda; Kenneth Chukwuemeka Iregbu; Md Rabiul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Faisal Ismail; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Masao Iwagami; Chidozie C. D. Iwu; Ihoghosa Osamuyi Iyamu; Mahalaxmi Iyer; J. Linda Merin; Jalil Jaafari; Louis Jacob; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Morteza Jafarinia; Abdollah Jafarzadeh; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Nityanand Jain; Ammar Abdulrahman Jairoun; Abhishek Jaiswal; Elham Jamshidi; Mark M. Janko; Abubakar Ibrahim Jatau; Sabzali Javadov; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Rime Jebai; Sun Ha Jee; Jayakumar Jeganathan; Anil K. Jha; Ravi Prakash Jha; Heng Jiang; Yingzhao Jin; Olatunji Johnson; Mohammad Jokar; Jost B. Jonas; Tamas Joo; Abel Joseph; Nitin Joseph; Charity Ehimwenma Joshua; Grace Joshy; Jacek Jerzy Jozwiak; Mikk Jurisson; K. Vaishali; Billingsley Kaambwa; Ali Kabir; Zubair Kabir; Vidya Kadashetti; Dler Hussein Kadir; Rizwan Kalani; Laleh R. Kalankesh; Leila R. Kalankesh; Feroze Kaliyadan; Sanjay Kalra; Vineet Kumar Kamal; Sivesh Kathir Kamarajah; Rajesh Kamath; Zahra Kamiab; Naser Kamyari; Thanigaivelan Kanagasabai; Tanuj Kanchan; Himal Kandel; Arun R. Kanmanthareddy; Edmund Wedam Kanmiki; Kehinde Kazeem Kanmodi; S. Suthanthira Kannan; Sushil Kumar Kansal; Rami S. Kantar; Neeti Kapoor; Mehrdad Karajizadeh; Shama D. Karanth; Reema A. Karasneh; Ibraheem M. Karaye; Andre Karch; Asima Karim; Salah Eddin Karimi; Arman Karimi Behnagh; Faizan Zaffar Kashoo; Qalandar Hussein Abdulkarim Kasnazani; Hengameh Kasraei; Nicholas J. Kassebaum; Molly B. Kassel; Joonas H. Kauppila; Navjot Kaur; Norito Kawakami; Gbenga A. Kayode; Foad Kazemi; Sina Kazemian; Tahseen Haider Kazmi; Getu Mosisa Kebebew; Adera Debella Kebede; Fassikaw Kebede; Tibebeselassie S. Keflie; Peter Njenga Keiyoro; Cathleen Keller; Jaimon Terence Kelly; John H. Kempen; Jessica A. Kerr; Emmanuelle Kesse-Guyot; Himanshu Khajuria; Amirmohammad Khalaji; Nauman Khalid; Anees Ahmed Khalil; Alireza Khalilian; Faham Khamesipour; Ajmal Khan; Asaduzzaman Khan; Gulfaraz Khan; Ikramullah Khan; Imteyaz A. Khan; M. Nuruzzaman Khan; Mohammad Jobair Khan; Moien Ab Khan; Zeeshan Ali Khan; Mahammed Ziauddin Khan Suheb; Shaghayegh Khanmohammadi
Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Natalia V. Bhattacharjee; Austin E. Schumacher; Amirali Aali; Yohannes Habtegiorgis Abate; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Sherief Abd-Elsalam; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Olumide Abiodun; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Michael R.M. Abrigo; Dariush Abtahi; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen M.E. Abu-Rmeileh; Tadele Girum Girum Adal; Mesafint Molla Adane; Oluwafemi Atanda Adeagbo Adeagbo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Bashir Aden; Abiola Victor Adepoju; Olatunji O. Adetokunboh; Juliana Bunmi Adetunji; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Rotimi Felix Afolabi; Shadi Afyouni; Muhammad Sohail Afzal; Saira Afzal; Shahin Aghamiri; Antonella Agodi; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Austin J. Ahlstrom; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Sajjad Ahmad; Tauseef Ahmad; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Meqdad Saleh Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Gizachew Taddesse Akalu; Hossein Akbarialiabad; Rufus Olusola Akinyemi; Mohammed Ahmed Akkaif; Sreelatha Akkala; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Mohammad Al Qadire; Tareq Mohammed Ali AL-Ahdal; Samer O. Alalalmeh; Tariq A. Alalwan; Ziyad Al-Aly; Khurshid Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Almaza Albakri; Mohammed Albashtawy; Mohammad T. AlBataineh; Hediyeh Alemi; Sharifullah Alemi; Yihun Mulugeta Alemu; Ayman Al-Eyadhy; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Noora Alhajri; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Abid Ali; Beriwan Abdulqadir Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Sheikh Mohammad Alif; Mohammad Aligol; Mehran Alijanzadeh; Mohammad A.M. Aljasir; Syed Mohamed Aljunid; Sabah Al-Marwani; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jaber S. Alqahtani; Ahmed Yaseen Alqutaibi; Rajaa M. Al-Raddadi; Salman Khalifah Al-Sabah; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Farrukh Jawad Alvi; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Mostafa Amini-Rarani; Sohrab Amiri; Irene Gyamfuah Ampomah; Dickson A. Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Abhishek Anil; Sneha Anil; Adnan Ansar; Alireza Ansari-Moghaddam; Catherine M. Antony; Ernoiz Antriyandarti; Saeid Anvari; Saleha Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Jalal Arabloo; Razman Arabzadeh Bahri; Elshaimaa A. Arafa; Mosab Arafat; Ana Margarida Araujo; Aleksandr Y. Aravkin; Abdulfatai Aremu; Timur Aripov; Mesay Arkew; Benedetta Armocida; Johan Ärnlöv; Mahwish Arooj; Anton A. Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Ashokan Arumugam; Mohsen Asadi-Lari; Zatollah Asemi; Saeed Asgary; Mona Asghariahmadabad; Mohammad Asghari-Jafarabadi; Mubarek Yesse Ashemo; Muhammad Ashraf; Tahira Ashraf; Marvellous O. Asika; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Amlaku Mulat Aweke; Getnet Melaku Ayele; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Rui M.S. Azevedo; Ahmed Y. Azzam; Muhammad Badar; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Najmeh Bahmanziari; Ruhai Bai; Atif Amin Baig; Jennifer L. Baker; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Madhan Balasubramanian; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Hansi Bansal; Mehmet Firat Baran; Martina Barchitta; Mainak Bardhan; Erfan Bardideh; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Sandra Barteit; Zarrin Basharat; Asma'u I.J. Bashir; Hameed Akande Bashiru; Afisu Basiru; Joao Diogo Basso; Sanjay Basu; Abdul-Monim Mohammad Batiha; Kavita Batra; Bernhard T. Baune; Mohsen Bayati; Tahmina Begum; Emad Behboudi; Amir Hossein Behnoush; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Alehegn Bekele; Sefealem Assefa Belay; Uzma Iqbal Belgaumi; Michelle L. Bell; Olorunjuwon Omolaja Bello; Apostolos Beloukas; Isabela M. Bensenor; Zombor Berezvai; Alemshet Yirga Berhie; Amiel Nazer C. Bermudez; Paulo J.G. Bettencourt; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Sonu Bhaskar; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Manpreet S. Bhatti; Rajbir Bhatti; Antonio Biondi; Catherine Bisignano; Atanu Biswas; Raaj Kishore Biswas; Veera R. Bitra; Tone Bjørge; Elye Bliss; Micheal Kofi Boachie; Anca Vasilica Bobirca; Virginia Bodolica; Aadam Olalekan Bodunrin; Eyob Ketema Bogale; Kassawmar Angaw Bogale; Milad Bonakdar Hashemi; Berrak Bora Basara; Souad Bouaoud; Dejana Braithwaite; Michael Brauer; Nicholas J.K. Breitborde; Dana Bryazka; Norma B. Bulamu; Danilo Buonsenso; Katrin Burkart; Richard A. Burns; Yasser Bustanji; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Daniela Calina; Ismael R. Campos-Nonato; Fan Cao; Shujin Cao; Angelo Capodici; Giulia Carreras; Andrea Carugno; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Maria Sofia Cattaruzza; Arthur Caye; Luca Cegolon; Francieli Cembranel; Ester Cerin; Joshua Chadwick; Yaacoub Chahine; Chiranjib Chakraborty; Julian Chalek; Jeffrey Shi Kai Chan; Periklis Charalampous; Vijay Kumar Chattu; Sarika Chaturvedi; Malizgani Paul Chavula; An-Tian Chen; Haowei Chen; Simiao Chen; Gerald Chi; Fatemeh Chichagi; Ju-Huei Chien; Patrick R. Ching; William C.S. Cho; Sungchul Choi; Bryan Chong; Hitesh Chopra; Sonali Gajanan Choudhari; Devasahayam J. Christopher; Dinh-Toi Chu; Isaac Sunday Chukwu; Eric Chung; Sheng-Chia Chung; Zinhle Cindi; Iolanda Cioffi; Raffaela Ciuffreda; Rafael M. Claro; Kaleb Coberly; Alyssa Columbus; Haley Comfort; Joao Conde; Michael H. Criqui; Natalia Cruz-Martins; Silvia Magali Cuadra-Hernández; Sriharsha Dadana; Omid Dadras; Tukur Dahiru; Zhaoli Dai; Bronte Dalton; Giovanni Damiani; Aso Mohammad Darwesh; Jai K. Das; Saswati Das; Mohsen Dashti; Anna Dastiridou; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Aklilu Tamire Debele; Shayom Debopadhaya; Somayeh Delavari; Ivan Delgado-Enciso; Dessalegn Demeke; Berecha Hundessa Demessa; Xinlei Deng; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Arkadeep Dhali; Kuldeep Dhama; Meghnath Dhimal; Vishal R. Dhulipala; Diana Dias Da Silva; Daniel Diaz; Michael J. Diaz; Adriana Dima; Delaney D. Ding; M. Ashworth Dirac; Thanh Chi Do; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Sushil Dohare; Wanyue Dong; Mario D'Oria; Wendel Mombaque Dos Santos; Leila Doshmangir; Robert Kokou Dowou; Ashel Chelsea Dsouza; Haneil Larson Dsouza; Viola Dsouza; John Dube; Joe Duprey; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Sulagna Dutta; Laura Dwyer-Lindgren; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Alireza Ebrahimi; Hisham Atan Edinur; Kristina Edvardsson; Ferry Efendi; Terje Andreas Eikemo; Michael Ekholuenetale; Maha El Tantawi; Noha Mousaad Elemam; Ghada Metwally Tawfik ElGohary; Muhammed Elhadi; Legesse Tesfaye Elilo; Omar Abdelsadek Abdou Elmeligy; Mohamed A. Elmonem; Mohammed Elshaer; Ibrahim Elsohaby; Amir Emami Zeydi; Luchuo Engelbert Bain; Sharareh