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    PublicationArticle
    Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2022) Hmwe Hmwe Kyu; Avina Vongpradith; Sarah Brooke Sirota; Amanda Novotney; Christopher E Troeger; Matthew C Doxey; Rose G Bender; Jorge R Ledesma; Molly H Biehl; Samuel B Albertson; Joseph Jon Frostad; Katrin Burkart; Fiona B Bennitt; Jeff T Zhao; William M Gardner; Hailey Hagins; Dana Bryazka; Regina-Mae Villanueva Dominguez; Semagn Mekonnen Abate; Michael Abdelmasseh; Amir Abdoli; Gholamreza Abdoli; Aidin Abedi; Vida Abedi; Tadesse M Abegaz; Hassan Abidi; Richard Gyan Aboagye; Hassan Abolhassani; Yonas Derso Abtew; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Ahmed Abu-Zaid; Kidist Adamu; Isaac Yeboah Addo; Oyelola A Adegboye; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Muhammad Sohail Afzal; Saira Afzal; Bright Opoku Ahinkorah; Aqeel Ahmad; Araz Ramazan Ahmad; Sajjad Ahmad; Ali Ahmadi; Sepideh Ahmadi; Haroon Ahmed; Jivan Qasim Ahmed; Tarik Ahmed Rashid; Mostafa Akbarzadeh-Khiavi; Hanadi Al Hamad; Luciana Albano; Mamoon A Aldeyab; Bezatu Mengistie Alemu; Kefyalew Addis Alene; Abdelazeem M Algammal; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Beriwan Abdulqadir Ali; Liaqat Ali; Musa Mohammed Ali; Syed Shujait Ali; Yousef Alimohamadi; Vahid Alipour; Adel Al-Jumaily; Syed Mohamed Aljunid; Sami Almustanyir; Rajaa M Al-Raddadi; Rami H Hani Al-Rifai; Saif Aldeen S AlRyalat; Nelson Alvis-Guzman; Nelson J Alvis-Zakzuk; Edward Kwabena Ameyaw; Javad Javad Aminian Dehkordi; John H Amuasi; Dickson A Amugsi; Etsay Woldu Anbesu; Adnan Ansar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Demelash Areda; Ayele Mamo Argaw; Zeleke Gebru Argaw; Judie Arulappan; Raphael Taiwo Aruleba; Mulusew A Asemahagn; Seyyed Shamsadin Athari; Daniel Atlaw; Engi F Attia; Sameh Attia; Avinash Aujayeb; Tewachew Awoke; Tegegn Mulatu Ayana; Martin Amogre Ayanore; Sina Azadnajafabad; Mohammadreza Azangou-Khyavy; Samad Azari; Amirhossein Azari Jafari; Muhammad Badar; Ashish D Badiye; Nayereh Baghcheghi; Sara Bagherieh; Atif Amin Baig; MacIej Banach; Indrajit Banerjee; Mainak Bardhan; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Azadeh Bashiri; Quique Bassat; Abdul-Monim Mohammad Batiha; Abate Bekele Belachew; Melaku Ashagrie Belete; Uzma Iqbal Belgaumi; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Parth Bhatt; Vijayalakshmi S Bhojaraja; Zulfiqar A Bhutta; Soumitra S Bhuyan; Ali Bijani; Saeid Bitaraf; Belay Boda Abule Bodicha; Nikolay Ivanovich Briko; Danilo Buonsenso; Muhammad Hammad Butt; Jiao Cai; Paulo Camargos; Luis Alberto Cámera; Promit Ananyo Chakraborty; Muluken Genetu Chanie; Jaykaran Charan; Vijay Kumar Chattu; Patrick R Ching; Sungchul Choi; Yuen Yu Chong; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Devasahayam J Christopher; Dinh-Toi Chu; Natalie L Cobb; Aaron J Cohen; Natália Cruz-Martins; Omid Dadras; Fentaw Teshome Dagnaw; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; An Thi Minh Dao; Sisay Abebe Debela; Biniyam Demisse; Fitsum Wolde Demisse; Solomon Demissie; Diriba Dereje; Hardik Dineshbhai Desai; Abebaw Alemayehu Desta; Belay Desye; Sameer Dhingra; Nancy Diao; Daniel Diaz; Lankamo Ena Digesa; Linh Phuong Doan; Milad Dodangeh; Deepa Dongarwar; Fariba Dorostkar; Wendel Mombaque Dos Santos; Haneil Larson Dsouza; Eleonora Dubljanin; Oyewole Christopher Durojaiye; Hisham Atan Edinur; Elham Ehsani-Chimeh; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Eman D El Desouky; Iman El Sayed; Maysaa El Sayed Zaki; Muhammed Elhadi; Ahmed Mahmoud Rabie Elkhapery; Amir Emami; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Farshid Etaee; Mohamad Ezati Asar; Adeniyi Francis Fagbamigbe; Shahab Falahi; Aida Fallahzadeh; Anwar Faraj; Emerito Jose A Faraon; Ali Fatehizadeh; Pietro Ferrara; Allegra Allegra Ferrari; Getahun Fetensa; Florian Fischer; Joanne Flavel; Masoud Foroutan; Peter Andras Gaal; Abhay Motiramji Gaidhane; Santosh Gaihre; Nasrin Galehdar; Alberto L Garcia-Basteiro; Tushar Garg; Mesfin Damtew Gebrehiwot; Mathewos Alemu Gebremichael; Yibeltal Yismaw Gela; Belete Negese Belete Gemeda; Bradford D Gessner; Melaku Getachew; Asmare Getie; Seyyed-Hadi Ghamari; Mohammad Ghasemi Nour; Ahmad Ghashghaee; Ali Gholamrezanezhad; Abdolmajid Gholizadeh; Rakesh Ghosh; Sherief Ghozy; Pouya Goleij; Mohamad Golitaleb; Giuseppe Gorini; Alessandra C Goulart; Girma Garedew Goyomsa; Habtamu Alganeh Guadie; Zewdie Gudisa; Rashid Abdi Guled; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Alemu Guta; Parham Habibzadeh; Arvin Haj-Mirzaian; Rabih Halwani; Samer Hamidi; Md Abdul Hannan; Mehdi Harorani; Ahmed I Hasaballah; Hamidreza Hasani; Abbas M Hassan; Shokoufeh Hassani; Hossein Hassanian-Moghaddam; Hadi Hassankhani; Khezar Hayat; Behzad Heibati; Mohammad Heidari; Demisu Zenbaba Heyi; Kamal Hezam; Ramesh Holla; Sung Hwi Hong; Nobuyuki Horita; Mohammad-Salar Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Soodabeh Hoveidamanesh; Junjie Huang; Nawfal R Hussein; Ivo Iavicoli; Segun Emmanuel Ibitoye; Kevin S Ikuta; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mustapha Immurana; Nahlah Elkudssiah Ismail; Masao Iwagami; Jalil Jaafari; Elham Jamshidi; Sung-In Jang; Amirreza Javadi Mamaghani; Tahereh Javaheri; Fatemeh Javanmardi; Javad Javidnia; Sathish Kumar Jayapal; Umesh Jayarajah; Shubha Jayaram; Alelign Tasew Jema; Wonjeong Jeong; Jost B Jonas; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; V. K; Zubair Kabir; Salah Eddine Oussama Kacimi; Vidya Kadashetti; Laleh R Kalankesh; Rohollah Kalhor; Ashwin Kamath; Bhushan Dattatray Kamble; Himal Kandel; Tesfaye K Kanko; Ibraheem M Karaye; André Karch; Samad Karkhah; Bekalu Getnet Kassa; Patrick D M C Katoto; Harkiran Kaur; Rimple Jeet Kaur; Leila Keikavoosi-Arani; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Ejaz Ahmad Khan; Gulfaraz Khan; Imteyaz A Khan; Maseer Khan; Md Nuruzzaman Khan; Moien A B Khan; Yusra H Khan; Moawiah Mohammad Khatatbeh; Mina Khosravifar; Jagdish Khubchandani; Min Seo Kim; Ruth W Kimokoti; Adnan Kisa; Sezer Kisa; Niranjan Kissoon; Luke D Knibbs; Sonali Kochhar; Farzad Kompani; Hamid Reza Koohestani; Vladimir Andreevich Korshunov; Soewarta Kosen; Parvaiz A Koul; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; G Anil Kumar; Om P Kurmi; Ambily Kuttikkattu; Dharmesh Kumar Lal; Judit Lám; Iván Landires; Caterina Ledda; Sang-Woong Lee; Miriam Levi; Sonia Lewycka; Gang Liu; Wei Liu; Rakesh Lodha; László Lorenzovici; Mojgan Lotfi; Joana A Loureiro; Farzan Madadizadeh; Ata Mahmoodpoor; Razzagh Mahmoudi; Marzieh Mahmoudimanesh; Jamal Majidpoor; Alaa Makki; Elaheh Malakan Rad; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Yosef Manla; Clara N Matei; Alexander G Mathioudakis; Richard James Maude; Entezar Mehrabi Nasab; Addisu Melese; Ziad A Memish; Oliver Mendoza-Cano; Alexios-Fotios A Mentis; Tuomo J Meretoja; Mehari Woldemariam Merid; Tomislav Mestrovic; Ana Carolina Micheletti Gomide Nogueira De Sá; Gelana Fekadu Worku Mijena; Le Huu Nhat Minh; Shabir Ahmad Mir; Reza Mirfakhraie; Seyyedmohammadsadeq Mirmoeeni; Agha Zeeshan Mirza; Moonis Mirza; Mohammad Mirza-Aghazadeh-Attari; Abay Sisay Misganaw; Awoke Temesgen Misganaw; Esmaeil Mohammadi; Mokhtar Mohammadi; Arif Mohammed; Shafiu Mohammed; Syam Mohan; Mohammad Mohseni; Nagabhishek Moka; Ali H Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Md Moniruzzaman; Fateme Montazeri; Catrin E Moore; Abdolvahab Moradi; Lidia Morawska; Jonathan F Mosser; Ebrahim Mostafavi; Majid Motaghinejad; Haleh Mousavi Isfahani; Seyed Ali Mousavi-Aghdas; Sumaira Mubarik; Efrén Murillo-Zamora; Ghulam Mustafa; Sanjeev Nair; Tapas Sadasivan Nair; Houshang Najafi; Atta Abbas Naqvi; Sreenivas Narasimha Swamy; Zuhair S Natto; Biswa Prakash Nayak; Seyed Aria Nejadghaderi; Huy Van Nguyen Nguyen; Robina Khan Niazi; Antonio Tolentino Nogueira De Sá; Hasti Nouraei; Ali Nowroozi; Virginia Nuñez-Samudio; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Chimedsuren Ochir; Oluwakemi Ololade Odukoya; Hassan Okati-Aliabad; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Isaac Iyinoluwa Olufadewa; Ahmed Omar Bali; Emad Omer; Eyal Oren; Erika Ota; Nikita Otstavnov; Abderrahim Oulhaj; P.A. Mahesh; Jagadish Rao Padubidri; Keyvan Pakshir; Reza Pakzad; Tamás Palicz; Anamika Pandey; Suman Pant; Shahina Pardhan; Eun-Cheol Park; Eun-Kee Park; Fatemeh Pashazadeh Kan; Rajan Paudel; Shrikant Pawar; Minjin Peng; Gavin Pereira; Simone Perna; Navaraj Perumalsamy; Ionela-Roxana Petcu; David M Pigott; Zahra Zahid Piracha; Vivek Podder; Roman V Polibin; Maarten J Postma; Hamid Pourasghari; Naeimeh Pourtaheri; Mirza Muhammad Fahd Qadir; Mathieu Raad; Mohammad Rabiee; Navid Rabiee; Saber Raeghi; Alireza Rafiei; Fakher Rahim; Mehran Rahimi; Vafa Rahimi-Movaghar; Azizur Rahman; Md Obaidur Rahman; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Pradhum Ram; Kiana Ramezanzadeh; Juwel Rana; Priyanga Ranasinghe; Usha Rani; Sowmya J Rao; Sina Rashedi; Mohammad-Mahdi Rashidi; Azad Rasul; Zubair Ahmed Ratan; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Marissa B Reitsma; Andre M N Renzaho; Mohsen Rezaeian; Abanoub Riad; Reza Rikhtegar; Jefferson Antonio Buendia Rodriguez; Emma L B Rogowski; Luca Ronfani; Kristina E Rudd; Basema Saddik; Erfan Sadeghi; Umar Saeed; Azam Safary; Sher Zaman Safi; Maryam Sahebazzamani; Amirhossein Sahebkar; Sateesh Sakhamuri; Sana Salehi; Muhammad Salman; Hossein Samadi Kafil; Abdallah M Samy; Milena M Santric-Milicevic; Bruno Piassi Sao Jose; Maryam Sarkhosh; Brijesh Sathian; Monika Sawhney; Ganesh Kumar Saya; Abdul-Aziz Seidu; Allen Seylani; Amira A Shaheen; Masood Ali Shaikh; Elaheh Shaker; Hina Shamshad; Mequannent Melaku Sharew; Asaad Sharhani; Azam Sharifi; Purva Sharma; Ali Sheidaei; Suchitra M Shenoy; Jeevan K Shetty; Damtew Solomon Shiferaw; Mika Shigematsu; Jae Il Shin; Hesamaddin Shirzad-Aski; K.M. Shivakumar; Siddharudha Shivalli; Parnian Shobeiri; Wudneh Simegn; Colin R Simpson; Harpreet Singh; Jasvinder A Singh; Paramdeep Singh; Samarjeet Singh Siwal; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Mohammad Sadegh Soltani-Zangbar; Suhang Song; Yimeng Song; Prashant Sood; Chandrashekhar T Sreeramareddy; Paschalis Steiropoulos; Muhammad Suleman; Seyed-Amir Tabatabaeizadeh; Alireza Tahamtan; Majid Taheri; Moslem Taheri Soodejani; Elahe Taki; Iman M Talaat; Mircea Tampa; Sarmila Tandukar; Nathan Y Tat; Vivian Y Tat; Yibekal Manaye Tefera; Gebremaryam Temesgen; Mohamad-Hani Temsah; Azene Tesfaye; Degefa Gomora Tesfaye; Belay Tessema; Rekha Thapar; Jansje Henny Vera Ticoalu; Amir Tiyuri; Imad I Tleyjeh; Munkhsaikhan Togtmol; Marcos Roberto Tovani-Palone; Derara Girma Tufa; Irfan Ullah; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R Valdez; Rohollah Valizadeh; Constantine Vardavas; Tommi Juhani Vasankari; Bay Vo; Linh Gia Vu; Birhanu Wagaye; Yasir Waheed; Yu Wang; Abdul Waris; T Eoin West; Nuwan Darshana Wickramasinghe; Xiaoyue Xu; Sajad Yaghoubi; Gahin Abdulraheem Tayib Yahya; Seyed Hossein Yahyazadeh Jabbari; Dong Keon Yon; Naohiro Yonemoto; Burhan Abdullah Zaman; Alireza Zandifar; Moein Zangiabadian; Heather J Zar; Iman Zare; Zahra Zareshahrabadi; Armin Zarrintan; Mikhail Sergeevich Zastrozhin; Wu Zeng; Mengxi Zhang; Zhi-Jiang Zhang; Chenwen Zhong; Mohammad Zoladl; Alimuddin Zumla; Stephen S Lim; Theo Vos; Mohsen Naghavi; Michael Brauer; Simon I Hay; Christopher J L Murray
    Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–482.8, 483.0–483.9, 484.1–484.2, 484.6–484.7, and 487–489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4–B97.6, J09–J15.8, J16–J16.9, J20–J21.9, J91.0, P23.0–P23.4, and U04–U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age–sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age–sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. Findings: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240–275) LRI incident episodes in males and 232 million (217–248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18–1·42) male deaths and 1·20 million (1·07–1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16–1·18) and 1·31 times (95% UI 1·23–1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4–131·1]) and deaths (100·0% [83·4–115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (–70·7% [–77·2 to –61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7–61·8] in males and 56·4% [40·7–65·1] in females), and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6–35·5] for males and PAF 25·8% [16·3–35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4–25·2) in those aged 15–49 years, 30·5% (24·1–36·9) in those aged 50–69 years, and 21·9% (16·8–27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5–27·9) in those aged 15–49 years and 18·2% (12·5–24·5) in those aged 50–69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2–15·8) of LRI deaths. Interpretation: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    PublicationArticle
    Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2022) Annie Haakenstad; Jamal Akeem Yearwood; Nancy Fullman; Corinne Bintz; Kelly Bienhoff; Marcia R Weaver; Vishnu Nandakumar; Jonah N Joffe; Kate E LeGrand; Megan Knight; Cristiana Abbafati; Mohsen Abbasi-Kangevari; Amir Abdoli; Roberto Ariel Abeldaño Zuñiga; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Olatunji O Adetokunboh; Muhammad Sohail Afzal; Saira Afzal; Marcela Agudelo-Botero; Bright Opoku Ahinkorah; Sajjad Ahmad; Ali Ahmadi; Sepideh Ahmadi; Ali Ahmed; Tarik Ahmed Rashid; Budi Aji; Wuraola Akande-Sholabi; Khurshid Alam; Hanadi Al Hamad; Robert Kaba Alhassan; Liaqat Ali; Vahid Alipour; Syed Mohamed Aljunid; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Hubert Amu; Dickson A Amugsi; Robert Ancuceanu; Pedro Prata Andrade; Afifa Anjum; Jalal Arabloo; Morteza Arab-Zozani; Hany Ariffin; Judie Arulappan; Zahra Aryan; Tahira Ashraf; Desta Debalkie Atnafu; Alok Atreya; Marcel Ausloos; Leticia Avila-Burgos; Getinet Ayano; Martin Amogre Ayanore; Samad Azari; Ashish D Badiye; Atif Amin Baig; Mohan Bairwa; Shankar M Bakkannavar; Shrikala Baliga; Palash Chandra Banik; Till Winfried Bärnighausen; Fabio Barra; Amadou Barrow; Sanjay Basu; Mohsen Bayati; Rebuma Belete; Arielle Wilder Bell; Devidas S Bhagat; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Nikha Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Zulfiqar A Bhutta; Sadia Bibi; Ali Bijani; Boris Bikbov; Antonio Biondi; Obasanjo Afolabi Bolarinwa; Aime Bonny; Hermann Brenner; Danilo Buonsenso; Katrin Burkart; Reinhard Busse; Zahid A Butt; Nadeem Shafique Butt; Florentino Luciano Caetano Dos Santos; Lucero Cahuana-Hurtado; Luis Alberto Cámera; Rosario Cárdenas; Vera L A Carneiro; Ferrán Catalá-López; Joht Singh Chandan; Jaykaran Charan; Prachi P Chavan; Simiao Chen; Shu Chen; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Mohiuddin Ahsanul Kabir Chowdhury; Massimo Cirillo; Barbara Corso; Omid Dadras; Saad M A Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; William James Dangel; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Keshab Deuba; Meghnath Dhimal; Mandira Lamichhane Dhimal; Shirin Djalalinia; Huyen Phuc Do; Leila Doshmangir; Bruce B Duncan; Andem Effiong; Elham Ehsani-Chimeh; Islam Y Elgendy; Muhammed Elhadi; Iman El Sayed; Maha El Tantawi; Daniel Asfaw Erku; Sharareh Eskandarieh; Jawad Fares; Farshad Farzadfar; Simone Ferrero; Lorenzo Ferro Desideri; Florian Fischer; Nataliya A Foigt; Masoud Foroutan; Takeshi Fukumoto; Peter Andras Gaal; Santosh Gaihre; William M Gardner; Tushar Garg; Abera Getachew Obsa; Mansour Ghafourifard; Ahmad Ghashghaee; Nermin Ghith; Syed Amir Gilani; Paramjit Singh Gill; Salime Goharinezhad; Mahaveer Golechha; Jenny S Guadamuz; Yuming Guo; Rajat Das Gupta; Rajeev Gupta; Vivek Kumar Gupta; Veer Bala Gupta; Mohammad Hamiduzzaman; Asif Hanif; Josep Maria Haro; Ahmed I Hasaballah; Md Mehedi Hasan; M Tasdik Hasan; Abdiwahab Hashi; Simon I Hay; Khezar Hayat; Mohammad Heidari; Golnaz Heidari; Nathaniel J Henry; Claudiu Herteliu; Ramesh Holla; Sahadat Hossain; Sheikh Jamal Hossain; Mohammad Bellal Hossain Hossain; Mehdi Hosseinzadeh; Sorin Hostiuc; Soodabeh Hoveidamanesh; Vivian Chia-Rong Hsieh; Guoqing Hu; Junjie Huang; M Mamun Huda; Susan C Ifeagwu; Kevin S Ikuta; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Rakibul M Islam; Sheikh Mohammed Shariful Islam; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Ramaiah Itumalla; Masao Iwagami; Mohammad Ali Jahani; Nader Jahanmehr; Rajesh Jain; Mihajlo Jakovljevic; Manthan Dilipkumar Janodia; Sathish Kumar Jayapal; Shubha Jayaram; Ravi Prakash Jha; Jost B Jonas; Tamas Joo; Nitin Joseph; Mikk Jürisson; Ali Kabir; Leila R Kalankesh; Rohollah Kalhor; Aruna M Kamath; Kaloyan Kamenov; Himal Kandel; Rami S Kantar; Neeti Kapoor; Marina Karanikolos; Srinivasa Vittal Katikireddi; Taras Kavetskyy; Norito Kawakami; Gbenga A Kayode; Leila Keikavoosi-Arani; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Rovshan Khalilov; Mohammad Khammarnia; Md Nuruzzaman Khan; Moien A B Khan; Maseer Khan; Mehdi Khezeli; Min Seo Kim; Yun Jin Kim; Sezer Kisa; Adnan Kisa; Vitalii Klymchuk; Kamrun Nahar Koly; Oleksii Korzh; Soewarta Kosen; Parvaiz A Koul; Barthelemy Kuate Defo; G Anil Kumar; Dian Kusuma; Hmwe Hmwe Kyu; Anders O Larsson; Savita Lasrado; Wei-Chen Lee; Yo Han Lee; Chiachi Bonnie Lee; Shanshan Li; Giancarlo Lucchetti; Preetam Bhalchandra Mahajan; Azeem Majeed; Alaa Makki; Reza Malekzadeh; Ahmad Azam Malik; Deborah Carvalho Malta; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Adolfo Martinez-Valle; Francisco Rogerlândio Martins-Melo; Seyedeh Zahra Masoumi; Manu Raj Mathur; Richard James Maude; Pallab K Maulik; Martin McKee; Walter Mendoza; Ritesh G Menezes; George A Mensah; Atte Meretoja; Tuomo J Meretoja; Tomislav Mestrovic; Irmina Maria Michalek; Erkin M Mirrakhimov; Awoke Misganaw; Sanjeev Misra; Babak Moazen; Mokhtar Mohammadi; Shafiu Mohammed; Modhurima Moitra; Ali H Mokdad; Mariam Molokhia; Lorenzo Monasta; Mohammad Ali Moni; Ghobad Moradi; Rafael Silveira Moreira; Jonathan F Mosser; Ebrahim Mostafavi; Simin Mouodi; Ahamarshan Jayaraman Nagarajan; Chie Nagata; Mohsen Naghavi; Vinay Nangia; Sreenivas Narasimha Swamy; Aparna Ichalangod Narayana; Bruno Ramos Nascimento; Hasan Nassereldine; Biswa Prakash Nayak; Javad Nazari; Ionut Negoi; Samata Nepal; Sandhya Neupane Kandel; Josephine W Ngunjiri; Huong Lan Thi Nguyen; Cuong Tat Nguyen; Dina Nur Anggraini Ningrum; Jean Jacques Noubiap; Bogdan Oancea; Onome Bright Oghenetega; In-Hwan Oh; Andrew T Olagunju; Babayemi Oluwaseun Olakunde; Ahmed Omar Bali; Emad Omer; Obinna E Onwujekwe; Adrian Otoiu; Jagadish Rao Padubidri; Raffaele Palladino; Adrian Pana; Songhomitra Panda-Jonas; Seithikurippu R Pandi-Perumal; Shahina Pardhan; Deepak Kumar Pasupula; Praveen Kumar Pathak; George C Patton; Shrikant Pawar; Jeevan Pereira; Manju Pilania; Bakhtiar Piroozi; Vivek Podder; Khem Narayan Pokhrel; Maarten J Postma; Sergio I Prada; Zahiruddin Quazi Syed; Navid Rabiee; Raghu Anekal Radhakrishnan; Md. Mosfequr Rahman; Mosiur Rahman; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Amir Masoud Rahmani; Chhabi Lal Ranabhat; Chythra R Rao; Sowmya J Rao; Davide Rasella; Salman Rawaf; David Laith Rawaf; Lal Rawal; Andre M N Renzaho; Bhageerathy Reshmi; Serge Resnikoff; Aziz Rezapour; Seyed Mohammad Riahi; Rezaul Karim Ripon; Simona Sacco; Masoumeh Sadeghi; Umar Saeed; Amirhossein Sahebkar; Biniyam Sahiledengle; Harihar Sahoo; Maitreyi Sahu; Joseph S Salama; Payman Salamati; Abdallah M Samy; Juan Sanabria; Milena M Santric-Milicevic; Brijesh Sathian; Monika Sawhney; Maria Inês Schmidt; Abdul-Aziz Seidu; Sadaf G Sepanlou; Allen Seylani; Masood Ali Shaikh; Aziz Sheikh; Adithi Shetty; Mika Shigematsu; Rahman Shiri; K.M. Shivakumar; Azad Shokri; Jasvinder A Singh; Dhirendra Narain Sinha; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Ahmad Sofi-Mahmudi; Raúl A R C Sousa; Jacqueline H Stephens; Jing Sun; Miklós Szócska; Rafael Tabarés-Seisdedos; Hooman Tadbiri; Animut Tagele Tamiru; Kavumpurathu Raman Thankappan; Roman Topor-Madry; Marcos Roberto Tovani-Palone; Mai Thi Ngoc Tran; Bach Xuan Tran; Niharika Tripathi; Jaya Prasad Tripathy; Christopher E Troeger; Deinzel Robles Uezono; Saif Ullah; Anayat Ullah; Bhaskaran Unnikrishnan; Marco Vacante; Sahel Valadan Tahbaz; Pascual R Valdez; Milena Vasic; Massimiliano Veroux; Dominique Vervoort; Francesco S Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Bay Vo; Yasir Waheed; Richard G Wamai; Yuan-Pang Wang; Yanzhong Wang; Paul Ward; Taweewat Wiangkham; Lalit Yadav; Seyed Hossein Yahyazadeh Jabbari; Kazumasa Yamagishi; Sanni Yaya; Vahid Yazdi-Feyzabadi; Siyan Yi; Vahit Yiǧit; Naohiro Yonemoto; Mustafa Z Younis; Chuanhua Yu; Ismaeel Yunusa; Sojib Bin Zaman; Mikhail Sergeevich Zastrozhin; Zhi-Jiang Zhang; Chenwen Zhong; Yves Miel H Zuniga; Stephen S Lim; Christopher J L Murray; Rafael Lozano
    Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0–74 years) from scores for select age groups: the young (ages 0–14 years), working (ages 15–64 years), and post-working (ages 65–74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9–21·3), as well as among the young (22·5, 19·9–24·7), working (17·2, 15·2–19·1), and post-working (15·1, 13·2–17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6–33·0) on average in low-SDI countries to 83·4 (82·4–84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4–89·0), working (33·8–82·8), and post-working (30·4–79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2022) Ewerton Cousin; Bruce B. Duncan; Caroline Stein; Kanyin Liane Ong; Theo Vos; Cristiana Abbafati; Mohsen Abbasi-Kangevari; Michael Abdelmasseh; Amir Abdoli; Rami Abd-Rabu; Hassan Abolhassani; Eman Abu-Gharbieh; Manfred Mario Kokou Accrombessi; Qorinah Estiningtyas Sakilah Adnani; Muhammad Sohail Afzal; Gina Agarwal; Krishna K. Agrawaal; Marcela Agudelo-Botero; Bright Opoku Ahinkorah; Sajjad Ahmad; Tauseef Ahmad; Keivan Ahmadi; Sepideh Ahmadi; Ali Ahmadi; Ali Ahmed; Yusra Ahmed Salih; Wuraola Akande-Sholabi; Tayyaba Akram; Hanadi Al Hamad; Ziyad Al-Aly; Jacqueline Elizabeth Alcalde-Rabanal; Vahid Alipour; Syed Mohamed Aljunid; Rajaa M. Al-Raddadi; Nelson Alvis-Guzman; Saeed Amini; Robert Ancuceanu; Tudorel Andrei; Catalina Liliana Andrei; Ranjit Mohan Anjana; Adnan Ansar; Ippazio Cosimo Antonazzo; Benny Antony; Anayochukwu Edward Anyasodor; Jalal Arabloo; Damian Arizmendi; Benedetta Armocida; Anton A. Artamonov; Judie Arulappan; Zahra Aryan; Samaneh Asgari; Tahira Ashraf; Thomas Astell-Burt; Prince Atorkey; Maha Moh'd Wahbi Atout; Martin Amogre Ayanore; Ashish D. Badiye; Atif Amin Baig; Mohan Bairwa; Jennifer L. Baker; Ovidiu Constantin Baltatu; Palash Chandra Banik; Anthony Barnett; Mark Thomaz Ugliara Barone; Francesco Barone-Adesi; Amadou Barrow; Neeraj Bedi; Rebuma Belete; Uzma Iqbal Belgaumi; Arielle Wilder Bell; Derrick A. Bennett; Isabela M. Bensenor; David Beran; Akshaya Srikanth Bhagavathula; Sonu Bhaskar; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Ali Bijani; Boris Bikbov; Setognal Birara; Virginia Bodolica; Aime Bonny; Hermann Brenner; Nikolay Ivanovich Briko; Zahid A. Butt; Florentino Luciano Caetano dos Santos; Luis Alberto Cámera; Ismael R. Campos-Nonato; Yin Cao; Chao Cao; Ester Cerin; Promit Ananyo Chakraborty; Joht Singh Chandan; Vijay Kumar Chattu; Simiao Chen; Jee-Young Jasmine Choi; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Dinh-Toi Chu; Barbara Corso; Omid Dadras; Xiaochen Dai; Albertino Antonio Moura Damasceno; Lalit Dandona; Rakhi Dandona; Claudio Alberto Dávila-Cervantes; Jan-Walter De Neve; Edgar Denova-Gutiérrez; Deepak Dhamnetiya; Daniel Diaz; Sanam Ebtehaj; Hisham Atan Edinur; Sahar Eftekharzadeh; Iman El Sayed; Islam Y. Elgendy; Muhammed Elhadi; Mohamed A. Elmonem; Mohammed Faisaluddin; Umar Farooque; Xiaoqi Feng; Eduarda Fernandes; Florian Fischer; David Flood; Marisa Freitas; Peter Andras Gaal; Mohamed M. Gad; Piyada Gaewkhiew; Lemma Getacher; Mansour Ghafourifard; Reza Ghanei Gheshlagh; Ahmad Ghashghaee; Nermin Ghith; Ghozali Ghozali; Paramjit Singh Gill; Ibrahim Abdelmageed Ginawi; Ekaterina Vladimirovna Glushkova; Mahaveer Golechha; Sameer Vali Gopalani; Rafael Alves Guimarães; Rajat Das Gupta; Rajeev Gupta; Vivek Kumar Gupta; Veer Bala Gupta; Sapna Gupta; Tesfa Dejenie Habtewold; Nima Hafezi-Nejad; Rabih Halwani; Asif Hanif; Graeme J. Hankey; Shafiul Haque; Ahmed I. Hasaballah; Syed Shahzad Hasan; Abdiwahab Hashi; Soheil Hassanipour; Simon I. Hay; Khezar Hayat; Mohammad Heidari; Mohammad Bellal Hossain Hossain; Sahadat Hossain; Mostafa Hosseini; Soodabeh Hoveidamanesh; Junjie Huang; Ayesha Humayun; Rabia Hussain; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Kevin S. Ikuta; Leeberk Raja Inbaraj; Usman Iqbal; Md Shariful Islam; Sheikh Mohammed Shariful Islam; Rakibul M. Islam; Nahlah Elkudssiah Ismail; Gaetano Isola; Ramaiah Itumalla; Masao Iwagami; Ihoghosa Osamuyi Iyamu; Mohammad Ali Jahani; Mihajlo Jakovljevic; Ranil Jayawardena; Ravi Prakash Jha; Oommen John; Jost B. Jonas; Tamas Joo; Ali Kabir; Rohollah Kalhor; Ashwin Kamath; Tanuj Kanchan; Himal Kandel; Neeti Kapoor; Gbenga A. Kayode; Sewnet Adem Kebede; Pedram Keshavarz; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Moien A. B. Khan; Md Nuruzzaman Khan; Maseer Khan; Amir M. Khater; Tawfik Ahmed Muthafer Khoja; Jagdish Khubchandani; Min Seo Kim; Yun Jin Kim; Ruth W. Kimokoti; Sezer Kisa; Adnan Kisa; Mika Kivimäki; Vladimir Andreevich Korshunov; Oleksii Korzh; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; G. Anil Kumar; Nithin Kumar; Dian Kusuma; Carlo La Vecchia; Ben Lacey; Anders O. Larsson; Savita Lasrado; Wei-Chen Lee; Chiachi Bonnie Lee; Paul H. Lee; Shaun Wen Huey Lee; Ming-Chieh Li; Stephen S. Lim; Lee-Ling Lim; Giancarlo Lucchetti; Azeem Majeed; Ahmad Azam Malik; Borhan Mansouri; Lorenzo Giovanni Mantovani; Santi Martini; Prashant Mathur; Colm McAlinden; Nafiul Mehedi; Teferi Mekonnen; Ritesh G. Menezes; Amanual Getnet Mersha; Junmei Miao Jonasson; Tomasz Miazgowski; Irmina Maria Michalek; Andreea Mirica; Erkin M. Mirrakhimov; Agha Zeeshan Mirza; Prasanna Mithra; Abdollah Mohammadian-Hafshejani; Reza Mohammadpourhodki; Arif Mohammed; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Mohammad Ali Moni; Farhad Moradpour; Rahmatollah Moradzadeh; Ebrahim Mostafavi; Ulrich Otto Mueller; Christopher J. L. Murray; Ahmad Mustafa; Gabriele Nagel; Vinay Nangia; Atta Abbas Naqvi; Biswa Prakash Nayak; Javad Nazari; Rawlance Ndejjo; Ruxandra Irina Negoi; Sandhya Neupane Kandel; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Jean Jacques Noubiap; Christoph Nowak; Bogdan Oancea; Oluwakemi Ololade Odukoya; Ayodipupo Sikiru Oguntade; Temitope T. Ojo; Andrew T. Olagunju; Obinna E. Onwujekwe; Alberto Ortiz; Mayowa O. Owolabi; Raffaele Palladino; Songhomitra Panda-Jonas; Seithikurippu R. Pandi-Perumal; Shahina Pardhan; Tarang Parekh; Mojtaba Parvizi; Veincent Christian Filipino Pepito; Arokiasamy Perianayagam; Ionela-Roxana Petcu; Manju Pilania; Vivek Podder; Roman V. Polibin; Maarten J. Postma; Akila Prashant; Navid Rabiee; Mohammad Rabiee; Vafa Rahimi-Movaghar; Muhammad Aziz Rahman; Md. Mosfequr Rahman; Mosiur Rahman; Setyaningrum Rahmawaty; Nazanin Rajai; Pradhum Ram; Juwel Rana; Kamal Ranabhat; Priyanga Ranasinghe; Chythra R. Rao; Satish Rao; Salman Rawaf; David Laith Rawaf; Lal Rawal; Andre M. N. Renzaho; Nima Rezaei; Aziz Rezapour; Seyed Mohammad Riahi; Daniela Ribeiro; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; Peter Rohloff; Godfrey M. Rwegerera; Paul MacDaragh Ryan; Maha Mohamed Saber-Ayad; Siamak Sabour; Basema Saddik; Sahar Saeedi Moghaddam; Amirhossein Sahebkar; Harihar Sahoo; K.M. Saif-Ur-Rahman; Hamideh Salimzadeh; Mehrnoosh Samaei; Juan Sanabria; Milena M. Santric-Milicevic; Brijesh Sathian; Thirunavukkarasu Sathish; Markus P. Schlaich; Abdul-Aziz Seidu; Mario Šekerija; Nachimuthu Senthil Kumar; Allen Seylani; Masood Ali Shaikh; Hina Shamshad; Md Shajedur Rahman Shawon; Sara Sheikhbahaei; Jeevan K. Shetty; Rahman Shiri; K.M. Shivakumar; Kerem Shuval; Jasvinder A. Singh; Ambrish Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Ahmad Sofi-Mahmudi; Amin Soheili; Jing Sun; Viktória Szerencsés; Miklós Szócska; Rafael Tabarés-Seisdedos; Hooman Tadbiri; Eyayou Girma Tadesse; Md. Tariqujjaman; Kavumpurathu Raman Thankappan; Rekha Thapar; Nihal Thomas; Binod Timalsina; Ruoyan Tobe-Gai; Marcello Tonelli; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Jaya Prasad Tripathy; Lorainne Tudor Car; Biruk Shalmeno Tusa; Riaz Uddin; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R. Valdez; Tommi Juhani Vasankari; Madhur Verma; Victor E. Villalobos-Daniel; Sergey Konstantinovitch Vladimirov; Bay Vo; Giang Thu Vu; Rade Vukovic; Yasir Waheed; Richard G. Wamai; Andrea Werdecker; Nuwan Darshana Wickramasinghe; Andrea Sylvia Winkler; Befikadu Legesse Wubishet; Xiaoyue Xu; Suowen Xu; Seyed Hossein Yahyazadeh Jabbari; Hiroshi Yatsuya; Sanni Yaya; Taklo Simeneh Yazie Yazie; Siyan Yi; Naohiro Yonemoto; Ismaeel Yunusa; Siddhesh Zadey; Sojib Bin Zaman; Maryam Zamanian; Nelson Zamora; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Chenwen Zhong; Mohammad Zmaili; Alimuddin Zumla; Mohsen Naghavi; Maria Inês Schmidt
    Background: Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings: In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−28·4 to −2·9) for all diabetes, and by 21·0% (–33·0 to −5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (−13·6% [–28·4 to 3·4]) and for type 1 diabetes (−13·6% [–29·3 to 8·9]). Interpretation: Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2022) Emma Nichols; Jaimie D. Steinmetz; Stein Emil Vollset; Kai Fukutaki; Julian Chalek; Foad Abd-Allah; Amir Abdoli; Ahmed Abualhasan; Eman Abu-Gharbieh; Tayyaba Tayyaba Akram; Hanadi Al Hamad; Fares Alahdab; Fahad Mashhour Alanezi; Vahid Alipour; Sami Almustanyir; Hubert Amu; Iman Ansari; Jalal Arabloo; Tahira Ashraf; Thomas Astell-Burt; Getinet Ayano; Jose L. Ayuso-Mateos; Atif Amin Baig; Anthony Barnett; Amadou Barrow; Bernhard T. Baune; Yannick Béjot; Woldesellassie M. Mequanint Bezabhe; Yihienew Mequanint Bezabih; Akshaya Srikanth Bhagavathula; Sonu Bhaskar; Krittika Bhattacharyya; Ali Bijani; Atanu Biswas; Srinivasa Rao Bolla; Archith Boloor; Carol Brayne; Hermann Brenner; Katrin Burkart; Richard A. Burns; Luis Alberto Cámera; Chao Cao; Felix Carvalho; Luis F.S. Castro-De-Araujo; Ferrán Catalá-López; Ester Cerin; Prachi P. Chavan; Nicolas Cherbuin; Dinh-Toi Chu; Vera Marisa Costa; Rosa A.S. Couto; Omid Dadras; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Vanessa De la Cruz-Góngora; Deepak Dhamnetiya; Diana Dias da Silva; Daniel Diaz; Abdel Douiri; David Edvardsson; Michael Ekholuenetale; Iman El Sayed; Shaimaa I. El-Jaafary; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Jawad Fares; Andre Faro; Umar Farooque; Valery L. Feigin; Xiaoqi Feng; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Pietro Ferrara; Irina Filip; Howard Fillit; Florian Fischer; Shilpa Gaidhane; Lucia Galluzzo; Ahmad Ghashghaee; Nermin Ghith; Alessandro Gialluisi; Syed Amir Gilani; Ionela-Roxana Glavan; Elena V. Gnedovskaya; Mahaveer Golechha; Rajeev Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Mohammad Rifat Haider; Brian J. Hall; Samer Hamidi; Asif Hanif; Graeme J. Hankey; Shafiul Haque; Risky Kusuma Hartono; Ahmed I. Hasaballah; M. Tasdik Hasan; Amr Hassan; Simon I. Hay; Khezar Hayat; Mohamed I. Hegazy; Golnaz Heidari; Reza Heidari-Soureshjani; Claudiu Herteliu; Mowafa Househ; Rabia Hussain; Bing-Fang Hwang; Licia Iacoviello; Ivo Iavicoli; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Seyed Sina Naghibi Irvani; Hiroyasu Iso; Masao Iwagami; Roxana Jabbarinejad; Louis Jacob; Vardhmaan Jain; Sathish Kumar Jayapal; Ranil Jayawardena; Ravi Prakash Jha; Jost B. Jonas; Nitin Joseph; Rizwan Kalani; Amit Kandel; Himal Kandel; André Karch; Ayele Semachew Kasa; Gizat M. Kassie; Pedram Keshavarz; Moien A.B. Khan; Mahalaqua Nazli Khatib; Tawfik Ahmed Muthafer Khoja; Jagdish Khubchandani; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Mika Kivimäki; Walter J. Koroshetz; Ai Koyanagi; G. Anil Kumar; Manasi Kumar; Hassan Mehmood Lak; Matilde Leonardi; Bingyu Li; Stephen S. Lim; Xuefeng Liu; Yuewei Liu; Giancarlo Logroscino; Stefan Lorkowski; Giancarlo Lucchetti; Ricardo Lutzky Saute; Francesca Giulia Magnani; Ahmad Azam Malik; João Massano; Man Mohan Mehndiratta; Ritesh G. Menezes; Atte Meretoja; Bahram Mohajer; Norlinah Mohamed Ibrahim; Yousef Mohammad; Arif Mohammed; Ali H. Mokdad; Stefania Mondello; Mohammad Ali Moni; Md Moniruzzaman; Tilahun Belete Mossie; Gabriele Nagel; Muhammad Naveed; Vinod C. Nayak; Sandhya Neupane Kandel; Trang Huyen Nguyen; Bogdan Oancea; Nikita Otstavnov; Stanislav S. Otstavnov; Mayowa O. Owolabi; Songhomitra Panda-Jonas; Fatemeh Pashazadeh Kan; Maja Pasovic; Urvish K. Patel; Mona Pathak; Mario F.P. Peres; Arokiasamy Perianayagam; Carrie B. Peterson; Michael R. Phillips; Marina Pinheiro; Michael A. Piradov; Constance Dimity Pond; Michele H. Potashman; Faheem Hyder Pottoo; Sergio I. Prada; Amir Radfar; Alberto Raggi; Fakher Rahim; Mosiur Rahman; Pradhum Ram; Priyanga Ranasinghe; David Laith Rawaf; Salman Rawaf; Nima Rezaei; Aziz Rezapour; Stephen R. Robinson; Michele Romoli; Gholamreza Roshandel; Ramesh Sahathevan; Amirhossein Sahebkar; Mohammad Ali Sahraian; Brijesh Sathian; Davide Sattin; Monika Sawhney; Mete Saylan; Silvia Schiavolin; Allen Seylani; Feng Sha; Masood Ali Shaikh; K.S. Shaji; Mohammed Shannawaz; Jeevan K. Shetty; Mika Shigematsu; Jae Il Shin; Rahman Shiri; Diego Augusto Santos Silva; Joao Pedro Silva; Renata Silva; Jasvinder A. Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Amanda E. Smith; Sergey Soshnikov; Emma Elizabeth Spurlock; Dan J. Stein; Jing Sun; Rafael Tabarés-Seisdedos; Bhaskar Thakur; Binod Timalsina; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Gebiyaw Wudie Tsegaye; Sahel Valadan Tahbaz; Pascual R. Valdez; Narayanaswamy Venketasubramanian; Vasily Vlassov; Giang Thu Vu; Linh Gia Vu; Yuan-Pang Wang; Anders Wimo; Andrea Sylvia Winkler; Lalit Yadav; Seyed Hossein Yahyazadeh Jabbari; Kazumasa Yamagishi; Lin Yang; Yuichiro Yano; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Siddhesh Zadey; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Christopher J.L. Murray; Theo Vos
    Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. Methods: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. Findings: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4–65·1) million cases globally in 2019 to 152·8 (130·8–175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [–7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64–1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52–1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41–67]) and western Europe (74% [58–90]), and the largest in north Africa and the Middle East (367% [329–403]) and eastern sub-Saharan Africa (357% [323–395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Interpretation: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. Funding: Bill & Melinda Gates Foundation and Gates Ventures. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2023) Sara Momtazmanesh; Sahar Saeedi Moghaddam; Seyyed-Hadi Ghamari; Elaheh Malakan Rad; Negar Rezaei; Parnian Shobeiri; Amirali Aali; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Michael Abdelmasseh; Meriem Abdoun; Deldar Morad Abdulah; Abu Yousuf Md Abdullah; Aidin Abedi; Hassan Abolhassani; Zahra Abrehdari-Tafreshi; Basavaprabhu Achappa; Denberu Eshetie Adane Adane; Tigist Demssew Adane; Isaac Yeboah Addo; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Sajjad Ahmad; Ali Ahmadi; Keivan Ahmadi; Ali Ahmed; Ayman Ahmed; Tarik Ahmed Rashid; Hanadi Al Hamad; Fares Alahdab; Astawus Alemayehu; Sheikh Mohammad Alif; Syed Mohamed Aljunid; Sami Almustanyir; Khalid A Altirkawi; Nelson Alvis-Guzman; Javad Aminian Dehkordi; Mehrdad Amir-Behghadami; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Catherine M Antony; Anayochukwu Edward Anyasodor; Jalal Arabloo; Judie Arulappan; Tahira Ashraf; Seyyed Shamsadin Athari; Engi F Attia; Meshesha Tsegazeab Ayele; Sina Azadnajafabad; Abraham Samuel Babu; Sara Bagherieh; Ovidiu Constantin Baltatu; MacIej Banach; Mainak Bardhan; Francesco Barone-Adesi; Amadou Barrow; Saurav Basu; Nebiyou Simegnew Bayileyegn; Isabela M Bensenor; Nikha Bhardwaj; Pankaj Bhardwaj; Ajay Nagesh Bhat; Krittika Bhattacharyya; Souad Bouaoud; Dejana Braithwaite; Michael Brauer; Muhammad Hammad Butt; Zahid A Butt; Daniela Calina; Luis Alberto Cámera; Gashaw Sisay Chanie; Periklis Charalampous; Vijay Kumar Chattu; Odgerel Chimed-Ochir; Dinh-Toi Chu; Aaron J Cohen; Natália Cruz-Martins; Omid Dadras; Aso Mohammad Darwesh; Saswati Das; Sisay Abebe Debela; Laura Delgado-Ortiz; Diriba Dereje; Mostafa Dianatinasab; Nancy Diao; Daniel Diaz; Lankamo Ena Digesa; Gebisa Dirirsa; Paul Narh Doku; Deepa Dongarwar; Abdel Douiri; Haneil Larson Dsouza; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Ahmed Elabbas Mustafa Elagali; Muhammed Elhadi; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Farshid Etaee; Adeniyi Francis Fagbamigbe; Andre Faro; Ali Fatehizadeh; Ginenus Fekadu; Irina Filip; Florian Fischer; Masoud Foroutan; Richard Charles Franklin; Peter Andras Gaal; Santosh Gaihre; Abduzhappar Gaipov; Mesfin Gebrehiwot; Urge Gerema; Motuma Erena Getachew; Tamiru Getachew; Mansour Ghafourifard; Reza Ghanbari; Ahmad Ghashghaee; Ali Gholami; Artyom Urievich Gil; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Habtamu Alganeh Guadie; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Mostafa Hadei; Rabih Halwani; Asif Hanif; Arief Hargono; Mehdi Harorani; Risky Kusuma Hartono; Hamidreza Hasani; Abdiwahab Hashi; Simon I Hay; Mohammad Heidari; Merel E Hellemons; Claudiu Herteliu; Ramesh Holla; Nobuyuki Horita; Mohammad Hoseini; Mehdi Hosseinzadeh; Junjie Huang; Salman Hussain; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Sufyan Ibrahim; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mustapha Immurana; Nahlah Elkudssiah Ismail; Linda Merin J; Mihajlo Jakovljevic; Elham Jamshidi; Manthan Dilipkumar Janodia; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Ravi Prakash Jha; Olatunji Johnson; Tamas Joo; Nitin Joseph; Jacek Jerzy Jozwiak; Vaishali Kraghuabr; Billingsley Kaambwa; Zubair Kabir; Laleh R Kalankesh; Rohollah Kalhor; Himal Kandel; Shama D Karanth; Ibraheem M Karaye; Bekalu Getnet Kassa; Gizat M Kassie; Leila Keikavoosi-Arani; Mohammad Keykhaei; Himanshu Khajuria; Imteyaz A Khan; Moien A B Khan; Yusra H Khan; Haneen Khreis; Min Seo Kim; Adnan Kisa; Sezer Kisa; Luke D Knibbs; Pavel Kolkhir; Somayeh Komaki; Farzad Kompani; Hamid Reza Koohestani; Ali Koolivand; Oleksii Korzh; Ai Koyanagi; Kewal Krishan; Kris J Krohn; Naveen Kumar; Nithin Kumar; Om P Kurmi; Ambily Kuttikkattu; Carlo La Vecchia; Judit Lám; Qing Lan; Savita Lasrado; Kamaluddin Latief; Paolo Lauriola; Sang-Woong Lee; Yo Han Lee; Samson Mideksa Legesse; Jacopo Lenzi; Ming-Chieh Li; Ro-Ting Lin; Gang Liu; Wei Liu; Chun-Han Lo; László Lorenzovici; Yifei Lu; Soundarya Mahalingam; Elham Mahmoudi; Narayan B Mahotra; Mohammad-Reza Malekpour; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Borhan Mansouri; Elezebeth Mathews; Sazan Qadir Maulud; Enkeleint A Mechili; Entezar Mehrabi Nasab; Ritesh G Menezes; Dechasa Adare Mengistu; Alexios-Fotios A Mentis; Mahboobeh Meshkat; Tomislav Mestrovic; Ana Carolina Micheletti Gomide Nogueira De Sá; Erkin M Mirrakhimov; Awoke Misganaw; Prasanna Mithra; Javad Moghadasi; Esmaeil Mohammadi; Mokhtar Mohammadi; Marita Mohammadshahi; Shafiu Mohammed; Syam Mohan; Nagabhishek Moka; Lorenzo Monasta; Mohammad Ali Moni; Md Moniruzzaman; Fateme Montazeri; Maryam Moradi; Ebrahim Mostafavi; Christine Mpundu-Kaambwa; Efrén Murillo-Zamora; Christopher J L Murray; Tapas Sadasivan Nair; Vinay Nangia; Sreenivas Narasimha Swamy; Aparna Ichalangod Narayana; Zuhair S Natto; Biswa Prakash Nayak; Wogene Wogene Negash; Evangelia Nena; Sandhya Neupane Kandel; Robina Khan Niazi; Antonio Tolentino Nogueira De Sá; Ali Nowroozi; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Rahman Md Obaidur; Oluwakemi Ololade Odukoya; Hassan Okati-Aliabad; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Ahmed Omar Bali; Sergej M Ostojic; P.A. Mahesh; Alicia Padron-Monedero; Jagadish Rao Padubidri; Mohammad Taha Pahlevan Fallahy; Tamás Palicz; Adrian Pana; Eun-Kee Park; Jay Patel; Rajan Paudel; Uttam Paudel; Paolo Pedersini; Marcos Pereira; Renato B Pereira; Ionela-Roxana Petcu; Majid Pirestani; Maarten J Postma; Akila Prashant; Mohammad Rabiee; Amir Radfar; Sima Rafiei; Fakher Rahim; Mohammad Hifz Ur Rahman; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Shayan Rahmani; Vahid Rahmanian; Prashant Rajput; Juwel Rana; Chythra R Rao; Sowmya J Rao; Sina Rashedi; Mohammad-Mahdi Rashidi; Zubair Ahmed Ratan; David Laith Rawaf; Salman Rawaf; Lal Rawal; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Maryam Rezaei; Nazila Rezaei; Nima Rezaei; Mohsen Rezaeian; Mónica Rodrigues; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; David Rojas-Rueda; Kristina E Rudd; Aly M A Saad; Siamak Sabour; Basema Saddik; Erfan Sadeghi; Masoumeh Sadeghi; Umar Saeed; Maryam Sahebazzamani; Amirhossein Sahebkar; Harihar Sahoo; Mirza Rizwan Sajid; Sateesh Sakhamuri; Sana Salehi; Abdallah M Samy; Milena M Santric-Milicevic; Bruno Piassi Sao Jose; Brijesh Sathian; Maheswar Satpathy; Ganesh Kumar Saya; Subramanian Senthilkumaran; Allen Seylani; Saeed Shahabi; Masood Ali Shaikh; Mohd Shanawaz; Mohammed Shannawaz; Rahim Ali Sheikhi; Shashank Shekhar; Migbar Mekonnen Sibhat; Colin R Simpson; Jasvinder A Singh; Paramdeep Singh; Surjit Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Mohammad Sadegh Soltani-Zangbar; Suhang Song; Ireneous N Soyiri; Paschalis Steiropoulos; Leo Stockfelt; Jing Sun; Ken Takahashi; Iman M Talaat; Ker-Kan Tan; Nathan Y Tat; Vivian Y Tat; Birhan Tsegaw Taye; Pugazhenthan Thangaraju; Rekha Thapar; Friedrich Thienemann; Amir Tiyuri; Mai Thi Ngoc Tran; Jaya Prasad Tripathy; Lorainne Tudor Car; Biruk Shalmeno Tusa; Irfan Ullah; Sana Ullah; Marco Vacante; Pascual R Valdez; Rohollah Valizadeh; Job F M Van Boven; Tommi Juhani Vasankari; Siavash Vaziri; Francesco S Violante; Bay Vo; Ning Wang; Melissa Y Wei; Ronny Westerman; Nuwan Darshana Wickramasinghe; Suowen Xu; Xiaoyue Xu; Lalit Yadav; Yazachew Yismaw; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Yong Yu; Ismaeel Yunusa; Mazyar Zahir; Moein Zangiabadian; Zahra Zareshahrabadi; Armin Zarrintan; Mikhail Sergeevich Zastrozhin; Zelalem Banjaw Zegeye; Yunquan Zhang; Mohsen Naghavi; Bagher Larijani; Farshad Farzadfar
    Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries. Funding: Bill & Melinda Gates Foundation. © 2023 The Authors
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    Global 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. 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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
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    Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019
    (Elsevier B.V., 2022) Kevin S Ikuta; Lucien R Swetschinski; Gisela Robles Aguilar; Fablina Sharara; Tomislav Mestrovic; Authia P Gray; Nicole Davis Weaver; Eve E Wool; Chieh Han; Anna Gershberg Hayoon; Amirali Aali; Semagn Mekonnen Abate; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Sherief Abd-Elsalam; Getachew Abebe; Aidin Abedi; Amir Parsa Abhari; Hassan Abidi; Richard Gyan Aboagye; Abdorrahim Absalan; Hiwa Abubaker Ali; Juan Manuel Acuna; Tigist Demssew Adane; Isaac Yeboah Addo; Oyelola A Adegboye; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Muhammad Sohail Afzal; Saira Afzal; Zahra Babaei Aghdam; Bright Opoku Ahinkorah; Aqeel Ahmad; Araz Ramazan Ahmad; Rizwan Ahmad; Sajjad Ahmad; Sohail Ahmad; Sepideh Ahmadi; Ali Ahmed; Haroon Ahmed; Jivan Qasim Ahmed; Tarik Ahmed Rashid; Marjan Ajami; Budi Aji; Mostafa Akbarzadeh-Khiavi; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Ziyad Al-Aly; Mamoon A Aldeyab; Alicia V Aleman; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Beriwan Abdulqadir Ali; Liaqat Ali; Syed Shujait Ali; Yousef Alimohamadi; Vahid Alipour; Atiyeh Alizadeh; Syed Mohamed Aljunid; Kasim Allel; Sami Almustanyir; Edward Kwabena Ameyaw; Arianna Maever L Amit; Nivedita Anandavelane; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Dewi Anggraini; Adnan Ansar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Aleksandr Y Aravkin; Demelash Areda; Timur Aripov; Anton A Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Muhammad Asaduzzaman; Tahira Ashraf; Seyyed Shamsadin Athari; Daniel Atlaw; Sameh Attia; Marcel Ausloos; Tewachew Awoke; Beatriz Paulina Ayala Quintanilla; Tegegn Mulatu Ayana; Sina Azadnajafabad; Amirhossein Azari Jafari; B. Darshan; Muhammad Badar; Ashish D Badiye; Nayereh Baghcheghi; Sara Bagherieh; Atif Amin Baig; Indrajit Banerjee; Aleksandra Barac; Mainak Bardhan; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Pritish Baskaran; Saurav Basu; Abdul-Monim Mohammad Batiha; Neeraj Bedi; Melaku Ashagrie Belete; Uzma Iqbal Belgaumi; Rose G Bender; Bharti Bhandari; Dinesh Bhandari; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Suraj Bhattarai; Saeid Bitaraf; Danilo Buonsenso; Zahid A Butt; Florentino Luciano Caetano Dos Santos; Jiao Cai; Daniela Calina; Paulo Camargos; Luis Alberto Cámera; Rosario Cárdenas; Muge Cevik; Joshua Chadwick; Jaykaran Charan; Akhilanand Chaurasia; Patrick R Ching; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Fazle Rabbi Chowdhury; Dinh-Toi Chu; Isaac Sunday Chukwu; Omid Dadras; Fentaw Teshome Dagnaw; Xiaochen Dai; Saswati Das; Anna Dastiridou; Sisay Abebe Debela; Fitsum Wolde Demisse; Solomon Demissie; Diriba Dereje; Msganaw Derese; Hardik Dineshbhai Desai; Fikadu Nugusu Dessalegn; Samuel Abebe A Dessalegni; Belay Desye; Kartik Dhaduk; Meghnath Dhimal; Sameer Dhingra; Nancy Diao; Daniel Diaz; Shirin Djalalinia; Milad Dodangeh; Deepa Dongarwar; Bezabih Terefe Dora; Fariba Dorostkar; Haneil Larson Dsouza; Eleonora Dubljanin; Susanna J Dunachie; Oyewole Christopher Durojaiye; Hisham Atan Edinur; Habtamu Bekele Ejigu; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Hassan El-Abid; Muhammed Elhadi; Mohamed A Elmonem; Amir Emami; Luchuo Engelbert Bain; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Babak Eshrati; Farshid Etaee; Adeniyi Francis Fagbamigbe; Shahab Falahi; Aida Fallahzadeh; Emerito Jose A Faraon; Ali Fatehizadeh; Ginenus Fekadu; João C Fernandes; Allegra Ferrari; Getahun Fetensa; Irina Filip; Florian Fischer; Masoud Foroutan; Peter Andras Gaal; Muktar A Gadanya; Abhay Motiramji Gaidhane; Balasankar Ganesan; Mesfin Gebrehiwot; Reza Ghanbari; Mohammad Ghasemi Nour; Ahmad Ghashghaee; Ali Gholamrezanezhad; Abdolmajid Gholizadeh; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Amador Goodridge; Damitha Asanga Gunawardane; Yuming Guo; Rajat Das Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Alemu Guta; Parham Habibzadeh; Atlas Haddadi Avval; Rabih Halwani; Asif Hanif; Md Abdul Hannan; Harapan Harapan; Shoaib Hassan; Hadi Hassankhani; Khezar Hayat; Behzad Heibati; Golnaz Heidari; Mohammad Heidari; Reza Heidari-Soureshjani; Claudiu Herteliu; Demisu Zenbaba Heyi; Kamal Hezam; Praveen Hoogar; Nobuyuki Horita; Md Mahbub Hossain; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Soodabeh Hoveidamanesh; Junjie Huang; Salman Hussain; Nawfal R Hussein; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mohammad Tarique Imam; Mustapha Immurana; Leeberk Raja Inbaraj; Arnaud Iradukunda; Nahlah Elkudssiah Ismail; Chidozie C D Iwu; Chinwe Juliana Iwu; Merin J. Linda; Mihajlo Jakovljevic; Elham Jamshidi; Tahereh Javaheri; Fatemeh Javanmardi; Javad Javidnia; Sathish Kumar Jayapal; Umesh Jayarajah; Rime Jebai; Ravi Prakash Jha; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Salah Eddine Oussama Kacimi; Vidya Kadashetti; Laleh R Kalankesh; Rohollah Kalhor; Vineet Kumar Kamal; Himal Kandel; Neeti Kapoor; Samad Karkhah; Bekalu Getnet Kassa; Nicholas J Kassebaum; Patrick D.M.C. Katoto; Mohammad Keykhaei; Himanshu Khajuria; Abbas Khan; Imteyaz A. Khan; Maseer Khan; Md Nuruzzaman Khan; Moien A.B. Khan; Moawiah Mohammad Khatatbeh; Mona M Khater; Hamid Reza Khayat Kashani; Jagdish Khubchandani; Hanna Kim; Min Seo Kim; Ruth W Kimokoti; Niranjan Kissoon; Sonali Kochhar; Farzad Kompani; Soewarta Kosen; Parvaiz A Koul; Sindhura Lakshmi Koulmane Laxminarayana; Fiorella Krapp Lopez; Kewal Krishan; Vijay Krishnamoorthy; Vishnutheertha Kulkarni; Naveen Kumar; Om P Kurmi; Ambily Kuttikkattu; Hmwe Hmwe Kyu; Dharmesh Kumar Lal; Judit Lám; Iván Landires; Savita Lasrado; Sang-Woong Lee; Jacopo Lenzi; Sonia Lewycka; Shanshan Li; Stephen S Lim; Wei Liu; Rakesh Lodha; Michael J Loftus; Ayush Lohiya; Lászl Lorenzovici; Mojgan Lotfi; Ata Mahmoodpoor; Mansour Adam Mahmoud; Razzagh Mahmoudi; Azeem Majeed; Jamal Majidpoor; Alaa Makki; Galana Ayana Mamo; Yosef Manla; Miquel Martorell; Clara N Matei; Barney Mcmanigal; Entezar Mehrabi Nasab; Ravi Mehrotra; Addisu Melese; Oliver Mendoza-Cano; Ritesh G Menezes; Alexios-Fotios A Mentis; Georgia Micha; Irmina Maria Michalek; Ana Carolina Micheletti Gomide Nogueira Des; Neda Milevska Kostova; Shabir Ahmad Mir; Mojgan Mirghafourvand; Seyyedmohammadsadeq Mirmoeeni; Erkin M Mirrakhimov; Mohammad Mirza-Aghazadeh-attari; Abay Sisay Misganaw; Awoke Misganaw; Sanjeev Misra; Esmaeil Mohammadi; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Syam Mohan; Mohammad Mohseni; Ali H Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Catrin E Moore; Maryam Moradi; Mostafa Moradi Sarabi; Shane Douglas Morrison; Majid Motaghinejad; Haleh Mousavi Isfahani; Amin Mousavi Khaneghah; Seyed Ali Mousavi-Aghdas; Sumaira Mubarik; Francesk Mulita; Getaneh Baye B Mulu; Sandra B Munro; Saravanan Muthupandian; Tapas Sadasivan Nair; Atta Abbas Naqvi; Himanshi Narang; Zuhair S Natto; Muhammad Naveed; Biswa Prakash Nayak; Shumaila Naz; Ionut Negoi; Seyed Aria Nejadghaderi; Sandhya Neupane Kandel; Che Henry Ngwa; Robina Khan Niazi; Antonio Tolentino Nogueira Des; Nafise Noroozi; Hasti Nouraei; Ali Nowroozi; Virginia Nuñez-Samudio; Jerry John Nutor; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Rahman Md Obaidur; Vivek Anand Ojha; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Bolajoko Olubukunola Olusanya; Ahmed Omar Bali; Emad Omer; Nikita Otstavnov; Bilcha Oumer; Jagadish Rao Padubidri; Keyvan Pakshir; Tamás Palicz; Adrian Pana; Shahina Pardhan; Jose L Paredes; Utsav Parekh; Eun-Cheol Park; Seoyeon Park; Ashish Pathak; Rajan Paudel; Uttam Paudel; Shrikant Pawar; Hamidreza Pazoki Toroudi; Minjin Peng; Umberto Pensato; Veincent Christian Filipino Pepito; Marcos Pereira; Mario F P Peres; Norberto Perico; Ionela-Roxana Petcu; Zahra Zahid Piracha; Indrashis Podder; Nayanum Pokhrel; Ramesh Poluru; Maarten J Postma; Naeimeh Pourtaheri; Akila Prashant; Ibrahim Qattea; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Saber Raeghi; Sima Rafiei; Pankaja Raghav Raghav; Leila Rahbarnia; Vafa Rahimi-Movaghar; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Pradhum Ram; Muhammad Modassar Ali Nawaz Ranjha; Sowmya J Rao; Mohammad-Mahdi Rashidi; Azad Rasul; Zubair Ahmed Ratan; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Misganu Teshoma Regasa; Giuseppe Remuzzi; Melese Abate Reta; Nazila Rezaei; Aziz Rezapour; Abanoub Riad; Rezaul Karim Ripon; Kristina E Rudd; Basema Saddik; Saeid Sadeghian; Umar Saeed; Mohsen Safaei; Azam Safary; Sher Zaman Safi; Maryam Sahebazzamani; Amirhossein Sahebkar; Harihar Sahoo; Saina Salahi; Sarvenaz Salahi; Hedayat Salari; Sana Salehi; Hossein Samadi Kafil; Abdallah M Samy; Nima Sanadgol; Senthilkumar Sankararaman; Francesco Sanmarchi; Brijesh Sathian; Monika Sawhney; Ganesh Kumar Saya; Subramanian Senthilkumaran; Allen Seylani; Pritik A Shah; Masood Ali Shaikh; Elaheh Shaker; Murad Ziyaudinovich Shakhmardanov; Mequannent Melaku Sharew; Athena Sharifi-Razavi; Purva Sharma; Rahim Ali Sheikhi; Ali Sheikhy; Pavanchand H Shetty; Mika Shigematsu; Jae Il Shin; Hesamaddin Shirzad-Aski; K.M. Shivakumar; Parnian Shobeiri; Seyed Afshin Shorofi; Sunil Shrestha; Migbar Mekonnen Sibhat; Negussie Boti Sidemo; Mustafa Kamal Sikder; Luís Manuel Lopes Rodrigues Silva; Jasvinder A Singh; Paramdeep Singh; Surjit Singh; Md Shahjahan Siraj; Samarjeet Singh Siwal; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Bogdan Socea; Damtew Damtew Solomon; Yimeng Song; Chandrashekhar T Sreeramareddy; Muhammad Suleman; Rizwan Suliankatchi Abdulkader; Saima Sultana; Miklós Szócska; Seyed-Amir Tabatabaeizadeh; Mohammad Tabish; Majid Taheri; Elahe Taki; Ker-Kan Tan; Sarmila Tandukar; Nathan Y Tat; Vivian Y Tat; Belay Negash Tefera; Yibekal Manaye Tefera; Gebremaryam Temesgen; Mohamad-Hani Temsah; Samar Tharwat; Arulmani Thiyagarajan; Imad I Tleyjeh; Christopher E Troeger; Krishna Kishore Umapathi; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R Valdez; Jef Van Den Eynde; H Rogier Van Doorn; Siavash Vaziri; Georgios-Ioannis Verras; Harimadhav Viswanathan; Bay Vo; Abdul Waris; Gizachew Tadesse Wassie; Nuwan Darshana Wickramasinghe; Sajad Yaghoubi; Gahin Abdulraheem Tayib Yahya Yahya; Seyed Hossein Yahyazadeh Jabbari; Arzu Yigit; Vahit Yigit; Dong Keon Yon; Naohiro Yonemoto; Mazyar Zahir; Burhan Abdullah Zaman; Sojib Bin Zaman; Moein Zangiabadian; Iman Zare; Mikhail Sergeevich Zastrozhin; Zhi-Jiang Zhang; Peng Zheng; Chenwen Zhong; Mohammad Zoladl; Alimuddin Zumla; Simon I Hay; Christiane Dolecek; Benn Sartorius; Christopher J L Murray; Mohsen Naghavi
    Background: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. Findings: From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Global, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021
