Browsing by Author "Rakesh Aggarwal"

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2019 Update of Indian National Association for Study of the Liver Consensus on Prevention, Diagnosis, and Management of Hepatocellular Carcinoma in India: The Puri II Recommendations
(Elsevier B.V., 2020) Ashish Kumar; Subrat K. Acharya; Shivaram P. Singh; Anil Arora; Radha K. Dhiman; Rakesh Aggarwal; Anil C. Anand; Prashant Bhangui; Yogesh K. Chawla; Siddhartha Datta Gupta; Vinod K. Dixit; Ajay Duseja; Naveen Kalra; Premashish Kar; Suyash S. Kulkarni; Rakesh Kumar; Manoj Kumar; Ram Madhavan; V.G. Mohan Prasad; Amar Mukund; Aabha Nagral; Dipanjan Panda; Shashi B. Paul; Padaki N. Rao; Mohamed Rela; Manoj K. Sahu; Vivek A. Saraswat; Samir R. Shah; Shalimar; Praveen Sharma; Sunil Taneja; Manav Wadhawan
Hepatocellular carcinoma (HCC) is one of the major causes of morbidity, mortality, and healthcare expenditure in patients with chronic liver disease in India. The Indian National Association for Study of the Liver (INASL) had published its first guidelines on diagnosis and management of HCC (The Puri Recommendations) in 2014, and these guidelines were very well received by the healthcare community involved in diagnosis and management of HCC in India and neighboring countries. However, since 2014, many new developments have taken place in the field of HCC diagnosis and management, hence INASL endeavored to update its 2014 consensus guidelines. A new Task Force on HCC was constituted that reviewed the previous guidelines as well as the recent developments in various aspects of HCC that needed to be incorporated in the new guidelines. A 2-day round table discussion was held on 5th and 6th May 2018 at Puri, Odisha, to discuss, debate, and finalize the revised consensus statements. Each statement of the guideline was graded according to the Grading of Recommendations Assessment Development and Evaluation system with minor modifications. We present here the 2019 Update of INASL Consensus on Prevention, Diagnosis, and Management of Hepatocellular Carcinoma in India: The Puri-2 Recommendations. © 2019
Acute hepatitis E in India appears to be caused exclusively by genotype 1 hepatitis E virus
(Indian Society of Gastroenterology, 2018) Neha Gupta; Aditya N. Sarangi; Sunil Dadhich; V.K. Dixit; Kamal Chetri; Amit Goel; Rakesh Aggarwal
Background: Hepatitis E is caused by infection with hepatitis E virus (HEV), which has four well-known genotypes. Genotypes 1 and 2 HEV have been reported from human cases in areas where the disease is highly endemic. By contrast, genotypes 3 and 4 HEV, which primarily infect several animal species worldwide, have been reported mainly from sporadic human cases in non-endemic areas such as Japan and high-income countries of Europe and North America. To determine whether genotype 3/4 HEV cause sporadic disease in India, a disease-endemic area, we determined HEV genotype in a group of patients with such disease. Methods: A part of the HEV open reading frame (ORF) 1 was amplified and sequenced from sera of 74 patients with sporadic acute viral hepatitis E from four cities in India. The sequences were compared with prototype sequences for various HEV genotypes and subgenotypes and analyzed using phylogenetic tools to determine the genotype of the isolates. For 12 specimens, a part of HEV ORF2 was also similarly analyzed. Results: Partial ORF1 sequences of all the 74 isolates belonged to genotype 1 HEV, with 88.2% to 100% nucleotide identity with the prototype genotype 1 isolates. Partial ORF2 sequences for all the 12 isolates also belonged to genotype 1 HEV. On phylogenetic analysis, 71 isolates clustered with prototype genotype 1a HEV; the remaining three isolates were located between subgenotypes 1a and 1c but were closer to the former. Conclusion: Human sporadic acute hepatitis E in India is caused almost exclusively by genotype 1 HEV. © 2018, Indian Society of Gastroenterology.
Authors’ response
(Wolters Kluwer Medknow Publications, 2023) Manickam Ponnaiah; Tarun Bhatnagar; Rizwan Suliankachi Abdulkader; Rajalakshmi Elumalai; Janani Surya; Kathiresan Jeyashree; Muthusamy Santhosh Kumar; Ranjithkumar Govindaraju; Jeromie Wesley Vivian Thangaraj; Hari Krishan Aggarwal; Suresh Balan; Tridip Dutta Baruah; Ayan Basu; Yogita Bavaskar; Ajeet Singh Bhadoria; Ashish Bhalla; Pankaj Bhardwaj; Rachana Bhat; Jaya Chakravarty; Gina Maryann Chandy; Bal Kishan Gupta; Rakesh Kakkar; Ali Hasan Faiz Karnam; Sushila Kataria; Janakkumar Khambholja; Dewesh Kumar; Nithin Kumar; Monaliza Lyngdoh; M. Selva Meena; Kedar Mehta; M.P. Sheethal; Subhasis Mukherjee; Anuj Mundra; Arun Murugan; Seetharaman Narayanan; Balamurugan Nathan; Jutika Ojah; Pushpa Patil; Sunita Pawar; A. Charles Pon Ruban; R. Vadivelu; Rishabh Kumar Rana; S. Nagendra Boopathy; S. Priya; Saroj Kumar Sahoo; Arti Shah; Mohammad Shameem; Karthikeyan Shanmugam; Sachin K. Shivnitwar; Abhishek Singhai; Saurabh Srivastava; Sudheera Sulgante; Arunansu Talukdar; Alka Verma; Rajaat Vohra; Rabbanie Tariq Wani; Bhargavi Bathula; Gayathri Kumari; Divya Saravana Kumar; Aishwariya Narasimhan; N.C. Krupa; Thirumaran Senguttuvan; Parvathi Surendran; Dharsikaa Tamilmani; Alka Turuk; Gunjan Kumar; Aparna Murkherjee; Rakesh Aggarwal; Manoj Vasant Murhekar
[No abstract available]
Authors’ response
(Wolters Kluwer Medknow Publications, 2024) Manickam Ponnaiah; Tarun Bhatnagar; Rizwan Suliankachi Abdulkader; Rajalakshmi Elumalai; Janani Surya; Kathiresan Jeyashree; Muthusamy Santhosh Kumar; Ranjithkumar Govindaraju; Jeromie Wesley Vivian Thangaraj; Hari Krishan Aggarwal; Suresh Balan; Tridip Dutta Baruah; Ayan Basu; Yogita Bavaskar; Ajeet Singh Bhadoria; Ashish Bhalla; Pankaj Bhardwaj; Rachana Bhat; Jaya Chakravarty; Gina Maryann Chandy; Bal Kishan Gupta; Rakesh Kakkar; Ali Hasan Faiz Karnam; Sushila Kataria; Janakkumar Khambholja; Dewesh Kumar; Nithin Kumar; Monaliza Lyngdoh; M. Selva Meena; Kedar Mehta; M.P. Sheethal; Subhasis Mukherjee; Anuj Mundra; Arun Murugan; Seetharaman Narayanan; Balamurugan Nathan; Jutika Ojah; Pushpa Patil; Sunita Pawar; A. Charles Pon Ruban; R. Vadivelu; Rishabh Kumar Rana; S. Nagendra Boopathy; S. Priya; Saroj Kumar Sahoo; Arti Shah; Mohammad Shameem; Karthikeyan Shanmugam; Sachin K. Shivnitwar; Abhishek Singhai; Saurabh Srivastava; Sudheera Sulgante; Arunansu Talukdar; Alka Verma; Rajaat Vohra; Rabbanie Tariq Wani; Bhargavi Bathula; Gayathri Kumari; Divya Saravana Kumar; Aishwariya Narasimhan; N.C. Krupa; Thirumaran Senguttuvan; Parvathi Surendran; Dharsikaa Tamilmani; Alka Turuk; Gunjan Kumar; Aparna Murkherjee; Rakesh Aggarwal; Manoj Vasant Murhekar
[No abstract available]
Consensus statement of HCV task force of the Indian National Association for Study of the Liver (INASL). Part I: Status report of HCV infection in India
(Elsevier, 2014) Pankaj Puri; Anil C. Anand; Vivek A. Saraswat; Subrat K. Acharya; Radha K. Dhiman; Rakesh Aggarwal; Shivram P. Singh; Deepak Amarapurkar; Anil Arora; Mohinish Chhabra; Kamal Chetri; Gourdas Choudhuri; Vinod K. Dixit; Ajay Duseja; Ajay K. Jain; Dharmesh Kapoorz; Premashis Kar; Abraham Koshy; Ashish Kumar; Kaushal Madan; Sri P. Misra; Mohan V.G. Prasad; Aabha Nagral; Amarendra S. Puri; R. Jeyamani; Sanjiv Saigal; Shiv K. Sarin; Samir Shah; P.K. Sharma; Ajit Sood; Sandeep Thareja; Manav Wadhawan
Globally, around 150 million people are infected with hepatitis C virus (HCV). India contributes a large proportion of this HCV burden. The prevalence of HCV infection in India is estimated at between 0.5% and 1.5%. It is higher in the northeastern part, tribal populations and Punjab, areas which may represent HCV hotspots, and is lower in western and eastern parts of the country. The predominant modes of HCV transmission in India are blood transfusion and unsafe therapeutic injections. There is a need for large field studies to better understand HCV epidemiology and identify high-prevalence areas, and to identify and spread awareness about the modes of transmission of this infection in an attempt to prevent disease transmission. © 2014 INASL.