Eskandarieh; Francesco Esposito; Kara Estep; Farshid Etaee; Natalia Fabin; Adeniyi Francis Fagbamigbe; Saman Fahimi; Aliasghar Fakhri-Demeshghieh; Luca Falzone; Ali Faramarzi; MoezAlIslam Ezzat Mahmoud Faris; Sam Farmer; Andre Faro; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Pietro Ferrara; Nuno Ferreira; Getahun Fetensa; Irina Filip; Florian Fischer; Joanne Flavel; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Behzad Foroutan; Matteo Foschi; Kayode Raphael Fowobaje; Kate Louise Francis; Alberto Freitas; Takeshi Fukumoto; John E. Fuller; Blima Fux; Peter Andras Gaal; Muktar A. Gadanya; Abhay Motiramji Gaidhane; Yaseen Galali; Silvano Gallus; Aravind P. Gandhi; Balasankar Ganesan; Mohammad Arfat Ganiyani; M.A. Garcia-Gordillo; Naval Garg; Rupesh K. Gautam; Federica Gazzelloni; Semiu Olatunde Gbadamosi; Miglas W. Gebregergis; Mesfin Gebrehiwot; Tesfay Brhane Gebremariam; Teferi Gebru Gebremeskel; Yohannes Fikadu Geda; Simona Roxana Georgescu; Urge Gerema; Habtamu Geremew; Motuma Erena Getachew; Peter W. Gething; MohammadReza Ghasemi; Ghazal Ghasempour Dabaghi; Afsaneh Ghasemzadeh; Fariba Ghassemi; Ramy Mohamed Ghazy; Sailaja Ghimire; Asadollah Gholamian; Ali Gholamrezanezhad; Mahsa Ghorbani; Aloke Gopal Ghoshal; Arun Digambarrao Ghuge; Artyom Urievich Gil; Tiffany K. Gill; Matteo Giorgi; Alem Girmay; James C. Glasbey; Laszlo Göbölös; Amit Goel; Ali Golchin; Mahaveer Golechha; Pouya Goleij; Sameer Vali Gopalani; Houman Goudarzi; Alessandra C. Goulart; Anmol Goyal; Simon Matthew Graham; Michal Grivna; Shi-Yang Guan; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Stefano Guicciardi; Snigdha Gulati; David Gulisashvili; Damitha Asanga Gunawardane; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Manoj Kumar Gupta; Mohak Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Annie Haakenstad; Farrokh Habibzadeh; Najah R. Hadi; Nils Haep; Ramtin Hajibeygi; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Nadia M. Hamdy; Sajid Hameed; Samer Hamidi; Qiuxia Han; Alexis J. Handal; Graeme J. Hankey; Md Nuruzzaman Haque; Josep Maria Haro; Ahmed I. Hasaballah; Ikramul Hasan; Mohammad Jahid Hasan; S.M. Mahmudul Hasan; Hamidreza Hasani; Md Saquib Hasnain; Amr Hassan; Ikrama Hassan; Soheil Hassanipour; Hadi Hassankhani; Simon I. Hay; Jeffrey J. Hebert; Omar E. Hegazi; Mohammad Heidari; Bartosz Helfer; Mehdi Hemmati; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Kamran Hessami; Kamal Hezam; Yuta Hiraike; Nguyen Quoc Hoan; Ramesh Holla; Nobuyuki Horita; Md Mahbub Hossain; Mohammad Bellal Hossain Hossain; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Vivian Chia-Rong Hsieh; Chengxi Hu; Junjie Huang; M. Mamun Huda; Ayesha Humayun; Javid Hussain; Nawfal R. Hussein; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Pulwasha Maria Iftikhar; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Leeberk Raja Inbaraj; Afrin Iqbal; Md. Rabiul Islam; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Masao Iwagami; Mahalaxmi Iyer; J. Linda Merin; Jalil Jaafari; Louis Jacob; Farhad Jadidi-Niaragh; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Mihajlo Jakovljevic; Elham Jamshidi; Sabzali Javadov; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Sun Ha Jee; Jayakumar Jeganathan; Anil K. Jha; Ravi Prakash Jha; Heng Jiang; Mohammad Jokar; Jost B. Jonas; Tamas Joo; Nitin Joseph; Charity Ehimwenma Joshua; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; K. Vaishali; Billingsley Kaambwa; Abdulkareem Kabir; Ali Kabir; Hannaneh Kabir; Zubair Kabir; Rizwan Kalani; Leila R. Kalankesh; Feroze Kaliyadan; Sanjay Kalra; Rajesh Kamath; Sagarika Kamath; Tanuj Kanchan; Edmund Wedam Kanmiki; Kehinde Kazeem Kanmodi; S. Suthanthira Kannan; Sushil Kumar Kansal; Rami S. Kantar; Neeti Kapoor; Mehrdad Karajizadeh; Manoochehr Karami; Ibraheem M. Karaye; Faizan Zaffar Kashoo; Hengameh Kasraei; Nicholas J. Kassebaum; Molly B. Kassel; Joonas H. Kauppila; Foad Kazemi; Sara Kazeminia; John H. Kempen; Evie Shoshannah Kendal; Kamyab Keshtkar; Mohammad Keykhaei; Himanshu Khajuria; Amirmohammad Khalaji; Nauman Khalid; Anees Ahmed Khalil; Alireza Khalilian; Faham Khamesipour; Ajmal Khan; Asaduzzaman Khan; Ikramullah Khan; M. Nuruzzaman Khan; Maseer Khan; Mohammad Jobair Khan; Moien A.B. Khan; Young-Ho Khang; Shaghayegh Khanmohammadi; Khaled Khatab; Armin Khavandegar; Hamid Reza Khayat Kashani; Feriha Fatima Khidri; Moein Khormali; Mohammad Ali Khosravi; Mahmood Khosrowjerdi; Wondwosen Teklesilasie Kidane; Zemene Demelash Kifle; Julie Sojin Kim; Min Seo Kim; Ruth W. Kimokoti; Kasey E. Kinzel; Girmay Tsegay Kiross; Adnan Kisa; Sezer Kisa; Ali-Asghar Kolahi; Farzad Kompani; Gerbrand Koren; Oleksii Korzh; Soewarta Kosen; Sindhura Lakshmi Koulmane Laxminarayana; Kewal Krishan; Varun Krishna; Vijay Krishnamoorthy; Barthelemy Kuate Defo; Connor M. Kubeisy; Burcu Kucuk Bicer; Md Abdul Kuddus; Mohammed Kuddus; Ilari Kuitunen; Mukhtar Kulimbet; Harish Kumar; Satyajit Kundu; Kunle Rotimi Kunle; Om P. Kurmi; Asep Kusnali; Dian Kusuma; Evans F. Kyei; Ilias Kyriopoulos; Carlo La Vecchia; Ben Lacey; Muhammad Awwal Ladan; Lucie Laflamme; Chandrakant Lahariya; Daphne Teck Ching Lai; Dharmesh Kumar Lal; Ratilal Lalloo; Judit Lám; Demetris Lamnisos; Ivan Landires; Francesco Lanfranchi; Berthold Langguth; Ariane Laplante-Lévesque; Heidi Jane Larson; Anders O. Larsson; Savita Lasrado; Kamaluddin Latief; Kaveh Latifinaibin; Long Khanh Dao Le; Nhi Huu Hanh Le; Trang Diep Thanh Le; Caterina Ledda; Munjae Lee; Paul H. Lee; Seung Won Lee; Yo Han Lee; Gebretsadik Kiros Lema; Elvynna Leong; Temesgen L. Lerango; An Li; Ming-Chieh Li; Shanshan Li; Wei Li; Xiaopan Li; Virendra S. Ligade; Stephen S. Lim; Ro-Ting Lin; Paulina A. Lindstedt; Stefan Listl; Gang Liu; Jue Liu; Xiaofeng Liu; Xuefeng Liu; Yuewei Liu; Erand Llanaj; Ruben López-Bueno; Platon D. Lopukhov; Laszlo Lorenzovici; Paulo A. Lotufo; Jailos Lubinda; Giancarlo Lucchetti; Alessandra Lugo; Raimundas Lunevicius; Hengliang Lv; Zheng Feei Ma; Kelsey Lynn Maass; Monika MacHoy; Áurea M. Madureira-Carvalho; Mohammed Magdy Abd El Razek; Azzam A. Maghazachi; Soleiman Mahjoub; Mansour Adam Mahmoud; Azeem Majeed; Jeadran N. Malagón-Rojas; Elaheh Malakan Rad; Kashish Malhotra; Ahmad Azam Malik; Iram Malik; Deborah Carvalho Malta; Abdullah A. Mamun; Yosef Manla; Yasaman Mansoori; Ali Mansour; Borhan Mansouri; Zeinab Mansouri; Mohammad Ali Mansournia; Joemer C. Maravilla; Mirko Marino; Abdoljalal Marjani; Gabriel Martinez; Ramon Martinez-Piedra; Francisco Rogerlandio Martins-Melo; Miquel Martorell; Sharmeen Maryam; Roy Rillera Marzo; Alireza Masoudi; Jishanth Mattumpuram; Richard James Maude; Andrea Maugeri; Erin A. May; Mahsa Mayeli; Maryam Mazaheri; John J. McGrath; Martin McKee; Anna Laura Wensel McKowen; Susan A. McLaughlin; Steven M. McPhail; Rahul Mehra; Kamran Mehrabani-Zeinabad; Entezar Mehrabi Nasab; Tesfahun Mekene Meto; Max Alberto Mendez Mendez-Lopez; Walter Mendoza; Ritesh G. Menezes; George A. Mensah; Alexios-Fotios A. Mentis; Sultan Ayoub Meo; Mohsen Merati; Atte Meretoja; Tuomo J. Meretoja; Abera M. Mersha; Tomislav Mestrovic; Pouya Metanat; Kukulege Chamila Dinushi Mettananda; Sachith Mettananda; Adquate Mhlanga; Laurette Mhlanga; Tianyue Mi; Tomasz Miazgowski; Georgia Micha; Irmina Maria Michalek; Ted R. Miller; Le Huu Nhat Minh; Mojgan Mirghafourvand; Erkin M. Mirrakhimov; Mizan Kiros Mirutse; Moonis Mirza; Roya Mirzaei; Ashim Mishra; Sanjeev Misra; Philip B. Mitchell; Chaitanya Mittal; Babak Moazen; Abdalla Z. Mohamed; Ahmed Ismail Mohamed; Jama Mohamed; Mouhand F.H. Mohamed; Nouh Saad Mohamed; Sakineh Mohammad-Alizadeh-Charandabi; Soheil Mohammadi; Abdollah Mohammadian-Hafshejani; Mustapha Mohammed; Salahuddin Mohammed; Shafiu Mohammed; Ali H. Mokdad; Peyman Mokhtarzadehazar; Hossein Molavi Vardanjani; Sabrina Molinaro; Lorenzo Monasta; Mohammad Ali Moni; Maryam Moradi; Yousef Moradi; Paula Moraga; Rafael Silveira Moreira; Negar Morovatdar; Shane Douglas Morrison; Jakub Morze; Abbas Mosapour; Elias Mossialos; Rohith Motappa; Parsa Mousavi; Amin Mousavi Khaneghah; Christine Mpundu-Kaambwa; Sumaira Mubarik; Lorenzo Muccioli; Francesk Mulita; Kavita Munjal; Efren Murillo-Zamora; Jonah Musa; Fungai Musaigwa; Ana-Maria Musina; Sathish Muthu; Saravanan Muthupandian; Muhammad Muzaffar; Woojae Myung; Ahamarshan Jayaraman Nagarajan; Gabriele Nagel; Pirouz Naghavi; Ganesh R. Naik; Gurudatta Naik; Mukhammad David Naimzada; Firzan Nainu; Vinay Nangia; Sreenivas Narasimha Swamy; Bruno Ramos Nascimento; Gustavo G. Nascimento; Abdallah Y. Naser; Mohammad Javad Nasiri; Zuhair S. Natto; Javaid Nauman; Muhammad Naveed; Biswa Prakash Nayak; Vinod C. Nayak; Rawlance Ndejjo; Sabina Onyinye Nduaguba; Hadush Negash; Chernet Tafere Negesse; Ionut Negoi; Ruxandra Irina Negoi; Seyed Aria Nejadghaderi; Chakib Nejjari; Samata Nepal; Henok Biresaw Netsere; Georges Nguefack-Tsague; Josephine W. Ngunjiri; Dang H. Nguyen; Hau Thi Hien Nguyen; Phuong The Nguyen; QuynhAnh P. Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Yeshambel T. Nigatu; Taxiarchis Konstantinos Nikolouzakis; Ali Nikoobar; Amin Reza Nikpoor; Chukwudi A. Nnaji; Lawrence Achilles Nnyanzi; Efaq Ali Noman; Shuhei Nomura; Mamoona Noreen; Nafise Noroozi; Chisom Adaobi Nri-Ezedi; Mengistu H. Nunemo; Virginia Nuñez-Samudio; Dieta Nurrika; Jerry John Nutor; Bogdan Oancea; Kehinde O. Obamiro; Ismail A. Odetokun; Nkechi Martina Odogwu; Martin James O'Donnell; Oluwakemi Ololade Odukoya; Ayodipupo Sikiru Oguntade; James Odhiambo Oguta; In-Hwan Oh; Sylvester Reuben Okeke; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Patrick Godwin Okwute; Andrew T. Olagunju; Omotola O. Olasupo; Matthew Idowu Olatubi; Glaucia Maria Moraes Oliveira; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Gideon Olamilekan Oluwatunase; Hany A. Omar; Goran Latif Omer; Obinna E. Onwujekwe; Michal Ordak; Orish Ebere Orisakwe; Verner N. Orish; Doris V. Ortega-Altamirano; Alberto Ortiz; Esteban Ortiz-Prado; Wael M.S. Osman; Uchechukwu Levi Osuagwu; Olayinka Osuolale; Adrian Otoiu; Stanislav S. Otstavnov; Amel Ouyahia; Guoqing Ouyang; Mayowa O. Owolabi; Yaz Ozten; P.A. Mahesh Padukudru; Mohammad Taha Pahlevan Fallahy; Feng Pan; Hai-Feng Pan; Adrian Pana; Paramjot Panda; Songhomitra Panda-Jonas
