Browsing by Author "Sonali Gajanan Choudhari"

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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
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
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
Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Mohsen Naghavi; Kanyin Liane Ong; Amirali Aali; Hazim S. Ababneh; Yohannes Habtegiorgis Abate; Cristiana Abbafati; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Deldar Morad Abdulah; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Aidin Abedi; Kedir Hussein Abegaz; E.S. Abhilash; Hassan Abidi; Olumide Abiodun; Richard Gyan Aboagye; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimaraes Abreu; Woldu Aberhe Abrha; Dariush Abtahi; Samir Abu Rumeileh; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen Me Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Manfred Mario Kokou Accrombessi; Tadele Girum Adal; Abdu A. Adamu; Isaac Yeboah Addo; Giovanni Addolorato; Akindele Olupelumi Adebiyi; Victor Adekanmbi; Abiola Victor Adepoju; Charles Oluwaseun Adetunji; Juliana Bunmi Adetunji; Temitayo Esther Adeyeoluwa; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Biruk Adie Admass; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Aanuoluwapo Adeyimika Afolabi; Muhammad Sohail Afzal; Saira Afzal; Suneth Buddhika Agampodi; Pradyumna Agasthi; Manik Aggarwal; Shahin Aghamiri; Feleke Doyore Agide; Antonella Agodi; Anurag Agrawal; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M Ahmad; Sajjad Ahmad; Shahzaib Ahmad; Tauseef Ahmad; Keivan Ahmadi; Amir Mahmoud Ahmadzade; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Mehrunnisha Sharif Ahmed; Meqdad Saleh Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Essona Matatom Akara; Hossein Akbarialiabad; Karolina Akinosoglou; Tomi Akinyemiju; Mohammed Ahmed Akkaif; Samuel Akyirem; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Fares Alahdab; Samer O. Alalalmeh; Tariq A. Alalwan; Ziyad Al-Aly; Khurshid Alam; Manjurul Alam; Noore Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Sayer Al-Azzam; Almaza Albakri; Mohammed Albashtawy; Mohammad T. AlBataineh; Jacqueline Elizabeth Alcalde-Rabanal; Khalifah A. Aldawsari; Wafa A. Aldhaleei; Robert W. Aldridge; Haileselasie Berhane Alema; Mulubirhan Assefa Alemayohu; Sharifullah Alemi; Yihun Mulugeta Alemu; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Khaled Al-Hanawi; Abid Ali; Amjad Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Shahid Ali; Syed Shujait Shujait Ali; Gianfranco Alicandro; Sheikh Mohammad Alif; Reyhaneh Alikhani; Yousef Alimohamadi; Ahmednur Adem Aliyi; Mohammad A. M. Aljasir; Syed Mohamed Aljunid; Francois Alla; Peter Allebeck; Sabah Al-Marwani; Sadeq Ali Ali Al-Maweri; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Louay Almidani; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jordi Alonso; Jaber S. Alqahtani; Shehabaldin Alqalyoobi; Ahmed Yaseen Alqutaibi; Salman Khalifah Al-Sabah; Zaid Altaany; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Reza Amani; Azmeraw T. Amare; Prince M. Amegbor; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Sohrab Amiri; Mohammad Hosein Amirzade-Iranaq; Hubert Amu; Dickson A. Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; David B. Anderson; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Colin Angus; Abhishek Anil; Sneha Anil; Amir Anoushiravani; Hossein Ansari; Ansariadi Ansariadi; Alireza Ansari-Moghaddam; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Saeid Anvari; Saleha Anwar; Sumadi Lukman Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Muhammad Aqeel; Juan Pablo Arab; Jalal Arabloo; Mosab Arafat; Aleksandr Y. Aravkin; Demelash Areda; Abdulfatai Aremu; Olatunde Aremu; Hany Ariffin; Mesay Arkew; Benedetta Armocida; Michael Benjamin Arndt; Johan Arnlov; Mahwish Arooj; Anton A. Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Ashokan Arumugam; Malke Asaad; Mohsen Asadi-Lari; Akeza Awealom Asgedom; Mona Asghariahmadabad; Mohammad Asghari-Jafarabadi; Muhammad Ashraf; Armin Aslani; Thomas Astell-Burt; Mohammad Athar; Seyyed Shamsadin Athari; Bantalem Tilaye Tilaye Atinafu; Habtamu Wondmagegn Atlaw; Prince Atorkey; Maha Moh'D Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Atalel Fentahun Awedew; Amlaku Mulat Aweke; Beatriz Paulina Ayala Quintanilla; Haleh Ayatollahi; Jose L. Ayuso-Mateos; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Rui M. S. Azevedo; Ahmed Y. Azzam; B.B. Darshan; Abraham Samuel Babu; Muhammad Badar; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Sulaiman Bah; Saeed Bahadorikhalili; Najmeh Bahmanziari; Ruhai Bai; Atif Amin Baig; Jennifer L. Baker; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Senthilkumar Balakrishnan; Madhan Balasubramanian; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Palash Chandra Banik; Hansi Bansal; Kannu Bansal; Franca Barbic; Martina Barchitta; Mainak Bardhan; Erfan Bardideh; Suzanne Lyn Barker-Collo; Till Winfried Barnighausen; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Lope H. Barrero; Amadou Barrow; Sandra Barteit; Lingkan Barua; Zarrin Basharat; Azadeh Bashiri; Afisu Basiru; Pritish Baskaran; Buddha Basnyat; Quique Bassat; João Diogo Basso; Ann V. L. Basting; Sanjay Basu; Kavita Batra; Bernhard T. Baune; Mohsen Bayati; Nebiyou Simegnew Bayileyegn; Thomas Beaney; Neeraj Bedi; Massimiliano Beghi; Emad Behboudi; Priyamadhaba Behera; Amir Hossein Behnoush; Masoud Behzadifar; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Yannick Béjot; Sefealem Assefa Belay; Chalie Mulu Belete; Michelle L. Bell; Muhammad Bashir Bello; Olorunjuwon Omolaja Bello; Luis Belo; Apostolos Beloukas; Rose Grace Bender; Isabela M. Bensenor; Azizullah Beran; Zombor Berezvai; Alemshet Yirga Berhie; Betyna N. Berice; Robert S. Bernstein; Gregory J. Bertolacci; Paulo J. G. Bettencourt; Kebede A. Beyene; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Dinesh Bhandari; Kayleigh Bhangdia; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Ashish Bhargava; Sonu Bhaskar; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Manpreet S. Bhatti; Rajbir Bhatti; Zulfiqar A. Bhutta; Boris Bikbov; Jessica Devin Bishai; Catherine Bisignano; Francesca Bisulli; Atanu Biswas; Bijit Biswas; Saeid Bitaraf; Bikes Destaw Bitew; Veera R. Bitra; Tone Bjørge; Micheal Kofi Boachie; Mary Sefa Boampong; Anca Vasilica Bobirca; Virginia Bodolica; Aadam Olalekan Bodunrin; Eyob Ketema Bogale; Kassawmar Angaw Bogale; Somayeh Bohlouli; Obasanjo Afolabi Bolarinwa; Archith Boloor; Milad Bonakdar Hashemi; Aime Bonny; Kaustubh Bora; Berrak Bora Basara; Hamed Borhany; Arturo Borzutzky; Souad Bouaoud; Antoine Boustany; Christopher Boxe; Edward J. Boyko; Oliver J. Brady; Dejana Braithwaite; Luisa C. Brant; Michael Brauer; Alexandra Brazinova; Javier Brazo-Sayavera; Nicholas J. K. Breitborde; Susanne Breitner; Hermann Brenner; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Gabrielle Britton; Julie