    (Elsevier Ltd, 2024) Jorge R. Ledesma; Jianing Ma; Meixin Zhang; Ann V. L. Basting; Huong Thi Chu; Avina Vongpradith; Amanda Novotney; Kate E. LeGrand; Yvonne Yiru Xu; Xiaochen Dai; Sneha Ingle Nicholson; Lauryn K. Stafford; Austin Carter; Jennifer M. Ross; Hedayat Abbastabar; Meriem Abdoun; Deldar Morad Abdulah; Richard Gyan Aboagye; Hassan Abolhassani; Woldu Aberhe Abrha; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Salahdein Aburuz; Isaac Yeboah Addo; Abiola Victor Adepoju; Kishor Adhikari; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Abel Afework; Shahin Aghamiri; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Danish Ahmad; Sajjad Ahmad; Amir Mahmoud Ahmadzade; Haroon Ahmed; Mohammed Ahmed; Ayman Ahmed; Karolina Akinosoglou; Tareq Mohammed Ali Al-Ahdal; Nazmul Alam; Mohammed Albashtawy; Mohammad T. AlBataineh; Adel Ali Saeed Al-Gheethi; Abid Ali; Endale Alemayehu Ali; Liaqat Ali; Zahid Ali; Syed Shujait Shujait Ali; Kasim Allel; Awais Altaf; Jaffar A. Al-Tawfiq; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Reza Amani; Ganiyu Adeniyi Amusa; Jimoh Amzat; Jason R. Andrews; Abhishek Anil; Razique Anwer; Aleksandr Y. Aravkin; Damelash Areda; Anton A. Artamonov; Raphael Taiwo Aruleba; Mulusew A. Asemahagn; Sachin R. Atre; Avinash Aujayeb; Davood Azadi; Sina Azadnajafabad; Ahmed Y. Azzam; Muhammad Badar; Ashish D. Badiye; Sara Bagherieh; Saeed Bahadorikhalili; Atif Amin Baig; Maciej Banach; Biswajit Banik; Mainak Bardhan; Hiba Jawdat Barqawi; Zarrin Basharat; Pritish Baskaran; Saurav Basu; Maryam Beiranvand; Melaku Ashagrie Belete; Makda Abate Belew; Uzma Iqbal Belgaumi; Apostolos Beloukas; Paulo J. G. Bettencourt; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Ashish Bhargava; Vivek Bhat; Jasvinder Singh Bhatti; Gurjit Kaur Bhatti; Boris Bikbov; Veera R. Bitra; Vesna Bjegovic-Mikanovic; Danilo Buonsenso; Katrin Burkart; Yasser Bustanji; Zahid A. Butt; Paulo Camargos; Yu Cao; Sinclair Carr; Felix Carvalho; Luca Cegolon; Muthia Cenderadewi; Muge Cevik; Yaacoub Chahine; Vijay Kumar Chattu; Patrick R. Ching; Hitesh Chopra; Eunice Chung; Mareli M. Claassens; Kaleb Coberly; Natália Cruz-Martins; Bashir Dabo; Sriharsha Dadana; Omid Dadras; Isaac Darban; Jiregna Darega Gela; Aso Mohammad Darwesh; Mahmood Dashti; Berecha Hundessa Demessa; Biniyam Demisse; Solomon Demissie; Awoke Masrie Asrat Derese; Kebede Deribe; Hardik Dineshbhai Desai; Vinoth Gnana Chellaiyan Devanbu; Arkadeep Dhali; Kuldeep Dhama; Sameer Dhingra; Thao Huynh Phuong Do; Deepa Dongarwar; Haneil Larson Dsouza; John Dube; Arkadiusz Marian Dziedzic; Abdelaziz Ed-Dra; Ferry Efendi; Diyan Ermawan Effendi; Aziz Eftekharimehrabad; Nopryan Ekadinata; Temitope Cyrus Ekundayo; Muhammed Elhadi; Legesse Tesfaye Elilo; Theophilus I. Emeto; Luchuo Engelbert Bain; Adeniyi Francis Fagbamigbe; Ayesha Fahim; Alireza Feizkhah; Getahun Fetensa; Florian Fischer; Abduzhappar Gaipov; Aravind P. Gandhi; Rupesh K. Gautam; Miglas W. Gebregergis; Mesfin Gebrehiwot; Kahsu Gebrekirstos Gebrekidan; Kazem Ghaffari; Fariba Ghassemi; Ramy Mohamed Ghazy; Amador Goodridge; Anmol Goyal; Shi-Yang Guan; Mesay Dechasa Gudeta; Rashid Abdi Guled; Novianti Br Gultom; Veer Bala Gupta; Vivek Kumar Gupta; Sapna Gupta; Hailey Hagins; Semira Goitom Hailu; Wase Benti Hailu; Samer Hamidi; Asif Hanif; Harapan Harapan; Rumina Syeda Hasan; Shoaib Hassan; Johannes Haubold; Kamal Hezam; Sung Hwi Hong; Nobuyuki Horita; Md Belal Hossain; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Hong-Han Huynh; Segun Emmanuel Ibitoye; Kevin S. Ikuta; Irena M. Ilic; Milena D. Ilic; Md Rabiul Islam; Nahlah Elkudssiah Ismail; Faisal Ismail; Abdollah Jafarzadeh; Mihajlo Jakovljevic; Mahsa Jalili; Manthan Dilipkumar Janodia; Nabi Jomehzadeh; Jost B. Jonas; Nitin Joseph; Charity Ehimwenma Joshua; Zubair Kabir; Bhushan Dattatray Kamble; Tanuj Kanchan; Himal Kandel; Kehinde Kazeem Kanmodi; Rami S. Kantar; Ibraheem M. Karaye; Arman Karimi Behnagh; Gebrehiwot G. Kassa; Rimple Jeet Kaur; Navjot Kaur; Himanshu Khajuria; Faham Khamesipour; Yusra H. Khan; M. Nuruzzaman Khan; Mahammed Ziauddin Khan Suheb; Khaled Khatab; Fatemeh Khatami; Min Seo Kim; Soewarta Kosen; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Kewal Krishan; Burcu Kucuk Bicer; Md Abdul Kuddus; Mukhtar Kulimbet; Nithin Kumar; Dharmesh Kumar Lal; Iván Landires; Kamaluddin Latief; Trang Diep Thanh Le; Thao Thi Thu Le; Caterina Ledda; Munjae Lee; Seung Won Lee; Temesgen L. Lerango; Stephen S. Lim; Chaojie Liu; Xuefeng Liu; Platon D. Lopukhov; Hong Luo; Hengliang Lv; Preetam Bhalchandra Mahajan; Amir Ali Mahboobipour; Azeem Majeed; Elaheh Malakan Rad; Kashish Malhotra; Muhammad Sajeel Ahmed Malik; Lesibana Anthony Malinga; Tauqeer Hussain Mallhi; Aseer Manilal; Bernardo Alfonso Martinez-Guerra; Francisco Rogerlândio Martins-Melo; Roy Rillera Marzo; Hossein Masoumi-Asl; Vasundhara Mathur; Richard James Maude; Ravi Mehrotra; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Muayad Aghali Merza; Tomislav Mestrovic; Laurette Mhlanga; Sanjeev Misra; Arup Kumar Misra; Prasanna Mithra; Babak Moazen; Hussen Mohammed; Ali H. Mokdad; Lorenzo Monasta; Catrin E. Moore; Parsa Mousavi; Francesk Mulita; Fungai Musaigwa; Raman Muthusamy; Ahamarshan Jayaraman Nagarajan; Pirouz Naghavi; Ganesh R. Naik; Gurudatta Naik; Sanjeev Nair; Tapas Sadasivan Nair; Zuhair S. Natto; Biswa Prakash Nayak; Hadush Negash; Dang H. Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Chukwudi A. Nnaji; Lawrence Achilles Nnyanzi; Efaq Ali Noman; Shuhei Nomura; Bogdan Oancea; Kehinde O. Obamiro; Ismail A. Odetokun; Daniel Bogale Odo Odo; Oluwakemi Ololade Odukoya; In-Hwan Oh; Chukwuma O. Okereke; Osaretin Christabel Okonji; Eyal Oren; Edgar Ortiz-Brizuela; Uchechukwu Levi Osuagwu; Amel Ouyahia; P.A. Mahesh Padukudru; Pragyan Paramita Parija; Romil R. Parikh; Seoyeon Park; Ashwaghosha Parthasarathi; Shankargouda Patil; Shrikant Pawar; Minjin Peng; Veincent Christian Filipino Pepito; Prince Peprah; João Perdigão; Norberto Perico; Hoang Tran Pham; Maarten J. Postma; Attur Ravindra Attur Prabhu; Manya Prasad; Akila Prashant; Elton Junio Sady Prates; Fakher Rahim; Mosiur Rahman; Muhammad Aziz Rahman; Masoud Rahmati; Sathish Rajaa; Shakthi Kumaran Ramasamy; Indu Ramachandra Rao; Sowmya J. Rao; Deepthi Rapaka; Ahmed Mustafa Rashid; Zubair Ahmed Ratan; Nakul Ravikumar; Salman Rawaf; Murali Mohan Rama Krishna Reddy; Elrashdy Moustafa Mohamed Redwan; Giuseppe Remuzzi; Luis Felipe Reyes; Nazila Rezaei; Mohsen Rezaeian; Omid Rezahosseini; Mónica Rodrigues; Priyanka Roy; Guilherme de Andrade Ruela; Siamak Sabour; Basema Saddik; Umar Saeed; Sher Zaman Safi; Narjes Saheb Sharif-Askari; Fatemeh Saheb Sharif-Askari; Amirhossein Sahebkar; Biniyam Sahiledengle; Soumya Swaroop Sahoo; Nasir Salam; Afeez Abolarinwa Salami; Samreen Saleem; Mohamed A. Saleh; Hossein Samadi Kafil; Sara Samadzadeh; Yoseph Leonardo Samodra; Rama Krishna Sanjeev; Aswini Saravanan; Susan M. Sawyer; Siddharthan Selvaraj; Sabyasachi Senapati; Subramanian Senthilkumaran; Pritik A. Shah; Samiah Shahid; Masood Ali Shaikh; Sunder Sham; Mohammad Ali Shamshirgaran; Mohd Shanawaz; Medha Sharath; Samendra P. Sherchan; Ranjitha S. Shetty; Hesamaddin Shirzad-Aski; Aminu Shittu; Emmanuel Edwar Siddig; João Pedro Silva; Surjit Singh; Paramdeep Singh; Harpreet Singh; Jasvinder A. Singh; Md Shahjahan Siraj; Siswanto Siswanto; Ranjan Solanki; Yonatan Solomon; Joan B. Soriano; Chandrashekhar T. Sreeramareddy; Vijay Kumar Srivastava; Paschalis Steiropoulos; Chandan Kumar Swain; Takahiro Tabuchi; Mircea Tampa; Jacques J. L. Lukenze Tamuzi; Nathan Y. Tat; Razieh Tavakoli Oliaee; Gebrehiwot Teklay; Edosa Geta Tesfaye; Belay Tessema; Pugazhenthan Thangaraju; Rekha Thapar; Chern Choong Chern Thum; Jansje Henny Vera Ticoalu; Imad M. Tleyjeh; Ruoyan Tobe-Gai; Temesgen Mohammed Toma; Khai Hoan Tram; Aniefiok John Udoakang; Tungki Pratama Umar; Chukwuma David Umeokonkwo; Seyed Mohammad Vahabi; Asokan Govindaraj Vaithinathan; Job F. M. van Boven; Shoban Babu Varthya; Ziyue Wang; Muktar S. A. Warsame; Ronny Westerman; Tewodros Eshete Wonde; Sajad Yaghoubi; Siyan Yi; Vahit Yigit; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Fathiah Zakham; Moein Zangiabadian; Francis Zeukeng; Haijun Zhang; Yang Zhao; Peng Zheng; Magdalena Zielinska; Joshua A. Salomon; Robert C. Reiner; Mohsen Naghavi; Theo Vos; Simon I. Hay; Christopher J. L. Murray; Hmwe Hmwe Kyu
    Background: Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to 2021, and to report on age-specific progress between 2015 and 2020. Methods: We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021) analytical framework to compute age-specific tuberculosis mortality and incidence estimates for 204 countries and territories (1990–2021 inclusive). We quantified tuberculosis mortality among individuals without HIV co-infection using 22 603 site-years of vital registration data, 1718 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, 680 site-years of mortality surveillance data, and 9 site-years of minimally invasive tissue sample (MITS) diagnoses data as inputs into the Cause of Death Ensemble modelling platform. Age-specific HIV and tuberculosis deaths were established with a population attributable fraction approach. We analysed all available population-based data sources, including prevalence surveys, annual case notifications, tuberculin surveys, and tuberculosis mortality, in DisMod-MR 2.1 to produce internally consistent age-specific estimates of tuberculosis incidence, prevalence, and mortality. We also estimated age-specific tuberculosis mortality without HIV co-infection that is attributable to the independent and combined effects of three risk factors (smoking, alcohol use, and diabetes). As a secondary analysis, we examined the potential impact of the COVID-19 pandemic on tuberculosis mortality without HIV co-infection by comparing expected tuberculosis deaths, modelled with trends in tuberculosis deaths from 2015 to 2019 in vital registration data, with observed tuberculosis deaths in 2020 and 2021 for countries with available cause-specific mortality data. Findings: We estimated 9·40 million (95% uncertainty interval [UI] 8·36 to 10·5) tuberculosis incident cases and 1·35 million (1·23 to 1·52) deaths due to tuberculosis in 2021. At the global level, the all-age tuberculosis incidence rate declined by 6·26% (5·27 to 7·25) between 2015 and 2020 (the WHO End TB strategy evaluation period). 15 of 204 countries achieved a 20% decrease in all-age tuberculosis incidence between 2015 and 2020, eight of which were in western sub-Saharan Africa. When stratified by age, global tuberculosis incidence rates decreased by 16·5% (14·8 to 18·4) in children younger than 5 years, 16·2% (14·2 to 17·9) in those aged 5–14 years, 6·29% (5·05 to 7·70) in those aged 15–49 years, 5·72% (4·02 to 7·39) in those aged 50–69 years, and 8·48% (6·74 to 10·4) in those aged 70 years and older, from 2015 to 2020. Global tuberculosis deaths decreased by 11·9% (5·77 to 17·0) from 2015 to 2020. 17 countries attained a 35% reduction in deaths due to tuberculosis between 2015 and 2020, most of which were in eastern Europe (six countries) and central Europe (four countries). There was variable progress by age: a 35·3% (26·7 to 41·7) decrease in tuberculosis deaths in children younger than 5 years, a 29·5% (25·5 to 34·1) decrease in those aged 5–14 years, a 15·2% (10·0 to 20·2) decrease in those aged 15–49 years, a 7·97% (0·472 to 14·1) decrease in those aged 50–69 years, and a 3·29% (–5·56 to 9·07) decrease in those aged 70 years and older. Removing the combined effects of the three attributable risk factors would have reduced the number of all-age tuberculosis deaths from 1·39 million (1·28 to 1·54) to 1·00 million (0·703 to 1·23) in 2020, representing a 36·5% (21·5 to 54·8) reduction in tuberculosis deaths compared to those observed in 2015. 41 countries were included in our analysis of the impact of the COVID-19 pandemic on tuberculosis deaths without HIV co-infection in 2020, and 20 countries were included in the analysis for 2021. In 2020, 50 900 (95% CI 49 700 to 52 400) deaths were expected across all ages, compared to an observed 45 500 deaths, corresponding to 5340 (4070 to 6920) fewer deaths; in 2021, 39 600 (38 300 to 41 100) deaths were expected across all ages compared to an observed 39 000 deaths, corresponding to 657 (–713 to 2180) fewer deaths. Interpretation: Despite accelerated progress in reducing the global burden of tuberculosis in the past decade, the world did not attain the first interim milestones of the WHO End TB Strategy in 2020. The pace of decline has been unequal with respect to age, with older adults (ie, those aged >50 years) having the slowest progress. As countries refine their national tuberculosis programmes and recalibrate for achieving the 2035 targets, they could consider learning from the strategies of countries that achieved the 2020 milestones, as well as consider targeted interventions to improve outcomes in older age groups. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019
    (John Wiley and Sons Inc, 2023) Youn Ho Shin; Jimin Hwang; Rosie Kwon; Seung Won Lee; Min Seo Kim; Jae Il Shin; Dong Keon Yon; Yohannes Habtegiorgis Abate; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Michael Abdelmasseh; Deldar Morad Abdulah; Richard Gyan Aboagye; Hassan Abolhassani; Elissa M. Abrams; Yonas Derso Abtew; Eman Abu-Gharbieh; Denberu Eshetie Adane Adane; Tigist Demssew Adane; Isaac Yeboah Addo; Rishan Adha; Amin Adibi; Qorinah Estiningtyas Sakilah Adnani; Anurag Agrawal; Sohail Ahmad; Ali Ahmadi; Ali Ahmed; Ayman Ahmed; Sayer Al-Azzam; Fadwa Alhalaiqa Naji Alhalaiqa; Sheikh Mohammad Alif; Vahid Alipour; Zaid Altaany; Khalid A. Altirkawi; Nelson Alvis-Guzman; Hany Aly; Adnan Ansar; Judie Arulappan; Mohammad Asghari-Jafarabadi; Tahira Ashraf; Seyyed Shamsadin Athari; Daniel Atlaw; Avinash Aujayeb; Sina Azadnajafabad; Mahsa Babaei; Hassan Babamohamadi; Alaa Badawi; Nayereh Baghcheghi; Sara Bagherieh; Khuloud Bajbouj; Maciej Banach; Mainak Bardhan; Francesco Barone-Adesi; Amadou Barrow; Azadeh Bashiri; Nebiyou Simegnew Bayileyegn; Isabela M. Bensenor; Alemshet Yirga Berhie; Kebede A. Beyene; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Ajay Nagesh Bhat; Vijayalakshmi S. Bhojaraja; Ali Bijani; Andras Bikov; Jiao Cai; Paulo Camargos; Josip Car; Sinclair Carr; Andrea Carugno; Promit Ananyo Chakraborty; Jeffrey Shi Kai Chan; Periklis Charalampous; Mohammadreza Chashmyazdan; Vijay Kumar Chattu; Mohiuddin Ahsanul Kabir Chowdhury; Dinh-Toi Chu; Barbara Corso; Natália Cruz-Martins; Omid Dadras; Xiaochen Dai; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; Dessalegn Demeke; Biniyam Demisse; Daniel Diaz; Mengistie Diress; Deepa Dongarwar; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Muhammed Elhadi; Omar Abdelsadek Abdou Elmeligy; Habtamu Esubalew; Farshid Etaee; Azin Etemadimanesh; Adeniyi Francis Fagbamigbe; Ildar Ravisovich Fakhradiyev; Ali Fatehizadeh; Syeda Anum Fatima Fatima; Xiaoqi Feng; Mohammad Fereidouni; Nuno Ferreira; Getahun Fetensa; Florian Fischer; Masoud Foroutan; Takeshi Fukumoto; Abduzhappar Gaipov; Yibeltal Yismaw Gela; Abera Getachew Obsa; Fataneh Ghadirian; Seyyed-Hadi Ghamari; Sherief Ghozy; Richard F. Gillum; Abraham Tamirat Gizaw; Admasu Belay AB Gizaw; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Sapna Gupta; Vivek Kumar Gupta; Arvin Haj-Mirzaian; Rabih Halwani; Samer Hamidi; Md Abdul Hannan; Ahmed I. Hasaballah; Hamidreza Hasani; Abdiwahab Hashi; Mohammed Bheser Hassen; Behzad Heibati; Golnaz Heidari; Mohammad Heidari; Mahsa Heidari-Foroozan; Ramesh Holla; Nobuyuki Horita; Md Shakhaoat Hossain; Salman Hussain; Bing-Fang Hwang; Irena M. Ilic; Milena D. Ilic; Rana Irilouzadian; Nahlah Elkudssiah Ismail; Zhanat Bakhitovna I. Z. B. Ispayeva; Chidozie C. D. Iwu; Linda Merin J; Maziar Jajarmi; Elham Jamshidi; Manthan Dilipkumar Janodia; Shubha Jayaram; Rime Jebai; Jost B. Jonas; Nitin Joseph; Billingsley Kaambwa; Zubair Kabir; Feroze Kaliyadan; Himal Kandel; Rami S. Kantar; Ibraheem M. Karaye; Hanie Karimi; Harkiran Kaur; Leila Keikavoosi-Arani; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Imteyaz A. Khan; Maseer Khan; Moien A. B. Khan; Saval Khanal; Moawiah Mohammad Khatatbeh; Jagdish Khubchandani; Biruk Getahun Kibret; Adnan Kisa; Sezer Kisa; Pavel Kolkhir; Farzad Kompani; Hamid Reza Koohestani; Oleksii Korzh; Parvaiz A. Koul; Ai Koyanagi; Kewal Krishan; Claudia E. Kuehni; G. Anil Kumar; Om P. Kurmi; L. V. Simhachalam Kutikuppala; Ambily Kuttikkattu; Judit Lám; Bagher Larijani; Kamaluddin Latief; Paolo Lauriola; Thao Thi Thu Le; Yo Han Lee; Jacopo Lenzi; Ming-Chieh Li; Shanshan Li; Virendra S. Ligade; Stephen S. Lim; Gang Liu; Wei Liu; Xuefeng Liu; Chun-Han Lo; Graciliana Lopes; Soundarya Mahalingam; Sandeep B. Maharaj; Mansour Adam Mahmoud; Azeem Majeed; Mohammad-Reza Malekpour; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Abdullah A. Mamun; Seyedeh Zahra Masoumi; Andrea Maugeri; John Robert Carabeo Medina; Ritesh G. Menezes; George A. Mensah; Alexios-Fotios A. Mentis; Tomislav Mestrovic; Irmina Maria Michalek; Le Huu Nhat Minh; Erkin M. Mirrakhimov; Awoke Misganaw; Manish Mishra; Shafiu Mohammed; Ali H. Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Md Moniruzzaman; Temesgen Mulugeta; Daniel Munblit; Efrén Murillo-Zamora; Ghulam Mustafa; Tapas Sadasivan Nair; Vinay Nangia; Sreenivas Narasimha Swamy; Hasan Nassereldine; Zuhair S. Natto; Biswa Prakash Nayak; Javad Nazari; Tze Pin Ng; Dang H. Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Hasti Nouraei; Ogochukwu Janet Nzoputam; Bogdan Oancea; Rahman Md Obaidur; Hassan Okati-Aliabad; Osaretin Christabel Okonji; Patrick Godwin Okwute; Andrew T. Olagunju; Isaac Iyinoluwa Olufadewa; Hans Orru; P.A. Mahesh; Jagadish Rao Padubidri; Anamika Pandey; Shahina Pardhan; Eun-Kee Park; Jay Patel; Shankargouda Patil; Venkata Suresh Patthipati; Uttam Paudel; Marcos Pereira; Renato B. Pereira; Ionela-Roxana Petcu; Indrashis Podder; Vivek Podder; Arash Pour Mohammad; Ibrahim Qattea; Navid Rabiee; Mehran Rahimi; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Shayan Rahmani; Vahid Rahmanian; Prashant Rajput; Pradhum Ram; Premkumar Ramasubramani; Indu Ramachandra Rao; Ahmed Mustafa Rashid; Zubair Ahmed Ratan; Nakul Ravikumar; Salman Rawaf; Lal Rawal; Elrashdy Moustafa Mohamed Redwan; Aavishkar Raj Regmi; Nazila Rezaei; Negar Rezaei; Nima Rezaei; Saeid Rezaei; Mohsen Rezaeian; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; Esperanza Romero-Rodríguez; Luca Ronfani; Aly M. A. Saad; Basema Saddik; Umar Saeed; Dominic Sagoe; Fatemeh Saheb Sharif-Askari; Amirhossein Sahebkar; Harihar Sahoo; Mirza Rizwan Sajid; Joseph W. Sakshaug; Saina Salahi; Sana Salehi; Abdallah M. Samy; Milena M. Santric-Milicevic; Made Ary Sarasmita; Maryam Sarkhosh; Ganesh Kumar Saya; Subramanian Senthilkumaran; Humaira Shah; Masood Ali Shaikh; Mohd Shanawaz; Aziz Sheikh; Shashank Shekhar; Mika Shigematsu; Parnian Shobeiri; Seyed Afshin Shorofi; Migbar Mekonnen Sibhat; Colin R. Simpson; Jasvinder A. Singh; Paramdeep Singh; Surjit Singh; Virendra Singh; Md Shahjahan Siraj; Anna Aleksandrovna Skryabina; Yonatan Solomon; Suhang Song; Sergey Soshnikov; Ireneous N. Soyiri; Paschalis Steiropoulos; Mindy D. Szeto; Iman M. Talaat; Jacques J. L. Lukenze Tamuzi; Ker-Kan Tan; Nathan Y. Tat; Mohamad-Hani Temsah; Dufera Rikitu Terefa; Riki Tesler; Pugazhenthan Thangaraju; Jansje Henny Vera Ticoalu; Tala Tillawi; Mai Thi Ngoc Tran; Biruk Shalmeno Tusa; Irfan Ullah; Saif Ullah; Sana Ullah; Era Upadhyay; Seyed Mohammad Vahabi; Job F. M. van Boven; Tommi Juhani Vasankari; Georgios-Ioannis Verras; Rafael José Vieira; Francesco S. Violante; Theo Vos; Ronny Westerman; Nuwan Darshana Wickramasinghe; Hywel C. Williams; Dereje Y. Yada; Yazachew Yismaw; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mazyar Zahir; Heather J. Zar; Iman Zare; Mikhail Sergeevich Zastrozhin; Mohammad A. Zeineddine; Getachew Assefa Zenebe; Zhi-Jiang Zhang; Hanqing Zhao; Mohammad Zoladl