Background: Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods: To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings: During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation: Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: A systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017
(Elsevier Ltd, 2019) Tahvi D. Frank; Austin Carter; Deepa Jahagirdar; Molly H. Biehl; Dirk Douwes-Schultz; Samantha Leigh Larson; Megha Arora; Laura Dwyer-Lindgren; Krista M. Steuben; Hedayat Abbastabar; Laith Jamal Abu-Raddad; Direslgne Misker Abyu; Maryam Adabi; Oladimeji M. Adebayo; Victor Adekanmbi; Olatunji O. Adetokunboh; Alireza Ahmadi; Keivan Ahmadi; Elham Ahmadian; Ehsan Ahmadpour; Muktar Beshir Ahmed; Chalachew Genet Akal; Fares Alahdab; Noore Alam; Samuel B. Albertson; Birhan Tamene T. Alemnew; Kefyalew Addis Alene; Vahid Alipour; Nelson Alvis-Guzman; Saeed Amini; Zohreh Anbari; Nahla Hamed Anber; Mina Anjomshoa; Carl Abelardo T. Antonio; Jalal Arabloo; Olatunde Aremu; Habtamu Abera Areri; Ephrem Tsegay Asfaw; Alebachew Fasil Ashagre; Daniel Asmelash; Anemaw A. Asrat; Euripide F.G.A. Avokpaho; Ashish Awasthi; Nefsu Awoke; Martin Amogre Ayanore; Samad Azari; Alaa Badawi; Mojtaba Bagherzadeh; Maciej Banach; Aleksandra Barac; Till Winfried Bärnighausen; Sanjay Basu; Neeraj Bedi; Masoud Behzadifar; Bayu Begashaw Bekele; Saba Abraham Belay; Yared Belete Belay; Yaschilal Muche Muche Belayneh; Adugnaw Berhane; Anusha Ganapati Bhat; Krittika Bhattacharyya; Belete Biadgo; Ali Bijani; Muhammad Shahdaat Bin Sayeed; Helen Bitew; Andrew Blinov; Kassawmar Angaw Bogale; Hunduma Amensisa Bojia; Sharath B.N. Burugina Nagaraja; Zahid A. Butt; Lucero Cahuana-Hurtado; Julio Cesar Campuzano Rincon; Félix Carvalho; Vijay Kumar Chattu; Devasahayam J. Christopher; Dinh-Toi Chu; Raquel Crider; Tukur Dahiru; Lalit Dandona; Rakhi Dandona; Ahmad Daryani; José Das Neves; Jan-Walter De Neve; Louisa Degenhardt; Feleke Mekonnen Demeke; Asmamaw Bizuneh Bizuneh Demis; Dereje Bayissa Demissie; Gebre Teklemariam Demoz; Kebede Deribe; Don Des Jarlais; Govinda Prasad Dhungana; Daniel Diaz; Shirin Djalalinia; Huyen Phuc Do; Linh Phuong Doan; Herbert Duber; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bereket Duko Adema; Andem Effiong; Aziz Eftekhari; Maysaa El Sayed Zaki; Shaimaa I. El-Jaafary; Ziad El-Khatib; Aisha Elsharkawy; Aman Yesuf Endries; Sharareh Eskandarieh; Oghenowede Eyawo; Farshad Farzadfar; Batool Fatima; Netsanet Fentahun; Eduarda Fernandes; Irina Filip; Florian Fischer; Morenike Oluwatoyin Folayan; Masoud Foroutan; Takeshi Fukumoto; Nancy Fullman; Alberto L. Garcia-Basteiro; Reta Tsegaye Gayesa; Ketema Bizuwork Gebremedhin; Gebreamlak Gebremedhn Gebremeskel; Kelali Kalaye Gebreyohannes; Getnet Azeze Gedefaw; Belayneh K. Gelaw; Hailay Abrha Gesesew; Birhanu Geta; Kebede Embaye Gezae; Keyghobad Ghadiri; Ahmad Ghashghaee; Themba T.G. Ginindza; Harish Chander Gugnani; Rafael Alves Guimarães; Michael Tamene Haile; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Samer Hamidi; Senad Handanagic; Demelash Woldeyohannes Handiso; Lolemo Kelbiso Hanfore; Amir Hasanzadeh; Hadi Hassankhani; Hamid Yimam Hassen; Simon I. Hay; Andualem Henok; Chi Linh Hoang; H. Dean Hosgood; Mehdi Hosseinzadeh; Mohamed Hsairi; Segun Emmanuel Ibitoye; Bulat Idrisov; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Chinwe Juliana Iwu; Kathryn H. Jacobsen; Spencer L. James; Ensiyeh Jenabi; Ravi Prakash Jha; Jost B. Jonas; Zahra Jorjoran Shushtari; Ali Kabir; Zubair Kabir; Rajendra Kadel; Amir Kasaeian; Belete Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Gbenga A. Kayode; Mihiretu M. Kebede; Adane Teshome Kefale; Andre Pascal Kengne; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Nauman Khalid; Ejaz Ahmad Khan; Gulfaraz Khan; Junaid Khan; Young-Ho Khang; Khaled Khatab; Salman Khazaei; Abdullah T. Khoja; Aliasghar A. Kiadaliri; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Sonali Kochhar; Hamidreza Komaki; Parvaiz A. Koul; Ai Koyanagi; Barthelemy Kuate Defo; G. Anil Kumar; Manasi Kumar; Desmond Kuupiel; Dharmesh Kumar Lal; Jane Jean-Hee Lee; Tsegaye Lolaso Lenjebo; Cheru Tesema Leshargie; Erlyn Rachelle King Macarayan; Emilie R. Maddison; Hassan Magdy Abd El Razek; Carlos Magis-Rodriguez; Phetole Walter Mahasha; Marek Majdan; Azeem Majeed; Reza Malekzadeh; Navid Manafi; Chabila Christopher Mapoma; Francisco Rogerlândio Martins-Melo; Anthony Masaka; Emmanuel Ngassa Laurent Mayenga; Varshil Mehta; Gebrekiros Gebremichael Meles; Hagazi Gebre Meles; Addisu Melese; Mulugeta Melku; Peter T.N. Memiah; Ziad A. Memish; Alemayehu Toma Mena; Walter Mendoza; Desalegn Tadese Mengistu; Getnet Mengistu; Tuomo J. Meretoja; Tomislav Mestrovic; Ted R. Miller; Babak Moazen; Bahram Mohajer; Amjad Mohamadi-Bolbanabad; Karzan Abdulmuhsin Mohammad; Yousef Mohammad; Aso Mohammad Darwesh; Naser Mohammad Gholi Mezerji; Moslem Mohammadi; Roghayeh Mohammadibakhsh; Milad Mohammadoo-Khorasani; Jemal Abdu Mohammed; Shafiu Mohammed; Farnam Mohebi; Ali H. Mokdad; Yoshan Moodley; Maryam Moossavi; Ghobad Moradi; Maziar Moradi-Lakeh; Marilita M. Moschos; Tilahun Belete Mossie; Seyyed Meysam Mousavi; Kindie Fentahun Muchie; Atalay Goshu Muluneh; Moses K. Muriithi; Ghulam Mustafa; Saravanan Muthupandian; Ahamarshan Jayaraman Nagarajan; Gurudatta Naik; Farid Najafi; Javad Nazari; Duduzile Edith Ndwandwe; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Son Hoang Nguyen; Trang Huyen Nguyen; Dina Nur Anggraini Ningrum; Molly R. Nixon; Chukwudi A. Nnaji; Mehdi Noroozi; Jean Jacques Noubiap; Malihe Nourollahpour Shiadeh; Mohammed Suleiman Obsa; Emmanuel Ankrah Odame; Richard Ofori-Asenso; Felix Akpojene Ogbo; Anselm Okoro; Olanrewaju Oladimeji; Andrew T. Olagunju; Tinuke O. Olagunju; Solomon Olum; Kwaku Oppong Asante; Eyal Oren; Stanislav S. Otstavnov; P.A. Mahesh; Jagadish Rao Padubidri; Smita Pakhale; Amir H. Pakpour; Sangram Kishor Patel; Kebreab Paulos; Veincent Christian Filipino Pepito; Emmanuel K. Peprah; Bakhtiar Piroozi; Akram Pourshams; Mostafa Qorbani; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Sajjad Ur Rahman; Chhabi Lal Ranabhat; Salman Rawaf; Cesar Reis; Vishnu Renjith; Melese Abate Reta; Mohammad Sadegh Rezai; Carlos Miguel Rios González; Elias E.M. Merdassa Roro; Ali Rostami; Salvatore Rubino; Sahar Saeedi Moghaddam; Saeed Safari; Rajesh Sagar; Mohammad Ali Sahraian; Marwa R. Rashad Salem; Yahya Salimi; Joshua A. Salomon; Evanson Zondani Sambala; Abdallah M. Samy; Benn Sartorius; Maheswar Satpathy; Monika Sawhney; Mehdi Sayyah; Aletta Elisabeth Schutte; Sadaf G. Sepanlou; Seyedmojtaba Seyedmousavi; Hosein Shabaninejad; Amira A. Shaheen; Masood Ali Shaikh; Seifadin Ahmed Shallo; Morteza Shamsizadeh; Hamid Sharifi; Kenji Shibuya; Jae Il Shin; Reza Shirkoohi; Diego Augusto Santos Silva; Dayane Gabriele Alves Silveira; Jasvinder A. Singh; Malede Mequanent M. Sisay; Mekonnen Sisay; Solomon Sisay; Amanda E. Smith; Anton Sokhan; Ranjani Somayaji; Sergey Soshnikov; Dan J. Stein; Mu'awiyyah Babale Sufiyan; Bruno F. Sunguya; Bryan L. Sykes; Birkneh Tilahun Tadesse; Degena Bahrey Tadesse; Koku Sisay Tamirat; Nuno Taveira; Shishay Wahdey Tekelemedhin; Habtamu Denekew Temesgen; Fisaha Haile Tesfay; Manaye Yihune Teshale; Subash Thapa; Kenean Getaneh Tlaye; Stephanie M. Topp; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Khanh Bao Tran; Irfan Ullah; Bhaskaran Unnikrishnan; Olalekan A. Uthman; Yousef Veisani; Sergey Konstantinovitch Vladimirov; Fiseha Wadilo Wada; Yasir Waheed; Kidu Gidey Weldegwergs; Girmay Teklay T. Weldesamuel; Ronny Westerman; Tissa Wijeratne; Haileab Fekadu Wolde; Dawit Zewdu Wondafrash; Tewodros Eshete Wonde; Berhanu Yazew Wondmagegn; Addisu Gize Yeshanew; Mekdes Tigistu Yilma; Ebrahim M. Yimer; Naohiro Yonemoto; Marcel Yotebieng; Yoosik Youm; Chuanhua Yu; Zoubida Zaidi; Afshin Zarghi; Zerihun Menlkalew Zenebe; Taye Abuhay Zewale; Arash Ziapour; Sanjay Zodpey; Mohsen Naghavi; Stein Emil Vollset; Haidong Wang; Stephen S. Lim; Hmwe Hmwe Kyu; Christopher J.L. Murray
Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package - a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce agesex- specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact. © 2019 The Author(s).
Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990–2019, for 204 countries and territories: the Global Burden of Diseases Study 2019
(Elsevier Ltd, 2021) Deepa Jahagirdar; Magdalene K. Walters; Amanda Novotney; Edmond D. Brewer; Tahvi D. Frank; Austin Carter; Molly H. Biehl; Hedayat Abbastabar; E.S. Abhilash; Eman Abu-Gharbieh; Laith Jamal Abu-Raddad; Victor Adekanmbi; Daniel Adedayo Adeyinka; Qorinah Estiningtyas Sakilah Adnani; Saira Afzal; Soodabeh Aghababaei; Bright Opoku Ahinkorah; Sajjad Ahmad; Keivan Ahmadi; Sepideh Ahmadi; Ehsan Ahmadpour; Muktar Beshir Ahmed; Tarik Ahmed Rashid; Yusra Ahmed Salih; Addis Aklilu; Tayyaba Akram; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Fahad Mashhour Alanezi; Ekaterina A. Aleksandrova; Kefyalew Addis Alene; Liaqat Ali; Vahid Alipour; Sami Almustanyir; Nelson Alvis-Guzman; Edward Kwabena Ameyaw; Hubert Amu; Catalina Liliana Andrei; Tudorel Andrei; Davood Anvari; Jalal Arabloo; Olatunde Aremu; Judie Arulappan; Desta Debalkie Atnafu; Beatriz Paulina Ayala Quintanilla; Muluken Altaye Ayza; Samad Azari; B.B. Darshan; Maciej Banach; Till Winfried Bärnighausen; Fabio Barra; Amadou Barrow; Sanjay Basu; Shahrzad Bazargan-Hejazi; Habtamu Gebrehana Belay; Tezera Moshago Berheto; Woldesellassie Mequanint Bezabhe; Yihienew Mequanint Bezabih; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Sadia Bibi; Ali Bijani; Catherine Bisignano; Obasanjo Afolabi Bolarinwa; Archith Boloor; Azizbek A. Boltaev; Nikolay Ivanovich Briko; Danilo Buonsenso; Katrin Burkart; Zahid A. Butt; Chao Cao; Jaykaran Charan; Souranshu Chatterjee; Soosanna Kumary Chattu; Vijay Kumar Chattu; Sonali Gajanan Choudhari; Dinh-Toi Chu; Rosa A.S. Couto; Richard G. Cowden; Berihun Assefa Dachew; Omid Dadras; Amare Belachew Dagnew; Saad M.A. Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; José das Neves; Louisa Degenhardt; Feleke Mekonnen Demeke; Abebaw Alemayehu Desta; Keshab Deuba; Deepak Dhamnetiya; Govinda Prasad Dhungana; Mostafa Dianatinasab; Daniel Diaz; Shirin Djalalinia; Linh Phuong Doan; Fariba Dorostkar; Hisham Atan Edinur; Andem Effiong; Sahar Eftekharzadeh; Maysaa El Sayed Zaki; Rajesh Elayedath; Muhammed Elhadi; Shaimaa I. El-Jaafary; Ziad El-Khatib; Aisha Elsharkawy; Aklilu Endalamaw; Aman Yesuf Endries; Sharareh Eskandarieh; Ifeanyi Jude Ezeonwumelu; Sayeh Ezzikouri; Mohammad Farahmand; Emerito Jose A. Faraon; Abidemi Omolara Fasanmi; Simone Ferrero; Lorenzo Ferro Desideri; Irina Filip; Florian Fischer; Morenike Oluwatoyin Folayan; Masoud Foroutan; Takeshi Fukumoto; Mohamed M. Gad; Muktar A. Gadanya; Abhay Motiramji Gaidhane; Tushar Garg; Reta Tsegaye Gayesa; Eyob Alemayehu Gebreyohannes; Hailay Abrha Gesesew; Abera Getachew Obsa; Keyghobad Ghadiri; Ahmad Ghashghaee; Syed Amir Gilani; Themba G. Ginindza; Ionela-Roxana Glăvan; Ekaterina Vladimirovna Glushkova; Mahaveer Golechha; Harish Chander Gugnani; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Samer Hamidi; Senad Handanagic; Shafiul Haque; Harapan Harapan; Arief Hargono; Ahmed I. Hasaballah; Abdiwahab Hashi; Shoaib Hassan; Soheil Hassanipour; Khezar Hayat; Ileana Heredia-Pi; Kamal Hezam; Ramesh Holla; Praveen Hoogar; Mohammad Enamul Hoque; Mostafa Hosseini; Mehdi Hosseinzadeh; Mohamed Hsairi; Rabia Hussain; Segun Emmanuel Ibitoye; Bulat Idrisov; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Seyed Sina Naghibi Irvani; M. Mofizul Islam; Nahlah Elkudssiah Ismail; Ramaiah Itumalla; Ihoghosa Osamuyi Iyamu; Roxana Jabbarinejad; Vardhmaan Jain; Ranil Jayawardena; Ravi Prakash Jha; Nitin Joseph; Ali Kabir; Zubair Kabir; Rohollah Kalhor; Feroze Kaliyadan; Ashwin Kamath; Tanuj Kanchan; Himal Kandel; Getinet Kassahun; Patrick D.M.C. Katoto; Gbenga A. Kayode; Ermiyas Mulu Kebede; Hafte Kahsay Kebede; Himanshu Khajuria; Nauman Khalid; Ejaz Ahmad Khan; Gulfaraz Khan; Khaled Khatab; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Sonali Kochhar; Vladimir Andreevich Korshunov; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; G. Anil Kumar; Manasi Kumar; Nithin Kumar; Alexander Kwarteng; Dharmesh Kumar Lal; Iván Landires; Savita Lasrado; Zohra S. Lassi; Jeffrey V. Lazarus; Jane Jean-Hee Lee; Yeong Yeh Lee; Kate E. LeGrand; Christine Lin; Xuefeng Liu; Emilie R. Maddison; Hassan Magdy Abd El Razek; Phetole Walter Mahasha; Azeem Majeed; Alaa Makki; Ahmad Azam Malik; Wondimu Ayele Manamo; Mohammad Ali Mansournia; Francisco Rogerlândio Martins-Melo; Seyedeh Zahra Masoumi; Ziad A. Memish; Ritesh G. Menezes; Endalkachew Worku Mengesha; Hayimro Edemealem Merie; Amanual Getnet Mersha; Tomislav Mestrovic; Peter Meylakhs; Nour Mheidly; Ted R. Miller; Andreea Mirica; Babak Moazen; Yousef Mohammad; Mokhtar Mohammadi; Arif Mohammed; Salahuddin Mohammed; Shafiu Mohammed; Modhurima Moitra; Ali H. Mokdad; Mariam Molokhia; Mohammad Ali Moni; Ghobad Moradi; Yousef Moradi; Christine Mpundu-Kaambwa; Sumaira Mubarik; Sandra B. Munro; Lillian Mwanri; Jean B. Nachega; Ahamarshan Jayaraman Nagarajan; Aparna Ichalangod Narayana; Muhammad Naveed; Biswa Prakash Nayak; Sabina O. Nduaguba; Sandhya Neupane Kandel; Georges Nguefack-Tsague; Trang Huyen Nguyen; Molly R. Nixon; Chukwudi A. Nnaji; Jean Jacques Noubiap; Virginia Nuñez-Samudio; Thomas Elliot Nyirenda; Onome Bright Oghenetega; Andrew T. Olagunju; Babayemi Oluwaseun Olakunde; Oluwatomi Funbi Owopetu; P.A. Mahesh; Jagadish Rao Padubidri; Smita Pakhale; Tarang Parekh; Fatemeh Pashazadeh Kan; Shrikant Pawar; Veincent Christian Filipino Pepito; Emmanuel K. Peprah; Marina Pinheiro; Khem Narayan Pokhrel; Roman V. Polibin; Richard Charles G. Pollok; Maarten J. Postma; Zahiruddin Quazi Syed; Amir Radfar; Raghu Anekal Radhakrishnan; Fakher Rahim; Vafa Rahimi-Movaghar; Shadi Rahimzadeh; Mosiur Rahman; Amir Masoud Rahmani; Pradhum Ram; Chhabi Lal Ranabhat; Priyanga Ranasinghe; Chythra R. Rao; Sowmya J. Rao; Priya Rathi; David Laith Rawaf; Salman Rawaf; Lemma Demissie Regassa; Inayat ur Rehman; Andre M.N. Renzaho; Nima Rezaei; Omid Rezahosseini; Mohammad Sadegh Rezai; Aziz Rezapour; Rezaul Karim Ripon; Voilet Rodrigues; Denis O. Roshchin; Godfrey M. Rwegerera; Umar Saeed; Sahar Saeedi Moghaddam; Rajesh Sagar; K.M. Saif-Ur-Rahman; Marwa Rashad Salem; Mehrnoosh Samaei; Abdallah M. Samy; Milena M. Santric-Milicevic; Satish Saroshe; Brijesh Sathian; Maheswar Satpathy; Monika Sawhney; Aletta Elisabeth Schutte; Allen Seylani; Masood Ali Shaikh; Mohammed Feyisso Shaka; Hina Shamshad; Morteza Shamsizadeh; Mohammed Shannawaz; Adithi Shetty; Jae Il Shin; K.M. Shivakumar; Jasvinder A. Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Ranjani Somayaji; Sergey Soshnikov; Emma Elizabeth Spurlock; Dan J. Stein; Mu'awiyyah Babale Sufiyan; Hooman Tadbiri; Birkneh Tilahun Tadesse; Eyayou Girma Tadesse; Animut Tagele Tamiru; Elvis Enowbeyang Tarkang; Nuno Taveira; Yohannes Tekalegn; Fisaha Haile Tesfay; Gizachew Assefa Tessema; Rekha Thapar; Marcos Roberto Tovani-Palone; Eugenio Traini; Bach Xuan Tran; Alexander C. Tsai; Biruk Shalmeno Tusa; Saif Ullah; Chukwuma David Umeokonkwo; Bhaskaran Unnikrishnan; Sahel Valadan Tahbaz; Jorge Hugo Villafañe; Sergey Konstantinovitch Vladimirov; Bay Vo; Avina Vongpradith; Giang Thu Vu; Yasir Waheed; Richard G. Wamai; Guan Wang; Yanzhong Wang; Paul Ward; Ronny Westerman; Andrea Sylvia Winkler; Lalit Yadav; Seyed Hossein Yahyazadeh Jabbari; Taklo Simeneh Yazie; Siyan Yi; Vahit Yiğit; Birhanu Wubale Yirdaw; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Alimuddin Zumla; Joshua A. Salomon; Jeffrey W. Eaton; Mohsen Naghavi; Laura Dwyer-Lindgren; Haidong Wang; Stephen S. Lim; Simon I. Hay; Christopher J.L. Murray; Hmwe H. Kyu
Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018
(BioMed Central Ltd, 2022) Emily Haeuser; Audrey L. Serfes; Michael A. Cork; Mingyou Yang; Hedayat Abbastabar; E.S. Abhilash; Maryam Adabi; Oladimeji M. Adebayo; Victor Adekanmbi; Daniel Adedayo Adeyinka; Saira Afzal; Bright Opoku Ahinkorah; Keivan Ahmadi; Muktar Beshir Ahmed; Yonas Akalu; Rufus Olusola Akinyemi; Chisom Joyqueenet Akunna; Fares Alahdab; Fahad Mashhour Alanezi; Turki M. Alanzi; Kefyalew Addis Alene; Robert Kaba Alhassan; Vahid Alipour; Amir Almasi-Hashiani; Nelson Alvis-Guzman; Edward Kwabena Ameyaw; Saeed Amini; Dickson A. Amugsi; Robert Ancuceanu; Davood Anvari; Seth Christopher Yaw Appiah; Jalal Arabloo; Olatunde Aremu; Mulusew A. Asemahagn; Mohammad Asghari Jafarabadi; Atalel Fentahun Awedew; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Yared Asmare Aynalem; Samad Azari; Zelalem Nigussie Azene; B.B. Darshan; Tesleem Kayode Babalola; Atif Amin Baig; Maciej Banach; Till Winfried Bärnighausen; Arielle Wilder Bell; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Ali Bijani; Zebenay Workneh Bitew; Somayeh Bohlouli; Obasanjo Afolabi Bolarinwa; Archith Boloor; Ivana Bozicevic; Zahid A. Butt; Rosario Cárdenas; Felix Carvalho; Jaykaran Charan; Vijay Kumar Chattu; Mohiuddin Ahsanul Kabir Chowdhury; Dinh-Toi Chu; Richard G. Cowden; Saad M. A. Dahlawi; Giovanni Damiani; Eugene Kofuor Maafo Darteh; Aso Mohammad Darwesh; José das Neves; Nicole Davis Weaver; Diego De Leo; Jan-Walter De Neve; Kebede Deribe; Keshab Deuba; Samath Dharmaratne; Mostafa Dianatinasab; Daniel Diaz; Alireza Didarloo; Shirin Djalalinia; Fariba Dorostkar; Eleonora Dubljanin; Bereket Duko; Maha El Tantawi; Shaimaa I. El-Jaafary; Babak Eshrati; Sharareh Eskandarieh; Oghenowede Eyawo; Ifeanyi Jude Ezeonwumelu; Sayeh Ezzikouri; Farshad Farzadfar; Nazir Fattahi; Nelsensius Klau Fauk; Eduarda Fernandes; Irina Filip; Florian Fischer; Nataliya A. Foigt; Masoud Foroutan; Takeshi Fukumoto; Mohamed M. Gad; Abhay Motiramji Gaidhane; Birhan Gebresillassie Gebregiorgis; Ketema Bizuwork Gebremedhin; Lemma Getacher; Keyghobad Ghadiri; Ahmad Ghashghaee; Mahaveer Golechha; Mohammed Ibrahim Mohialdeen Gubari; Harish