Brown; Traolach Brugha; Norma B. Bulamu; Lemma N. Bulto; Danilo Buonsenso; Richard A. Burns; Reinhard Busse; Yasser Bustanji; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Daniela Calina; Luis Alberto Camera; Luciana Aparecida Campos; Ismael R. Campos-Nonato; Chao Cao; Yin Cao; Angelo Capodici; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Juan J. Carrero; Andrea Carugno; Cristina G. Carvalheiro; Felix Carvalho; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Ferrán Catalá-López; Alberico L. Catapano; Maria Sofia Cattaruzza; Christopher R. Cederroth; Luca Cegolon; Francieli Cembranel; Muthia Cenderadewi; Kelly M. Cercy; Ester Cerin; Muge Cevik; Joshua Chadwick; Yaacoub Chahine; Chiranjib Chakraborty; Promit Ananyo Chakraborty; Jeffrey Shi Kai Chan; Raymond N. C. Chan; Rama Mohan Chandika; Eeshwar K. Chandrasekar; Chin-Kuo Chang; Jung-Chen Chang; Gashaw Sisay Chanie; Periklis Charalampous; Vijay Kumar Chattu; Pankaj Chaturvedi; Victoria Chatzimavridou-Grigoriadou; Akhilanand Chaurasia; Angela W. Chen; An-Tian Chen; Catherine S. Chen; Haowei Chen; Meng Xuan Chen; Simiao Chen; Ching-Yu Cheng; Esther T. W. Cheng; Nicolas Cherbuin; Wondimye Ashenafi Cheru; Ju-Huei Chien; Odgerel Chimed-Ochir; Ritesh Chimoriya; Patrick R. Ching; Jesus Lorenzo Chirinos-Caceres; Abdulaal Chitheer; William C. S. Cho; Bryan Chong; Hitesh Chopra; Sonali Gajanan Choudhari; Rajiv Chowdhury; Devasahayam J. Christopher; Isaac Sunday Chukwu; Eric Chung; Erin Chung; Eunice Chung; Sheng-Chia Chung; Muhammad Chutiyami; Zinhle Cindi; Iolanda Cioffi; Mareli M. Claassens; Rafael M. Claro; Kaleb Coberly; Rebecca M. Cogen; Alyssa Columbus; Haley Comfort; Joao Conde; Samuele Cortese; Paolo Angelo Cortesi; Vera Marisa Costa; Simona Costanzo; Ewerton Cousin; Rosa A. S. Couto; Richard G. Cowden; Kenneth Michael Cramer; Michael H. Criqui; Natalia Cruz-Martins; Silvia Magali Cuadra-Hernandez; Garland T. Culbreth; Patricia Cullen; Matthew Cunningham; Maria Paula Curado; Sriharsha Dadana; Omid Dadras; Siyu Dai; Xiaochen Dai; Zhaoli Dai; Lachlan L. Dalli; Giovanni Damiani; Jiregna Darega Gela; Jai K. Das; Saswati Das; Subasish Das; Ana Maria Dascalu; Nihar Ranjan Dash; Mohsen Dashti; Anna Dastiridou; Gail Davey; Claudio Alberto Davila-Cervantes; Nicole Davis Weaver; Kairat Davletov; Diego De Leo; Katie De Luca; Aklilu Tamire Debele; Shayom Debopadhaya; Louisa Degenhardt; Azizallah Dehghan; Lee Deitesfeld; Cristian Del Bo; Ivan Delgado-Enciso; Berecha Hundessa Demessa; Andreas K. Demetriades; Ke Deng; Xinlei Deng; Edgar Denova-Gutierrez; Niloofar Deravi; Nebiyu Dereje; Nikolaos Dervenis; Emina Dervišević; Don C. Des Jarlais; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Syed Masudur Rahman Dewan; Arkadeep Dhali; Kuldeep Dhama; Meghnath Dhimal; Sameer Dhingra; Vishal R. Dhulipala; Diana Dias Da Silva; Daniel Diaz; Michael J. Diaz; Adriana Dima; Delaney D. Ding; Huanghe Ding; Ricardo Jorge Dinis-Oliveira; M. Ashworth Dirac; Shirin Djalalinia; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Saeid Doaei; Masoud Dodangeh; Milad Dodangeh; Sushil Dohare; Klara Georgieva Dokova; Christiane Dolecek; Regina-Mae Villanueva Dominguez; Wanyue Dong; Deepa Dongarwar; Mario D'Oria; Fariba Dorostkar; E. Ray Dorsey; Wendel Mombaque Dos Santos; Rajkumar Doshi; Leila Doshmangir; Robert Kokou Dowou; Tim Robert Driscoll; Haneil Larson Dsouza; Viola Dsouza; Mi Du; John Dube; Bruce B. Duncan; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Laura