Consensus statement of HCV task force of the Indian National Association for Study of the Liver (INASL). Part II: INASL recommendations for management of HCV in India
(Elsevier, 2014) Pankaj Puri; Anil C. Anand; Vivek A. Saraswat; Subrat K. Acharya; Shiv K. Sarin; Radha K. Dhiman; Rakesh Aggarwal; Shivaram P. Singh; Deepak Amarapurkar; Anil Arora; Mohinish Chhabra; Kamal Chetri; Gourdas Choudhuri; Vinod K. Dixit; Ajay Duseja; Ajay K. Jain; Dharmesh Kapoor; Premashis Kar; Abraham Koshy; Ashish Kumar; Kaushal Madan; Sri P. Misra; Mohan V.G. Prasad; Aabha Nagral; Amarendra S. Puri; R. Jeyamani; Sanjiv Saigal; Samir Shah; Praveen K. Sharma; Ajit Sood; Sandeep Thareja; Manav Wadhawan
The estimated prevalence of hepatitis C virus (HCV) infection in India is between 0.5 and 1.5% with hotspots showing much higher prevalence in some areas of northeast India, in some tribal populations and in certain parts of Punjab. Genotype 3 is the most prevalent type of infection. Recent years have seen development of a large number of new molecules that are revolutionizing the treatment of hepatitis C. Some of the new directly acting agents (DAAs) like sofosbuvir have been called game-changers because they offer the prospect of interferon-free regimens for the treatment of HCV infection. These new drugs have not yet been approved in India and their cost and availability is uncertain at present. Till these drugs become available at an affordable cost, the treatment that was standard of care for the whole world before these newer drugs were approved should continue to be recommended. For India, cheaper options, which are as effective as the standard-of-care (SOC) in carefully selected patients, are also explored to bring treatment within reach of poorer patients. It may be prudent to withhold treatment at present for selected patients with genotype 1 or 4 infection and low levels of fibrosis (F1 or F2), and for patients who are non-responders to initial therapy, interferon intolerant, those with decompensated liver disease, and patients in special populations such as stable patients after liver and kidney transplantation, HIV co-infected patients and those with cirrhosis of liver. © 2014 INASL.
Factors associated with unexplained sudden deaths among adults aged 18-45 years in India – A multicentric matched case–control study
(Wolters Kluwer Medknow Publications, 2023) Manickam Ponnaiah; Tarun Bhatnagar; Rizwan Suliankachi Abdulkader; Rajalakshmi Elumalai; Janani Surya; Kathiresan Jeyashree; Muthusamy Santhosh Kumar; Ranjithkumar Govindaraju; Jeromie Wesley Vivian Thangaraj; Hari Krishan Aggarwal; Suresh Balan; Tridip Dutta Baruah; Ayan Basu; Yogita Bavaskar; Ajeet Singh Bhadoria; Ashish Bhalla; Pankaj Bhardwaj; Rachana Bhat; Jaya Chakravarty; Gina Maryann Chandy; Bal Kishan Gupta; Rakesh Kakkar; Ali Hasan Faiz Karnam; Sushila Kataria; Janakkumar Khambholja; Dewesh Kumar; Nithin Kumar; Monaliza Lyngdoh; M. Selva Meena; Kedar Mehta; M.P. Sheethal; Subhasis Mukherjee; Anuj Mundra; Arun Murugan; Seetharaman Narayanan; Balamurugan Nathan; Jutika Ojah; Pushpa Patil; Sunita Pawar; A. Charles Pon Ruban; R. Vadivelu; Rishabh Kumar Rana; S. Nagendra Boopathy; S. Priya; Saroj Kumar Sahoo; Arti Shah; Mohammad Shameem; Karthikeyan Shanmugam; Sachin K. Shivnitwar; Abhishek Singhai; Saurabh Srivastava; Sudheera Sulgante; Arunansu Talukdar; Alka Verma; Rajaat Vohra; Rabbanie Tariq Wani; Bhargavi Bathula; Gayathri Kumari; Divya Saravana Kumar; Aishwariya Narasimhan; N.C. Krupa; Thirumaran Senguttuvan; Parvathi Surendran; Dharsikaa Tamilmani; Alka Turuk; Gunjan Kumar; Aparna Murkherjee; Rakesh Aggarwal; Manoj Vasant Murhekar; Anjan Jyoti Talukdhar; Raj Prathim Das; Pranab Jyoti Bhattacharyya; Pankaj Jyoti Barman; Partha Pratim Das; P.V.M. Lakshmi; Naveen Panday; Ashok Kumar Pannu; Debaprasad Dhibar; Pankaj Kumar Kanauje; Satyajit Singh; Sabah Siddiqui; Nitin Bhajandas Borkar; Mayur Adalja; Sandip Shah Varsha Godbole; Rikin Raj; Nehal Shah; Nilay Suthar; Hemang Purohit; Bhargav Patel; Rutika Pathkjee; Niraj Pandit; Siddharth Shah; Bhavesh Patel; Anuja Agrawal; Deepak Jain; Manish Bansal; Vikas Deswal; Pooja Sharma; Farhana Siraj; Aamir Rashid; Anjum Bashir Fazili; Pradip Kumar Bhattacharya; Hirendra Birua; Manoj Kumar Prasad; Shashi Bhushan Singh; Umendra Kumar Ojha; Ravi Ranjan Jha; L.M. Manuja; S.K. Raghavendra; Vijay Hugar; R. Radha; Pallavi Kesari; Sunil Tapse; Ambrish Avate; Prasanna Kumar; Bhaskaran Unnikrishnan; T. Rekha; A. Basavaprabhu; Mithun Rao; Prithvishree Ravindra; Chythra R. Rao; Jayaraj Mymbilly Balakrishnan; Vikram Palimar; S. Ashwini; Bhavana Hiremath; Rajnikanth Malapur; Ankur Joshi; Manoj Nagar; Atul S. Keche; Arjun Lal Kakrani; Shubhangi Kanitkar; Srikanth Tripathy; Savita Mahajan; Akshada Shinde; Sunil Patil; Vijay Gaikwad; Ganesh Lokhande; Astha Ganeriwal; Ramesh Wasnik; Ashwini Kalantri; Dhiraj Bhandari; Preetam Salunkhe; Abhishek Raut; Star Pala; K.G. Lynrah; Nari Lyngdoh; Rajani Thabah; Manish Kapoor; Sadananda Barik; Chitta Ranjan Mohanty; Sonu Hangma Subba; Satyabrata Guru; Manu Ayyan; Sitanshu Sekhar Kar; Nanda Kishore Maroju; Naveen Kumar; Roselin Mohandas; Charulatha Tamilselvan; Saranya Rajaram; Ankita Kankaria; Moonis Mirza; Preeti Singh Dhoat; Jaspreet Shergill; Manoj Kumar Gupta; Akhil Dhanesh Goel; Amit Kumar Rohila; Durga Shankar Meena; Archana Paliwal; Niti Gahlot; Nikita Sharma; Harkesh Kumar; Dinesh Choudhary; Shyam Lal Meena; Dinesh Bhambhu; Jigyasa Gupta; G. Priya; Sonia Samuel; S. Bagyalakshmi; Sathish Kumar T; Aazmi Mohamed; G. Rathna Kumar; A. Rajesh; V. Rajendran; M. Soorya; P.N. Sridevi; A. Karthika; K. Santha Sheela Kumari; K. Sathish Kumar; Pavithra Gnanavel; Dasarathan Ramesh; Aravind Gunasekaran; R. Kaverikannan; Madhumitha Manohar; P. Sofia; R. Abishek; Jeevithan Shanmugam; Mohan Kumar; Aparnavi Periyasamy; Dhilipan Kumar; G. Selvarani; Thirukumaran Ramasamy; N. Suresh; Kannan Muthuraman Alagappan; Mathavasami Vijayageetha; Sudha Ramalingam; Petchiappan Velammal; Yamini Subramani; Lakshmi Marappa; Viswanathan Pandurangan; T.R. Muralidharan; M. Rajkumar; Senthil Murugan Ramasamy; Bodhare Trupti; Bharath Rajh; Duvuru Amareswar Reddy; Rashmi Upadhyay; Anurag Srivastava; Rakesh Gupta; Ranjan Bhattnagar; Manaswi Chaubey; Soumik Ghosh; Nilesh Kumar; Mohammad Azharuddin; Nafees A. Khan; Mohammad Aslam; Asad Mahmood; R.K. Singh; Priyank Yadav; Aditya Kapoor; Om Prakash Sanjeev; Shyam Sundar; Prasan Kumar Panda; Mukesh Bairwa; Mahendera Singh Gehlot; Pooja Bhadoria; Arup Chakravorty; Sarmistha Chakravorty; Arindam Ray; Aparup Dhua; Amitava Pal; Priyanka Ghosh; Yogiraj Roy; Sinjita Dutta; Subhro Samujjal Basu