Chander Gugnani; Rafael Alves Guimarães; Mohammad Rifat Haider; Arvin Haj-Mirzaian; Samer Hamidi; Abdiwahab Hashi; Soheil Hassanipour; Hadi Hassankhani; Khezar Hayat; Claudiu Herteliu; Hung Chak Ho; Ramesh Holla; Mostafa Hosseini; Mehdi Hosseinzadeh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Rakibul M. Islam; Chidozie C. D. Iwu; Mihajlo Jakovljevic; Ravi Prakash Jha; John S. Ji; Kimberly B. Johnson; Nitin Joseph; Vasna Joshua; Farahnaz Joukar; Jacek Jerzy Jozwiak; Leila R. Kalankesh; Rohollah Kalhor; Naser Kamyari; Tanuj Kanchan; Behzad Karami Matin; Salah Eddin Karimi; Gbenga A. Kayode; Ali Kazemi Karyani; Maryam Keramati; Ejaz Ahmad Khan; Gulfaraz Khan; Md Nuruzzaman Khan; Khaled Khatab; Jagdish Khubchandani; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Jacek A. Kopec; Soewarta Kosen; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; Nuworza Kugbey; Vaman Kulkarni; Manasi Kumar; Nithin Kumar; Dian Kusuma; Carlo La Vecchia; Dharmesh Kumar Lal; Iván Landires; Heidi Jane Larson; Savita Lasrado; Paul H. Lee; Shanshan Li; Xuefeng Liu; Afshin Maleki; Preeti Malik; Mohammad Ali Mansournia; Francisco Rogerlândio Martins-Melo; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; Tuomo J. Meretoja; Tomislav Mestrovic; Andreea Mirica; Babak Moazen; Osama Mohamad; Yousef Mohammad; Abdollah Mohammadian-Hafshejani; Reza Mohammadpourhodki; Salahuddin Mohammed; Shafiu Mohammed; Ali H. Mokdad; Masoud Moradi; Paula Moraga; Sumaira Mubarik; Getaneh Baye B. Mulu; Lillian Mwanri; Ahamarshan Jayaraman Nagarajan; Mukhammad David Naimzada; Muhammad Naveed; Javad Nazari; Rawlance Ndejjo; Ionut Negoi; Frida N. Ngalesoni; Georges Nguefack-Tsague; Josephine W. Ngunjiri; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Chukwudi A. Nnaji; Jean Jacques Noubiap; Virginia Nuñez-Samudio; Vincent Ebuka Nwatah; Bogdan Oancea; Oluwakemi Ololade Odukoya; Andrew T. Olagunju; Babayemi Oluwaseun Olakunde; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Ahmed Omar Bali; Obinna E. Onwujekwe; Orish Ebere Orisakwe; Nikita Otstavnov; Stanislav S. Otstavnov; Mayowa O. Owolabi; P.A. Mahesh; Jagadish Rao Padubidri; Adrian Pana; Ashok Pandey; Seithikurippu R. Pandi-Perumal; Fatemeh Pashazadeh Kan; George C. Patton; Shrikant Pawar; Emmanuel K. Peprah; Maarten J. Postma; Liliana Preotescu; Zahiruddin Quazi Syed; Navid Rabiee; Amir Radfar; Alireza Rafiei; Fakher Rahim; Vafa Rahimi-Movaghar; Amir Masoud Rahmani; Kiana Ramezanzadeh; Juwel Rana; Chhabi Lal Ranabhat; Sowmya J. Rao; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Lemma Demissie Regassa; Nima Rezaei; Aziz Rezapour; Mavra A. Riaz; Ana Isabel Ribeiro; Jennifer M. Ross; Enrico Rubagotti; Susan Fred Rumisha; Godfrey M. Rwegerera; Sahar Saeedi Moghaddam; Rajesh Sagar; Biniyam Sahiledengle; Maitreyi Sahu; Marwa Rashad Salem; Hossein Samadi Kafil; Abdallah M. Samy; Benn Sartorius; Brijesh Sathian; Abdul-Aziz Seidu; Amira A. Shaheen; Masood Ali Shaikh; Morteza Shamsizadeh; Wondimeneh Shibabaw Shiferaw; Jae Il Shin; Roman Shrestha; Jasvinder A. Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Shahin Soltani; Mu’awiyyah Babale Sufiyan; Takahiro Tabuchi; Eyayou Girma Tadesse; Nuno Taveira; Fisaha Haile Tesfay; Rekha Thapar; Marcos Roberto Tovani-Palone; Gebiyaw Wudie Tsegaye; Chukwuma David Umeokonkwo; Bhaskaran Unnikrishnan; Jorge Hugo Villafañe; Francesco S. Violante; Bay Vo; Giang Thu Vu; Yohannes Dibaba Wado; Yasir Waheed; Richard G. Wamai; Yanzhong Wang; Paul Ward; Nuwan Darshana Wickramasinghe; Katherine Wilson; Sanni Yaya; Paul Yip; Naohiro Yonemoto; Chuanhua Yu; Mikhail Sergeevich Zastrozhin; Yunquan Zhang; Zhi-Jiang Zhang; Simon I. Hay; Laura Dwyer-Lindgren
Background: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA. © 2022, The Author(s).
Mapping child growth failure across low- and middle-income countries
(Nature Research, 2020) Damaris K. Kinyoki; Aaron E. Osgood-Zimmerman; Brandon V. Pickering; Lauren E. Schaeffer; Laurie B. Marczak; Alice Lazzar-Atwood; Michael L. Collison; Nathaniel J. Henry; Zegeye Abebe; Abdu A. Adamu; Victor Adekanmbi; Keivan Ahmadi; Olufemi Ajumobi; Ayman Al-Eyadhy; Rajaa M. Al-Raddadi; Fares Alahdab; Mehran Alijanzadeh; Vahid Alipour; Khalid Altirkawi; Saeed Amini; Catalina Liliana Andrei; Carl Abelardo T. Antonio; Jalal Arabloo; Olatunde Aremu; Mehran Asadi-Aliabadi; Suleman Atique; Marcel Ausloos; Marco Avila; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Samad Azari; Alaa Badawi; Till Winfried Bärnighausen; Quique Bassat; Kaleab Baye; Neeraj Bedi; Bayu Begashaw Bekele; Michelle L. Bell; Natalia V. Bhattacharjee; Krittika Bhattacharyya; Suraj Bhattarai; Zulfiqar A. Bhutta; Belete Biadgo; Boris Bikbov; Andrey Nikolaevich Briko; Gabrielle Britton; Roy Burstein; Zahid A. Butt; Josip Car; Carlos A. Castañeda-Orjuela; Franz Castro; Ester Cerin; Michael G. Chipeta; Dinh-Toi Chu; Michael A. Cork; Elizabeth A. Cromwell; Lucía Cuevas-Nasu; Lalit Dandona; Rakhi Dandona; Farah Daoud; Rajat Das Gupta; Nicole Davis Weaver; Diego De Leo; Jan-Walter De Neve; Kebede Deribe; Beruk Berhanu Desalegn; Aniruddha Deshpande; Melaku Desta; Daniel Diaz; Mesfin Tadese Dinberu; David Teye Doku; Manisha Dubey; Andre R. Durães; Laura Dwyer-Lindgren; Lucas Earl; Andem Effiong; Maysaa El Sayed Zaki; Maha El Tantawi; Ziad El-Khatib; Babak Eshrati; Mohammad Fareed; Andre Faro; Seyed-Mohammad Fereshtehnejad; Irina Filip; Florian Fischer; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Takeshi Fukumoto; Tsegaye Tewelde Gebrehiwot; Kebede Embaye Gezae; Alireza Ghajar; Paramjit Singh Gill; Philimon N. Gona; Sameer Vali Gopalani; Ayman Grada; Yuming Guo; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Jason B. Hall; Samer Hamidi; Andualem Henok; Bernardo Hernández Prado; Mario Herrero; Claudiu Herteliu; Chi Linh Hoang; Michael K. Hole; Naznin Hossain; Mehdi Hosseinzadeh; Guoqing Hu; Sheikh Mohammed Shariful Islam; Mihajlo Jakovljevic; Ravi Prakash Jha; Jost B. Jonas; Jacek Jerzy Jozwiak; Amaha Kahsay; Tanuj Kanchan; Manoochehr Karami; Amir Kasaeian; Yousef Saleh Khader; Ejaz Ahmad Khan; Mona M. Khater; Yun Jin Kim; Ruth W. Kimokoti; Adnan Kisa; Sonali Kochhar; Soewarta Kosen; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; G. Anil Kumar; Manasi Kumar; Sheetal D. Lad; Faris Hasan Lami; Paul H. Lee; Aubrey J. Levine; Shanshan Li; Shai Linn; Rakesh Lodha; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Marek Majdan; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Mohammad Ali Mansournia; Francisco Rogerlândio Martins-Melo; Anthony Masaka; Benjamin Ballard Massenburg; Benjamin K. Mayala; Fabiola Mejia-Rodriguez; Mulugeta Melku; Walter Mendoza; George A. Mensah; Tomasz Miazgowski; Ted R. Miller; G.K. Mini; Erkin M. Mirrakhimov; Babak Moazen; Aso Mohammad Darwesh; Shafiu Mohammed; Farnam Mohebi; Ali H. Mokdad; Yoshan Moodley; Ghobad Moradi; Maziar Moradi-Lakeh; Paula Moraga; Shane Douglas Morrison; Jonathan F. Mosser; Seyyed Meysam Mousavi; Ulrich Otto Mueller; Christopher J. L. Murray; Ghulam Mustafa; Mehdi Naderi; Mohsen Naghavi; Farid Najafi; Vinay Nangia; Duduzile Edith Ndwandwe; Ionut Negoi; Josephine W. Ngunjiri; Huong Lan Thi Nguyen; Long Hoang Nguyen; Son Hoang Nguyen; Jing Nie; Chukwudi A. Nnaji; Jean Jacques Noubiap; Malihe Nourollahpour Shiadeh; Peter S. Nyasulu; Felix Akpojene Ogbo; Andrew T. Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Eduardo Ortiz-Panozo; Stanislav S. Otstavnov; Mahesh P. A; Adrian Pana; Anamika Pandey; Sanghamitra Pati; Snehal T. Patil; George C. Patton; Norberto Perico; David M. Pigott; Meghdad Pirsaheb; Ellen G. Piwoz; Maarten J. Postma; Akram Pourshams; Swayam Prakash; Hedley Quintana; Amir Radfar; Alireza Rafiei; Vafa Rahimi-Movaghar; Rajesh Kumar Rai; Fatemeh Rajati; David Laith Rawaf; Salman Rawaf; Rahul Rawat; Giuseppe Remuzzi; Andre M. N. Renzaho; Carlos Rios-González; Leonardo Roever; Jennifer M. Ross; Ali Rostami; Nafis Sadat; Yahya Safari; Mahdi Safdarian; Amirhossein Sahebkar; Nasir Salam; Payman Salamati; Yahya Salimi; Hamideh Salimzadeh; Abdallah M. Samy; Benn Sartorius; Brijesh Sathian; Megan F. Schipp; David C. Schwebel; Anbissa Muleta Senbeta; Sadaf G. Sepanlou; Masood Ali Shaikh; Teresa Shamah Levy; Mohammadbagher Shamsi; Kiomars Sharafi; Rajesh Sharma; Aziz Sheikh; Apurba Shil; Diego Augusto Santos Silva; Jasvinder A. Singh; Dhirendra Narain Sinha; Moslem Soofi; Agus Sudaryanto; Muawiyyah Babale Sufiyan; Rafael Tabarés-Seisdedos; Birkneh Tilahun Tadesse; Mohamad-Hani Temsah; Abdullah Sulieman Terkawi; Zemenu Tadesse Tessema; Andrew L. Thorne-Lyman; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Khanh Bao Tran; Irfan Ullah; Olalekan A. Uthman; Masoud Vaezghasemi; Afsane Vaezi; Pascual R. Valdez; John Vanderheide; Yousef Veisani; Francesco S. Violante; Vasily Vlassov; Giang Thu Vu; Linh Gia Vu; Yasir Waheed; Judd L. Walson; Yafeng Wang; Yuan-Pang Wang; Elizabeth N. Wangia; Andrea Werdecker; Gelin Xu; Tomohide Yamada; Engida Yisma; Naohiro Yonemoto; Mustafa Z. Younis; Mahmoud Yousefifard; Chuanhua Yu; Sojib Bin Zaman; Mohammad Zamani; Yunquan Zhang; Nicholas J. Kassebaum; Simon I. Hay
Childhood malnutrition is associated with high morbidity and mortality globally1. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood2. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0–59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards3–5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization’s median growth reference standards for a healthy population6. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)7; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes8. Building from our previous work mapping CGF in Africa9, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live1, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications. © 2020, The Author(s).