Dwyer-Lindgren; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Abdel Rahman E'Mar; Ejemai Eboreime; Alireza Ebrahimi; Chidiebere Peter Echieh; Hisham Atan Edinur; David Edvardsson; Kristina Edvardsson; Defi Efendi; Ferry Efendi; Diyan Ermawan Effendi; Terje Andreas Eikemo; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Iffat Elbarazi; Teshome Bekele Elema; Noha Mousaad Elemam; Frank J. Elgar; Islam Y. Elgendy; Ghada Metwally Tawfik ElGohary; Hala Rashad Elhabashy; Muhammed Elhadi; Waseem El-Huneidi; Legesse Tesfaye Elilo; Omar Abdelsadek Abdou Elmeligy; Mohamed A. Elmonem; Mohammed Elshaer; Ibrahim Elsohaby; Theophilus I. Emeto; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Christopher Imokhuede Esezobor; Babak Eshrati; Sharareh Eskandarieh; Juan Espinosa-Montero; Habtamu Esubalew; Farshid Etaee; Natalia Fabin; Adewale Oluwaseun Fadaka; Adeniyi Francis Fagbamigbe; Ayesha Fahim; Saman Fahimi; Aliasghar Fakhri-Demeshghieh; Luca Falzone; Mohammad Fareed; Carla Sofia E Sa Farinha; Moezalislam Ezzat Mahmoud Faris; Pawan Sirwan Faris; Andre Faro; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Hamed Fattahi; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Alireza Feizkhah; Ginenus Fekadu; Xiaoru Feng; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Daniela Ferrante; Alize J. Ferrari; Nuno Ferreira; Getahun Fetensa; Bikila Regassa Feyisa; Irina Filip; Florian Fischer; Joanne Flavel; David Flood; Bobirca Teodor Florin; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Behzad Foroutan; Masoud Foroutan; Ingeborg Forthun; Daniela Fortuna; Matteo Foschi; Kayode Raphael Fowobaje; Kate Louise Francis; Richard Charles Franklin; Alberto Freitas; Joseph Friedman; Sara D. Friedman; Takeshi Fukumoto; John E. Fuller; Blima Fux; Peter Andras Gaal; Muktar A. Gadanya; Abhay Motiramji Gaidhane; Santosh Gaihre; Emmanuela Gakidou; Yaseen Galali; Natalie C. Galles; Silvano Gallus; Mandukhai Ganbat; Aravind P. Gandhi; Balasankar Ganesan; Mohammad Arfat Ganiyani; Ma Garcia-Gordillo; William M. Gardner; Jalaj Garg; Naval Garg; Rupesh K. Gautam; Semiu Olatunde Gbadamosi; Tilaye Gebru Gebi; Miglas W. Gebregergis; Mesfin Gebrehiwot; Teferi Gebru Gebremeskel; Simona Roxana Georgescu; Tamirat Getachew; Peter W. Gething; Molla Getie; Keyghobad Ghadiri; Sulmaz Ghahramani; Khalid Yaser Ghailan; Mohammad-Reza Ghasemi; Ghazal Ghasempour Dabaghi; Afsaneh Ghasemzadeh; Ahmad Ghashghaee; Fariba Ghassemi; Ramy Mohamed Ghazy; Ajnish Ghimire; Sama Ghoba; Maryam Gholamalizadeh; Asadollah Gholamian; Ali Gholamrezanezhad; Nasim Gholizadeh; Mahsa Ghorbani; Pooyan Ghorbani Vajargah; Aloke Gopal Ghoshal; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Themba G. Ginindza; Alem Girmay; James C. Glasbey; Elena V. Gnedovskaya; Laszlo Gobolos; Myron Anthony Godinho; Amit Goel; Ali Golchin; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Nelson G. M. Gomes; Philimon N. Gona; Sameer Vali Gopalani; Giuseppe Gorini; Houman Goudarzi; Alessandra C. Goulart; Barbara Niegia Garcia Goulart; Anmol Goyal; Ayman Grada; Simon Matthew Graham; Michal Grivna; Giuseppe Grosso; Shi-Yang Guan; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Avirup Guha; Stefano Guicciardi; Rafael Alves Guimaraes; Snigdha Gulati; Damitha Asanga Gunawardane; Sasidhar Gunturu; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Manoj Kumar Gupta; Mohak Gupta; Rajat Das Gupta; Rajeev Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Lami Gurmessa; Reyna Alma Gutierrez; Farrokh Habibzadeh; Parham Habibzadeh; Rasool Haddadi; Mostafa Hadei; Najah R. Hadi; Nils Haep; Nima Hafezi-Nejad; Demewoz Haile; Alemayehu Hailu; Arvin Haj-Mirzaian; Esam S. Halboub; Brian J. Hall; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Sajid Hameed; Samer Hamidi; Erin B. Hamilton; Chieh Han; Qiuxia Han; Asif Hanif; Nasrin Hanifi; Graeme J. 