    Background: Asthma and atopic dermatitis (AD) are chronic allergic conditions, along with allergic rhinitis and food allergy and cause high morbidity and mortality both in children and adults. This study aims to evaluate the global, regional, national, and temporal trends of the burden of asthma and AD from 1990 to 2019 and analyze their associations with geographic, demographic, social, and clinical factors. Methods: Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019, we assessed the age-standardized prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of both asthma and AD from 1990 to 2019, stratified by geographic region, age, sex, and socio-demographic index (SDI). DALYs were calculated as the sum of years lived with disability and years of life lost to premature mortality. Additionally, the disease burden of asthma attributable to high body mass index, occupational asthmagens, and smoking was described. Results: In 2019, there were a total of 262 million [95% uncertainty interval (UI): 224–309 million] cases of asthma and 171 million [95% UI: 165–178 million] total cases of AD globally; age-standardized prevalence rates were 3416 [95% UI: 2899–4066] and 2277 [95% UI: 2192–2369] per 100,000 population for asthma and AD, respectively, a 24.1% [95% UI: −27.2 to −20.8] decrease for asthma and a 4.3% [95% UI: 3.8–4.8] decrease for AD compared to baseline in 1990. Both asthma and AD had similar trends according to age, with age-specific prevalence rates peaking at age 5–9 years and rising again in adulthood. The prevalence and incidence of asthma and AD were both higher for individuals with higher SDI; however, mortality and DALYs rates of individuals with asthma had a reverse trend, with higher mortality and DALYs rates in those in the lower SDI quintiles. Of the three risk factors, high body mass index contributed to the highest DALYs and deaths due to asthma, accounting for a total of 3.65 million [95% UI: 2.14–5.60 million] asthma DALYs and 75,377 [95% UI: 40,615–122,841] asthma deaths. Conclusions: Asthma and AD continue to cause significant morbidity worldwide, having increased in total prevalence and incidence cases worldwide, but having decreased in age-standardized prevalence rates from 1990 to 2019. Although both are more frequent at younger ages and more prevalent in high-SDI countries, each condition has distinct temporal and regional characteristics. Understanding the temporospatial trends in the disease burden of asthma and AD could guide future policies and interventions to better manage these diseases worldwide and achieve equity in prevention, diagnosis, and treatment. © 2023 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
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    Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2022) Rajesh Sharma; Mohsen Abbasi-Kangevari; Rami Abd-Rabu; Hassan Abidi; Eman Abu-Gharbieh; Juan Manuel Acuna; Sangeet Adhikari; Shailesh M. Advani; Muhammad Sohail Afzal; Mohamad Aghaie Meybodi; Bright Opoku Ahinkorah; Sajjad Ahmad; Ali Ahmadi; Sepideh Ahmadi; Haroon Ahmed; Luai A. Ahmed; Muktar Beshir Ahmed; Hanadi Al Hamad; Fares Alahdab; Fahad Mashhour Alanezi; Turki M. Alanzi; Fadwa Alhalaiqa Naji Alhalaiqa; Yousef Alimohamadi; Vahid Alipour; Syed Mohamed Aljunid; Motasem Alkhayyat; Sami Almustanyir; Rajaa M. Al-Raddadi; Saba Alvand; Nelson Alvis-Guzman; Saeed Amini; Robert Ancuceanu; Amir Anoushiravani; Ali Arash Anoushirvani; Alireza Ansari-Moghaddam; Jalal Arabloo; Armin Aryannejad; Mohammad Asghari Jafarabadi; Seyyed Shamsadin Athari; Floriane Ausloos; Marcel Ausloos; Atalel Fentahun Awedew; Mamaru Ayenew Awoke; Tegegn Mulatu Ayana; Sina Azadnajafabad; Hiva Azami; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Ashish D. Badiye; Sara Bagherieh; Saeed Bahadory; Atif Amin Baig; Jennifer L. Baker; Maciej Banach; Amadou Barrow; Alemshet Yirga Berhie; Sima Besharat; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Sadia Bibi; Ali Bijani; Antonio Biondi; Tone Bjørge; Belay Boda Abule Bodicha; Dejana Braithwaite; Hermann Brenner; Daniela Calina; Chao Cao; Yin Cao; Giulia Carreras; Felix Carvalho; Ester Cerin; Raja Chandra Chakinala; William C.S. Cho; Dinh-Toi Chu; Joao Conde; Vera Marisa Costa; Natália Cruz-Martins; Omid Dadras; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Anna Danielewicz; Feleke Mekonnen Demeke; Getu Debalkie Demissie; Rupak Desai; Deepak Dhamnetiya; Mostafa Dianatinasab; Daniel Diaz; Mojtaba Didehdar; Saeid Doaei; Linh Phuong Doan; Milad Dodangeh; Fatemeh Eghbalian; Debela Debela Ejeta; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Muhammed Elhadi; Daniel Berhanie Enyew; Tahir Eyayu; Rana Ezzeddini; Ildar Ravisovich Fakhradiyev; Umar Farooque; Hossein Farrokhpour; Farshad Farzadfar; Ali Fatehizadeh; Hamed Fattahi; Nima Fattahi; Masood Fereidoonnezhad; Eduarda Fernandes; Getahun Fetensa; Irina Filip; Florian Fischer; Masoud Foroutan; Peter Andras Gaal; Mohamed M. Gad; Silvano Gallus; Tushar Garg; Tamiru Getachew; Seyyed-Hadi Ghamari; Ahmad Ghashghaee; Nermin Ghith; Maryam Gholamalizadeh; Jamshid Gholizadeh Navashenaq; Abraham Tamirat Gizaw; James C. Glasbey; Mahaveer Golechha; Pouya Goleij; Kebebe Bekele Gonfa; Giuseppe Gorini; Avirup Guha; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Rasool Haddadi; Nima Hafezi-Nejad; Arvin Haj-Mirzaian; Rabih Halwani; Shafiul Haque; Sanam Hariri; Ahmed I. Hasaballah; Soheil Hassanipour; Simon I. Hay; Claudiu Herteliu; Ramesh Holla; Mohammad-Salar Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Junjie Huang; Ayesha Humayun; Ivo Iavicoli; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Farhad Islami; Masao Iwagami; Mohammad Ali Jahani; Mihajlo Jakovljevic; Tahereh Javaheri; Ranil Jayawardena; Rime Jebai; Ravi Prakash Jha; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Ali Kabir; Rohollah Kalhor; Ashwin Kamath; Neeti Kapoor; Ibraheem M. Karaye; Amirali Karimi; Joonas H. Kauppila; Asma Kazemi; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Rovshan Khalilov; Javad Khanali; Maryam Khayamzadeh; Mahmoud Khodadost; Hanna Kim; Min Seo Kim; Adnan Kisa; Sezer Kisa; Ali-Asghar Kolahi; Hamid Reza Koohestani; Jacek A. Kopec; Rajasekaran Koteeswaran; Ai Koyanagi; Yuvaraj Krishnamoorthy; G. Anil Kumar; Manoj Kumar; Vivek Kumar; Carlo La Vecchia; Faris Hasan Lami; Iván Landires; Caterina Ledda; Sang-Woong Lee; Wei-Chen Lee; Yeong Yeh Lee; Elvynna Leong; Bingyu Li; Stephen S. Lim; Stany W. Lobo; Joana A. Loureiro; Raimundas Lunevicius; Farzan Madadizadeh; Ata Mahmoodpoor; Azeem Majeed; Mohammad-Reza Malekpour; Reza Malekzadeh; Ahmad Azam Malik; Fariborz Mansour-Ghanaei; Lorenzo Giovanni Mantovani; Miquel Martorell; Sahar Masoudi; Prashant Mathur; Jitendra Kumar Meena; Entezar Mehrabi Nasab; Walter Mendoza; Alexios-Fotios A. Mentis; Tomislav Mestrovic; Junmei Miao Jonasson; Bartosz Miazgowski; Tomasz Miazgowski; Gelana Fekadu Worku Mijena; Seyyedmohammadsadeq Mirmoeeni; Mohammad Mirza-Aghazadeh-Attari; Hamed Mirzaei; Sanjeev Misra; Karzan Abdulmuhsin Mohammad; Esmaeil Mohammadi; Saeed Mohammadi; Seyyede Momeneh Mohammadi; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Teroj Abdulrahman Mohammed; Nagabhishek Moka; Ali H. Mokdad; Zeinab Mokhtari; Mariam Molokhia; Sara Momtazmanesh; Lorenzo Monasta; Ghobad Moradi; Rahmatollah Moradzadeh; Paula Moraga; Joana Morgado-Da-Costa; Sumaira Mubarik; Francesk Mulita; Mohsen Naghavi; Mukhammad David Naimzada; Hae Sung Nam; Zuhair S. Natto; Biswa Prakash Nayak; Javad Nazari; Ehsan Nazemalhosseini-Mojarad; Ionut Negoi; Cuong Tat Nguyen; Son Hoang Nguyen; Nurulamin M. Noor; Maryam Noori; Seyyed Mohammad Ali Noori; Virginia Nuñez-Samudio; Chimezie Igwegbe Nzoputam; Bogdan Oancea; Oluwakemi Ololade Odukoya; Ayodipupo Sikiru Oguntade; Hassan Okati-Aliabad; Andrew T. Olagunju; Tinuke O. Olagunju; Sokking Ong; Samuel M. Ostroff; Alicia Padron-Monedero; Reza Pakzad; Adrian Pana; Anamika Pandey; Fatemeh Pashazadeh Kan; Urvish K. Patel; Uttam Paudel; Renato B. Pereira; Navaraj Perumalsamy; Richard G. Pestell; Zahra Zahid Piracha; Richard Charles G. Pollok; Akram Pourshams; Naeimeh Pourtaheri; Akila Prashant; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Sima Rafiei; Mosiur Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Nazanin Rajai; Aashish Rajesh; Vajiheh Ramezani-Doroh; Kiana Ramezanzadeh; Kamal Ranabhat; Sina Rashedi; Amirfarzan Rashidi; Mahsa Rashidi; Mohammad-Mahdi Rashidi; Mandana Rastegar; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Andre M.N. Renzaho; Negar Rezaei; Nima Rezaei; Saeid Rezaei; Mohsen Rezaeian; Sahba Rezazadeh-Khadem; Gholamreza Roshandel; Maha Mohamed Saber-Ayad; Bahar Saberzadeh-Ardestani; Basema Saddik; Hossein Sadeghi; Umar Saeed; Maryam Sahebazzamani; Amirhossein Sahebkar; Amir Salek Farrokhi; Amir Salimi; Hamideh Salimzadeh; Pouria Samadi; Mehrnoosh Samaei; Abdallah M. Samy; Juan Sanabria; Milena M. Santric-Milicevic; Muhammad Arif Nadeem Saqib; Arash Sarveazad; Brijesh Sathian; Maheswar Satpathy; Ione Jayce Ceola Schneider; Mario Šekerija; Sadaf G. Sepanlou; Allen Seylani; Feng Sha; Sayed Mohammad Shafiee; Zahra Shaghaghi; Saeed Shahabi; Elaheh Shaker; Maedeh Sharifian; Javad Sharifi-Rad; Sara Sheikhbahaei; Jeevan K. Shetty; Reza Shirkoohi; Parnian Shobeiri; Sudeep K. Siddappa Malleshappa; Diego Augusto Santos Silva; Guilherme Silva Julian; Achintya Dinesh Singh; Jasvinder A. Singh; Md Shahjahan Siraj; Gholam Reza Sivandzadeh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Bogdan Socea; Marco Solmi; Mohammad Sadegh Soltani-Zangbar; Suhang Song; Viktória Szerencsés; Miklós Szócska; Rafael Tabarés-Seisdedos; Elnaz Tabibian; Majid Taheri; Yasaman Taheri Abkenar; Amir Taherkhani; Iman M. Talaat; Ker-Kan Tan; Abdelghani Tbakhi; Bekele Tesfaye; Amir Tiyuri; Daniel Nigusse Tollosa; Mathilde Touvier; Bach Xuan Tran; Biruk Shalmeno Tusa; Irfan Ullah; Saif Ullah; Marco Vacante; Sahel Valadan Tahbaz; Massimiliano Veroux; Bay Vo; Theo Vos; Cong Wang; Ronny Westerman; Melat Woldemariam; Seyed Hossein Yahyazadeh Jabbari; Lin Yang; Fereshteh Yazdanpanah; Chuanhua Yu; Deniz Yuce; Ismaeel Yunusa; Vesna Zadnik; Mazyar Zahir; Iman Zare; Zhi-Jiang Zhang; Mohammad Zoladi
    Background: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods: Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990–2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. Findings: Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408–868 574) to 2·17 million (2·00–2·34), and deaths increased from 518 126 (493 682–537 877) to 1·09 million (1·02–1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3–23·0) per 100 000 to 26·7 (24·6–28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5–14·9) per 100 000 to 13·7 (12·6–14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7–320·7) per 100 000 to 295·5 (275·2–313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9–80·0] per 100 000), Monaco (60·7 [48·5–73·6] per 100 000), and Andorra (56·6 [42·8–71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0–37·1] per 100 000), Brunei (30·3 [26·6–34·1] per 100 000), and Hungary (28·6 [23·6–34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019. Interpretation: The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2022) Brittney S. Sheena; Lindsey Hiebert; Hannah Han; Helen Ippolito; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Hedayat Abbastabar; Amir Abdoli; Hiwa Abubaker Ali; Mesafint Molla Adane; Oyelola A. Adegboye; Qorinah Estiningtyas Sakilah Adnani; Shailesh M. Advani; Muhammad Sohail Afzal; Saira Afzal; Mohamad Aghaie Meybodi; Bahman Ahadinezhad; Bright Opoku Ahinkorah; Sajjad Ahmad; Tauseef Ahmad; Sepideh Ahmadi; Haroon Ahmed; Muktar Beshir Ahmed; Tarik Ahmed Rashid; Gizachew Taddesse Akalu; Addis Aklilu; Tayyaba Akram; Hanadi Al Hamad; Fares Alahdab; Adugnaw Zeleke Alem; Dejene Tsegaye Alem; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Liaqat Ali; Muhammad Ashar Ali; Yousef Alimohamadi; Vahid Alipour; Motasem Alkhayyat; Sami Almustanyir; Rajaa M. Al-Raddadi; Haya Altawalah; Saeed Amini; Hubert Amu; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Amir Anoushiravani; Adnan Ansar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Morteza Arab-Zozani; Ayele Mamo Argaw; Zeleke Gebru Argaw; Muhammad Arshad; Anton A. Artamonov; Tahira Ashraf; Daniel Atlaw; Floriane Ausloos; Marcel Ausloos; Sina Azadnajafabad; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Ghasem Azarian; Sayna Bagheri; Saeed Bahadory; Atif Amin Baig; Maciej Banach; Nastaran Barati; Amadou Barrow; Abdul-Monim Mohammad Batiha; Diana Fernanda Bejarano Ramirez; Uzma Iqbal Belgaumi; Alemshet Yirga Berhie; Devidas S. Bhagat; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Ali Bijani; Antonio Biondi; Belay Boda Abule Bodicha; Hunduma Amensisa Bojia; Archith Boloor; Cristina Bosetti; Dejana Braithwaite; Nikolay Ivanovich Briko; Zahid A. Butt; Luis Alberto Cámera; Raja Chandra Chakinala; Promit Ananyo Chakraborty; Jaykaran Charan; Shu Chen; Jee-Young Jasmine Choi; Sonali Gajanan Choudhari; Fazle Rabbi Chowdhury; Dinh-Toi Chu; Sheng-Chia Chung; Paolo Angelo Cortesi; Benjamin C. Cowie; Garland T. Culbreth; Omid Dadras; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Fernando Pio De La Hoz; Sisay Abebe Debela; Mohammed Gebre Dedefo; Feleke Mekonnen Demeke; Takele Gezahegn G. Demie; Getu Debalkie Demissie; Meseret Derbew Molla; Abebaw Alemayehu Desta; Deepak Dhamnetiya; Mandira Lamichhane Dhimal; Meghnath Dhimal; Mojtaba Didehdar; Linh Phuong Doan; Fariba Dorostkar; Thomas M. Drake; Fatemeh Eghbalian; Michael Ekholuenetale; Iman El Sayed; Maysaa El Sayed Zaki; Muhammed Elhadi; Mohamed A. Elmonem; Aisha Elsharkawy; Shymaa Enany; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Sharareh Eskandarieh; Firooz Esmaeilzadeh; Sayeh Ezzikouri; Hossein Farrokhpour; Getahun Fetensa; Florian Fischer; Masoud Foroutan; Mohamed M. Gad; Abhay Motiramji Gaidhane; Shilpa Gaidhane; Natalie C. Galles; Silvano Gallus; Teferi Gebru Gebremeskel; Eyob Alemayehu Gebreyohannes; Keyghobad Ghadiri; Kazem Ghaffari; Mansour Ghafourifard; Seyyed-Hadi Ghamari; Ahmad Ghashghaee; Ali Gholami; Abdolmajid Gholizadeh; Aima Gilani; Amit Goel; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Giuseppe Gorini; Yitayal Ayalew Goshu; Max G. Griswold; Mohammed Ibrahim Mohialdeen Gubari; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Rasool Haddadi; Rabih Halwani; Saeed S. Hamid; Samer Hamidi; Asif Hanif; Shafiul Haque; Harapan Harapan; Arief Hargono; Sanam Hariri; Ahmed I. Hasaballah; S.M. Mahmudul Hasan; Soheil Hassanipour; Hadi Hassankhani; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Claudiu Herteliu; Demisu Zenbaba Heyi; Kamal Hezam; Ramesh Holla; Mohammad-Salar Hosseini; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Junjie Huang; Nawfal R. Hussein; Ivo Iavicoli; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Lalu Muhammad Irham; Jessica Y. Islam; Nahlah Elkudssiah Ismail; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Amirreza Javadi Mamaghani; Shubha Jayaram; Ranil Jayawardena; Rime Jebai; Ravi Prakash Jha; Nitin Joseph; Farahnaz Joukar; Billingsley Kaambwa; Ali Kabir; Zubair Kabir; Rohollah Kalhor; Himal Kandel; Tesfaye K. Tesfaye Kanko; Rami S. Kantar; Ibraheem M. Karaye; Bekalu Getnet Kassa; Phillip M. Kemp Bohan; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Gulfaraz Khan; Imteyaz A. Khan; Junaid Khan; Moien A.B. Khan; Javad Khanali; Amir M. Khater; Mahalaqua Nazli Khatib; Mahmoud Khodadost; Abdullah T. Khoja; Omid Khosravizadeh; Jagdish Khubchandani; Gyu Ri Kim; Hanna Kim; Min Seo Kim; Yun Jin Kim; Jonathan M. Kocarnik; Ali-Asghar Kolahi; Rajasekaran Koteeswaran; G. Anil Kumar; Carlo La Vecchia; Dharmesh Kumar Lal; Iván Landires; Savita Lasrado; Jeffrey V. Lazarus; Caterina Ledda; Doo Woong Lee; Sang-Woong Lee; Yeong Yeh Lee; Miriam Levi; Jiarui Li; Stephen S. Lim; Stany W. Lobo; Platon D. Lopukhov; Joana A. Loureiro; Jennifer H. MacLachlan; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Azeem Majeed; Alaa Makki; Mohammad-Reza Malekpour; Reza Malekzadeh; Ahmad Azam Malik; Fariborz Mansour-Ghanaei; Mohammad Ali Mansournia; Francisco Rogerlândio Martins-Melo; Philippa C. Matthews; Walter Mendoza; Ritesh G. Menezes; Tuomo J. Meretoja; Amanual Getnet Mersha; Tomislav Mestrovic; Ted R. Miller; Le Huu Nhat Minh; Andreea Mirica; Seyyedmohammadsadeq Mirmoeeni; Erkin M. Mirrakhimov; Sanjeev Misra; Prasanna Mithra; Babak Moazen; Ashraf Mohamadkhani; Mokhtar Mohammadi; Shafiu Mohammed; Nagabhishek Moka; Ali H. Mokdad; Jalal Moludi; Sara Momtazmanesh; Lorenzo Monasta; Ghobad Moradi; Maliheh Moradzadeh; Rahmatollah Moradzadeh; Paula Moraga; Ebrahim Mostafavi; Sumaira Mubarik; Malaisamy Muniyandi; Christopher J.L. Murray; Mohsen Naghavi; Mukhammad David Naimzada; Sreenivas Narasimha Swamy; Zuhair S. Natto; Biswa Prakash Nayak; Javad Nazari; Ionut Negoi; Serban Mircea Negru; Seyed Aria Nejadghaderi; Sandhya Neupane Kandel; Huong Lan Thi Nguyen; Che Henry Ngwa; Robina Khan Niazi; Chukwudi A. Nnaji; Jean Jacques Noubiap; Ali Nowroozi; Virginia Nuñez-Samudio; Bogdan Oancea; Chimedsuren Ochir; Oluwakemi Ololade Odukoya; In-Hwan Oh; Andrew T. Olagunju; Babayemi Oluwaseun Olakunde; Ahmed Omar Bali; Emad Omer; Stanislav S. Otstavnov; Bilcha Oumer; Jagadish Rao Padubidri; Adrian Pana; Anamika Pandey; Eun-Cheol Park; Fatemeh Pashazadeh Kan; Urvish K. Patel; Uttam Paudel; Ionela-Roxana Petcu; Zahra Zahid Piracha; Richard Charles G. Pollok; Maarten J. Postma; Akram Pourshams; Hossein Poustchi; Mohammad Rabiee; Navid Rabiee; Alireza Rafiei; Sima Rafiei; Pavan Manibettu Raghuram; Mosiur Rahman; Amir Masoud Rahmani; Setyaningrum Rahmawaty; Aashish Rajesh; Priyanga Ranasinghe; Chythra R. Rao; Sowmya J. Rao; Mahsa Rashidi; Mohammad-Mahdi Rashidi; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Negar Rezaei; Aziz Rezapour; Sahba Rezazadeh-Khadem; Jefferson Antonio Buendia Rodriguez; Godfrey M. Rwegerera; Siamak Sabour; Basema Saddik; Mohammad Reza Saeb; Umar Saeed; Amirhossein Sahebkar; K.M. Saif-Ur-Rahman; Sarvenaz Salahi; Hamideh Salimzadeh; Chethan Sampath; Abdallah M. Samy; Juan Sanabria; Francesco Sanmarchi; Milena M. Santric-Milicevic; Arash Sarveazad; Brijesh Sathian; Monika Sawhney; Abdul-Aziz Seidu; Sadaf G. Sepanlou; Allen Seylani; Saeed Shahabi; Masood Ali Shaikh; Elaheh Shaker; Murad Ziyaudinovich Shakhmardanov; Mohammed Shannawaz; Suchitra M. Shenoy; Jeevan K. Shetty; Pavanchand H. Shetty; Kenji Shibuya; Jae Il Shin; Parnian Shobeiri; Migbar Mekonnen Sibhat; Achintya Dinesh Singh; Jasvinder A. Singh; Surjit Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Amir Ali Sohrabpour; Suhang Song; Seidamir Pasha Tabaeian; Eyayou Girma Tadesse; Majid Taheri; Mircea Tampa; Ker-Kan Tan; Ahmad Tavakoli; Abdelghani Tbakhi; Belay Negash Tefera; Arash Tehrani-Banihashemi; Habtamu Molla Tesfaw; Rekha Thapar; Aravind Thavamani; Seyed Abolfazl Tohidast; Daniel Nigusse Tollosa; Maria Elena Tosti; Marcos Roberto Tovani-Palone; Eugenio Traini; Mai Thi Ngoc Tran; Indang Trihandini; Biruk Shalmeno Tusa; Irfan Ullah; Marco Vacante; Sahel Valadan Tahbaz; Pascual R. Valdez; Shoban Babu Varthya; Bay Vo; Yasir Waheed; Adisu Birhanu Weldesenbet; Melat Woldemariam; Suowen Xu; Seyed Hossein Yahyazadeh Jabbari; Mehdi Yaseri; Yigizie Yeshaw; Vahit Yiǧit; Birhanu Wubale Yirdaw; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mazyar Zahir; Leila Zaki; Mohammad Zamani; Maryam Zamanian; Mikhail Sergeevich Zastrozhin; Theo Vos; John W. Ward; M. Ashworth Dirac