Mapping disparities in education across low- and middle-income countries
(Nature Research, 2020) Nicholas Graetz; Lauren Woyczynski; Katherine F. Wilson; Jason B. Hall; Kalkidan Hassen Abate; Foad Abd-Allah; Oladimeji M. Adebayo; Victor Adekanmbi; Mahdi Afshari; Olufemi Ajumobi; Tomi Akinyemiju; Fares Alahdab; Ziyad Al-Aly; Jacqueline Elizabeth Alcalde Rabanal; Mehran Alijanzadeh; Vahid Alipour; Khalid Altirkawi; Mohammadreza Amiresmaili; Nahla Hamed Anber; Catalina Liliana Andrei; Mina Anjomshoa; Carl Abelardo T. Antonio; Jalal Arabloo; Olatunde Aremu; Krishna K. Aryal; Mehran Asadi-Aliabadi; Suleman Atique; Marcel Ausloos; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Samad Azari; Alaa Badawi; Joseph Adel Mattar Banoub; Suzanne Lyn Barker-Collo; Anthony Barnett; Neeraj Bedi; Derrick A. Bennett; Natalia V. Bhattacharjee; Krittika Bhattacharyya; Suraj Bhattarai; Zulfiqar A. Bhutta; Ali Bijani; Boris Bikbov; Gabrielle Britton; Roy Burstein; Zahid A. Butt; Rosario Cárdenas; Félix Carvalho; Carlos A. Castañeda-Orjuela; Franz Castro; Ester Cerin; Jung-Chen Chang; Michael L. Collison; Cyrus Cooper; Michael A. Cork; Farah Daoud; Rajat Das Gupta; Nicole Davis Weaver; Jan-Walter De Neve; Kebede Deribe; Beruk Berhanu Desalegn; Aniruddha Deshpande; Melaku Desta; Meghnath Dhimal; Daniel Diaz; Mesfin Tadese Dinberu; Shirin Djalalinia; Manisha Dubey; Eleonora Dubljanin; Andre R. Durães; Laura Dwyer-Lindgren; Lucas Earl; Mohammad Ebrahimi Kalan; Ziad El-Khatib; Babak Eshrati; Mahbobeh Faramarzi; Mohammad Fareed; Andre Faro; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Irina Filip; Florian Fischer; Takeshi Fukumoto; Jose A. García; Paramjit Singh Gill; Tiffany K. Gill; Philimon N. Gona; Sameer Vali Gopalani; Ayman Grada; Yuming Guo; Rajeev Gupta; Vipin Gupta; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Mehedi Hasan; Hamid Yimam Hassen; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Bernardo Hernández Prado; Claudiu Herteliu; Michael K. Hole; Naznin Hossain; Mehdi Hosseinzadeh; Guoqing Hu; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Neda Izadi; Mihajlo Jakovljevic; Ravi Prakash Jha; John S. Ji; Jost B. Jonas; Zahra Jorjoran Shushtari; Jacek Jerzy Jozwiak; Tanuj Kanchan; Amir Kasaeian; Ali Kazemi Karyani; Peter Njenga Keiyoro; Chandrasekharan Nair Kesavachandran; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Ejaz Ahmad Khan; Mona M. Khater; Aliasghar A. Kiadaliri; Daniel N. Kiirithio; Yun Jin Kim; Ruth W. Kimokoti; Damaris K. Kinyoki; Adnan Kisa; Soewarta Kosen; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; Manasi Kumar; Pushpendra Kumar; Faris Hasan Lami; Paul H. Lee; Aubrey J. Levine; Shanshan Li; Yu Liao; Lee-Ling Lim; Stefan Listl; Jaifred Christian F. Lopez; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Mohammad Ali Mansournia; Francisco Rogerlândio Martins-Melo; Anthony Masaka; Benjamin Ballard Massenburg; Benjamin K. Mayala; Kala M. Mehta; Walter Mendoza; George A. Mensah; Tuomo J. Meretoja; Tomislav Mestrovic; Ted R. Miller; G.K. Mini; Erkin M. Mirrakhimov; Babak Moazen; Dara K. Mohammad; Aso Mohammad Darwesh; Shafiu Mohammed; Farnam Mohebi; Ali H. Mokdad; Lorenzo Monasta; Yoshan Moodley; Mahmood Moosazadeh; Ghobad Moradi; Maziar Moradi-Lakeh; Paula Moraga; Lidia Morawska; Shane Douglas Morrison; Jonathan F. Mosser; Seyyed Meysam Mousavi; Christopher J. L. Murray; Ghulam Mustafa; Azin Nahvijou; Farid Najafi; Vinay Nangia; Duduzile Edith Ndwandwe; Ionut Negoi; Ruxandra Irina Negoi; Josephine W. Ngunjiri; Cuong Tat Nguyen; Long Hoang Nguyen; Dina Nur Anggraini Ningrum; Jean Jacques Noubiap; Malihe Nourollahpour Shiadeh; Peter S. Nyasulu; Felix Akpojene Ogbo; Andrew T. Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Obinna E. Onwujekwe; Doris D. V. Ortega-Altamirano; Eduardo Ortiz-Panozo; Simon Øverland; P.A. Mahesh; Adrian Pana; Songhomitra Panda-Jonas; Sanghamitra Pati; George C. Patton; Norberto Perico; David M. Pigott; Meghdad Pirsaheb; Maarten J. Postma; Akram Pourshams; Swayam Prakash; Parul Puri; Mostafa Qorbani; Amir Radfar; Fakher Rahim; Vafa Rahimi-Movaghar; Mohammad Hifz Ur Rahman; Fatemeh Rajati; Chhabi Lal Ranabhat; David Laith Rawaf; Salman Rawaf; Robert C. Reiner; Giuseppe Remuzzi; Andre M. N. Renzaho; Satar Rezaei; Aziz Rezapour; Carlos Rios-González; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Enrico Rubagotti; Nafis Sadat; Ehsan Sadeghi; Yahya Safari; Rajesh Sagar; Nasir Salam; Payman Salamati; Yahya Salimi; Hamideh Salimzadeh; Abdallah M. Samy; Juan Sanabria; Milena M. Santric Milicevic; Benn Sartorius; Brijesh Sathian; Arundhati R. Sawant; Lauren E. Schaeffer; Megan F. Schipp; David C. Schwebel; Anbissa Muleta Senbeta; Sadaf G. Sepanlou; Masood Ali Shaikh; Mehran Shams-Beyranvand; Morteza Shamsizadeh; Kiomars Sharafi; Rajesh Sharma; Jun She; Aziz Sheikh; Mika Shigematsu; Soraya Siabani; Dayane Gabriele Alves Silveira; Jasvinder A. Singh; Dhirendra Narain Sinha; Vegard Skirbekk; Amber Sligar; Badr Hasan Sobaih; Moslem Soofi; Joan B. Soriano; Ireneous N. Soyiri; Chandrashekhar T. Sreeramareddy; Agus Sudaryanto; Muawiyyah Babale Sufiyan; Ipsita Sutradhar; Pn Sylaja; Rafael Tabarés-Seisdedos; Birkneh Tilahun Tadesse; Mohamad-Hani Temsah; Abdullah Sulieman Terkawi; Belay Tessema; Zemenu Tadesse Tessema; Kavumpurathu Raman Thankappan; Roman Topor-Madry; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Lorainne Tudor Car; Irfan Ullah; Olalekan A. Uthman; Pascual R. Valdez; Yousef Veisani; Francesco S. Violante; Vasily Vlassov; Sebastian Vollmer; Giang Thu Vu; Yasir Waheed; Yuan-Pang Wang; John C. Wilkinson; Andrea Sylvia Winkler; Charles D. A. Wolfe; Tomohide Yamada; Alex Yeshaneh; Paul Yip; Engida Yisma; Naohiro Yonemoto; Mustafa Z. Younis; Mahmoud Yousefifard; Chuanhua Yu; Sojib Bin Zaman; Jianrong Zhang; Yunquan Zhang; Sanjay Zodpey; Emmanuela Gakidou; Simon I. Hay
Educational attainment is an important social determinant of maternal, newborn, and child health1–3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4–6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9–11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but—to our knowledge—no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries12–14. By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations. © 2019, The Author(s).
Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems
(BioMed Central Ltd, 2021) Michael A. Cork; Nathaniel J. Henry; Stefanie Watson; Andrew J. Croneberger; Mathew Baumann; Ian D. Letourneau; Mingyou Yang; Audrey L. Serfes; Jaffar Abbas; Nooshin Abbasi; Hedayat Abbastabar; Lucas G. Abreu; Eman Abu-Gharbieh; Basavaprabhu Achappa; Maryam Adabi; Tadele G. Adal; Adeyinka E. Adegbosin; Victor Adekanmbi; Olatunji O. Adetokunboh; Marcela Agudelo-Botero; Bright O. Ahinkorah; Keivan Ahmadi; Muktar B. Ahmed; Robert K. Alhassan; Vahid Alipour; Amir Almasi-Hashiani; Nelson Alvis-Guzman; Robert Ancuceanu; Tudorel Andrei; Davood Anvari; Muhammad Aqeel; Jalal Arabloo; Olatunde Aremu; Malke Asaad; Desta D. Atnafu; Alok Atreya; Beatriz Paulina Ayala Quintanilla; Samad Azari; Darshan B. B; Atif A. Baig; Maciej Banach; Simachew A. Bante; Miguel A. Barboza; Sanjay Basu; Neeraj Bedi; Diana F Bejarano Ramirez; Isabela M. Bensenor; Fenta-Hun Y. Beyene; Yihienew M. Bezabih; Akshaya S. Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Zulfiqar A. Bhutta; Ali Bijani; Sait M. Birlik; Zebenay W. Bitew; Somayeh Bohlouli; Archith Boloor; Andre R. Brunoni; Zahid A. Butt; Rosario Cárdenas; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Casta-ñeda-orjuela; Jaykaran Charan; Souranshu Chatterjee; Vijay Kumar Chattu; Soosanna Kumary Chattu; Mohiuddin Ahsanul Kabir Chowdhury; Devasahayam J. Christopher; Dinh-Toi Chu; Aubrey J. Cook; Natalie M. Cormier; Saad M A. Dahlawi; Farah Daoud; Claudio A. Dávila-Cervantes; Nicole Davis Weaver; Fernando P. De la Hoz; Feleke M. Demeke; Edgar Denova-Gutiérrez; Kebede Deribe; Keshab Deuba; Samath D. Dharmaratne; Govinda P. Dhungana; Daniel Diaz; Shirin Djalalinia; Andre R. Duraes; Arielle W. Eagan; Lucas Earl; Andem Effiong; Maysaa El Sayed Zaki; Maha El Tantawi; Rajesh Elayedath; Shaimaa I. El-Jaafary; Emerito Jose A. Faraon; Andre Faro; Nazir Fattahi; Nelsensius K. Fauk; Eduarda Fernandes; Irina Filip; Florian Fischer; Nataliya A. Foigt; Masoud Foroutan; Takeshi Fukumoto; Mohamed M. Gad; Tesfay B B. Gebremariam; Ketema B. Gebremed-Hin; Gebreamlak G. Gebremeskel; Hailay A. Gesesew; Keyghobad Ghadiri; Ahmad Ghashghaee; Syed Amir Gilani; Mahaveer Golechha; Ugo Gori; Alessandra C. Goulart; Bárbara N G. Goulart; Harish C. Gugnani; Mark D C. Guimaraes; Rafael A. Guimarães; Yum-Ing Guo; Rahul Gupta; Emily Haeuser; Mohammad Rifat Haider; Teklehaimanot G. Haile; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Asif Hanif; Arief Hargono; Ninuk Hariyani; Soheil Hassanipour; Hadi Hassankhani; Khezar Hayat; Claudiu Herteliu; Hung Chak Ho; Ramesh Holla; Mehdi Hosseinzadeh; Mowafa Househ; Bing-Fang Hwang; Charles U. Ibeneme; Segun E. Ibitoye; Olayinka S. Ile-Sanmi; Milena D. Ilic; Irena M. Ilic; Usman Iqbal; Deepa Jahagir-Dar; Vardhmaan Jain; Mihajlo Jakovljevic; Ravi P. Jha; Kimberly B. Johnson; Nitin Joseph; Farahnaz Joukar; Leila R. Kalankesh; Rohol-Lah Kalhor; Tanuj Kanchan; Behzad Karami Matin; André Karch; Salah Eddin Karimi; Getinet Kassahun; Gbenga A. Kayode; Ali Kazemi Karyani; Maryam Keramati; Nauman Khalid; Ejaz A. Khan; Gulfaraz Khan; Md Nuruzzaman N. Khan; Khaled Khatab; Neda Kianipour; Yun Jin Kim; Sezer Kisa; Adnan Kisa; Soewarta Kosen; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; Ricardo S. Kuchenbecker; Vaman Kulkarni; Nithin Kumar; Manasi Kumar; Om P. Kurmi; Dian Kusuma; Carlo La Vecchia; Dharmesh K. Lal; Iván Landires; Savita Lasrado; Paul H. Lee; Kate E. Legrand; Bingyu Li; Shanshan Li; Xuefeng Liu; Hawraz I M. Amin; Daiane B. Machado; Deepak Madi; Carlos Magis-Rodriguez; Deborah C. Malta; Mohammad Ali Mansournia; Md Dilshad Manzar; Carlos A Marrugo Arnedo; Francisco R. Martins-Melo; Seyedeh Zahra Masoumi; Benjamin K. Mayala; Carlo E. Medina-Solís; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Tomislav Mestrovic; Andreea Mirica; Babak Moazen; Yousef Mohammad; Naser Mohammad Gholi Mezerji; Abdollah Mohammadian-Hafshejani; Reza Mohammadpourhodki; Shafiu Mohammed; Ali H. Mokdad; Mohammad Ali Moni; Masoud Moradi; Yousef Moradi; Rahmatollah Moradzadeh; Paula Moraga; Amin Mou-Savi Khaneghah; Ghulam Mustafa; Lillian Mwanri; Ravishankar Nagaraja; Ahamarshan J. Nagarajan; Mukhammad David Naim-Zada; Bruno R. Nascimento; Dr M. Naveed; Vinod C. Nayak; Javad Nazari; Hadush Negash; Ionut Negoi; Samata Nepal; Georges Nguefack-Tsague; Cuong T. Nguyen; Huong L T. Nguyen; Rajan Nikbakhsh; Jean Jacques Noubiap; Virginia Nunez-Samudio; Bogdan Oancea; Felix A. Ogbo; Andrew T. Olagunju; Nikita Otstav-Nov; Mahesh P. A; Jagadish Rao Padubidri; Seithikurippu R. Pandi-Perumal; Ana M. Pardo-Montaño; Urvish K. Patel; Shrikant Pawar; Emmanuel K. Peprah; Alexandre Pereira; Samantha Perkins; Julia M. Pescarini; Khem N. Pokhrel; Maarten J. Postma; Faheem H. Pot-Too; Sergio I. Prada; Liliana Preotescu; Dimas R A. Pribadi; Amir Radfar; Fakher Rahim; Mohammad Hifz Ur Rahman; Amir Masoud Rahmani; Kiana Ramezanzadeh; Juwel Rana; Chhabi L. Ranabhat; Sowmya J. Rao; Priya Rathi; Salman Rawaf; David L. Rawaf; Reza Rawassizadeh; Vishnu Renjith; Nima Rezaei; Aziz Rezapour; Ana Isabel Ribeiro; Leonardo Roever; Enrico Rubagotti; Susan F. Rumisha; Godfrey M. Rwegerera; Rajesh Sagar; S. Mohammad Sajadi; Marwa R. Salem; Abdallah M. Samy; Rodrigo Sarmiento-Suárez; Brijesh Sathian; Lauren E. Schaeffer; Ione J C. Schneider; Abdul-Aziz Seidu; Feng Sha; Masood A. Shaikh; Kio-Mars Sharafi; Aziz Sheikh; Kenji Shibuya; Jae Il Shin; Diego A S. Silva; Jasvinder A. Singh; Valentin Y. Skryabin; Anna A. Skryabina; Amber Sligar; Amin Soheili; Krista M. Steuben; Mu’Awiyyah B. Sufiyan; Eyayou G. Tadesse; Ayenew K T. Tesema; Fisaha H. Tesfay; Rekha Thapar; Robert L. Thompson; Marcos R. Tovani-Palone; Bach X. Tran; Gebiyaw W. Tsegaye; Chukwuma D. Umeokonkwo; Bhaskaran Unnikrish-Nan; Yasser Vasseghian; Francesco S. Violante; Bay Vo; Giang T. Vu; Yasir Waheed; Yuan-Pang Wang; Yanzhong Wang; Paul Ward; Fissaha T. Welay; Ronny Westerman; Nuwan D. Wickramasinghe; Sanni Yaya; Paul Yip; Naohiro Yonemoto; Chuanhua Yu; Deniz Yuce; Hasan Yusefzadeh; Maryam Zamanian; Mikhail S. Zastroz-Hin; Zhi-Jiang Zhang; Yunquan Zhang; Arash Ziapour; Simon I. Hay; Laura Dwyer-Lindgren
Background: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods: We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results: All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions: Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths. © 2021, The Author(s).