Background & objectives: In view of anecdotal reports of sudden unexplained deaths in India’s apparently healthy young adults, linking to coronavirus disease 2019 (COVID-19) infection or vaccination, we determined the factors associated with such deaths in individuals aged 18-45 years through a multicentric matched case–control study. Methods: This study was conducted through participation of 47 tertiary care hospitals across India. Cases were apparently healthy individuals aged 18-45 years without any known co-morbidity, who suddenly (<24 h of hospitalization or seen apparently healthy 24 h before death) died of unexplained causes during 1st October 2021-31st March 2023. Four controls were included per case matched for age, gender and neighborhood. We interviewed/perused records to collect data on COVID-19 vaccination/infection and post-COVID-19 conditions, family history of sudden death, smoking, recreational drug use, alcohol frequency and binge drinking and vigorous-intensity physical activity two days before death/interviews. We developed regression models considering COVID-19 vaccination ≤42 days before outcome, any vaccine received anytime and vaccine doses to compute an adjusted matched odds ratio (aOR) with 95 per cent confidence interval (CI). Results: Seven hundred twenty nine cases and 2916 controls were included in the analysis. Receipt of at least one dose of COVID-19 vaccine lowered the odds [aOR (95% CI)] for unexplained sudden death [0.58 (0.37, 0.92)], whereas past COVID-19 hospitalization [3.8 (1.36, 10.61)], family history of sudden death [2.53 (1.52, 4.21)], binge drinking 48 h before death/interview [5.29 (2.57, 10.89)], use of recreational drug/substance [2.92 (1.1, 7.71)] and performing vigorous-intensity physical activity 48 h before death/interview [3.7 (1.36, 10.05)] were positively associated. Two doses lowered the odds of unexplained sudden death [0.51 (0.28, 0.91)], whereas single dose did not. Interpretation & conclusions: COVID-19 vaccination did not increase the risk of unexplained sudden death among young adults in India. Past COVID-19 hospitalization, family history of sudden death and certain lifestyle behaviors increased the likelihood of unexplained sudden death. © 2023 Indian Journal of Medical Research, published by Wolters Kluwer - Medknow for Director-General, Indian Council of Medical Research.
Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Daniel Dicker; Grant Nguyen; Degu Abate; Kalkidan Hassen Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Omar Abdel-Rahman; Alireza Abdi; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Ahmed Abdulahi Abdurahman; Haftom Temesgen Abebe; Molla Abebe; Zegeye Abebe; Teshome Abuka Abebo; Victor Aboyans; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Niveen ME Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Pawan Acharya; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Rufus Adesoji Adedoyin; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Tara Ballav Adhikari; Mina G. Adib; ArsÃ¨ne Kouablan Adou; Jose C. Adsuar; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Rakesh Aggarwal; Sargis Aghasi Aghayan; Sutapa Agrawal; Anurag Agrawal; Mehdi Ahmadi; Alireza Ahmadi; Hamid Ahmadieh; Mohamed Lemine Cheikh Brahim Ahmed; Sayem Ahmed; Muktar Beshir Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Ali S. Akanda; Mohammad Esmaeil Akbari; Mohammed Akibu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Nadia Akseer; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Animut Alebel; Alicia V. Aleman; Kefyalew Addis Alene; Ayman Al-Eyadhy; Raghib Ali; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Alaâ€™A Alkerwi; FranÃ§ois Alla; Peter Allebeck; Christine A. Allen; Jordi Alonso; Rajaa M. Al-Raddadi; Ubai Alsharif; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Erfan Amini; Walid Ammar; Yaw Ampem Amoako; Nahla Hamed Anber; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Degefaye Zelalem Anlay; Hossein Ansari; Ansariadi Ansariadi; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Seth Christopher Yaw Appiah; Olatunde Aremu; Habtamu Abera Areri; Johan Ã„rnlÃ¶v; Megha Arora; Al Artaman; Krishna K. Aryal; Mohsen Asadi-Lari; Hamid Asayesh; Ephrem Tsegay Asfaw; Solomon Weldegebreal Asgedom; Reza Assadi; Zerihun Ataro; Tesfay Mehari Mehari Atey; Seyyed Shamsadin Athari; Suleman Atique; Sachin R. Atre; Madhu Sudhan Atteraya; Engi F. Attia; Marcel Ausloos; Leticia Avila-Burgos; Euripide F G A. Avokpaho; Ashish Awasthi; Baffour Awuah; Beatriz Paulina Ayala Quintanilla; Henok Tadesse Ayele; Yohanes Ayele; Rakesh Ayer; Tambe B. Ayuk; Peter S. Azzopardi; Natasha Azzopardi-Muscat; Hamid Badali; Alaa Badawi; Kalpana Balakrishnan; Ayele Geleto Bali; Maciej Banach; Amrit Banstola; Aleksandra Barac; Miguel A. Barboza; Simon Barquera; Lope H. Barrero; Huda Basaleem; Quique Bassat; Arindam Basu; Sanjay Basu; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick BÃ©jot; Bayu Begashaw Bekele; Abate Bekele Belachew; Aregawi Gebreyesus Belay; Ezra Belay; Saba Abraham Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Adugnaw Berhane; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Mircea Beuran; Tina Beyranvand; Neeraj Bhala; Eesh Bhatia; Samir Bhatt; Suraj Bhattarai; Soumyadeeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Boris Bikbov; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Sait Mentes Birlik; Charles Birungi; Donal Bisanzio; Tuhin Biswas; Tone BjÃ¸rge; Archie Bleyer; Berrak Bora Basara; Dipan Bose; Cristina Bosetti; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Nicola Luigi Bragazzi; Luisa C. Brant; Alexandra Brazinova; Nicholas J K. Breitborde; Hermann Brenner; Gabrielle Britton; Traolach Brugha; Kristin E. Burke; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Charlton S K H. Callender; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jorge Cano; Mate Car; Rosario CÃ¡rdenas; Giulia Carreras; Juan J. Carrero; Austin Carter; FÃ©lix Carvalho; Carlos A. CastaÃ±eda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; FerrÃ¡n CatalÃ¡-LÃ³pez; Alanur Ã‡avlin; Ester Cerin; Yazan Chaiah; Ana Paula Champs; Hsing-Yi Chang; Jung-Chen Chang; Aparajita Chattopadhyay; Pankaj Chaturvedi; Wanqing Chen; Peggy Pei-Chia Chiang; Odgerel Chimed-Ochir; Ken Lee Chin; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Jee-Young J. Choi; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Aaron J. Cohen; Daniel Collado-Mateo; Maria-Magdalena Constantin; Sara Conti; Cyrus Cooper; Leslie Trumbull Cooper; Paolo Angelo Cortesi; Monica Cortinovis; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; Christopher Stephen Crowe; John A. Crump; Alexandra Cucu; Matthew Cunningham; Alemneh Kabeta Daba; Berihun Assefa Dachew; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Anh Kim Dang; Paul I. Dargan; Ahmad Daryani; Siddharth K. Das; Rajat Das Gupta; JosÃ© Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Nicole Davis Weaver; Dragos Virgil Davitoiu; Kairat Davletov; Anand Dayama; Barbora de Courten; Fernando Pio De la Hoz; Diego De leo; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Tizta T. Degfie; Selina Deiparine; Robert P. Dellavalle; Gebre Teklemariam Demoz; Balem Betsu Demtsu; Edgar Denova-GutiÃ©rrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Subhojit Dey; Samath Dhamminda Dharmaratne; Meghnath Dhimal; Eric L. Ding; Shirin Djalalinia; David Teye Doku; Kate A. Dolan; Christl A. Donnelly; E Ray Dorsey; Dirk Douwes-Schultz; Kerrie E. Doyle; Thomas M. Drake; Tim Robert Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Dumessa Edessa; David Edvardsson; Anne Elise Eggen; Charbel El Bcheraoui; Maysaa El Sayed Zaki; Mohammed Elfaramawi; Ziad El-Khatib; Christian Lycke Ellingsen; Iqbal R F. Elyazar; Ahmadali Enayati; Aman Yesuf Yesuf Endries; Benjamin Er; Sergey Petrovich Ermakov; Babak