Browsing by Author "Vivek Kumar Gupta"

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Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Amy E. Peden; Patricia Cullen; Kate Louise Francis; Holger Moeller; Margaret M. Peden; Pengpeng Ye; Maoyi Tian; Zhiyong Zou; Susan M. Sawyer; Amirali Aali; Zeinab Abbasi-Kangevari; Mohsen Abbasi-Kangevari; Michael Abdelmasseh; Meriem Abdoun; Rami Abd-Rabu; Deldar Morad Abdulah; Ame Mehadi Abdurehman; Getachew Abebe; Ayele Mamo Abebe; Aidin Abedi; Hassan Abidi; Richard Gyan Aboagye; Hiwa Abubaker Ali; Eman Abu Gharbieh; Denberu Eshetie Adane; Tigist Demssew Adane; Isaac Yeboah Addo; Ololade Grace Adewole; Sangeet Adhikari; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Aanuoluwapo Adeyimika Bachelor Afolabi; Saira Afzal; Muhammad Sohail Afzal; Zahra Babaei Aghdam; Bright Opoku Ahinkorah; Araz Ramazan Ahmad; Tauseef Ahmad; Sajjad Ahmad; Ali Ahmadi; Haroon Ahmed; Muktar Beshir Ahmed; Ali Ahmed; Ayman Ahmed; Jivan Qasim Ahmed; Tarik Ahmed Rashid; Janardhana P. Aithala; Budi Aji; Meisam Akhlaghdoust; Fares Alahdab; Fahad Mashhour Alanezi; Astawus Alemayehu; Hanadi Al Hamad; Syed Shujait Ali; Liaqat Ali; Yousef Alimohamadi; Vahid Alipour; Syed Mohamed Aljunid; Louay Almidani; Sami Almustanyir; Khalid A. Altirkawi; Nelson J. Alvis-Zakzuk; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Mehrdad Amir-Behghadami; Sohrab Amiri; Hoda Amiri; Tadele Fentabil Anagaw; Tudorel Andrei; Catalina Liliana Andrei; Davood Anvari; Sumadi Lukman Anwar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Morteza Arab-Zozani; Asrat Arja; Judie Arulappan; Ashokan Arumugam; Armin Aryannejad; Saeed Asgary; Tahira Ashraf; Seyyed Shamsadin Athari; Alok Atreya; Sameh Attia; Avinash Aujayeb; Atalel Fentahun Awedew; Sina Azadnajafabad; Mohammadreza Azangou-Khyavy; Samad Azari; Amirhossein Azari Jafari; Hosein Azizi; Ahmed Y. Azzam; Ashish D. Badiye; Nayereh Baghcheghi; Sara Bagherieh; Atif Amin Baig; Shankar M. Bakkannavar; Asaminew Birhanu Balta; MacIej Banach; Palash Chandra Banik; Hansi Bansal; Mainak Bardhan; Francesco BaroneAdesi; Amadou Barrow; Azadeh Bashiri; Pritish Baskaran; Saurav Basu; Nebiyou Simegnew Bayileyegn; Abebe Ayalew Bekel; Alehegn Bekele Bekele; Salaheddine Bendak; Isabela M. Bensenor; Alemshet Yirga Berhie; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Nikha Bhardwaj; Sonu Bhaskar; Ajay Nagesh Bhat; Krittika Bhattacharyya; Zulfiqar A. Bhutta; Sadia Bibi; Bagas Suryo Bintoro; Saeid Bitaraf; Belay Boda Abule Bodicha; Archith Boloor; Souad Bouaoud; Julie Brown; Katrin Burkart; Nadeem Shafique Butt; Muhammad Hammad Butt; Luis Alberto CÃ¡mera; Julio Cesar Campuzano Rincon; Chao Cao; Andre F. Carvalho; MÃ¡rcia Carvalho; Promit Ananyo Chakraborty; Eeshwar K. Chandrasekar; Jung-Chen Chang; Periklis Charalampous; Jaykaran Charan; Vijay Kumar Chattu; Bitew Mekonnen Chekole; Abdulaal Chitheer; Daniel Youngwhan Cho; Hitesh Chopra; Devasahayam J. Christopher; Isaac Sunday Chukwu; NatÃ¡lia Cruz-Martins; Omid Dadras; Saad M.A. Dahlawi; Xiaochen Dai; Giovanni Damiani; Gary L. Darmstadt; Reza Darvishi Cheshmeh Soltani; Aso Mohammad Darwesh; Saswati Das; Anna Dastiridou; Sisay Abebe Debela; Amin Dehghan; Getnet Makasha Demeke; Andreas K. Demetriades; Solomon Demissie; Fikadu Nugusu Dessalegn; Abebaw Alemayehu Desta; Mostafa Dianatinasab; Nancy Diao; Diana Dias Da Silva; Daniel Diaz; Lankamo Ena Digesa; Mengistie Diress; Shirin Djalalinia; Linh Phuong Doan; Milad Dodangeh; Paul Narh Doku; Deepa