Subnational mapping of HIV incidence and mortality among individuals aged 15–49 years in sub-Saharan Africa, 2000–18: a modelling study
(Elsevier Ltd, 2021) Benn Sartorius; John D. VanderHeide; Mingyou Yang; Erik A. Goosmann; Julia Hon; Emily Haeuser; Michael A. Cork; Samantha Perkins; Deepa Jahagirdar; Lauren E. Schaeffer; Audrey L. Serfes; Kate E. LeGrand; Hedayat Abbastabar; Zeleke Hailemariam Abebo; Akine Eshete Abosetugn; Eman Abu-Gharbieh; Manfred Mario Kokou Accrombessi; Oladimeji M. Adebayo; Adeyinka Emmanuel Adegbosin; Victor Adekanmbi; Olatunji O. Adetokunboh; Daniel Adedayo Adeyinka; Bright Opoku Ahinkorah; Keivan Ahmadi; Muktar Beshir Ahmed; Yonas Akalu; Oluwaseun Oladapo Akinyemi; Rufus Olusola Akinyemi; Addis Aklilu; Chisom Joyqueenet Akunna; Fares Alahdab; Ziyad Al-Aly; Noore Alam; Alehegn Aderaw Alamneh; Turki M. Alanzi; Biresaw Wassihun Alemu; Robert Kaba Alhassan; Tilahun Ali; Vahid Alipour; Saeed Amini; Robert Ancuceanu; Fereshteh Ansari; Zelalem Alamrew Anteneh; Davood Anvari; Razique Anwer; Seth Christopher Yaw Appiah; Jalal Arabloo; Mulusew A. Asemahagn; Mohammad Asghari Jafarabadi; Wondwossen Niguse Asmare; Desta Debalkie Atnafu; Maha Moh'd Wahbi Atout; Alok Atreya; Marcel Ausloos; Atalel Fentahun Awedew; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Yared Asmare Aynalem; Muluken Altaye Ayza; Samad Azari; Zelalem Nigussie Azene; Zaheer-Ud-Din Babar; Atif Amin Baig; Senthilkumar Balakrishnan; Maciej Banach; Till Winfried Bärnighausen; Sanjay Basu; Mohsen Bayati; Neeraj Bedi; Tariku Tesfaye Bekuma; Woldesellassie M. Mequanint Bezabhe; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Krittika Bhattacharyya; Zulfiqar A. Bhutta; Sadia Bibi; Boris Bikbov; Tsegaye Adane Birhan; Zebenay Workneh Bitew; Moses John Bockarie; Archith Boloor; Oliver J. Brady; Nicola Luigi Bragazzi; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Sharath Burugina Nagaraja; Zahid A. Butt; Rosario Cárdenas; Felix Carvalho; Jaykaran Charan; Souranshu Chatterjee; Soosanna Kumary Chattu; Vijay Kumar Chattu; Mohiuddin Ahsanul Kabir Chowdhury; Dinh-Toi Chu; Aubrey J. Cook; Natalie Maria Cormier; Richard G. Cowden; Carlos Culquichicon; Baye Dagnew; Saad M.A. Dahlawi; Giovanni Damiani; Parnaz Daneshpajouhnejad; Farah Daoud; Ahmad Daryani; José das Neves; Nicole Davis Weaver; Meseret Derbew Molla; Kebede Deribe; Abebaw Alemayehu Desta; Keshab Deuba; Samath Dhamminda Dharmaratne; Govinda Prasad Dhungana; Daniel Diaz; Shirin Djalalinia; Paul Narh Doku; Eleonora Dubljanin; Bereket Duko; Arielle Wilder Eagan; Lucas Earl; Jeffrey W. Eaton; Andem Effiong; Maysaa El Sayed Zaki; Maha El Tantawi; Rajesh Elayedath; Shaimaa I. El-Jaafary; Aisha Elsharkawy; Sharareh Eskandarieh; Oghenowede Eyawo; Sayeh Ezzikouri; Abidemi Omolara Fasanmi; Alebachew Fasil; Nelsensius Klau Fauk; Valery L. Feigin; Tomas Y. Ferede; Eduarda Fernandes; Florian Fischer; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Masoud Foroutan; Joel Msafiri Francis; Takeshi Fukumoto; Mohamed M. Gad; Biniyam Sahiledengle Geberemariyam; Birhan Gebresillassie Gebregiorgis; Berhe Gebremichael; Hailay Abrha Gesesew; Lemma Getacher; Keyghobad Ghadiri; Ahmad Ghashghaee; Syed Amir Gilani; Themba G. Ginindza; Mustefa Glagn; Mahaveer Golechha; Philimon N. Gona; Mohammed Ibrahim Mohialdeen Gubari; Harish Chander Gugnani; Davide Guido; Rashid Abdi Guled; Brian J. Hall; Samer Hamidi; Demelash Woldeyohannes Handiso; Arief Hargono; Abdiwahab Hashi; Soheil Hassanipour; Hadi Hassankhani; Khezar Hayat; Claudiu Herteliu; Hagos Degefa de Hidru; Ramesh Holla; H. Dean Hosgood; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mowafa Househ; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Seyed Sina Naghibi Irvani; Chidozie C.D. Iwu; Chinwe Juliana Iwu; Ihoghosa Osamuyi Iyamu; Vardhmaan Jain; Mihajlo Jakovljevic; Farzad Jalilian; Ravi Prakash Jha; Kimberly B. Johnson; Vasna Joshua; Farahnaz Joukar; Jacek Jerzy Jozwiak; Ali Kabir; Leila R. Kalankesh; Rohollah Kalhor; Ashwin Kamath; Naser Kamyari; Tanuj Kanchan; Behzad Karami Matin; André Karch; Salah Eddin Karimi; Ayele Semachew Kasa; Getinet Kassahun; Gbenga A. Kayode; Ali Kazemi Karyani; Peter Njenga Keiyoro; Bayew Kelkay; Nauman Khalid; Gulfaraz Khan; Junaid Khan; Md Nuruzzaman Khan; Khaled Khatab; Salman Khazaei; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Sonali Kochhar; Jacek A. Kopec; Soewarta Kosen; Sindhura Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; Nuworza Kugbey; Vaman Kulkarni; Manasi Kumar; Nithin Kumar; Om P. Kurmi; Dian Kusuma; Desmond Kuupiel; Hmwe Hmwe Kyu; Carlo La Vecchia; Dharmesh Kumar Lal; Jennifer O. Lam; Iván Landires; Savita Lasrado; Jeffrey V. Lazarus; Alice Lazzar-Atwood; Paul H. Lee; Cheru Tesema Leshargie; Bingyu Li; Xuefeng Liu; Platon D. Lopukhov; Hawraz Ibrahim M. Amin; Deepak Madi; Phetole Walter Mahasha; Azeem Majeed; Afshin Maleki; Shokofeh Maleki; Abdullah A. Mamun; Navid Manafi; Mohammad Ali Mansournia; Francisco Rogerlândio Martins-Melo; Seyedeh Zahra Masoumi; Benjamin K. Mayala; Birhanu Geta Meharie; Hailemariam Abiy Alemu Meheretu; Hagazi Gebre Meles; Mulugeta Melku; Walter Mendoza; Endalkachew Worku Mengesha; Tuomo J. Meretoja; Abera M. Mersha; Tomislav Mestrovic; Ted R. Miller; Andreea Mirica; Mehdi Mirzaei-Alavijeh; Osama Mohamad; Yousef Mohammad; Abdollah Mohammadian-Hafshejani; Jemal Abdu Mohammed; Salahuddin Mohammed; Shafiu Mohammed; Ali H. Mokdad; Taklu Marama Mokonnon; Mariam Molokhia; Masoud Moradi; Yousef Moradi; Rahmatollah Moradzadeh; Paula Moraga; Jonathan F. Mosser; Sandra B. Munro; Ghulam Mustafa; Saravanan Muthupandian; Mehdi Naderi; Ahamarshan Jayaraman Nagarajan; Mohsen Naghavi; Muhammad Naveed; Vinod C. Nayak; Javad Nazari; Rawlance Ndejjo; Samata Nepal; Henok Biresaw Netsere; Frida N. Ngalesoni; Georges Nguefack-Tsague; Josephine W. Ngunjiri; Yeshambel T. Nigatu; Samuel Negash Nigussie; Chukwudi A. Nnaji; Jean Jacques Noubiap; Virginia Nuñez-Samudio; Bogdan Oancea; Oluwakemi Ololade Odukoya; Felix Akpojene Ogbo; Olanrewaju Oladimeji; Andrew T. Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Muktar Omer Omer; Abidemi E. Emmanuel Omonisi; Obinna E. Onwujekwe; Orish Ebere Orisakwe; Nikita Otstavnov; Mayowa O. Owolabi; P.A. Mahesh; Jagadish Rao Padubidri; Smita Pakhale; Adrian Pana; Seithikurippu R. Pandi-Perumal; Urvish K. Patel; Mona Pathak; George C. Patton; Shrikant Pawar; Emmanuel K. Peprah; Khem Narayan Pokhrel; Maarten J. Postma; Faheem Hyder Pottoo; Hadi Pourjafar; Dimas Ria Angga Pribadi; Zahiruddin Quazi Syed; Alireza Rafiei; Fakher Rahim; Mohammad Hifz Ur Rahman; Amir Masoud Rahmani; Pradhum Ram; Juwel Rana; Chhabi Lal Ranabhat; Satish Rao; Sowmya J. Rao; Priya Rathi; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Vishnu Renjith; Melese Abate Reta; Nima Rezaei; Aziz Rezapour; Ana Isabel Ribeiro; Jennifer M. Ross; Susan Fred Rumisha; Rajesh Sagar; Maitreyi Sahu; S. Mohammad Sajadi; Marwa Rashad Salem; Abdallah M. Samy; Brijesh Sathian; Aletta Elisabeth Schutte; Abdul-Aziz Seidu; Feng Sha; Omid Shafaat; Mohammad Shahbaz; Masood Ali Shaikh; Mohammed Feyisso Shaka; Aziz Sheikh; Kenji Shibuya; Jae Il Shin; K.M. Shivakumar; Negussie Boti Sidemo; Jasvinder A. Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Amin Soheili; Shahin Soltani; Oluwaseyi Dolapo Somefun; Muluken Bekele Sorrie; Emma Elizabeth Spurlock; Mu'awiyyah Babale Sufiyan; Biruk Wogayehu Taddele; Eyayou Girma Tadesse; Zemenu Tamir; Animut Tagele Tamiru; Frank C. Tanser; Nuno Taveira; Arash Tehrani-Banihashemi; Yohannes Tekalegn; Fisaha Haile Tesfay; Belay Tessema; Zemenu Tadesse Tessema; Bhaskar Thakur; Musliu Adetola Tolani; Roman Topor-Madry; Marco Torrado; Marcos Roberto Tovani-Palone; Eugenio Traini; Alexander C. Tsai; Gebiyaw Wudie Tsegaye; Irfan Ullah; Saif Ullah; Chukwuma David Umeokonkwo; Bhaskaran Unnikrishnan; Constantine Vardavas; Francesco S. Violante; Bay Vo; Yohannes Dibaba Wado; Yasir Waheed; Richard G. Wamai; Yanzhong Wang; Paul Ward; Andrea Werdecker; Nuwan Darshana Wickramasinghe; Tissa Wijeratne; Charles Shey Wiysonge; Temesgen Gebeyehu Wondmeneh; Tomohide Yamada; Sanni Yaya; Yigizie Yeshaw; Yordanos Gizachew Yeshitila; Mekdes Tigistu Yilma; Paul Yip; Naohiro Yonemoto; Tewodros Yosef; Hasan Yusefzadeh; Syed Saoud Zaidi; Leila Zaki; Maryam Zamanian; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Dejene Tesfaye Zewdie; Yunquan Zhang; Zhi-Jiang Zhang; Arash Ziapour; Simon I. Hay; Laura Dwyer-Lindgren