Eshrati; Sharareh Eskandarieh; Reza Esmaeili; Alireza Esteghamati; Sadaf Esteghamati; Mahdi Fakhar; Hamed Fakhim; Tamer Farag; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Talha A. Farid; Carla Sofia E SÃ¡ Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Mir Sohail Fazeli; Valery L. Feigin; Andrea B. Feigl; Fariba Feizy; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Garumma Tolu Feyissa; Daniel Obadare Fijabi; Irina Filip; Samuel Finegold; Florian Fischer; Luisa Sorio Flor; Nataliya A. Foigt; John A. Ford; Kyle J. Foreman; Carla Fornari; Tahvi D. Frank; Richard Charles Franklin; Takeshi Fukumoto; John E. Fuller; Nancy Fullman; Thomas FÃ¼rst; JoÃ£o M. Furtado; Neal D. Futran; Adriana Galan; Silvano Gallus; Ketevan Gambashidze; Amiran Gamkrelidze; Fortune Gbetoho Gankpe; Alberto L. Garcia-Basteiro; Miguel A. Garcia-Gordillo; Teshome Gebre; Abadi Kahsu Gebre; Gebremedhin Berhe Gebregergs; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Tilayie Feto Gelano; Yalemzewod Assefa Gelaw; Johanna M. Geleijnse; Ricard Genova-Maleras; Bradford D. Gessner; Sefonias Getachew; Peter W. Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Hesam Ghiasvand; Mamata Ghimire; Aloke Gopal Ghoshal; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Giorgia Giussani; Shifalika Goenka; Srinivas Goli; Ricardo Santiago Gomez; Mari Carmen Gomez-Cabrera; Hector GÃ³mez-DantÃ©s; Philimon N. Gona; Amador Goodridge; Sameer Vali Gopalani; Atsushi Goto; Alessandra C. Goulart; BÃ¡rbara Niegia Garcia Goulart; Ayman Grada; Giuseppe Grosso; Harish Chander Gugnani; Andre Luiz Sena Guimaraes; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Bishal Gyawali; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Tekleberhan B. Hagos; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arya Haj-Mirzaian; Arvin Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Hamidreza Haririan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Roderick J. Hay; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Mohsen Heidari; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Ileana Heredia-Pi; Claudiu Herteliu; Fatemeh Heydarpour; Pouria Heydarpour; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Hans W. Hoek; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; Masako Horino; H Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Sorin Hostiuc; Mihaela Hostiuc; Peter J. Hotez; Damian G. Hoy; Mohamed Hsairi; Aung Soe Htet; Guoqing Hu; John J. Huang; Abdullatif Husseini; Mohammedaman Mama Hussen; Susan Hutfless; Kim Moesgaard Iburg; Ehimario U. Igumbor; Chad Thomas Ikeda; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Oluwaseyi Oluwakemi Isehunwa; Sheikh Mohammed Shariful Islam; Farhad Islami; Leila Jahangiry; Nader Jahanmehr; Rajesh Jain; Sudhir Kumar Jain; Mihajlo Jakovljevic; Spencer L. James; Mehdi Javanbakht; Sudha Jayaraman; Achala Upendra Jayatilleke; Sun Ha Jee; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Sarah Charlotte Johnson; Jost B. Jonas; Ankur Joshi; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk JÃ¼risson; K. Madhanraj; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Molla Kahssay; Rizwan Kalani; Umesh Kapil; Manoochehr Karami; Behzad Karami Matin; AndrÃ© Karch; Corine Karema; Narges Karimi; Seyed M. Karimi; Hamidreza Karimi-Sari; Amir Kasaeian; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Zemenu Yohannes Kassa; Nicholas J. Kassebaum; Marzieh Katibeh; Srinivasa Vittal Katikireddi; Anil Kaul; Norito Kawakami; Hossein Kazemeini; Zhila Kazemi; Ali Kazemi Karyani; K.C. Prakash; Seifu Kebede; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Maia Kereselidze; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Ejaz Ahmad Khan; Gulfaraz Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Tripti Khanna; Mona M. Khater; Alireza Khatony; Habibolah Khazaie; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Jagdish Khubchandani; Aliasghar A. Kiadaliri; Getiye D Dejenu Kibret; Cho-Il Kim; Daniel Kim; Jun Y. Kim; Young-Eun Kim; Ruth W. Kimokoti; Yohannes Kinfu; Sanjay Kinra; Adnan Kisa; Katarzyna Kissimova-Skarbek; Niranjan Kissoon; Mika KivimÃ¤ki; Marcus E. Kleber; Luke D. Knibbs; Ann Kristin Skrindo Knudsen; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Margaret N. Kosek; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Sanjay Krishnaswami; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Andreas A. Kudom; Ernst J. Kuipers; Xie Rachel Kulikoff; G Anil Kumar; Manasi Kumar; Pushpendra Kumar; Fekede Asefa Kumsa; Michael J. Kutz; Sheetal D. Lad; Alessandra Lafranconi; Dharmesh Kumar Lal; Ratilal Lalloo; Hilton Lam; Faris Hasan Lami; Qing Lan; SinÃ©ad M. Langan; Van C. Lansingh; Sonia Lansky; Heidi Jane Larson; Dennis Odai Laryea; Zohra S. Lassi; Arman Latifi; Pablo M. Lavados; Avula Laxmaiah; Jeffrey V. Lazarus; Georgy Lebedev; Paul H. Lee; James Leigh; Cheru Tesema Leshargie; Samson Leta; Miriam Levi; Shanshan Li; Yichong Li; Xiaohong Li; Juan Liang; Xiaofeng Liang; Misgan Legesse Liben; Lee-Ling Lim; Stephen S. Lim; Miteku Andualem Limenih; Shai Linn; Shiwei Liu; Yang Liu; Rakesh Lodha; Giancarlo Logroscino; Chris Lonsdale; Scott A. Lorch; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Tim C D. Lucas; Raimundas Lunevicius; Ronan A. Lyons; Stefan Ma; Crispin Mabika; Erlyn Rachelle King Macarayan; Mark T. Mackay; Emilie R. Maddison; Ralph Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Manzoor Ahmad Malik; Deborah Carvalho Malta; Abdullah A. Mamun; Wondimu Ayele Manamo; Ana-Laura Manda; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Chabila Christopher Mapoma; Dadi Marami; Joemer C. Maravilla; Wagner Marcenes; Shakhnazarova Marina; Jose Martinez-Raga; Sheila C O. Martins; Francisco RogerlÃ¢ndio Martins-Melo; Winfried MÃ¤rz; Melvin B. Marzan; Tivani Phosa Mashamba-Thompson; Felix Masiye; Benjamin Ballard Massenburg; Pallab K. Maulik; Mohsen Mazidi; John J. McGrath; Martin McKee; Suresh Mehata; Sanjay Madhav Mehendale; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Tesfa Mekonen; Tefera Chane Mekonnen; Hagazi Gebre Meles; Kidanu Gebremariam Meles; Addisu Melese; Mulugeta Melku; Peter T N. Memiah; Ziad A. Memish; Walter Mendoza; Desalegn Tadese Mengistu; Getnet Mengistu; George A. Mensah; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Haftay Berhane Mezgebe; Yode Miangotar; Bartosz Miazgowski; Tomasz Miazgowski; Ted R. Miller; G.K. Mini; Andreea Mirica; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Babak Moazen; Nurilign Abebe Moges; Karzan Abdulmuhsin Mohammad; Moslem Mohammadi; Noushin Mohammadifard; Maryam Mohammadi-Khanaposhtani; Mousa Mohammadnia-Afrouzi; Shafiu Mohammed; Mohammed A. Mohammed; Viswanathan Mohan; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Ghobad Moradi; Mahmoudreza Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Ilais Moreno VelÃ¡squez; Joana Morgado-Da-costa; Shane Douglas Morrison; Abbas Mosapour; Marilita M. Moschos; Seyyed Meysam Mousavi; Achenef Asmamaw Muche; Kindie Fentahun Muchie; Ulrich Otto Mueller; Satinath Mukhopadhyay; Erin C. Mullany; Kate Muller; Manoj Murhekar; Tasha B. Murphy; G.V.S. 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Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. © 2018 The Author(s).
Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016
(Lancet Publishing Group, 2017) Simon I. Hay; Amanuel Alemu Abajobir; Kalkidan Hassen Abate; Cristiana Abbafati; Kaja M. Abbas; Foad Abd-Allah; Abdishakur M. Abdulle; Teshome Abuka Abebo; Semaw Ferede Abera; Victor Aboyans; Laith J. Abu-Raddad; Ilana N. Ackerman; Isaac A. Adedeji; Olatunji Adetokunboh; Ashkan Afshin; Rakesh Aggarwal; Sutapa Agrawal; Anurag Agrawal; Aliasghar Ahmad Kiadaliri; Muktar Beshir Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Sneha Aiyar; Tomi F. Akinyemiju; Nadia Akseer; Faris Hasan Al Lami; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Noore Alam; Tahiya Alam; Deena Alasfoor; Kefyalew Addis Alene; Raghib Ali; Reza Alizadeh-Navaei; Juma M. Alkaabi; Ala'a Alkerwi; François Alla; Peter Allebeck; Christine Allen; Fatma Al-Maskari; Mohammad Abdulaziz Almazroa; Rajaa Al-Raddadi; Ubai Alsharif; Shirina Alsowaidi; Benjamin M. Althouse; Khalid A. Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Erfan Amini; Walid Ammar; Yaw Ampem Amoako; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Palwasha Anwari; Johan Ärnlöv; Megha Arora; Al Artaman; Krishna Kumar Aryal; Solomon W. Asgedom; Tesfay Mehari Atey; Niguse Tadele Atnafu; Leticia Avila-Burgos; Euripide Frinel G. Arthur Avokpaho; Ashish Awasthi; Shally Awasthi; Beatriz Paulina Ayala Quintanilla; Mahmoud Reza Azarpazhooh; Peter Azzopardi; Tesleem Kayode Babalola; Umar Bacha; Alaa Badawi; Kalpana Balakrishnan; Marlena S. Bannick; Aleksandra Barac; Suzanne L. Barker-Collo; Till Bärnighausen; Simon Barquera; Lope H. Barrero; Sanjay Basu; Robert Battista; Katherine E. Battle; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Justin Beardsley; Neeraj Bedi; Yannick Béjot; Bayu Begashaw Bekele; Michelle L. Bell; Derrick A. Bennett; James R. Bennett; Isabela M. Bensenor; Jennifer Benson; Adugnaw Berhane; Derbew Fikadu Berhe; Eduardo Bernabé; Balem Demtsu Betsu; Mircea Beuran; Addisu Shunu Beyene; Anil Bhansali; Samir Bhatt; Zulfqar A. Bhutta; Sibhatu Biadgilign; Kelly Bienhof; Boris Bikbov; Charles Birungi; Stan Biryukov; Donal Bisanzio; Habtamu Mellie Bizuayehu; Fiona M. Blyth; Dube Jara Boneya; Dipan Bose; Ibrahim R. Bou-Orm; Rupert R. A. Bourne; Michael Brainin; Carol E. G. Brayne; Alexandra Brazinova; Nicholas J. K. Breitborde; Paul S. Briant; Gabrielle Britton; Traolach S. Brugha; Rachelle Buchbinder; Lemma Negesa Bulto Bulto; Blair Bumgarner; Zahid A. Butt; Lucero Cahuana-Hurtado; Ewan Cameron; Ismael Ricardo Campos-Nonato; Hélène Carabin; Rosario Cárdenas; David O. Carpenter; Juan Jesus Carrero; Austin Carter; Felix Carvalho; Daniel Casey; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Chris D. Castle; Ferrán Catalá-López; Jung-Chen Chang; Fiona J. Charlson; Pankaj Chaturvedi; Honglei Chen; Mirriam Chibalabala; Chioma Ezinne Chibueze; Vesper Hichilombwe Chisumpa; Abdulaal A. Chitheer; Rajiv Chowdhury; Devasahayam Jesudas Christopher; Liliana G. Ciobanu; Massimo Cirillo; Danny Colombara; Leslie Trumbull Cooper; Cyrus Cooper; Paolo Angelo Cortesi; Monica Cortinovis; Michael H. Criqui; Elizabeth A. Cromwell; Marita Cross; John A. Crump; Abel Fekadu Dadi; Koustuv Dalal; Albertino Damasceno; Lalit Dandona; Rakhi Dandona; José Das Neves; Dragos V. Davitoiu; Kairat Davletov; Barbora De Courten; Diego De Leo; Hans De Steur; Louisa Degenhardt; Selina Deiparine; Robert P. Dellavalle; Kebede Deribe; Amare Deribew; Don C. Das Jarlais; Subhojit Dey; Samath D. Dharmaratne; Preet K. Dhillon; Daniel Dicker; Shirin Djalalinia; Huyen Phuc Do; Klara Dokova; David Teye Doku; E. Ray Dorsey; Kadine Priscila Bender Dos Santos; Tim R. Driscoll; Manisha Dubey; Bruce Bartholow Duncan; Beth E. 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Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE difered from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs ofset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the fve lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs ofset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention eforts, and development assistance for health, including fnancial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
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Background: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted lifeyears (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severityof ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-speci?c mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the ?ve leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Spencer L. James; Degu Abate; Kalkidan Hassen Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Zegeye Abebe; Semaw F. Abera; Olifan Zewdie Abil; Haftom Niguse Abraha; Laith Jamal Abu-Raddad; Niveen M.E. Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Pawan Acharya; Ilana N. Ackerman; Abdu A. Adamu; Oladimeji M. Adebayo; Victor Adekanmbi; Olatunji O. Adetokunboh; Mina G. Adib; Jose C. Adsuar; Kossivi Agbelenko Afanvi; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Kareha M. Agesa; Rakesh Aggarwal; Sargis Aghasi Aghayan; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Tomi Akinyemiju; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Hesham M. Al-Mekhlafi; Rajaa M. 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Briggs; Andrey Nikolaevich Briko; Gabrielle Britton; Traolach Brugha; Rachelle Buchbinder; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Jorge Cano; Rosario Cárdenas; Juan J. Carrero; Austin Carter; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; Ferrán Catalá-López; Kelly M. Cercy; Ester Cerin; Yazan Chaiah; Alex R. Chang; Hsing-Yi Chang; Jung-Chen Chang; Fiona J. Charlson; Aparajita Chattopadhyay; Vijay Kumar Chattu; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Ken Lee Chin; Abdulaal Chitheer; Jee-Young J. Choi; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Daniel Collado-Mateo; Cyrus Cooper; Josef Coresh; Paolo Angelo Cortesi; Monica Cortinovis; Megan Costa; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; Marita Cross; John A. Crump; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Paul I. Dargan; Ahmad Daryani; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Gail Davey; Adrian C. Davis; Dragos Virgil Davitoiu; Barbora De Courten; Fernando Pio De La Hoz; Diego De Leo; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Selina Deiparine; Robert P. Dellavalle; Gebre Teklemariam Demoz; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Subhojit Dey; Samath Dhamminda Dharmaratne; Mesfin Tadese Dinberu; M. Ashworth Dirac; Shirin Djalalinia; Linh Doan; Klara Dokova; David Teye Doku; E. Ray Dorsey; Kerrie E. Doyle; Tim Robert Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Michelle Marie Echko; David Edvardsson; Andem Effiong; Joshua R. Ehrlich; Charbel El Bcheraoui; Maysaa El Sayed Zaki; Ziad El-Khatib; Hajer Elkout; Iqbal R.F. Elyazar; Ahmadali Enayati; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Babak Eshrati; Sharareh Eskandarieh; Alireza Esteghamati; Sadaf Esteghamati; Hamed Fakhim; Vahid Fallah