    Background: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods: The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings: In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation: The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Global, regional, and national burden of stroke and its risk factors, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2021) Valery L. Feigin; Benjamin A. Stark; Catherine Owens Johnson; Gregory A. Roth; Catherine Bisignano; Gdiom Gebreheat Abady; Mitra Abbasifard; Mohsen Abbasi-Kangevari; Foad Abd-Allah; Vida Abedi; Ahmed Abualhasan; Niveen M.E. Abu-Rmeileh; Abdelrahman I. Abushouk; Oladimeji M. Adebayo; Gina Agarwal; Pradyumna Agasthi; Bright Opoku Ahinkorah; Sohail Ahmad; Sepideh Ahmadi; Yusra Ahmed Salih; Budi Aji; Samaneh Akbarpour; Rufus Olusola Akinyemi; Hanadi Al Hamad; Fares Alahdab; Sheikh Mohammad Alif; Vahid Alipour; Syed Mohamed Aljunid; Sami Almustanyir; Rajaa M Al-Raddadi; Rustam Al-Shahi Salman; Nelson Alvis-Guzman; Robert Ancuceanu; Deanna Anderlini; Jason A. Anderson; Adnan Ansar; Ippazio Cosimo Antonazzo; Jalal Arabloo; Johan Ärnlöv; Kurnia Dwi Artanti; Zahra Aryan; Samaneh Asgari; Tahira Ashraf; Mohammad Athar; Alok Atreya; Marcel Ausloos; Atif Amin Baig; Ovidiu Constantin Baltatu; MacIej Banach; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Mark Thomaz Ugliara Barone; Sanjay Basu; Gholamreza Bazmandegan; Ettore Beghi; Mahya Beheshti; Yannick Béjot; Arielle Wilder Bell; Derrick A. Bennett; Isabela M. Bensenor; Woldesellassie Mequanint Bezabhe; Yihienew Mequanint Bezabih; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Krittika Bhattacharyya; Ali Bijani; Boris Bikbov; Mulugeta M. Birhanu; Archith Boloor; Aime Bonny; Michael Brauer; Hermann Brenner; Dana Bryazka; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Ismael R. Campos-Nonato; Carlos Cantu-Brito; Juan J. Carrero; Carlos A. Castañeda-Orjuela; Alberico L. Catapano; Promit Ananyo Chakraborty; Jaykaran Charan; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Dinh-Toi Chu; Sheng-Chia Chung; David Colozza; Vera Marisa Costa; Simona Costanzo; Michael H. Criqui; Omid Dadras; Baye Dagnew; Xiaochen Dai; Koustuv Dalal; Albertino Antonio Moura Damasceno; Emanuele D'Amico; Lalit Dandona; Rakhi Dandona; Jiregna Darega Gela; Kairat Davletov; Vanessa De La Cruz-Góngora; Rupak Desai; Deepak Dhamnetiya; Samath Dhamminda Dharmaratne; Mandira Lamichhane Dhimal; Meghnath Dhimal; Daniel Diaz; Martin Dichgans; Klara Dokova; Rajkumar Doshi; Abdel Douiri; Bruce B. Duncan; Sahar Eftekharzadeh; Michael Ekholuenetale; Nevine El Nahas; Islam Y. Elgendy; Muhammed Elhadi; Shaimaa I El-Jaafary; Matthias Endres; Aman Yesuf Endries; Daniel Asfaw Erku; Emerito Jose A. Faraon; Umar Farooque; Farshad Farzadfar; Abdullah Hamid Feroze; Irina Filip; Florian Fischer; David Flood; Mohamed M. Gad; Shilpa Gaidhane; Reza Ghanei Gheshlagh; Ahmad Ghashghaee; Nermin Ghith; Ghozali Ghozali; Sherief Ghozy; Alessandro Gialluisi; Simona Giampaoli; Syed Amir Gilani; Paramjit Singh Gill; Elena V. Gnedovskaya; Mahaveer Golechha; Alessandra C. Goulart; Yuming Guo; Rajeev Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Pradip Gyanwali; Nima Hafezi-Nejad; Samer Hamidi; Asif Hanif; Graeme J. Hankey; Arief Hargono; Abdiwahab Hashi; Treska S. Hassan; Hamid Yimam Hassen; Rasmus J. Havmoeller; Simon I. Hay; Khezar Hayat; Mohamed I. Hegazy; Claudiu Herteliu; Ramesh Holla; Sorin Hostiuc; Mowafa Househ; Junjie Huang; Ayesha Humayun; Bing-Fang Hwang; Licia Iacoviello; Ivo Iavicoli; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Usman Iqbal; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Masao Iwagami; Louis Jacob; Vardhmaan Jain; Sung-In Jang; Sathish Kumar Jayapal; Shubha Jayaram; Ranil Jayawardena; Panniyammakal Jeemon; Ravi Prakash Jha; Walter D. Johnson; Jost B. Jonas; Nitin Joseph; Jacek Jerzy Jozwiak; Mikk Jürisson; Rizwan Kalani; Rohollah Kalhor; Yogeshwar Kalkonde; Ashwin Kamath; Zahra Kamiab; Tanuj Kanchan; Himal Kandel; André Karch; Patrick D.M.C. Katoto; Gbenga A. Kayode; Pedram Keshavarz; Yousef Saleh Khader; Ejaz Ahmad Khan; Imteyaz A. Khan; Maseer Khan; Moien A.B. Khan; Mahalaqua Nazli Khatib; Jagdish Khubchandani; Gyu Ri Kim; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Mika Kivimäki; Dhaval Kolte; Ali Koolivand; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Vijay Krishnamoorthy; Rita V. Krishnamurthi; G. Anil Kumar; Dian Kusuma; Carlo La Vecchia; Ben Lacey; Hassan Mehmood Lak; Tea Lallukka; Savita Lasrado; Pablo M. Lavados; Matilde Leonardi; Bingyu Li; Shanshan Li; Hualiang Lin; Ro-Ting Lin; Xuefeng Liu; Warren David Lo; Stefan Lorkowski; Giancarlo Lucchetti; Ricardo Lutzky Saute; Hassan Magdy Abd El Razek; Francesca Giulia Magnani; Preetam Bhalchandra Mahajan; Azeem Majeed; Alaa Makki; Reza Malekzadeh; Ahmad Azam Malik; Navid Manafi; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Santi Martini; Giampiero Mazzaglia; Man Mohan Mehndiratta; Ritesh G. Menezes; Atte Meretoja; Amanual Getnet Mersha; Junmei Miao Jonasson; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Erkin M. Mirrakhimov; Yousef Mohammad; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Ali H. Mokdad; Yaser Mokhayeri; Mariam Molokhia; Mohammad Ali Moni; Ahmed Al Montasir; Rahmatollah Moradzadeh; Lidia Morawska; Jakub Morze; Walter Muruet; Kamarul Imran Musa; Ahamarshan Jayaraman Nagarajan; Mohsen Naghavi; Sreenivas Narasimha Swamy; Bruno Ramos Nascimento; Ruxandra Irina Negoi; Sandhya Neupane Kandel; Trang Huyen Nguyen; Bo Norrving; Jean Jacques Noubiap; Vincent Ebuka Nwatah; Bogdan Oancea; Oluwakemi Ololade Odukoya; Andrew T. Olagunju; Hans Orru; Mayowa O. Owolabi; Jagadish Rao Padubidri; Adrian Pana; Tarang Parekh; Eun-Cheol Park; Fatemeh Pashazadeh Kan; Mona Pathak; Mario F.P. Peres; Arokiasamy Perianayagam; Truong-Minh Pham; Michael A. Piradov; Vivek Podder; Suzanne Polinder; Maarten J. Postma; Akram Pourshams; Amir Radfar; Alireza Rafiei; Alberto Raggi; Fakher Rahim; Vafa Rahimi-Movaghar; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Nazanin Rajai; Priyanga Ranasinghe; Chythra R. Rao; Sowmya J. Rao; Priya Rathi; David Laith Rawaf; Salman Rawaf; Marissa B. Reitsma; Vishnu Renjith; Andre M.N. Renzaho; Aziz Rezapour; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; Michele Romoli; Andrzej Rynkiewicz; Simona Sacco; Masoumeh Sadeghi; Sahar Saeedi Moghaddam; Amirhossein Sahebkar; K.M. Saif-Ur-Rahman; Rehab Salah; Mehrnoosh Samaei; Abdallah M. Samy; Itamar S. Santos; Milena M. Santric-Milicevic; Nizal Sarrafzadegan; Brijesh Sathian; Davide Sattin; Silvia Schiavolin; Markus P. Schlaich; Maria Inês Schmidt; Aletta Elisabeth Schutte; Sadaf G. Sepanlou; Allen Seylani; Feng Sha; Saeed Shahabi; Masood Ali Shaikh; Mohammed Shannawaz; Md. Shajedur Rahman Shawon; Aziz Sheikh; Sara Sheikhbahaei; Kenji Shibuya; Soraya Siabani; Diego Augusto Santos Silva; Jasvinder A. Singh; Jitendra Kumar Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Badr Hasan Sobaih; Stefan Stortecky; Saverio Stranges; Eyayou Girma Tadesse; Ingan Ukur Tarigan; Mohamad-Hani Temsah; Yvonne Teuschl; Amanda G. Thrift; Marcello Tonelli; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Manjari Tripathi; Gebiyaw Wudie Tsegaye; Anayat Ullah; Brigid Unim; Bhaskaran Unnikrishnan; Alireza Vakilian; Sahel Valadan Tahbaz; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Dominique Vervoort; Bay Vo; Victor Volovici; Kia Vosoughi; Giang Thu Vu; Linh Gia Vu; Hatem A. Wafa; Yasir Waheed; Yanzhong Wang; Tissa Wijeratne; Andrea Sylvia Winkler; Charles D.A. Wolfe; Mark Woodward; Jason H. Wu; Sarah Wulf Hanson; Xiaoyue Xu; Lalit Yadav; Ali Yadollahpour; Seyed Hossein Yahyazadeh Jabbari; Kazumasa Yamagishi; Hiroshi Yatsuya; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Muhammed Shahriar Zaman; Sojib Bin Zaman; Maryam Zamanian; Ramin Zand; Alireza Zandifar; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Yunquan Zhang; Zhi-Jiang Zhang; Chenwen Zhong; Yves Miel H. Zuniga; Christopher J.L. Murray
    Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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    Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
    (Elsevier Ltd, 2024) Valery L Feigin; Melsew Dagne Abate; Yohannes Habtegiorgis Abate; Samar Abd ElHafeez; Foad Abd-Allah; Ahmed Abdelalim; Atef Abdelkader; Michael Abdelmasseh; Sherief Abd-Elsalam; Parsa Abdi; Arash Abdollahi; Meriem Abdoun; Rami Abd-Rabu; Deldar Morad Abdulah; Auwal Abdullahi; Mesfin Abebe; Roberto Ariel Abeldaño Zuñiga; E.S. Abhilash; Olugbenga Olusola Abiodun; Olumide Abiodun; Rahim Abo Kasem; Richard Gyan Aboagye; Mohamed Abouzid; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Dariush Abtahi; Samir Abu Rumeileh; Ahmed Abualhasan; Hasan Abualruz; Eman Abu-Gharbieh; Hana J Abukhadijah; Niveen ME Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Juan Manuel Acuna; Denberu Eshetie Adane; Mesafint Molla Adane; Isaac Yeboah Addo; Rufus Adesoji Adedoyin; Oyelola A Adegboye; Victor Adekanmbi; Kishor Adhikari; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Leticia Akua Adzigbli; Abdelrahman Yousry Afify; Aanuoluwapo Adeyimika Afolabi; Fatemeh Afrashteh; Muhammad Sohail Afzal; Saira Afzal; Shahin Aghamiri; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Muayyad M Ahmad; Sajjad Ahmad; Shahzaib Ahmad; Tauseef Ahmad; Amir Mahmoud Ahmadzade; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Essona Matatom Akara; Rufus Olusola Akinyemi; Mohammed Ahmed Akkaif; Ashley E Akrami; Salah Al Awaidy; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Mohammad Al Qadire; Omar Al Ta'ani; Yazan Al-Ajlouni; Samer O Alalalmeh; Tariq A Alalwan; Ziyad Al-Aly; Rasmieh Mustafa Al-amer; Wafa A Aldhaleei; Mohammed S Aldossary; Seyedeh Yasaman Alemohammad; Bassam Al-Fatly; Adel Ali Saeed Al-Gheethi; Fadwa Naji Alhalaiqa; Maryam Alharrasi; Abid Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Ali; Waad Ali; Akram Al-Ibraheem; Sheikh Mohammad Alif; Syed Mohamed Aljunid; Wael Almahmeed; Sabah Al-Marwani; Mahmoud A Alomari; Jordi Alonso; Jaber S Alqahtani; Rajaa M Mohammad Al-Raddadi; Ahmad Alrawashdeh; Mohammed A Alsabri; Najim Z Alshahrani; Zaid Altaany; Awais Altaf; Alaa B Al-Tammemi; Diala Altwalbeh; Nelson Alvis-Guzman; Hassan Alwafi; Mohammad Al-Wardat; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Mohammad Sharif Ibrahim Alyahya; Karem H Alzoubi; Walid Adnan Al-Zyoud; Reza Amani; Prince M Amegbor; Tewodros Getnet Amera; Tarek Tawfik Amin; Alireza Amindarolzarbi; Sohrab Amiri; Hubert Amu; Dickson A Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; Dhanalakshmi Angappan; Abhishek Anil; Mohammed Tahir Tahir Ansari; Alireza Ansari-Moghaddam; Rockson Ansong; Saeid Anvari; Saleha Anwar; Sumadi Lukman Anwar; Ekenedilichukwu Emmanuel Anyabolo; Anayochukwu Edward Anyasodor; Geminn Louis Carace Apostol; Francis Appiah; Muhammad Aqeel; Jalal Arabloo; Razman Arabzadeh Bahri; Mosab Arafat; Aleksandr Y Aravkin; Ali Ardekani; Demelash Areda; Brhane Berhe Aregawi; Getnet Mesfin Aregu; Olatunde Aremu; Hidayat Arifin; Johan Ärnlöv; Anton A Artamonov; Judie Arulappan; Umesh Raj Aryal; Zahra Aryan; Akram M Asbeutah; Mulusew A Asemahagn; Mulu Tiruneh Asemu; Mohammad Asghari-Jafarabadi; Mubarek Yesse Ashemo; Tahira Ashraf; Armin Aslani; Haftu Asmerom Asmerom; Thomas Astell-Burt; Seyyed Shamsadin Athari; Prince Atorkey; Maha Moh'd Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Hamzeh Awad; Adedapo Wasiu Awotidebe; Lemessa Assefa A Ayana; Setognal Birara Aychiluhm; Amdehiwot A Aynalem; Zewdu Bishaw Aynalem; Sina Azadnajafabad; Hiva Azami; Shahkaar Aziz; Ahmed Y Azzam; Abraham Samuel Babu; Giridhara Rathnaiah Babu; Muhammad Badar; Ashish D Badiye; Pegah Bahrami Taghanaki; Saeed Bahramian; Ruhai Bai; Atif Amin Baig; Shankar M Bakkannavar; Abdulaziz T Bako; Ovidiu Constantin Baltatu; Kiran Bam; Maciej Banach; Morteza Banakar; Soham Bandyopadhyay; Palash Chandra Banik; Kannu Bansal; Yanping Bao; Miguel A Barboza; Mainak Bardhan; Noel C Barengo; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Hiba Jawdat Barqawi; Amadou Barrow; Lingkan Barua; Azadeh Bashiri; Hameed Akande Bashiru; Afisu Basiru; Mohammad-Mahdi Bastan; Sanjay Basu; Saurav Basu; Kavita Batra; Ahmet Begde; Babak Behnam; Amir Hossein Behnoush; Melesse B Y Belayneh; Michael Belingheri; Umar Muhammad Bello; Derrick A Bennett; Isabela M Bensenor; Fentaw Tadese Berhe; Amiel Nazer C Bermudez; Habtamu B B Beyene; Kebede A Beyene; Devidas S Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Nikha Bhardwaj; Pankaj Bhardwaj; Sonu Bhaskar; Ajay Nagesh Bhat; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Singh Bhatti; Mohiuddin Ahmed Bhuiyan; Subarna Bhusal; Boris Bikbov; Cem Bilgin; Antonio Biondi; Keralem Anteneh Bishaw; Atanu Biswas; Bijit Biswas; Trupti Bodhare; Eyob Ketema Bogale; Archith Boloor; Milad Bonakdar Hashemi; Aime Bonny; Berrak Bora Basara; Hamed Borhany; Samuel Adolf Bosoka; Souad Bouaoud; Abdelhakim Bouyahya; Edward J Boyko; Marija M Bozic; Dejana Braithwaite; Susanne Breitner; Hermann Brenner; Gabrielle Britton; Andre R Brunoni; Dana Bryazka; Raffaele Bugiardini; Lemma N Bulto; Katrin Burkart; Yasser Bustanji; Zahid A Butt; Florentino Luciano Caetano dos Santos; Luis Alberto Cámera; Luciana Aparecida Campos; Ismael R Campos-Nonato; Fan Cao; Angelo Capodici; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Andre F Carvalho; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A Castañeda-Orjuela; Giulio Castelpietra; Alberico L Catapano; Maria Sofia Cattaruzza; Luca Cegolon; Francieli Cembranel; Edina Cenko; Ester Cerin; Joshua Chadwick; Chiranjib Chakraborty; Sandip Chakraborty; Jeffrey Shi Kai Chan; Rama Mohan Chandika; Eeshwar K Chandrasekar; Gashaw Sisay Chanie; Vijay Kumar Chattu; Anis Ahmad Chaudhary; Akhilanand Chaurasia; Haowei Chen; Mingling Chen; Simiao Chen; Gerald Chi; Fatemeh Chichagi; Ritesh Chimoriya; Patrick R Ching; Abdulaal Chitheer; So Mi Jemma Cho; Dong-Woo Choi; Bryan Chong; Chean Lin Chong; Hitesh Chopra; Sonali Gajanan Choudhari; Rahul Choudhary; Dinh-Toi Chu; Isaac Sunday Chukwu; Sheng-Chia Chung; Zinhle Cindi; Iolanda Cioffi; Rebecca M Cogen; Alyssa Columbus; Simona Costanzo; Rosa A S Couto; Michael H Criqui; Natalia Cruz-Martins; Silvia Magali Cuadra-Hernández; Alanna Gomes da Silva; Sriharsha Dadana; Omid Dadras; Xiaochen Dai; Koustuv Dalal; Lachlan L Dalli; Giovanni Damiani; Emanuele D'Amico; Lalit Dandona; Rakhi Dandona; Amira Hamed Darwish; Saswati Das; Mohsen Dashti; Mohadese Dashtkoohi; Mohammad Dashtkoohi; Maedeh Dastmardi; Kairat Davletov; Vanessa De la Cruz-Góngora; Sean DeAngelo; Aklilu Tamire Debele; Shayom Debopadhaya; Ivan Delgado-Enciso; Berecha Hundessa Demessa; Andreas K Demetriades; Edgar Denova-Gutiérrez; Emina Dervišević; Hardik Dineshbhai Desai; Aragaw Tesfaw Desale; Fikreab Desta; Vinoth Gnana Chellaiyan Devanbu; Devananda Devegowda; Syed Masudur Rahman Dewan; Amol S Dhane; Meghnath Dhimal; Vishal R Dhulipala; Michael J Diaz; Mengistie Diress; Milad Dodangeh; Phidelia Theresa Doegah; Sushil Dohare; Mohamed Fahmy Doheim; Klara Georgieva Dokova; Deepa Dongarwar; Mario D'Oria; Ojas Prakashbhai Doshi; Rajkumar Prakashbhai Doshi; Abdel Douiri; Robert Kokou Dowou; Ashel Chelsea Dsouza; Haneil Larson Dsouza; Viola Savy Dsouza; Bruce B Duncan; Andre Rodrigues Duraes; Arkadiusz Marian Dziedzic; Michael Ekholuenetale; Ibrahim Farahat El Bayoumy; Maysaa El Sayed Zaki; Iffat Elbarazi; Faris El-Dahiyat; Islam Y Elgendy; Muhammed Elhadi; Waseem El-Huneidi; Mohamed A Elmonem; Adel B Elmoselhi; Chadi Eltaha; Theophilus I Emeto; Christopher Imokhuede Esezobor; Negin Esfandiari; Zahra Esmaeili; Francesco Esposito; Mohammad Etoom; Natalia Fabin; Ibtihal Fadhil; Adeniyi Francis Fagbamigbe; Omotayo Francis Fagbule; Shahriar Faghani; Ayesha Fahim; Ildar Ravisovich Fakhradiyev; Luca Falzone; Mohammad Fareed; Jawad Fares; Carla Sofia e Sá Farinha; MoezAlIslam Ezzat Mahmoud Faris; Pawan Sirwan Faris; Mohsen Farjoud Kouhanjani; Andre Faro; Hossein Farrokhpour; Abidemi Omolara Fasanmi; Nelsensius Klau Fauk; Patrick Fazeli; Timur Fazylov; Alireza Feizkhah; Ginenus Fekadu; Xiaoqi Feng; Seyed-Mohammad Fereshtehnejad; Pietro Ferrara; Nuno Ferreira; Getahun Fetensa; Bikila Regassa Feyisa; Florian Fischer; Luisa S Flor; Kristen Marie Foley; Ana Catarina Fonseca; Roham Foroumadi; Behzad Foroutan; Daniela Fortuna; Matteo Foschi; Richard Charles Franklin; Ni Kadek Yuni Fridayani; Sridevi G; Peter Andras Gaal; Abhay Motiramji Gaidhane; Abduzhappar Gaipov; Yaseen Galali; Silvano Gallus; Aravind P Gandhi; Balasankar Ganesan; Danijela Gasevic; Prem Gautam; Rupesh K Gautam; Miglas Welay Gebregergis; Mesfin Gebrehiwot; Kebre Gebrekirstos Gebrekidan; Lemma Getacher; Genanew K Getahun; Molla Getie; Delaram J Ghadimi; Fataneh Ghadirian; Amir Ghaffari Jolfayi; Mansour Ghafourifard; Mohammad-Reza Ghasemi; Afsaneh Ghasemzadeh; Ramy Mohamed Ghazy; Ehsan Gholami; Zainab Gholami; Sherief Ghozy; Stefano Giannoni Luza; Jaleed Ahmed Gilani; Tiffany K Gill; Richard F Gillum; Ebisa Zerihun Gindaba; Elena V Gnedovskaya; Amit Goel; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Philimon N Gona; Giuseppe Gorini; Alessandra C Goulart; Barbara Niegia Garcia Goulart; Mahdi Gouravani; Michal Grivna; Giuseppe Grosso; Ashna