Background: High-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa. Methods: In this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15–49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000–18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit. Findings: The estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2·8 (95% uncertainty interval 2·1–3·8) in Mauritania to 1585·9 (1369·4–1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7–0·9) in Mauritania to 676·5 (513·6–888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8–8120·3]) cases per 100 000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0–1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81·1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020. Interpretation: Our estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas. Funding: Bill & Melinda Gates Foundation. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
The overlapping burden of the three leading causes of disability and death in sub-Saharan African children
(Nature Research, 2022) Robert C. Reiner; Catherine A. Welgan; Christopher E. Troeger; Mathew M. Baumann; Daniel J. Weiss; Aniruddha Deshpande; Brigette F. Blacker; Molly K. Miller-Petrie; Lucas Earl; Samir Bhatt; Hassan Abolhassani; Akine Eshete Abosetugn; Eman Abu-Gharbieh; Victor Adekanmbi; Olatunji O. Adetokunboh; Mohammad Aghaali; Budi Aji; Fares Alahdab; Ziyad Al-Aly; Robert Kaba Alhassan; Saqib Ali; Hesam Alizade; Syed Mohamed Aljunid; Amir Almasi-Hashiani; Hesham M. Al-Mekhlafi; Khalid A. Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Saeed Amini; Dickson A. Amugsi; Robert Ancuceanu; Catalina Liliana Andrei; Fereshteh Ansari; Davood Anvari; Seth Christopher Yaw Appiah; Jalal Arabloo; Olatunde Aremu; Maha Moh’d Wahbi Atout; Marcel Ausloos; Floriane Ausloos; Martin Amogre Ayanore; Yared Asmare Aynalem; Zelalem Nigussie Azene; Alaa Badawi; Atif Amin Baig; Maciej Banach; Neeraj Bedi; Akshaya Srikanth Bhagavathula; Dinesh Bhandari; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Zulfiqar A. Bhutta; Ali Bijani; Tesega Tesega Mengistu Birhanu; Zebenay Workneh Bitew; Archith Boloor; Oliver J. Brady; Zahid A. Butt; Josip Car; Felix Carvalho; Daniel C. Casey; Vijay Kumar Chattu; Mohiuddin Ahsanul Kabir Chowdhury; Dinh-Toi Chu; Camila H. Coelho; Aubrey J. Cook; Giovanni Damiani; Farah Daoud; Jiregna Darega Gela; Amira Hamed Darwish; Ahmad Daryani; Jai K. Das; Nicole Davis Weaver; Kebede Deribe; Assefa Desalew; Samath Dhamminda Dharmaratne; Mostafa Dianatinasab; Daniel Diaz; Shirin Djalalinia; Fariba Dorostkar; Eleonora Dubljanin; Bereket Duko; Laura Dwyer-Lindgren; Andem Effiong; Maysaa El Sayed Zaki; Maha El Tantawi; Shymaa Enany; Nazir Fattahi; Valery L. Feigin; Eduarda Fernandes; Pietro Ferrara; Florian Fischer; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Masoud Foroutan; Joseph Jon Frostad; Takeshi Fukumoto; Abhay Motiramji Gaidhane; Hailemikael Gebrekidan G. K. Gebrekrstos; Leake Gebremeskel; Assefa Ayalew Gebreslassie; Peter W. Gething; Kebede Embaye Gezae; Keyghobad Ghadiri; Ahmad Ghashghaee; Mahaveer Golechha; Mohammed Ibrahim Mohialdeen Gubari; Fikaden Berhe Hadgu; Samer Hamidi; Demelash Woldeyohannes Handiso; Abdiwahab Hashi; Shoaib Hassan; Khezar Hayat; Claudiu Herteliu; Hung Chak Ho; Ramesh Holla; Mehdi Hosseinzadeh; Mowafa Househ; Rabia Hussain; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Seyed Sina Naghibi Irvani; Jalil Jaafari; Tahereh Javaheri; Ravi Prakash Jha; Kimberly B. Johnson; Jost B. Jonas; Jacek Jerzy Jozwiak; Ali Kabir; Rohollah Kalhor; Tanuj Kanchan; André Karch; Gbenga A. Kayode; Peter Njenga Keiyoro; Yousef Saleh Khader; Ibrahim A. Khalil; Md Nuruzzaman Khan; Maseer Khan; Gulfaraz Khan; Khaled Khatab; Mona M. Khater; Mahalaqua Nazli Khatib; Neda Kianipour; Yun Jin Kim; Ruth W. Kimokoti; Sezer Kisa; Adnan Kisa; Niranjan Kissoon; Sonali Kochhar; Ali Koolivand; Jacek A. Kopec; Ai Koyanagi; Kewal Krishan; Pushpendra Kumar; Om P. Kurmi; Dian Kusuma; Dharmesh Kumar Lal; Faris Hasan Lami; Iván Landires; Van Charles Lansingh; Savita Lasrado; Carlo La Vecchia; Alice Lazzar-Atwood; Paul H. Lee; Kate E. LeGrand; Sonia Lewycka; Bingyu Li; Stephen S. Lim; Paulina A. Lindstedt; Xuefeng Liu; Joshua Longbottom; Alan D. Lopez; Hassan Magdy Abd El Razek; Phetole Walter Mahasha; Afshin Maleki; Abdullah A. Mamun; Mohammad Ali Mansournia; Laurie B. Marczak; Francisco Rogerlândio Martins-Melo; Benjamin K. Mayala; Birhanu Geta Meharie; Addisu Melese; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; George A. Mensah; Tuomo J. Meretoja; Tomislav Mestrovic; Ted R. Miller; Erkin M. Mirrakhimov; Babak Moazen; Naser Mohammad Gholi Mezerji; Shadieh Mohammadi; Shafiu Mohammed; Ali H. Mokdad; Masoud Moradi; Rahmatollah Moradzadeh; Paula Moraga; Jonathan F. Mosser; Chrisopher J. L. Murray; Mehdi Naderi; Ahamarshan Jayaraman Nagarajan; Javad Nazari; Rawlance Ndejjo; Ionut Negoi; Josephine W. Ngunjiri; QuynhAnh P. Nguyen; Huong Lan Thi Nguyen; Chukwudi A. Nnaji; Jean Jacques Noubiap; Virginia Nuñez-Samudio; Andrew T. Olagunju; Jacob Olusegun Olusanya; Bolajoko Olubukunola Olusanya; Muktar Omer Omer; Obinna E. Onwujekwe; Nikita Otstavnov; Stanislav S. Otstavnov; Mayowa O. Owolabi; Mahesh P A; Jagadish Rao Padubidri; Adrian Pana; Emmanuel K. Peprah; Hai Quang Pham; David M. Pigott; Majid Pirestani; Maarten J. Postma; Faheem Hyder Pottoo; Hadi Pourjafar; Zahiruddin Quazi Syed; Fakher Rahim; Vafa Rahimi-Movaghar; Mohammad Hifz Ur Rahman; Sowmya J. Rao; Puja C. Rao; Priya Rathi; Salman Rawaf; David Laith Rawaf; Lal Rawal; Reza Rawassizadeh; Lemma Demissie Regassa; Andre M. N. Renzaho; Nima Rezaei; Mohammad Sadegh Rezai; Ana Isabel Ribeiro; Jennifer Rickard; Carlos Miguel Rios-González; Susan Fred Rumisha; Siamak Sabour; S. Mohammad Sajadi; Joshua A. Salomon; Hossein Samadi Kafil; Abdallah M. Samy; Juan Sanabria; Benn Sartorius; Deepak Saxena; Lauren E. Schaeffer; Subramanian Senthilkumaran; Feng Sha; Amira A. Shaheen; Masood Ali Shaikh; Rajesh Sharma; Aziz Sheikh; Kenji Shibuya; Mika Shigematsu; Jae Il Shin; Biagio Simonetti; Jasvinder A. Singh; David L. Smith; Amin Soheili; Anton Sokhan; Emma Elizabeth Spurlock; Chandrashekhar T. Sreeramareddy; Mu’awiyyah Babale Sufiyan; Scott J. Swartz; Degena Bahrey Tadesse; Animut Tagele Tamiru; Yonas Getaye Tefera; Mohamad-Hani Temsah; Zemenu Tadesse Tessema; Mariya Vladimirovna Titova; Bach Xuan Tran; Phuong N. Truong; Bhaskaran Unnikrishnan; Era Upadhyay; Tommi Juhani Vasankari; Yasser Vasseghian; Francesco S. Violante; Giang Thu Vu; Yasir Waheed; Richard G. Wamai; Emebet Gashaw Wassie; Fissaha Tekulu Welay; Nuwan Darshana Wickramasinghe; Kirsten E. Wiens; Tissa Wijeratne; Charles Shey Wiysonge; Temesgen Gebeyehu Wondmeneh; Tomohide Yamada; Sanni Yaya; Yordanos Gizachew Yeshitila; Paul Yip; Naohiro Yonemoto; Chuanhua Yu; Deniz Yuce; Hasan Yusefzadeh; Zoubida Zaidi; Maryam Zamanian; Alireza Zangeneh; Zhi-Jiang Zhang; Yunquan Zhang; Arash Ziapour; Simon I. Hay
Despite substantial declines since 2000, lower respiratory infections (LRIs), diarrhoeal diseases, and malaria remain among the leading causes of nonfatal and fatal disease burden for children under 5 years of age (under 5), primarily in sub-Saharan Africa (SSA). The spatial burden of each of these diseases has been estimated subnationally across SSA, yet no prior analyses have examined the pattern of their combined burden. Here we synthesise subnational estimates of the burden of LRIs, diarrhoea, and malaria in children under-5 from 2000 to 2017 for 43 sub-Saharan countries. Some units faced a relatively equal burden from each of the three diseases, while others had one or two dominant sources of unit-level burden, with no consistent pattern geographically across the entire subcontinent. Using a subnational counterfactual analysis, we show that nearly 300 million DALYs could have been averted since 2000 by raising all units to their national average. Our findings are directly relevant for decision-makers in determining which and targeting where the most appropriate interventions are for increasing child survival. © 2022, The Author(s).