Omrani; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Talha A. Farid; Carla Sofia Esá Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Valery L. Feigin; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Alize J. Ferrari; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; Christina Fitzmaurice; Nataliya A. Foigt; Kyle J. Foreman; Jack Fox; Tahvi D. Frank; Takeshi Fukumoto; Nancy Fullman; Thomas Fürst; João M. Furtado; Neal D. Futran; Seana Gall; Morsaleh Ganji; Fortune Gbetoho Gankpe; Alberto L. Garcia-Basteiro; William M. Gardner; Abadi Kahsu Gebre; Amanuel Tesfay Gebremedhin; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Ricard Genova-Maleras; Yilma Chisha Dea Geramo; Peter W. Gething; Kebede Embaye Gezae; Keyghobad Ghadiri; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Mamata Ghimire; Rakesh Ghosh; Aloke Gopal Ghoshal; Simona Giampaoli; Paramjit Singh Gill; Tiffany K. Gill; Ibrahim Abdelmageed Ginawi; Giorgia Giussani; Elena V. Gnedovskaya; Ellen M. Goldberg; Srinivas Goli; Hector Gómez-Dantés; Philimon N. Gona; Sameer Vali Gopalani; Taren M. Gorman; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Morgan E. Grams; Giuseppe Grosso; Harish Chander Gugnani; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Bishal Gyawali; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Hassan Haghparast Bidgoli; Tekleberhan B. Hagos; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Yuantao Hao; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Caitlin N. Hawley; Roderick J. Hay; Simon I. Hay; Akbar Hedayatizadeh-Omran; Behzad Heibati; Delia Hendrie; Andualem Henok; Claudiu Herteliu; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Huong Thanh Hoang; Hans W. Hoek; Howard J. Hoffman; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; H. Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Peter J. Hotez; Damian G. Hoy; Mohamed Hsairi; Aung Soe Htet; Guoqing Hu; John J. Huang; Chantal K. Huynh; Kim Moesgaard Iburg; Chad Thomas Ikeda; Bogdan Ileanu; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Sheikh Mohammed; Shariful Islam; Farhad Islami; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Catherine O. Johnson; Jost B. Jonas; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jürisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Tanuj Kanchan; Manoochehr Karami; Behzad Karami Matin; André Karch; Corine Karema; Narges Karimi; Seyed M. Karimi; Amir Kasaeian; Dessalegn H. Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Norito Kawakami; Ali Kazemi Karyani; Masoud Masoud Keighobadi; Peter Njenga Keiyoro; Laura Kemmer; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Yousef Saleh Khader; Behzad Khafaei; Morteza Abdullatif Khafaie; Alireza Khajavi; Ibrahim A. Khalil; Ejaz Ahmad Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Mohammad Khazaei; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Aliasghar A. Kiadaliri; Daniel N. Kiirithio; Cho-Il Kim; Daniel Kim; Pauline Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimäki; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Soewarta Kosen; Georgios A. Kotsakis; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Kristopher J. Krohn; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G. Anil Kumar; Manasi Kumar; Hmwe Hmwe Kyu; Deepesh P. Lad; Sheetal D. Lad; Alessandra Lafranconi; Ratilal Lalloo; Tea Lallukka; Faris Hasan Lami; Van C. Lansingh; Arman Latifi; Kathryn Mei-Ming Lau; Jeffrey V. Lazarus; Janet L. Leasher; Jorge R. Ledesma; Paul H. Lee; James Leigh; Janni Leung; Miriam Levi; Sonia Lewycka; Shanshan Li; Yichong Li; Yu Liao; Misgan Legesse Liben; Lee-Ling Lim; Stephen S. Lim; Shiwei Liu; Rakesh Lodha; Katharine J. Looker; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Nicola Low; Rafael Lozano; Tim C.D. Lucas; Lydia R. Lucchesi; Raimundas Lunevicius; Ronan A. Lyons; Stefan Ma; Erlyn Rachelle King Macarayan; Mark T. Mackay; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Narayan Bahadur Mahotra; Hue Thi Mai; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Ana-Laura Manda; Helena Manguerra; Treh Manhertz; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Chabila Christopher Mapoma; Joemer C. Maravilla; Wagner Marcenes; Ashley Marks; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Winfried März; Melvin B. Marzan; Tivani Phosa Mashamba-Thompson; Benjamin Ballard Massenburg; Manu Raj Mathur; Kunihiro Matsushita; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Fabiola Mejia-Rodriguez; Tesfa Mekonen; Addisu Melese; Mulugeta Melku; Michele Meltzer; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Desalegn Tadese Mengistu; Getnet Mengistu; George A. Mensah; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Naser Mohammad Gholi Mezerji; Bartosz Miazgowski; Tomasz Miazgowski; Anoushka I. Millear; Ted R. Miller; Benjamin Miltz; G.K. Mini; Mojde Mirarefin; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Philip B. Mitchell; Habtamu Mitiku; Babak Moazen; Bahram Mohajer; Karzan Abdulmuhsin Mohammad; Noushin Mohammadifard; Mousa Mohammadnia-Afrouzi; Mohammed A. Mohammed; Shafiu Mohammed; Farnam Mohebi; Modhurima Moitra; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Yoshan Moodley; Mahmood Moosazadeh; Ghobad Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Ilais Moreno Velásquez; Joana Morgado-Da-Costa; Shane Douglas Morrison; Marilita M. Moschos; Seyyed Meysam Mousavi; Kalayu Brhane Mruts; Achenef Asmamaw Muche; Kindie Fentahun Muchie; Ulrich Otto Mueller; Oumer Sada Muhammed; Satinath Mukhopadhyay; Kate Muller; John Everett Mumford; Manoj Murhekar; Jonah Musa; Kamarul Imran Musa; Ghulam Mustafa; Ashraf F. Nabhan; Chie Nagata; Mohsen Naghavi; Aliya Naheed; Azin Nahvijou; Gurudatta Naik; Nitish Naik; Farid Najafi; Luigi Naldi; Hae Sung Nam; Vinay Nangia; Jobert Richie Nansseu; Bruno Ramos Nascimento; Gopalakrishnan Natarajan; Nahid Neamati; Ionut Negoi; Ruxandra Irina Negoi; Subas Neupane; Charles Richard James Newton; Josephine W. Ngunjiri; Anh Quynh Nguyen; Ha Thu Nguyen; Huong Lan Thi Nguyen; Huong Thanh Nguyen; Long Hoang Nguyen; Minh Nguyen; Nam Ba Nguyen; Son Hoang Nguyen; Emma Nichols; Dina Nur Anggraini Ningrum; Molly R. Nixon; Nomonde Nolutshungu; Shuhei Nomura; Ole F. Norheim; Mehdi Noroozi; Bo Norrving; Jean Jacques Noubiap; Hamid Reza Nouri; Malihe Nourollahpour Shiadeh; Mohammad Reza Nowroozi; Elaine O. Nsoesie; Peter S. Nyasulu; Christopher M. Odell; Richard Ofori-Asenso; Felix Akpojene Ogbo; In-Hwan Oh; Olanrewaju Oladimeji; Andrew T. Olagunju; Tinuke O. Olagunju; Pedro R. Olivares; Helen Elizabeth Olsen; Bolajoko Olubukunola Olusanya; Kanyin L. Ong; Sok King Ong; Eyal Oren; Alberto Ortiz; Erika Ota; Stanislav S. Otstavnov; Simon øverland; Mayowa Ojo Owolabi; P.A. Mahesh; Rosana Pacella; Amir H. Pakpour; Adrian Pana; Songhomitra Panda-Jonas; Andrea Parisi; Eun-Kee Park; Charles D.H. Parry; Shanti Patel; Sanghamitra Pati; Snehal T. Patil; Ajay Patle; George C. Patton; Vishnupriya Rao Paturi; Katherine R. Paulson; Neil Pearce; David M. Pereira; Norberto Perico; Konrad Pesudovs; Hai Quang Pham; Michael R. Phillips; David