Grover; Shi-Yang Guan; Giovanni Guarducci; Avirup Guha; Stefano Guicciardi; Snigdha Gulati; Damitha Asanga Gunawardane; Cui Guo; Zhifeng Guo; Anish Kumar Gupta; Bhawna Gupta; Mohak Gupta; Rahul Gupta; Rajat Das Gupta; Rajeev Gupta; Sapna Gupta; Farrokh Habibzadeh; Najah R Hadi; Mohammad Haghani Dogahe; Hamed Haghi-Aminjan; Dariush Haghmorad; Arvin Haj-Mirzaian; Aram Halimi; Nadia M Hamdy; Samer Hamidi; Erin B Hamilton; Asif Hanif; Nasrin Hanifi; Graeme J Hankey; Md Abdul Hannan; Zaim Anan Haq; Arief Hargono; Netanja I Harlianto; Josep Maria Haro; Eka Mishbahatul Marah Has; Ahmed I Hasaballah; Ikramul Hasan; Md Saquib Hasnain; Ikrama Hassan; Mahgol Sadat Hassan Zadeh Tabatabaei; Johannes Haubold; Rasmus J Havmoeller; Simon I Hay; Youssef Hbid; Jeffrey J Hebert; Omar E Hegazi; Mohammad Heidari; Mehdi Hemmati; Demisu Zenbaba Heyi; Kamal Hezam; Yuta Hiraike; Nguyen Quoc Hoan; Ramesh Holla; Nobuyuki Horita; Md Mahbub Hossain; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Ahmad Hosseinzadeh Adli; Mihaela Hostiuc; Sorin Hostiuc; Ben Hu; Chengxi Hu; Junjie Huang; Ayesha Humayun; Salman Hussain; Le Duc Huy; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Nayu Ikeda; Adalia Ikiroma; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mohammad Tarique Imam; Mustapha Immurana; Leeberk Raja Inbaraj; Muhammad Iqhrammullah; Arnaud Iradukunda; Lalu Muhammad Irham; Md Rabiul Islam; Faisal Ismail; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Ramaiah Itumalla; Masao Iwagami; Chidozie Declan CD Iwu; Vinothini J; Jalil Jaafari; Louis Jacob; Abdollah Jafarzadeh; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Abhishek Jaiswal; Mihajlo Jakovljevic; Reza Jalilzadeh Yengejeh; Balamurugan Janakiraman; Abubakar Ibrahim Jatau; Sathish Kumar Jayapal; Shubha Jayaram; Sun Ha Jee; Jayakumar Jeganathan; Mihretu Jegnie; Alelign Tasew Jema; Bijay Mukesh Jeswani; Angeline Jeyakumar; Anil K Jha; Ravi Prakash Jha; Zixiang Ji; Heng Jiang; Shuai Jin; Yingzhao Jin; Mohammad Jokar; Jost B Jonas; Tamas Joo; Jobinse Jose; Nitin Joseph; Charity Ehimwenma Joshua; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Md Awal Kabir; Zubair Kabir; Vidya Kadashetti; Rizwan Kalani; Sanjay Kalra; Vineet Kumar Kamal; Arun Kamireddy; Haidong Kan; Mona Kanaan; Himal Kandel; Kehinde Kazeem Kanmodi; Rami S Kantar; Neeti Kapoor; Paschalis Karakasis; Ibraheem M Karaye; André Karch; Hanie Karimi; Salah Eddin Karimi; Yeganeh Karimi; Arman Karimi Behnagh; Prabin Karki; Hengameh Kasraei; Joonas H Kauppila; Harkiran Kaur; Neda Kaydi; Gbenga A Kayode; Foad Kazemi; Sina Kazemian; Emmanuelle Kesse-Guyot; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Inn Kynn Khaing; Himanshu Khajuria; Amirmohammad Khalaji; Nauman Khalid; Anees Ahmed Khalil; Asaduzzaman Khan; Fayaz Khan; M Nuruzzaman Khan; Maseer Khan; Mohammad Jobair Khan; Moien AB Khan; Yusra H Khan; Shaghayegh Khanmohammadi; Khaled Khatab; Haitham Khatatbeh; Moawiah Mohammad Khatatbeh; Sorour Khateri; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Hamid Reza Khayat Kashani; Feriha Fatima Khidri; Manoj Khokhar; Atulya Aman Khosla; Majid Khosravi; Jagdish Khubchandani; Saeid Kian; Kwanghyun Kim; Min Seo Kim; Yun Jin Kim; Ruth W Kimokoti; Adnan Kisa; Sezer Kisa; Ali-Asghar Kolahi; Kamrun Nahar Koly; Farzad Kompani; Shivakumar KM Marulasiddaiah Kondlahalli; Miikka Korja; Vladimir Andreevich Korshunov; Oleksii Korzh; Soewarta Kosen; Karel Kostev; Nikhil Kothari; Ashwin Laxmikant Kotnis; Sindhura Lakshmi Koulmane Laxminarayana; Kewal Krishan; Varun Krishna; Vijay Krishnamoorthy; Bindu Krishnan; Jera Kruja; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Md Abdul Kuddus; Mohammed Kuddus; Nuworza Kugbey; Mukhtar Kulimbet; Vishnutheertha Kulkarni; Akshay Kumar; Ashish Kumar; Dewesh Kumar; G Anil Kumar; Nithin Kumar; Rakesh Kumar; Senthil Kumaran D; Amartya Kundu; Satyajit Kundu; Setor K Kunutsor; Om P Kurmi; Dian Kusuma; L V Simhachalam Kutikuppala; Ambily Kuttikkattu; Ville Kytö; Carlo La Vecchia; Ben Lacey; Chandrakant Lahariya; Dharmesh Kumar Lal; Tea Lallukka; Judit Lám; Iván Landires; Anders O Larsson; Savita Lasrado; Kaveh Latifinaibin; Paolo Lauriola; Pablo M Lavados; Basira Kankia Lawal; Long Khanh Dao Le; Nhi Huu Hanh Le; Thao Thi Thu Le; Trang Diep Thanh Le; Paul H Lee; Seung Won Lee; Wei-Chen Lee; Yo Han Lee; Ming-Chieh Li; Wei Li; Xiaopan Li; Yichong Li; Lee-Ling Lim; Stephen S Lim; John C Lin; Daniel Lindholm; Shai Linn; Gang Liu; Runben Liu; Shuke Liu; Xiaofeng Liu; Xuefeng Liu; Erand Llanaj; Chun-Han Lo; Warren David Lo; Valerie Lohner; José Francisco López-Gil; László Lorenzovici; Stefan Lorkowski; Paulo A Lotufo; Giancarlo Lucchetti; Lisha Luo; Jay B Lusk; Zheng Feei Ma; Monika Machoy; Farzan Madadizadeh; Ralph Maddison; Elham Mahmoudi; Golnaz Mahmoudvand; Omar M Makram; Elaheh Malakan Rad; Kashish Malhotra; Ahmad Azam Malik; Iram Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Abdullah A Mamun; Yosef Manla; Mohammad Hadi Mansouri; Pejman Mansouri; Vahid Mansouri; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Emmanuel Manu; Hamid Reza Marateb; Abdoljalal Marjani; Daniela Martini; Santi Martini; Miquel Martorell; Sharmeen Maryam; Roy Rillera Marzo; Awoke Masrie; Yasith Mathangasinghe; Pallab K Maulik; Mahsa Mayeli; Mohsen Mazidi; Martin McKee; Steven M McPhail; Enkeleint A Mechili; Asim Mehmood; Kamran Mehrabani-Zeinabad; Tesfahun Mekene Meto; Hadush Negash Meles; Walter Mendoza; Ritesh G Menezes; George A Mensah; Sultan Ayoub Meo; Atte Meretoja; Tuomo J Meretoja; Tomislav Mestrovic; Chamila Dinushi Kukulege Mettananda; Tomasz Miazgowski; Irmina Maria Michalek; Ana Carolina Micheletti Gomide Nogueira de Sá; Giuseppe Minervini; Le Huu Nhat Minh; G.K. Mini; Mojgan Mirghafourvand; Andreea Mirica; Erkin M Mirrakhimov; Mohammad Mirza-Aghazadeh-Attari; Manish Mishra; Sanjeev Misra; Prasanna Mithra; Ahmed Ismail Mohamed; Jama Mohamed; Nouh Saad Mohamed; Ameen Mosa Mohammad; Esmaeil Mohammadi; Saeed Mohammadi; Soheil Mohammadi; Abdollah Mohammadian-Hafshejani; Ibrahim Mohammadzadeh; Hussen Mohammed; Mustapha Mohammed; Salahuddin Mohammed; Shafiu Mohammed; Ali H Mokdad; Hossein Molavi Vardanjani; Mariam Molokhia; Shaher Momani; Lorenzo Monasta; Mohammad Ali Moni; Fateme Montazeri; AmirAli Moodi Ghalibaf; Mahmood Moosazadeh; Maryam Moradi; Yousef Moradi; Paula Moraga; Lidia Morawska; Rafael Silveira Moreira; Shane Douglas Morrison; Reza Mosaddeghi Heris; Elias Mossialos; Parsa Mousavi; Ahmed Msherghi; Sumaira Mubarik; Lorenzo Muccioli; Admir Mulita; Malaisamy Muniyandi; Kavita Munjal; Efren Murillo-Zamora; Sathish Muthu; Woojae Myung; Amin Nabavi; Ashraf Fawzy Nabhan; Ayoub Nafei; Ahamarshan Jayaraman Nagarajan; Pirouz Naghavi; Ganesh R Naik; Gurudatta Naik; Mukhammad David Naimzada; Sanjeev Nair; Tapas Sadasivan Nair; Soroush Najdaghi; Hastyar Hama Rashid Najmuldeen; Noureddin Nakhostin Ansari; Vinay Nangia; Sreenivas Narasimha Swamy; Shumaila Nargus; Delaram Narimani Davani; Bruno Ramos Nascimento; Gustavo G Nascimento; Ali Nasrollahizadeh; Amir Nasrollahizadeh; Zuhair S Natto; Javaid Nauman; Samidi Nirasha Kumari Navaratna; Biswa Prakash Nayak; Vinod C Nayak; Athare Nazri-Panjaki; Rawlance Ndejjo; Ionut Negoi; Ruxandra Irina Negoi; Seyed Aria Nejadghaderi; Chakib Nejjari; Mohammad Hadi Nematollahi; Samata Nepal; Charles Richard James Newton; Dang H Nguyen; Duc Hoang Nguyen; Hau Thi Hien Nguyen; Hien Quang Nguyen; Nhien Ngoc Y Nguyen; Phat Tuan Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Yeshambel T Nigatu; Nasrin Nikravangolsefid; Dina Nur Anggraini Ningrum; Chukwudi A Nnaji; Lawrence Achilles Nnyanzi; Shuhei Nomura; Syed Toukir Ahmed Noor; Bo Norrving; Nawsherwan Nawsherwan; Jean Jacques Noubiap; Chisom Adaobi Nri-Ezedi; George Ntaios; Mpiko Ntsekhe; Fred Nugen; Mario Cesare Nurchis; Dieta Nurrika; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Kehinde O Obamiro; Ismail A Odetokun; Martin James O'Donnell; James Odhiambo Oguta; In-Hwan Oh; Tolulope R Ojo-Akosile; Hassan Okati-Aliabad; Sylvester Reuben Okeke; Akinkunmi Paul Okekunle; Lawrence Okidi; Osaretin Christabel Okonji; Morteza Oladnabi; Andrew T Olagunju; Muideen Tunbosun Olaiya; Oladotun Victor Olalusi; Tosin Abiola Olasehinde; Omotola O Olasupo; Matthew Idowu Olatubi; Arão Belitardo Oliveira; Gláucia Maria Moraes Oliveira; Abdulhakeem Abayomi Olorukooba; Isaac Iyinoluwa Olufadewa; Yinka Doris Doris Oluwafemi; Gideon Olamilekan Oluwatunase; Hany A Omar; Ahmed Omar Bali; Adrienne E O'Neil; Sok King Ong; Obinna E Onwujekwe; Abdulahi Opejin Opejin; Michal Ordak; Raffaele Ornello; Doris V Ortega-Altamirano; Alberto Ortiz; Esteban Ortiz-Prado; Wael M S Osman; Uchechukwu Levi Osuagwu; Stanislav S Otstavnov; Mayowa O Owolabi; Ifeoluwa Temitayo Oyeyemi; Ahmad Ozair; Mahesh Padukudru P A; Kevin Pacheco-Barrios; Alicia Padron-Monedero; Jagadish Rao Padubidri; Tamás Palicz; Raul Felipe Palma-Alvarez; Feng Pan; Songhomitra Panda-Jonas; Deepshikha Pande Katare; Anamika Pandey; Ashok Pandey; Seithikurippu R Pandi-Perumal; Leonidas D Panos; Ioannis Pantazopoulos; Paraskevi Papadopoulou; Shahina Pardhan; Pragyan Paramita Parija
    Background: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    PublicationArticle
    Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019
    (Elsevier Ltd, 2022) Jorge R. Ledesma; Jianing Ma; Avina Vongpradith; Emilie R. Maddison; Amanda Novotney; Molly H. Biehl; Kate E. Legrand; Jennifer M. Ross; Deepa Jahagirdar; Dana Bryazka; Rachel Feldman; Hassan Abolhassani; Akine Eshete Abosetugn; Eman Abu-Gharbieh; Oladimeji M. Adebayo; Qorinah Estiningtyas Sakilah Adnani; Saira Afzal; Bright Opoku Ahinkorah; Sajjad Ahmad Ahmad; Sepideh Ahmadi; Tarik Ahmed Rashid; Yusra Ahmed Salih; Addis Aklilu; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Yosef Alemayehu; Kefyalew Addis Alene; Beriwan Abdulqadir Ali; Liaqat Ali; Vahid Alipour; Hesam Alizade; Rajaa M. Al-Raddadi; Nelson Alvis-Guzman; Saeed Amini; Arianna Maever L. Amit; Jason A. Anderson; Sofa Androudi; Carl Abelardo T. Antonio; Catherine M. Antony; Razique Anwer; Jalal Arabloo; Asrat Arja; Mulusew A. Asemahagn; Sachin R. Atre; Gulrez Shah Azhar; B.B. Darshan; Zaheer-Ud-Din Babar; Atif Amin Baig; Maciej Banach; Hiba Jawdat Barqawi; Fabio Barra; Amadou Barrow; Sanjay Basu; Uzma Iqbal Belgaumi; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Natalia V. Bhattacharjee; Krittika Bhattacharyya; Ali Bijani; Boris Bikbov; Archith Boloor; Nikolay Ivanovich Briko; Danilo Buonsenso; Sharath Burugina Nagaraja; Zahid A. Butt; Austin Carter; Felix Carvalho; Jaykaran Charan; Souranshu Chatterjee; Soosanna Kumary Chattu; Vijay Kumar Chattu; Devasahayam J. Christopher; Dinh-Toi Chu; Mareli M. Claassens; Omid Dadras; Amare Belachew Dagnew; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; Aso Mohammad Darwesh; Deepak Dhamnetiya; Mostafa Dianatinasab; Daniel Diaz; Linh Phuong Doan; Sahar Eftekharzadeh; Muhammed Elhadi; Amir Emami; Shymaa Enany; Emerito Jose A. Faraon; Farshad Farzadfar; Eduarda Fernandes; Lorenzo Ferro Desideri; Irina Filip; Florian Fischer; Masoud Foroutan; Tahvi D. Frank; Alberto L. Garcia-Basteiro; Christian Garcia-Calavaro; Tushar Garg; Biniyam Sahiledengle Geberemariyam; Keyghobad Ghadiri; Ahmad Ghashghaee; Mahaveer Golechha; Amador Goodridge; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Mohammad Rifat Haider; Samer Hamidi; Asif Hanif; Shaful Haque; Harapan Harapan; Arief Hargono; Ahmed I. Hasaballah; Abdiwahab Hashi; Shoaib Hassan; Hadi Hassankhani; Khezar Hayat; Kamal Hezam; Ramesh Holla; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Rabia Hussain; Segun Emmanuel Ibitoye; Irena M. Ilic; Milena D. Ilic; Seyed Sina Naghibi Irvani; Nahlah Elkudssiah Ismail; Ramaiah Itumalla; Jalil Jaafari; Kathryn H. Jacobsen; Vardhmaan Jain; Fatemeh Javanmardi; Sathish Kumar Jayapal; Shubha Jayaram; Ravi Prakash Jha; Jost B. Jonas; Nitin Joseph; Farahnaz Joukar; Zubair Kabir; Ashwin Kamath; Tanuj Kanchan; Himal Kandel; Patrick D.M.C. Katoto; Gbenga A. Kayode; Parkes J. Kendrick; Amene Abebe Kerbo; Himanshu Khajuria; Rovshan Khalilov; Khaled Khatab; Abdullah T. Khoja; Jagdish Khubchandani; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Soewarta Kosen; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Burcu Kucuk Bicer; Avinash Kumar; G. Anil Kumar; Narinder Kumar; Nithin Kumar; Alexander Kwarteng; Hassan Mehmood Lak; Dharmesh Kumar Lal; Iván Landires; Savita Lasrado; Shaun Wen Huey Lee; Wei-Chen Lee; Christine Lin; Xuefeng Liu; Platon D. Lopukhov; Rafael Lozano; Daiane Borges Machado; Shilpashree Madhava Kunjathur; Deepak Madi; Preetam Bhalchandra Mahajan; Azeem Majeed; Ahmad Azam Malik; Francisco Rogerlândio Martins-Melo; Saurabh Mehta; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Hayimro Edemealem Merie; Amanual Getnet Mersha; Mohamed Kamal Mesregah; Tomislav Mestrovic; Nour Mheidly Mheidly; Sanjeev Misra; Prasanna Mithra; Masoud Moghadaszadeh; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Shafu Mohammed; Mariam Molokhia; Mohammad Ali Moni; Ahmed Al Montasir; Catrin E. Moore; Ahamarshan Jayaraman Nagarajan; Sanjeev Nair; Suma Nair; Atta Abbas Naqvi; Sreenivas Narasimha Swamy; Biswa Prakash Nayak; Javad Nazari; Sandhya Neupane Kandel; Trang Huyen Nguyen; Molly R. Nixon; Chukwudi A. Nnaji; Mpiko Ntsekhe; Virginia Nuñez-Samudio; Bogdan Oancea; Oluwakemi Ololade Odukoya; Andrew T. Olagunju; Eyal Oren; P.A. Mahesh; Ramakrishnan Parthasarathi; Fatemeh Pashazadeh Kan; Sanjay M. Pattanshetty; Rajan Paudel; Pintu Paul; Shrikant Pawar; Veincent Christian Filipino Pepito; Norberto Perico; Majid Pirestani; Roman V. Polibin; Maarten J. Postma; Akram Pourshams; Akila Prashant; Dimas Ria Angga Pribadi; Amir Radfar; Alireza Rafei; Fakher Rahim; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Mosiur Rahman; Amir Masoud Rahmani; Priyanga Ranasinghe; Chythra R. Rao; David Laith Rawaf; Salman Rawaf; Marissa B. Reitsma; Giuseppe Remuzzi; Andre M. N. Renzaho; Melese Abate Reta; Nima Rezaei; Omid Rezahosseini; Mohammad Sadegh Rezai; Aziz Rezapour; Gholamreza Roshandel; Denis O. Roshchin; Siamak Sabour; K.M. Saif-Ur-rahman; Nasir Salam; Hossein Samadi Kafl; Mehrnoosh Samaei; Abdallah M. Samy; Satish Saroshe; Benn Sartorius; Brijesh Sathian; Susan M. Sawyer; Subramanian Senthilkumaran; Allen Seylani; Omid Shafaat; Masood Ali Shaikh; Kiomars Sharaf; Ranjitha S. Shetty; Mika Shigematsu; Jae Il Shin; João Pedro Silva; Jitendra Kumar Singh; Smriti Sinha; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Emma Elizabeth Spurlock; Chandrashekhar T. Sreeramareddy; Paschalis Steiropoulos; Mu'awiyyah Babale Sufyan; Takahiro Tabuchi; Eyayou Girma Tadesse; Zemenu Tamir; Elvis Enowbeyang Tarkang; Yohannes Tekalegn; Fisaha Haile Tesfay; Belay Tessema; Rekha Thapar; Imad I. Tleyjeh; Ruoyan Tobe-Gai; Bach Xuan Tran; Berhan Tsegaye; Gebiyaw Wudie Tsegaye; Anayat Ullah; Chukwuma David Umeokonkwo; Sahel Valadan Tahbaz; Bay Vo; Giang Thu Vu; Yasir Waheed; Magdalene K. Walters; Joanna L. Whisnant; Mesfn Agachew Woldekidan; Befkadu Legesse Wubishet; Seyed Hossein Yahyazadeh Jabbari; Taklo Simeneh Yazie Yazie; Yigizie Yeshaw; Siyan Yi; Vahit Yigit; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Alimuddin Zumla; Ali H. Mokdad; Joshua A. Salomon; Robert C. Reiner; Stephen S. Lim; Mohsen Naghavi; Theo Vos; Simon I. Hay; Christopher J. L. Murray; Hmwe Hmwe Kyu
    Background: Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. Methods: We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. Findings: Globally, in 2019, among HIV-negative individuals, there were 1·18 million (95% uncertainty interval 1·08–1·29) deaths due to tuberculosis and 8·50 million (7·45–9·73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000–279 000) deaths due to tuberculosis and 1·15 million (1·01–1·32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000–425 000) more deaths and 1·01 million (0·82–1·23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820–11 400) more deaths and 81 100 (63 300–100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1·5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4·27 (3·69–5·02), 6·17 (5·48–7·02), and 1·17 (1·07–1·28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2·23 (2·03–2·44) times greater among males than females, whereas the fraction due to unsafe sex was 1·06 (1·05–1·08) times greater among females than males. Interpretation: As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestones. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    PublicationArticle
    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
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    Measuring routine childhood vaccination coverage in 204 countries and territories, 1980–2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1