Dongarwar; Haneil Larson Dsouza; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Ahmed Elabbas Mustafa Elagali; Mostafa Ahmed Elbahnasawy; Hala Rashad Elhabashy; Muhammed Elhadi; Maysaa El Sayed Zaki; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Sharareh Eskandarieh; Farshid Etaee; Adeniyi Francis Fagbamigbe; Pawan Sirwan Faris; Abbas Farmany; Andre Faro; Farshad Farzadfar; Ali Fatehizadeh; Seyed Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Getahun Fetensa; Bikila Regassa Feyisa; Irina Filip; Florian Fischer; Behzad Foroutan; Masoud Foroutan; Kayode Raphael Fowobaje; Richard Charles Franklin; Takeshi Fukumoto; Peter Andras Gaal; Muktar A. Gadanya; Yaseen Galali; Nasrin Galehdar; Balasankar Ganesan; Tushar Garg; Mesfin Gebrehiwot Damtew Gebrehiwot; Yosef Haile Gebremariam; Yibeltal Yismaw Gela; Urge Gerema; Mansour Ghafourifard; Seyyed-Hadi Ghamari; Reza Ghanbari; Mohammad Ghasemi Nour; Maryam Gholamalizadeh; Ali Gholami; Ali Gholamrezanezhad; Sherief Ghozy; Syed Amir Gilani; Tiffany K. Gill; Iago GinÃ©-VÃ¡zquez; Zeleke Abate Girma; James C. Glasbey; Franklin N. Glozah; Mahaveer Golechha; Pouya Goleij; Michal Grivna; Habtamu Alganeh Guadie; Damitha Asanga Gunawardane; Yuming Guo; Veer Bala Gupta; Sapna Gupta; Bhawna Gupta; Vivek Kumar Gupta; Arvin Haj-Mirzaian; Rabih Halwani; Randah R. Hamadeh; Sajid Hameed; Lolemo Kelbiso Hanfore; Asif Hanif; Arief Hargono; Netanja I. Harlianto; Mehdi Harorani; Ahmed I. Hasaballah; S.M. Mahmudul Hasan; Amr Hassan; Soheil Hassanipour; Hadi Hassankhani; Rasmus J. Havmoeller; Simon I. Hay; Mohammad Heidari; Delia Hendrie; Demisu Zenbaba Heyi; Yuta Hiraike; Ramesh Holla; Nobuyuki Horita; Sheikh Jamal Hossain; Mohammad Bellal Hossain Hossain; Sedighe Hosseini Shabanan; Mehdi Hosseinzadeh; Sorin Hostiuc; Amir Human Hoveidaei; Alexander Kevin Hsiao; Salman Hussain; Amal Hussein; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Behzad Imani; Mustapha Immurana; Leeberk Raja Inbaraj; Sheikh Mohammed Shariful Islam; Rakibul M. Islam; Mohammad Mainul Islam; Nahlah Elkudssiah Ismail; J. Linda Merin; Haitham Jahrami; Mihajlo Jakovljevic; Manthan Dilipkumar Janodia; Tahereh Javaheri; Sathish Kumar Jayapal; Umesh Umesh Jayarajah; Sudha Jayaraman; Jayakumar Jeganathan; Bedru Jemal; Ravi Prakash Jha; Jost B. Jonas; Tamas Joo; Nitin Joseph; Jacek Jerzy Jozwiak; Mikk JÃ¼risson; Ali Kabir; Vidya Kadashetti; Dler Hussein Kadir; Laleh R. Kalankesh; Leila R. Kalankesh; Rohollah Kalhor; Vineet Kumar Kamal; Rajesh Kamath; Himal Kandel; Rami S. Kantar; Neeti Kapoor; Hassan Karami; Ibraheem M. Karaye; Samad Karkhah; Patrick D.M.C. Katoto; Joonas H. Kauppila; Gbenga A. Kayode; Leila Keikavoosi-Arani; Cumali Keskin; Yousef Saleh Khader; Himanshu Khajuria; Mohammad Khammarnia; Ejaz Ahmad Khan; Md Nuruzzaman Khan; Maseer Khan; Yusra H. Khan; Imteyaz A. Khan; Abbas Khan; Moien A.B. Khan; Javad Khanali; Moawiah Mohammad Khatatbeh; Hamid Reza Khayat Kashani; Habibolah Khazaie; Jagdish Khubchandani; Zemene Demelash Kifle; Jihee Kim; Yun Jin Kim; Sezer Kisa; Adnan Kisa; Cameron J. Kneib; Farzad Kompani; Hamid Reza Koohestani; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Vijay Krishnamoorthy; Burcu Kucuk Bicer; Nithin Kumar; Naveen Kumar; Narinder Kumar; Manasi Kumar; Om P. Kurmi; Lucie Laflamme; Judit LÃ¡m; IvÃ¡n Landires; Bagher Larijani; Savita Lasrado; Paolo Lauriola; Carlo La Vecchia; Shaun Wen Huey Lee; Yo Han Lee; Sang-Woong Lee; Wei Chen Lee; Samson Mideksa Legesse; Shanshan Li; Stephen