M. Pigott; Julian David Pillay; Michael A. Piradov; Meghdad Pirsaheb; Farhad Pishgar; Oleguer Plana-Ripoll; Dietrich Plass; Suzanne Polinder; Svetlana Popova; Maarten J. Postma; Akram Pourshams; Hossein Poustchi; Dorairaj Prabhakaran; Swayam Prakash; V. Prakash; Caroline A. Purcell; Manorama B. Purwar; Mostafa Qorbani; D. Alex Quistberg; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Kazem Rahimi; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Sajjad Ur Rahman; Rajesh Kumar Rai; Fatemeh Rajati; Usha Ram; Prabhat Ranjan; Anna Ranta; Puja C. Rao; David Laith Rawaf; Salman Rawaf; K. Srinath Reddy; Robert C. Reiner; Nickolas Reinig; Marissa Bettay Reitsma; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Satar Rezaei; Mohammad Sadegh Rezai; Antonio Luiz P. Ribeiro; Stephen R. Robinson; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Gregory A. Roth; Ambuj Roy; Enrico Rubagotti; Perminder S. Sachdev; Nafis Sadat; Basema Saddik; Ehsan Sadeghi; Sahar Saeedi Moghaddam; Hosein Safari; Yahya Safari; Roya Safari-Faramani; Mahdi Safdarian; Sare Safi; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; Haniye Sadat Sajadi; Nasir Salam; Joseph S. Salama; Payman Salamati; Komal Saleem; Zikria Saleem; Yahya Salimi; Joshua A. Salomon; Sundeep Santosh Salvi; Inbal Salz; Abdallah M. Samy; Juan Sanabria; Yingying Sang; Damian Francesco Santomauro; Itamar S. Santos; João Vasco Santos; Milena M. Santric Milicevic; Bruno Piassi Sao Jose; Mayank Sardana; Abdur Razzaque Sarker; Nizal Sarrafzadegan; Benn Sartorius; Shahabeddin Sarvi; Brijesh Sathian; Maheswar Satpathy; Arundhati R. Sawant; Monika Sawhney; Sonia Saxena; Mete Saylan; Elke Schaeffner; Maria Inês Schmidt; Ione J.C. Schneider; Ben Schöttker; David C. Schwebel; Falk Schwendicke; James G. Scott; Mario Sekerija; Sadaf G. Sepanlou; Edson Serván-Mori; Seyedmojtaba Seyedmousavi; Hosein Shabaninejad; Azadeh Shafieesabet; Mehdi Shahbazi; Amira A. Shaheen; Masood Ali Shaikh; Mehran Shams-Beyranvand; Mohammadbagher Shamsi; Morteza Shamsizadeh; Heidar Sharafi; Kiomars Sharafi; Mehdi Sharif; Mahdi Sharif-Alhoseini; Meenakshi Sharma; Rajesh Sharma; Jun She; Aziz Sheikh; Peilin Shi; Kenji Shibuya; Mika Shigematsu; Rahman Shiri; Reza Shirkoohi; Kawkab Shishani; Ivy Shiue; Farhad Shokraneh; Haitham Shoman; Mark G. Shrime; Si Si; Soraya Siabani; Tariq J. Siddiqi; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; João Pedro Silva; Dayane Gabriele Alves Silveira; Narayana Sarma Venkata Singam; Jasvinder A. Singh; Narinder Pal Singh; Virendra Singh; Dhirendra Narain Sinha; Eirini Skiadaresi; Erica Leigh N. Slepak; Karen Sliwa; David L. Smith; Mari Smith; Adauto Martins Soares Filho; Badr Hasan Sobaih; Soheila Sobhani; Eugène Sobngwi; Samir S. Soneji; Moslem Soofi; Masoud Soosaraei; Reed J.D. Sorensen; Joan B. Soriano; Ireneous N. Soyiri; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Jeffrey D. Stanaway; Dan J. Stein; Caitlyn Steiner; Timothy J. Steiner; Mark A. Stokes; Lars Jacob Stovner; Michelle L. Subart; Agus Sudaryanto; Mu'awiyyah Babale Sufiyan; Bruno F. Sunguya; Patrick John Sur; Ipsita Sutradhar; Bryan L. Sykes; Dillon O. Sylte; Rafael Tabarés-Seisdedos; Santosh Kumar Tadakamadla; Birkneh Tilahun Tadesse; Nikhil Tandon; Segen Gebremeskel Tassew; Mohammad Tavakkoli; Nuno Taveira; Hugh R. Taylor; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Shishay Wahdey Tekelemedhin; Merhawi Gebremedhin Tekle; Habtamu Temesgen; Mohamad-Hani Temsah; Omar Temsah; Abdullah Sulieman Terkawi; Mebrahtu Teweldemedhin; Kavumpurathu Raman Thankappan; Nihal Thomas; Binyam Tilahun; Quyen G. To; Marcello Tonelli; Roman Topor-Madry; Fotis Topouzis; Anna E. Torre; Miguel Tortajada-Girbés; Mathilde Touvier; Marcos Roberto Tovani-Palone; Jeffrey A. Towbin; Bach Xuan Tran; Khanh Bao Tran; Christopher E. Troeger; Thomas Clement Truelsen; Miltiadis K. Tsilimbaris; Derrick Tsoi; Lorainne Tudor Car; E. Murat Tuzcu; Kingsley N. Ukwaja; Irfan Ullah; Eduardo A. Undurraga; Jurgen Unutzer; Rachel L. Updike; Muhammad Shariq Usman; Olalekan A. Uthman; Muthiah Vaduganathan; Afsane Vaezi; Pascual R. Valdez; Santosh Varughese; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Santos Villafaina; Francesco S. Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Stein Emil Vollset; Kia Vosoughi; Isidora S. Vujcic; Fasil Shiferaw Wagnew; Yasir Waheed; Stephen G. Waller; Yafeng Wang; Yuan-Pang Wang; Elisabete Weiderpass; Robert G. Weintraub; Daniel J. Weiss; Fitsum Weldegebreal; Kidu Gidey Weldegwergs; Andrea Werdecker; T. Eoin West; Harvey A. Whiteford; Justyna Widecka; Tissa Wijeratne; Lauren B. Wilner; Shadrach Wilson; Andrea Sylvia Winkler; Alison B. Wiyeh; Charles Shey Wiysonge; Charles D.A. Wolfe; Anthony D. Woolf; Shouling Wu; Yun-Chun Wu; Grant M.A. Wyper; Denis Xavier; Gelin Xu; Simon Yadgir; Ali Yadollahpour; Seyed Hossein Yahyazadeh Jabbari; Tomohide Yamada; Lijing L. Yan; Yuichiro Yano; Mehdi Yaseri; Yasin Jemal Yasin; Alex Yeshaneh; Ebrahim M. Yimer; Paul Yip; Engida Yisma; Naohiro Yonemoto; Seok-Jun Yoon; Marcel Yotebieng; Mustafa Z. Younis; Mahmoud Yousefifard; Chuanhua Yu; Vesna Zadnik; Zoubida Zaidi; Sojib Bin Zaman; Mohammad Zamani; Zohreh Zare; Ayalew Jejaw Zeleke
Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
INASL Guidelines on Management of Hepatitis B Virus Infection in Patients receiving Chemotherapy, Biologicals, Immunosupressants, or Corticosteroids
(Elsevier B.V., 2018) Anil Arora; Anil C. Anand; Ashish Kumar; Shivaram P. Singh; Rakesh Aggarwal; Radha K. Dhiman; Shyam Aggarwal; Seema Alam; Pradeep Bhaumik; Vinod K. Dixit; Ashish Goel; Bhabadev Goswami; Ashok Kumar; Manoj Kumar; Kaushal Madan; Natarajan Murugan; Aabha Nagral; Amarender S. Puri; Padaki N. Rao; Neeraj Saraf; Vivek A. Saraswat; Sanjeev Sehgal; Praveen Sharma; Koticherry T. Shenoy; Manav Wadhawan
Hepatitis B Virus (HBV) reactivation in patients receiving chemotherapy, biologicals, immunosupressants, or corticosteroids is emerging to be an important cause of morbidity and mortality in patients with current or prior exposure to HBV infection. These patients suffer a dual onslaught of illness: one from the primary disease for which they are receiving the culprit drug that led to HBV reactivation, and the other from HBV reactivation itself. The HBV reactivation not only leads to a compromised liver function, which may culminate into hepatic failure; it also adversely impacts the treatment outcome of the primary illness. Hence, identification of patients at risk of reactivation before starting these drugs, and starting treatment aimed at prevention of HBV reactivation is the best strategy of managing these patients. There are no Indian guidelines on management of HBV infection in patients receiving chemotherapy, biologicals, immunosupressants, or corticosteroids for the treatment of rheumatologic conditions, malignancies, inflammatory bowel disease, dermatologic conditions, or solid-organ or bone marrow transplantation. The Indian National Association for Study of the Liver (INASL) had set up a taskforce on HBV in 2016, with a mandate to develop consensus guidelines for management of various aspects of HBV infection, relevant to India. In 2017 the taskforce had published the first INASL guidelines on management of HBV infection in India. In the present guidelines, which are in continuation with the previous guidelines, the issues on management of HBV infection in patients receiving chemotherapy, biologicals, immunosupressants, or corticosteroids are addressed. © 2018