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Hussein; Foziya Mohammed Hussien; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Khalid S. Ibrahim; Pulwasha Maria Iftikhar; Desta Ijo; Adalia I. Ikiroma; Kevin S. Ikuta; Paul Chukwudi Ikwegbue; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mohammad Tarique Imam; Mustapha Immurana; Sumant Inamdar; Endang Indriasih; Muhammad Iqhrammullah; Arnaud Iradukunda; Kenneth Chukwuemeka Iregbu; Md Rabiul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Faisal Ismail; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Masao Iwagami; Chidozie C. D. Iwu; Ihoghosa Osamuyi Iyamu; Mahalaxmi Iyer; J. Linda Merin; Jalil Jaafari; Louis Jacob; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Morteza Jafarinia; Abdollah Jafarzadeh; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Nityanand Jain; Ammar Abdulrahman Jairoun; Abhishek Jaiswal; Elham Jamshidi; Mark M. Janko; Abubakar Ibrahim Jatau; Sabzali Javadov; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Rime Jebai; Sun Ha Jee; Jayakumar Jeganathan; Anil K. Jha; Ravi Prakash Jha; Heng Jiang; Yingzhao Jin; Olatunji Johnson; Mohammad Jokar; Jost B. Jonas; Tamas Joo; Abel Joseph; Nitin Joseph; Charity Ehimwenma Joshua; Grace Joshy; Jacek Jerzy Jozwiak; Mikk Jurisson; K. Vaishali; Billingsley Kaambwa; Ali Kabir; Zubair Kabir; Vidya Kadashetti; Dler Hussein Kadir; Rizwan Kalani; Laleh R. Kalankesh; Leila R. Kalankesh; Feroze Kaliyadan; Sanjay Kalra; Vineet Kumar Kamal; Sivesh Kathir Kamarajah; Rajesh Kamath; Zahra Kamiab; Naser Kamyari; Thanigaivelan Kanagasabai; Tanuj Kanchan; Himal Kandel; Arun R. Kanmanthareddy; Edmund Wedam Kanmiki; Kehinde Kazeem Kanmodi; S. Suthanthira Kannan; Sushil Kumar Kansal; Rami S. Kantar; Neeti Kapoor; Mehrdad Karajizadeh; Shama D. Karanth; Reema A. Karasneh; Ibraheem M. Karaye; Andre Karch; Asima Karim; Salah Eddin Karimi; Arman Karimi Behnagh; Faizan Zaffar Kashoo; Qalandar Hussein Abdulkarim Kasnazani; Hengameh Kasraei; Nicholas J. Kassebaum; Molly B. Kassel; Joonas H. Kauppila; Navjot Kaur; Norito Kawakami; Gbenga A. Kayode; Foad Kazemi; Sina Kazemian; Tahseen Haider Kazmi; Getu Mosisa Kebebew; Adera Debella Kebede; Fassikaw Kebede; Tibebeselassie S. Keflie; Peter Njenga Keiyoro; Cathleen Keller; Jaimon Terence Kelly; John H. Kempen; Jessica A. Kerr; Emmanuelle Kesse-Guyot; Himanshu Khajuria; Amirmohammad Khalaji; Nauman Khalid; Anees Ahmed Khalil; Alireza Khalilian; Faham Khamesipour; Ajmal Khan; Asaduzzaman Khan; Gulfaraz Khan; Ikramullah Khan; Imteyaz A. Khan; M. Nuruzzaman Khan; Mohammad Jobair Khan; Moien Ab Khan; Zeeshan Ali Khan; Mahammed Ziauddin Khan Suheb; Shaghayegh Khanmohammadi
Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Natalia V. Bhattacharjee; Austin E. Schumacher; Amirali Aali; Yohannes Habtegiorgis Abate; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Sherief Abd-Elsalam; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Olumide Abiodun; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Michael R.M. Abrigo; Dariush Abtahi; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen M.E. Abu-Rmeileh; Tadele Girum Girum Adal; Mesafint Molla Adane; Oluwafemi Atanda Adeagbo Adeagbo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Bashir Aden; Abiola Victor Adepoju; Olatunji O. Adetokunboh; Juliana Bunmi Adetunji; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Rotimi Felix Afolabi; Shadi Afyouni; Muhammad Sohail Afzal; Saira Afzal; Shahin Aghamiri; Antonella Agodi; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Austin J. Ahlstrom; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Sajjad Ahmad; Tauseef Ahmad; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Meqdad Saleh Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Gizachew Taddesse Akalu; Hossein Akbarialiabad; Rufus Olusola Akinyemi; Mohammed Ahmed Akkaif; Sreelatha Akkala; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Mohammad Al Qadire; Tareq Mohammed Ali AL-Ahdal; Samer O. Alalalmeh; Tariq A. Alalwan; Ziyad Al-Aly; Khurshid Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Almaza Albakri; Mohammed Albashtawy; Mohammad T. AlBataineh; Hediyeh Alemi; Sharifullah Alemi; Yihun Mulugeta Alemu; Ayman Al-Eyadhy; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Noora Alhajri; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Abid Ali; Beriwan Abdulqadir Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Sheikh Mohammad Alif; Mohammad Aligol; Mehran Alijanzadeh; Mohammad A.M. Aljasir; Syed Mohamed Aljunid; Sabah Al-Marwani; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jaber S. Alqahtani; Ahmed Yaseen Alqutaibi; Rajaa M. Al-Raddadi; Salman Khalifah Al-Sabah; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Farrukh Jawad Alvi; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Mostafa Amini-Rarani; Sohrab Amiri; Irene Gyamfuah Ampomah; Dickson A. 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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. 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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. 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Background: Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods: To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings: During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation: Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global 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
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
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.
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; 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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
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
Hearing loss prevalence and years lived with disability, 1990-2019: Findings from the Global Burden of Disease Study 2019
(Elsevier B.V., 2021) Lydia M. Haile; Kaloyan Kamenov; Paul Svitil Briant; Aislyn U. Orji; Jaimie D. Steinmetz; Amir Abdoli; Mohammad Abdollahi; Eman Abu-Gharbieh; Ashkan Afshin; Haroon Ahmed; Tarik Ahmed Rashid; Yonas Akalu; Fares Alahdab; Fahad Mashhour Alanezi; Turki M. Alanzi; Hanadi Al Hamad; Liaqat Ali; Vahid Alipour; Rajaa M. Al-Raddadi; Hubert Amu; Jalal Arabloo; Morteza Arab-Zozani; Judie Arulappan; Charlie Ashbaugh; Desta Debalkie Atnafu; Zaheer-Ud-Din Babar; Atif Amin Baig; Palash Chandra Banik; Till Winfried Bärnighausen; Amadou Barrow; Rose G. Bender; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Sadia Bibi; Ali Bijani; Katrin Burkart; Christopher R. Cederroth; Jaykaran Charan; Sonali Gajanan Choudhari; Dinh-Toi Chu; Rosa A.S. Couto; Amare Belachew Dagnew; Baye Dagnew; Saad M.A. Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Assefa Desalew; Deepak Dhamnetiya; Mandira Lamichhane Dhimal; Meghnath Dhimal; Kerrie E. Doyle; Bruce B. Duncan; Michael Ekholuenetale; Irina Filip; Florian Fischer; Richard Charles Franklin; Abhay Motiramji Gaidhane; Shilpa Gaidhane; Silvano Gallus; Farhad Ghamari; Ahmad Ghashghaee; Ghozali Ghozali; Syed Amir Gilani; Ionela-Roxana Glǎvan; Mahaveer Golechha; Barbara Niegia Garcia Goulart; Veer Bala Gupta; Vivek Kumar Gupta; Samer Hamidi; Billy Randall Hammond; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Howard J. Hoffman; Kathleen Pillsbury Hopf; Mehdi Hosseinzadeh; Mowafa Househ; Rabia Hussain; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Masao Iwagami; Louis Jacob; Sathish Kumar Jayapal; Ravi Prakash Jha; Jost B. Jonas; Rohollah Kalhor; Nawzad Kameran Al-Salihi; Himal Kandel; Ayele Semachew Kasa; Gbenga A. Kayode; Rovshan Khalilov; Ejaz Ahmad Khan; Mahalaqua Nazli Khatib; Soewarta Kosen; Ai Koyanagi; G. Anil Kumar; Ivan Landires; Savita Lasrado; Stephen S. Lim; Xuefeng Liu; Stany W. Lobo; Alessandra Lugo; Alaa Makki; Walter Mendoza; Amanual Getnet Mersha; Kebadnew Mulatu Mihretie; Ted R. Miller; Sanjeev Misra; Teroj Abdulrahman Mohamed; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Arif Mohammed; Ali H. Mokdad; Mohammad Ali Moni; Sandhya Neupane Kandel; Huong Lan Thi Nguyen; Molly R. Nixon; Jean Jacques Noubiap; Virginia Nuñez-Samudio; Bogdan Oancea; Victor Maduabuchi Oguoma; Andrew T. Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Hans Orru; Mayowa O. Owolabi; Jagadish Rao Padubidri; Keyvan Pakshir; Shahina Pardhan; Fatemeh Pashazadeh Kan; Maja Pasovic; Shrikant Pawar; Hai Quang Pham; Marina Pinheiro; Akram Pourshams; Navid Rabiee; Mohammad Rabiee; Amir Radfar; Fakher Rahim; Vafa Rahimi-Movaghar; Mohammad Hifz Ur Rahman; Mosiur Rahman; Amir Masoud Rahmani; Juwel Rana; Chythra R. Rao; Sowmya J. Rao; Vahid Rashedi; David Laith Rawaf; Salman Rawaf; Andre M.N. Renzaho; Aziz Rezapour; Rezaul Karim Ripon; Voilet Rodrigues; Neeti Rustagi; Umar Saeed; Amirhossein Sahebkar; Abdallah M. Samy; Milena M. Santric-Milicevic; Brijesh Sathian; Maheswar Satpathy; Monika Sawhney; Winfried Schlee; Maria Ines Schmidt; Allen Seylani; Masood Ali Shaikh; Mohammed Shannawaz; Wondimeneh Shibabaw Shiferaw; Soraya Siabani; Anjali Singal; Jasvinder A. Singh; Jitendra Kumar Singh; Deepika Singhal; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Houman Sotoudeh; Emma Elizabeth Spurlock; Biruk Wogayehu Taddele; Animut Tagele Tamiru; Md Ismail Tareque; Rekha Thapar; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Saif Ullah; Sahel Valadan Tahbaz; Francesco S. Violante; Vasily Vlassov; Bay Vo; Avina Vongpradith; Giang Thu Vu; Jingkai Wei; Ali Yadollahpour; Seyed Hossein Yahyazadeh Jabbari; Yigizie Yeshaw; Vahit Yiǧit; Birhanu Wubale Yirdaw; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mohammad Zamani; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Jeff T. Zhao; Christopher J.L. Murray; Adrian C. Davis; Theo Vos; Shelly Chadha
Background: Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods: We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings: An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation: As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings. Funding: Bill & Melinda Gates Foundation and WHO. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license