    (Elsevier B.V., 2021) Natalie C Galles; Patrick Y Liu; Rachel L Updike; Nancy Fullman; Jason Nguyen; Sam Rolfe; Alyssa N Sbarra; Megan F Schipp; Ashley Marks; Gdiom Gebreheat Abady; Kaja M Abbas; Sumra Wajid Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Amir Abdoli; Hassan Abolhassani; Akine Eshete Abosetugn; Maryam Adabi; Abdu A Adamu; Olatunji O Adetokunboh; Qorinah Estiningtyas Sakilah Adnani; Shailesh M Advani; Saira Afzal; Seyed Mohammad Kazem Aghamir; Bright Opoku Ahinkorah; Sohail Ahmad; Tauseef Ahmad; Sepideh Ahmadi; Haroon Ahmed; Muktar Beshir Ahmed; Tarik Ahmed Rashid; Yusra Ahmed Salih; Yonas Akalu; Addis Aklilu; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Luciana Albano; Yosef Alemayehu; Kefyalew Addis Alene; Ayman Al-Eyadhy; Robert Kaba Alhassan; Liaqat Ali; Syed Mohamed Aljunid; Sami Almustanyir; Khalid A Altirkawi; Nelson Alvis-Guzman; Hubert Amu; Catalina Liliana Andrei; Tudorel Andrei; Adnan Ansar; Alireza Ansari-Moghaddam; Ippazio Cosimo Antonazzo; Benny Antony; Jalal Arabloo; Morteza Arab-Zozani; Kurnia Dwi Artanti; Judie Arulappan; Asma Tahir Awan; Mamaru Ayenew Awoke; Muluken Altaye Ayza; Ghasem Azarian; Ahmed Y Azzam; Darshan B B; Zaheer-Ud-Din Babar; Senthilkumar Balakrishnan; Maciej Banach; Simachew Animen Bante; Till Winfried Bärnighausen; Hiba Jawdat Barqawi; Amadou Barrow; Quique Bassat; Narantuya Bayarmagnai; Diana Fernanda Bejarano Ramirez; Tariku Tesfaye Bekuma; Habtamu Gebrehana Belay; Uzma Iqbal Belgaumi; Akshaya Srikanth Bhagavathula; Dinesh Bhandari; Nikha Bhardwaj; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Sadia Bibi; Ali Bijani; Antonio Biondi; Archith Boloor; Dejana Braithwaite; Danilo Buonsenso; Zahid A Butt; Paulo Camargos; Giulia Carreras; Felix Carvalho; Carlos A Castañeda-Orjuela; Raja Chandra Chakinala; Jaykaran Charan; Souranshu Chatterjee; Soosanna Kumary Chattu; Vijay Kumar Chattu; Fazle Rabbi Chowdhury; Devasahayam J Christopher; Dinh-Toi Chu; Sheng-Chia Chung; Paolo Angelo Cortesi; Vera Marisa Costa; Rosa A S Couto; Omid Dadras; Amare Belachew Dagnew; Baye Dagnew; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Jan-Walter De Neve; Meseret Derbew Molla; Behailu Tariku Derseh; Rupak Desai; Abebaw Alemayehu Desta; Deepak Dhamnetiya; Mandira Lamichhane Dhimal; Meghnath Dhimal; Mostafa Dianatinasab; Daniel Diaz; Shirin Djalalinia; Fariba Dorostkar; Bassey Edem; Hisham Atan Edinur; Sahar Eftekharzadeh; Iman El Sayed; Maysaa El Sayed Zaki; Muhammed Elhadi; Shaimaa I El-Jaafary; Aisha Elsharkawy; Shymaa Enany; Ryenchindorj Erkhembayar; Christopher Imokhuede Esezobor; Sharareh Eskandarieh; Ifeanyi Jude Ezeonwumelu; Sayeh Ezzikouri; Jawad Fares; Pawan Sirwan Faris; Berhanu Elfu Feleke; Tomas Y Ferede; Eduarda Fernandes; João C Fernandes; Pietro Ferrara; Irina Filip; Florian Fischer; Mark Rohit Francis; Takeshi Fukumoto; Mohamed M Gad; Shilpa Gaidhane; Silvano Gallus; Tushar Garg; Biniyam Sahiledengle Geberemariyam; Teshome Gebre; Birhan Gebresillassie Gebregiorgis; Ketema Bizuwork Gebremedhin; Berhe Gebremichael; Bradford D Gessner; Keyghobad Ghadiri; Mansour Ghafourifard; Ahmad Ghashghaee; Syed Amir Gilani; Ionela-Roxana Glăvan; Ekaterina Vladimirovna Glushkova; Mahaveer Golechha; Kebebe Bekele Gonfa; Sameer Vali Gopalani; Houman Goudarzi; Mohammed Ibrahim Mohialdeen Gubari; Yuming Guo; Veer Bala Gupta; Vivek Kumar Gupta; Reyna Alma Gutiérrez; Emily Haeuser; Rabih Halwani; Samer Hamidi; Asif Hanif; Shafiul Haque; Harapan Harapan; Arief Hargono; Abdiwahab Hashi; Shoaib Hassan; Mohamed H Hassanein; Soheil Hassanipour; Hadi Hassankhani; Simon I Hay; Khezar Hayat; Mohamed I Hegazy; Golnaz Heidari; Kamal Hezam; Ramesh Holla; Mohammad Enamul Hoque; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Vivian Chia-rong Hsieh; Junjie Huang; Ayesha Humayun; Rabia Hussain; Nawfal R Hussein; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Sumant Inamdar; Usman Iqbal; Lalu Muhammad Irham; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Nahlah Elkudssiah Ismail; Ramaiah Itumalla; Ravi Prakash Jha; Farahnaz Joukar; Ali Kabir; Zubair Kabir; Rohollah Kalhor; Zul Kamal; Stanley M Kamande; Himal Kandel; André Karch; Getinet Kassahun; Nicholas J Kassebaum; Patrick DMC Katoto; Bayew Kelkay; Andre Pascal Kengne; Yousef Saleh Khader; Himanshu Khajuria; Ibrahim A Khalil; Ejaz Ahmad Khan; Gulfaraz Khan; Junaid Khan; Maseer Adnan Khan; Moien AB Khan; Young-Ho Khang; Abdullah T Khoja; Jagdish Khubchandani; Gyu Ri Kim; Min Seo Kim; Yun Jin Kim; Ruth W Kimokoti; Adnan Kisa; Sezer Kisa; Vladimir Andreevich Korshunov; Soewarta Kosen; Barthelemy Kuate Defo; Vaman Kulkarni; Avinash Kumar; G Anil Kumar; Nithin Kumar; Alexander Kwarteng; Carlo La Vecchia; Faris Hasan Lami; Iván Landires; Savita Lasrado; Zohra S Lassi; Hankil Lee; Yeong Yeh Lee; Miriam Levi; Sonia Lewycka; Shanshan Li; Xuefeng Liu; Stany W Lobo; Platon D Lopukhov; Rafael Lozano; Ricardo Lutzky Saute; Muhammed Magdy Abd El Razek; Alaa Makki; Ahmad Azam Malik; Fariborz Mansour-Ghanaei; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Francisco Rogerlândio Martins-Melo; Philippa C Matthews; John Robert Carabeo Medina; Walter Mendoza; Ritesh G Menezes; Endalkachew Worku Mengesha; Tuomo J Meretoja; Amanual Getnet Mersha; Mohamed Kamal Mesregah; Tomislav Mestrovic; Bartosz Miazgowski; George J Milne; Andreea Mirica; Erkin M Mirrakhimov; Hamid Reza Mirzaei; Sanjeev Misra; Prasanna Mithra; Masoud Moghadaszadeh; Teroj Abdulrahman Mohamed; Karzan Abdulmuhsin Mohammad; Yousef Mohammad; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Arif Mohammed; Shafiu Mohammed; Archisman Mohapatra; Ali H Mokdad; Mariam Molokhia; Lorenzo Monasta; Mohammad Ali Moni; Ahmed Al Montasir; Catrin E Moore; Ghobad Moradi; Rahmatollah Moradzadeh; Paula Moraga; Ulrich Otto Mueller; Sandra B Munro; Mohsen Naghavi; Mukhammad David Naimzada; Muhammad Naveed; Biswa Prakash Nayak; Ionut Negoi; Sandhya Neupane Kandel; Trang Huyen Nguyen; Rajan Nikbakhsh; Dina Nur Anggraini Ningrum; Molly R Nixon; Chukwudi A Nnaji; Jean Jacques Noubiap; Virginia Nuñez-Samudio; Vincent Ebuka Nwatah; Bogdan Oancea; Chimedsuren Ochir; Felix Akpojene Ogbo; Andrew T Olagunju; Babayemi Oluwaseun Olakunde; Obinna E Onwujekwe; Nikita Otstavnov; Stanislav S Otstavnov; Mayowa O Owolabi; Jagadish Rao Padubidri; Keyvan Pakshir; Eun-Cheol Park; Fatemeh Pashazadeh Kan; Mona Pathak; Rajan Paudel; Shrikant Pawar; Jeevan Pereira; Mario F P Peres; Arokiasamy Perianayagam; Marina Pinheiro; Majid Pirestani; Vivek Podder; Roman V Polibin; Richard Charles G Pollok; Maarten J Postma; Faheem Hyder Pottoo; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Alireza Rafiei; Vafa Rahimi-Movaghar; Mosiur Rahman; Amir Masoud Rahmani; Setyaningrum Rahmawaty; Aashish Rajesh; Rebecca E Ramshaw; Priyanga Ranasinghe; Chythra R Rao; Sowmya J Rao; Priya Rathi; David Laith Rawaf; Salman Rawaf; Andre M N Renzaho; Negar Rezaei; Mohammad Sadegh Rezai; Maria Rios-Blancas; Emma L B Rogowski; Luca Ronfani; Godfrey M Rwegerera; Anas M Saad; Siamak Sabour; Basema Saddik; Mohammad Reza Saeb; Umar Saeed; Amirhossein Sahebkar; Mohammad Ali Sahraian; Nasir Salam; Hamideh Salimzadeh; Mehrnoosh Samaei; A.M. Samy; Juan Sanabria; Francesco Sanmarchi; Milena M Santric-Milicevic; Benn Sartorius; Arash Sarveazad; Brijesh Sathian; Monika Sawhney; Deepak Saxena; Sonia Saxena; Abdul-Aziz Seidu; Allen Seylani; Masood Ali Shaikh; Morteza Shamsizadeh; Pavanchand H Shetty; Mika Shigematsu; Jae Il Shin; Negussie Boti Sidemo; Ambrish Singh; Jasvinder A Singh; Smriti Sinha; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Amin Soheili; Eyayou Girma Tadesse; Animut Tagele Tamiru; Ker-Kan Tan; Yohannes Tekalegn; Mohamad-Hani Temsah; Bhaskar Thakur; Rekha Thapar; Aravind Thavamani; Ruoyan Tobe-Gai; Hamid Reza Tohidinik; Marcos Roberto Tovani-Palone; Eugenio Traini; Bach Xuan Tran; Manjari Tripathi; Berhan Tsegaye; Gebiyaw Wudie Tsegaye; Anayat Ullah; Saif Ullah; Sana Ullah; Brigid Unim; Marco Vacante; Diana Zuleika Velazquez; Bay Vo; Sebastian Vollmer; Giang Thu Vu; Linh Gia Vu; Yasir Waheed; Andrea Sylvia Winkler; Charles Shey Wiysonge; Vahit Yiğit; Birhanu Wubale Yirdaw; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Deniz Yuce; Ismaeel Yunusa; Mohammad Zamani; Maryam Zamanian; Dejene Tesfaye Zewdie; Zhi-Jiang Zhang; Chenwen Zhong; Alimuddin Zumla; Christopher J L Murray; Stephen S Lim; Jonathan F Mosser; J. Nguyen; A. Marks; C.J.L. Murray; S.S. Lim; R. Dandona; C.J.L. Murray; S.S. Lim; L. Ali; A. Ullah; B.E. Feleke; A. Elsharkawy; H. Abolhassani; S. Ahmad; T. Ahmad; S. Sabour; H. Ahmed; M.B. Ahmed; T. Ahmed Rashid; D. Saxena; B. Dagnew; M. Derbew Molla; A. Aklilu; Y. Alemayehu; L. Albano; A. Al-Eyadhy; M. Temsah; Y. Mohammad; R.K. Alhassan; M. Hostiuc; I. Negoi; I. Glăvan; A. Ansar; I. Antonazzo; P. Ferrara; A. Singh Mtech; J. Arabloo; A. Ghashghaee; A. Ghashghaee; A. Sarveazad; K.D. Artanti; J. Arulappan; M.A. Awoke; P. Rathi; Z. Babar; B. Gebremichael; M. Zamani; A. Barrow; A. Barrow; V. Kulkarni; D. Saxena; J. Shin; S. Misra; K. Bhattacharyya; S. Bibi; S. Ullah; A. Boloor; S. Sinha; D. Braithwaite; D. Braithwaite; D. Buonsenso; D. Buonsenso; G.W. Tsegaye; J. De Neve; P. Camargos; M. Pinheiro; R. Chakinala; S. Chatterjee; V. Chattu; V. Chattu; I. Bill; D. Chu; S. Chung; S. Chung; L. Dandona; R. Dandona; A. Ansar; G. Kumar; R. Desai; M. Dhimal; S. Eftekharzadeh; M. Elhadi; S. Enany; A.T. Olagunju; P.S. Faris; B. Tsegaye; I. Filip; F. Fischer; M.R. Francis; M.R. Francis; T. Fukumoto; X. Liu; A.M. Saad; S. Gaidhane; T. Garg; Y. Tekalegn; S. Mohammed; T. Gebre; K. Ghadiri; K. Ghadiri; M. Ghafourifard; M. Moghadaszadeh; S. Gilani; S. Gilani; P.D. Lopukhov; M. Golechha; S.V. Gopalani; H. Goudarzi; M.B. Ahmed; H. Goudarzi; Y. Guo; S. Li; Y. Guo; V. Gupta; V.K. Gupta; R.A. Gutiérrez; A. Hargono Dr; S. Hassan; S. Hassan; G. Heidari; S. Islam; V. Hsieh; J. Huang; C. Zhong; A. Humayun; R. Hussain; A. Makki; J. Noubiap; U. Iqbal; S.N. Irvani; S. Islam; R. Kalhor; R. Kalhor; Z. Kamal; Z. Kamal; A. Karch; J. Khan; G. Kim; M. Kim; M. Kim; Y. Kim; S. Kosen; A. Kumar; A. Kwarteng; C. La Vecchia; I. Landires; V. Nuñez-Samudio; I. Landires; S. Lasrado; M. Levi; M. Levi; C.E. Moore; X. Liu; J. Sanabria; A. Thavamani; P.C. Matthews; J.C. Medina; J.C. Medina; W. Mendoza; R.G. Menezes; M.K. Mesregah; T. Mestrovic; M. Mohammadi; A. Mohammed; S. Mohammed; A. Mohapatra; M. Molokhia; E. Traini; H. Mirzaei; M. Zamanian; S.B. Munro; N. Otstavnov; M. Naveed; I. Negoi; T.H. Nguyen; T.H. Nguyen; B.O. Olakunde; M. Pathak; S. Pawar; M. Pirestani; M. Rabiee; M. Rahman; S. Rahmawaty; A. Rajesh; S. Rawaf; S. Rawaf; M. Saeb; U. Saeed; U. Saeed; M. Samaei; J. Sanabria; F. Sanmarchi; M. Sawhney; A. Seidu; A. Seidu; M.A. Shaikh; M. Shigematsu; A. Soheili; K. Tan; B. Thakur; A. Thavamani; E. Traini; M. Tripathi; S. Ullah; S. Ullah; B. Vo; G.T. Vu; A.S. Winkler; A.S. Winkler; C. Yu; D. Yuce
    Background: Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods: For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings: By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4–82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5–42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4–41·3] in 1980 to 83·6% [82·3–84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4–44·1) in 1980 to 79·8% (78·4–81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6–60·9) to 14·5 million (13·4–15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation: After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Funding: Bill & Melinda Gates Foundation. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020
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Artamonov; Zahra Aryan; Malke Asaad; Mulusew A. Asemahagn; Thomas Astell-Burt; Seyyed Shamsadin Athari; Desta Debalkie Atnafu; Prince Atorkey; Alok Atreya; Floriane Ausloos; Marcel Ausloos; Getinet Ayano; Martin Amogre Ayanore; Olatunde O. Ayinde; Jose L. Ayuso-Mateos; Sina Azadnajafabad; Melkalem Mamuye Azanaw; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Ahmed Y. Azzam; Ashish D. Badiye; Nasser Bagheri; Sara Bagherieh; Mohan Bairwa; Shankar M. Bakkannavar; Ravleen Kaur Bakshi; Awraris Hailu Balchut Bilchut; T.W. Bärnighausen; Fabio Barra; Amadou Barrow; Pritish Baskaran; Luis Belo; Derrick A. Bennett; Isabela M. Bensenor; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Nikha Bhardwaj; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Bagas Suryo Bintoro; Elena A. Elena Blokhina; Belay Boda Abule Bodicha; Archith Boloor; Cristina Bosetti; Dejana Braithwaite; Hermann Brenner; Nikolay Ivanovich Briko; Andre R. Brunoni; Zahid A. 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McGrath; Jitendra Kumar Meena; Entezar Mehrabi Nasab; Ritesh G. Menezes; Gert B.M. Mensink; Alexios-Fotios A. Mentis; Atte Meretoja; Bedasa Taye Merga; Tomislav Mestrovic; Junmei Miao Jonasson; Bartosz Miazgowski; Ana Carolina Micheletti Gomide Nogueira De Sá; Ted R. Miller; G.K. Mini; Andreea Mirica; Antonio Mirijello; Seyyedmohammadsadeq Mirmoeeni; Erkin M. Mirrakhimov; Sanjeev Misra; Babak Moazen; Maryam Mobarakabadi; Marcello Moccia; Yousef Mohammad; Esmaeil Mohammadi; Abdollah Mohammadian-Hafshejani; Teroj Abdulrahman Mohammed; Nagabhishek Moka; Ali H. Mokdad; Sara Momtazmanesh; Yousef Moradi; Ebrahim Mostafavi; Sumaira Mubarik; Erin C. Mullany; Beemnet Tekabe Mulugeta; Efrén Murillo-Zamora; Christopher J.L. Murray; Julius C. Mwita; Mohsen Naghavi; Mukhammad David Naimzada; Vinay Nangia; Biswa Prakash Nayak; Ionut Negoi; Ruxandra Irina Negoi; Seyed Aria Nejadghaderi; Samata Nepal; Sudan Prasad Prasad Neupane; Sandhya Neupane Kandel; Yeshambel T. Nigatu; Ali Nowroozi; Khan M. Nuruzzaman; Chimezie Igwegbe Nzoputam; Kehinde O. Obamiro; Felix Akpojene Ogbo; Ayodipupo Sikiru Oguntade; Hassan Okati-Aliabad; Babayemi Oluwaseun Olakunde; Gláucia Maria Moraes Oliveira; Ahmed Omar Bali; Emad Omer; Doris V. Ortega-Altamirano; Adrian Otoiu; Stanislav S. Otstavnov; Bilcha Oumer; P.A. Mahesh; Alicia Padron-Monedero; Raffaele Palladino; Adrian Pana; Songhomitra Panda-Jonas; Anamika Pandey; Ashok Pandey; Shahina Pardhan; Tarang Parekh; Eun-Kee Park; Charles D.H. Parry; Fatemeh Pashazadeh Kan; Jay Patel; Siddhartha Pati; George C. Patton; Uttam Paudel; Shrikant Pawar; Amy E. Peden; Ionela-Roxana Petcu; Michael R. Phillips; Marina Pinheiro; Evgenii Plotnikov; Pranil Man Singh Pradhan; Akila Prashant; Jianchao Quan; Amir Radfar; Alireza Rafiei; Pankaja Raghav Raghav; Vafa Rahimi-Movaghar; Azizur Rahman; Md.Mosfequr Rahman; Mosiur Rahman; Amir Masoud Rahmani; Shayan Rahmani; Chhabi Lal Ranabhat; Priyanga Ranasinghe; Chythra R. 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Yesera; Arzu Yigit; Vahit Yiğit; Ayenew Engida Yimaw; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Siddhesh Zadey; Mazyar Zahir; Iman Zare; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Chenwen Zhong; Mohammad Zmaili; Yves Miel H. Zuniga; Emmanuela Gakidou
    Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Background: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings: There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019
    (Elsevier B.V., 2022) Khanh Bao Tran; Justin J. Lang; Kelly Compton; Rixing Xu; Alistair R. Acheson; Hannah Jacqueline Henrikson; Jonathan M. Kocarnik; Louise Penberthy; Amirali Aali; Qamar Abbas; Behzad Abbasi; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Hedayat Abbastabar; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab Abdelwahab; Gholamreza Abdoli; Hanan Abdulkadir Abdulkadir; Aidin Abedi; Kedir Hussein Abegaz; Hassan Abidi; Richard Gyan Aboagye; Hassan Abolhassani; Abdorrahim Absalan; Yonas Derso Abtew; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Basavaprabhu Achappa; Juan Manuel Acuna; Daniel Addison; Isaac Yeboah Addo; Oyelola A. Adegboye; Miracle Ayomikun Adesina; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Shailesh M. Advani; Sumia Afrin; Muhammad Sohail Afzal; Manik Aggarwal; Bright Opoku Ahinkorah; Araz Ramazan Ahmad; Rizwan Ahmad; Sajjad Ahmad; Sohail Ahmad; Sepideh Ahmadi; Haroon Ahmed; Luai A. Ahmed; Muktar Beshir Ahmed; Tarik Ahmed Rashid; Wajeeha Aiman; Marjan Ajami; Gizachew Taddesse Akalu; Mostafa Akbarzadeh-Khiavi; Addis Aklilu; Maxwell Akonde; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Fahad Mashhour Alanezi; Turki M. Alanzi; Saleh Ali Alessy; Abdelazeem M. Algammal; Mohammed Khaled Al-Hanawi; Robert Kaba Alhassan; Beriwan Abdulqadir Ali; Liaqat Ali; Syed Shujait Ali; Yousef Alimohamadi; Vahid Alipour; Syed Mohamed Aljunid; Motasem Alkhayyat; Sadeq Ali Ali Al-Maweri; Sami Almustanyir; Nivaldo Alonso; Shehabaldin Alqalyoobi; Rajaa M. Al-Raddadi; Rami H. Hani Al-Rifai; Salman Khalifah Al-Sabah; Ala’a B. Al-Tammemi; Haya Altawalah; Nelson Alvis-Guzman; Firehiwot Amare; Edward Kwabena Ameyaw; Javad Javad Aminian Dehkordi; Mohammad Hosein Amirzade-Iranaq; Hubert Amu; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Jason A. 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Bhuyan; Sadia Bibi; Awraris Hailu Bilchut; Bagas Suryo Bintoro; Antonio Biondi; Mesfin Geremaw Birega Birega; Habitu Eshetu Birhan; Tone Bjørge; Oleg Blyuss; Belay Boda Abule Bodicha; Srinivasa Rao Bolla; Archith Boloor; Cristina Bosetti; Dejana Braithwaite; Michael Brauer; Hermann Brenner; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Christina Maree Buchanan; Norma B. Bulamu; Maria Teresa Bustamante-Teixeira; Muhammad Hammad Butt; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Luis Alberto Cámera; Chao Cao; Yin Cao; Giulia Carreras; Márcia Carvalho; Francieli Cembranel; Ester Cerin; Promit Ananyo Chakraborty; Periklis Charalampous; Vijay Kumar Chattu; Odgerel Chimed-Ochir; Jesus Lorenzo Chirinos-Caceres; Daniel Youngwhan Cho; William C.S. Cho; Devasahayam J. Christopher; Dinh-Toi Chu; Isaac Sunday Chukwu; Aaron J. Cohen; Joao Conde; Sandra Cortés; Vera Marisa Costa; Natália Cruz-Martins; Garland T. 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Jani; Tahereh Javaheri; Umesh Umesh Jayarajah; Shubha Jayaram; Seyed Behzad Jazayeri; Rime Jebai; Bedru Jemal; Wonjeong Jeong; Ravi Prakash Jha; Har Ashish Jindal; Yetunde O. John-Akinola; Jost B. Jonas; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Salah Eddine Oussama Kacimi; Vidya Kadashetti; Farima Kahe; Pradnya Vishal Kakodkar; Laleh R. Kalankesh; Leila R. Kalankesh; Rohollah Kalhor; Vineet Kumar Kamal; Farin Kamangar; Ashwin Kamath; Tanuj Kanchan; Eswar Kandaswamy; Himal Kandel; HyeJung Kang; Girum Gebremeskel Kanno; Neeti Kapoor; Sitanshu Sekhar Kar; Shama D. Karanth; Ibraheem M. Karaye; André Karch; Amirali Karimi; Bekalu Getnet Kassa; Patrick D.M.C. Katoto; Joonas H. Kauppila; Harkiran Kaur; Abinet Gebremickael Kebede; Leila Keikavoosi-Arani; Gemechu Gemechu Kejela; Phillip M. Kemp Bohan; Maryam Keramati; Mohammad Keykhaei; Himanshu Khajuria; Abbas Khan; Abdul Aziz Khan Khan; Ejaz Ahmad Khan; Gulfaraz Khan; Md. 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Lopukhov; László Lorenzovici; Mojgan Lotfi; Joana A. Loureiro; Raimundas Lunevicius; Farzan Madadizadeh; Ahmad R. Mafi; Sameh Magdeldin; Soleiman Mahjoub; Ata Mahmoodpoor; Morteza Mahmoudi; Marzieh Mahmoudimanesh; Rashidul Alam Mahumud; Azeem Majeed; Jamal Majidpoor; Alaa Makki; Konstantinos Christos Makris; Elaheh Malakan Rad; Mohammad-Reza Malekpour; Reza Malekzadeh; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Sneha Deepak Mallya; Mohammed A. Mamun; Ana Laura Manda; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Santi Martini; Miquel Martorell; Sahar Masoudi; Seyedeh Zahra Masoumi; Clara N. Matei; Elezebeth Mathews; Manu Raj Mathur; Vasundhara Mathur; Martin McKee; Jitendra Kumar Meena; Khalid Mehmood; Entezar Mehrabi Nasab; Ravi Mehrotra; Addisu Melese; Walter Mendoza; Ritesh G. Menezes; SIsay Derso Mengesha; Laverne G. Mensah; Alexios-Fotios A. Mentis; Andry Yasmid Mera Mera-Mamián; Tuomo J. 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    Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). Interpretation: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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