INASL-ISN Joint Position Statements on Management of Patients with Simultaneous Liver and Kidney Disease
(Elsevier B.V., 2021) Anil Arora; Ashish Kumar; Narayan Prasad; Ajay Duseja; Subrat K. Acharya; Sanjay K. Agarwal; Rakesh Aggarwal; Anil C. Anand; Anil K. Bhalla; Narendra S. Choudhary; Yogesh K. Chawla; Radha K. Dhiman; Vinod K. Dixit; Natarajan Gopalakrishnan; Ashwani Gupta; Umapati N. Hegde; Sanjiv Jasuja; Vivek Jha; Vijay Kher; Ajay Kumar; Kaushal Madan; Rakhi Maiwall; Rajendra P. Mathur; Suman L. Nayak; Gaurav Pandey; Rajendra Pandey; Pankaj Puri; Ramesh R. Rai; Sree B. Raju; Devinder S. Rana; Padaki N. Rao; Manish Rathi; Vivek A. Saraswat; Sanjiv Saxena; Shalimar; Praveen Sharma; Shivaram P. Singh; Ashwani K. Singal; Arvinder S. Soin; Sunil Taneja; Santosh Varughese
Renal dysfunction is very common among patients with chronic liver disease, and concomitant liver disease can occur among patients with chronic kidney disease. The spectrum of clinical presentation and underlying etiology is wide when concomitant kidney and liver disease occur in the same patient. Management of these patients with dual onslaught is challenging and requires a team approach of hepatologists and nephrologists. No recent guidelines exist on algorithmic approach toward diagnosis and management of these challenging patients. The Indian National Association for Study of Liver (INASL) in association with Indian Society of Nephrology (ISN) endeavored to develop joint guidelines on diagnosis and management of patients who have simultaneous liver and kidney disease. For generating these guidelines, an INASL-ISN Taskforce was constituted, which had members from both the societies. The taskforce first identified contentious issues on various aspects of simultaneous liver and kidney diseases, which were allotted to individual members of the taskforce who reviewed them in detail. A round-table meeting of the Taskforce was held on 20–21 October 2018 at New Delhi to discuss, debate, and finalize the consensus statements. The evidence and recommendations in these guidelines have been graded according to the Grading of Recommendations Assessment Development and Evaluation (GRADE) system with minor modifications. The strength of recommendations (strong and weak) thus reflects the quality (grade) of underlying evidence (I, II, III). We present here the INASL-ISN Joint Position Statements on Management of Patients with Simultaneous Liver and Kidney Disease. © 2020 Indian National Association for Study of the Liver
Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection in 2015
(Elsevier B.V., 2015) Pankaj Puri; Anil C. Anand; Vivek A. Saraswat; Subrat K. Acharya; Radha K. Dhiman; Shiv K. Sarin; Shivaram P. Singh; Yogesh K. Chawla; Rakesh Aggarwal; Deepak Amarapurkar; Anil Arora; Vinod K. Dixit; Ajit Sood; Samir Shah; Ajay Duseja; Dharmesh Kapoor; Shalimar; Kaushal Madan; Gaurav Pande; Aabha Nagral; Premashis Kar; Abraham Koshy; Amarender S. Puri; C.E. Eapen; Sandeep Thareja
Overall prevalence of HCV infection in India has been estimated to be approximately 1.3% in the general population. Recent introduction of sofosbuvir in India at a relatively affordable price has led to great optimism about prospects of cure for these patients. This drug is likely to form the backbone of current and future treatment regimes for HCV infection, displacing pegylated interferon. Availability of directly acting antiviral drugs (DAAs) has necessitated revision of INASL guidelines for the treatment of HCV published in 2014, as has happened across the world. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. Since only one DAA, sofosbuvir, is available in India, only two sofosbuvir-based regimes are possible: either dual drug therapy in combination with ribavirin alone for 6 months or triple drug therapy in combination with ribavirin and pegylated interferon for 3 months. The utility of these regimes in various situations has been discussed. Availability of a few other newer DAAs, expected in 2016, is expected to lead to more widespread use of these agents. Current guidance will be updated once newer DAAs, newer evidence with DAAs and 'real-life experience' with use of DAAs accumulate in India. © 2015 INASL.
Indian National Association for the Study of the Liver—Federation of Obstetric and Gynaecological Societies of India Position Statement on Management of Liver Diseases in Pregnancy
(Elsevier B.V., 2019) Anil Arora; Ashish Kumar; Anil C. Anand; Pankaj Puri; Radha K. Dhiman; Subrat K. Acharya; K. Aggarwal; Neelam Aggarwal; Rakesh Aggarwal; Yogesh K. Chawla; Vinod K. Dixit; Ajay Duseja; Chundamannil E. Eapen; Bhabadev Goswami; Kanwal Gujral; A. Gupta; A. Jindal; Premashish Kar; Krishna Kumari; Kaushal Madan; Jaideep Malhotra; Narendra Malhotra; Gaurav Pandey; Uma Pandey; Ratna D. Puri; Ramesh R. Rai; Padaki N. Rao; Shiv K. Sarin; Aparna Sharma; Praveen Sharma; Koticherry T. Shenoy; Karam R. Singh; Shivaram P. Singh; Vanita Suri; Nirupama Trehanpati; M. Wadhawan
Liver diseases occurring during pregnancy can be serious and can progress rapidly, affecting outcomes for both the mother and fetus. They are a common cause of concern to an obstetrician and an important reason for referral to a hepatologist, gastroenterologist, or physician. Liver diseases during pregnancy can be divided into disorders unique to pregnancy, those coincidental with pregnancy, and preexisting liver diseases exacerbated by pregnancy. A rapid differential diagnosis between liver diseases related or unrelated to pregnancy is required so that specialist and urgent management of these conditions can be carried out. Specific Indian guidelines for the management of these patients are lacking. The Indian National Association for the Study of the Liver (INASL) in association with the Federation of Obstetric and Gynaecological Societies of India (FOGSI) had set up a taskforce for development of consensus guidelines for management of patients with liver diseases during pregnancy, relevant to India. For development of these guidelines, a two-day roundtable meeting was held on 26–27 May 2018 in New Delhi, to discuss, debate, and finalize the consensus statements. Only those statements that were unanimously approved by most members of the taskforce were accepted. The primary objective of this review is to present the consensus statements approved jointly by the INASL and FOGSI for diagnosing and managing pregnant women with liver diseases. This article provides an overview of liver diseases occurring in pregnancy, an update on the key mechanisms involved in its pathogenesis, and the recommended treatment options. © 2019