S. Lim; LÃ¡szlÃ³ Lorenzovici; Amana Ogeto Luke; Farzan Madadizadeh; Áurea M. Madureira-Carvalho; Muhammed Magdy Abd El Razek; Soleiman Mahjoub; Ata Mahmoodpoor; Razzagh Mahmoudi; Marzieh Mahmoudimanesh; Azeem Majeed; Alaa Makki; Elaheh Malakan Rad; Mohammad-Reza Malekpour; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Borhan Mansouri; Mohammad Ali Mansournia; Elezebeth Mathews; Sazan Qadir Maulud; Dennis Mazingi; Entezar Mehrabi Nasab; Oliver Mendoza-Cano; Ritesh G. Menezes; Dechasa Adare Mengistu; Alexios-Fotios A. Mentis; Atte Meretoja; Mohamed Kamal Mesregah; Tomislav Mestrovic; Ana Carolina Micheletti Gomide Nogueira de Sá; Ted R. Miller; Seyed Peyman Mirghaderi; Andreea Mirica; Seyyedmohammadsadeq Mirmoeeni; Erkin M. Mirrakhimov; Moonis Mirza; Sanjeev Misra; Prasanna Mithra; Chaitanya Mittal; Madeline E. Moberg; Mokhtar Mohammadi; Soheil Mohammadi; Esmaeil Mohammadi; Reza Mohammadpourhodki; Shafiu Mohammed; Teroj Abdulrahman Mohammed; Mohammad Mohseni; Ali H. Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Mohammad Ali Moni; Rafael Silveira Moreira; Shane Douglas Morrison; Ebrahim Mostafavi; Haleh Mousavi Isfahani; Sumaira Mubarik; Lorenzo Muccioli; Soumyadeep Mukherjee; Francesk Mulita; Ghulam Mustafa; Ahamarshan Jayaraman Nagarajan; Mukhammad David Naimzada; Vinay Nangia; Hasan Nassereldine; Zuhair S. Natto; Biswa Prakash Nayak; Ionut Negoi; Seyed Aria Nejadghaderi; Samata Nepal; Sandhya Neupane Kandel; Nafise Noroozi; Virginia NuÃ±ez-Samudio; Ogochukwu Janet Nzoputam; Chimezie Igwegbe Nzoputam; Chimedsuren Ochir; Julius Nyerere Odhiambo; Oluwakemi Ololade Odukoya; Hassan Okati-Aliabad; Osaretin Christabel Okonji; Andrew T. Olagunju; Ahmed Omar Bali; Emad Omer; Adrian Otoiu; Stanislav S. Otstavnov; Nikita Otstavnov; Bilcha Oumer; Mayowa O. Owolabi; P.A. Mahesh; Alicia Padron-Monedero; Jagadish Rao Padubidri; Mohammad Taha Pahlevan Fallahy; Songhomitra Panda-Jonas; Seithikurippu R. Pandi-Perumal; Shahina Pardhan; Eun-Kee Park; Sangram Kishor Patel; Aslam Ramjan Pathan; Siddhartha Pati; Uttam Paudel; Shrikant Pawar; Paolo Pedersini; Mario F.P. Peres; Ionela-Roxana Petcu; Michael R. Phillips; Julian David Pillay; Zahra Zahid Piracha; Mohsen Poursadeqiyan; Naeimeh Pourtaheri; Ibrahim Qattea; Amir Radfar; Ata Rafiee; Pankaja Raghav Raghav; Fakher Rahim; Muhammad Aziz Rahman; Firman Suryadi Rahman; Mosiur Rahman; Amir Masoud Rahmani; Shayan Rahmani; Sheetal Raj Moolambally; Sheena Ramazanu; Kiana Ramezanzadeh; Juwel Rana; Saleem Muhammad Rana; Chythra R. Rao; Sowmya J. Rao; Vahid Rashedi; Mohammad Mahdi Rashidi; Prateek Rastogi; Azad Rasul; Salman Rawaf; David Laith Rawaf; Lal Rawal; Reza Rawassizadeh; Negar Rezaei; Nazila Rezaei; Mohsen Rezaeian; Aziz Rezapour; Abanoub Riad; Muhammad Riaz; Jennifer Rickard; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; Luca Ronfani; Bedanta Roy; S. Manjula; Aly M.A. Saad; Siamak Sabour; Leila Sabzmakan; Basema Saddik; Malihe Sadeghi; Mohammad Reza Saeb; Umar Saeed; Sahar Saeedi Moghaddam; Sher Zaman Safi; Biniyam Sahiledengle; Harihar Sahoo; Mohammad Ali Sahraian; Morteza Saki; Payman Salamati; Sana Salehi; Marwa Rashad Salem; Abdallah M. Samy; Juan Sanabria; Milena M. Santric-Milicevic; Muhammad Arif Nadeem Saqib; Yaser Sarikhani; Arash Sarveazad; Brijesh Sathian; Maheswar Satpathy; Ganesh Kumar Saya; Ione Jayce Ceola Schneider; David C. Schwebel; Hamed Seddighi; Subramanian Senthilkumaran; Allen Seylani; Hosein Shabaninejad; Melika Shafeghat; Pritik A. Shah; Saeed Shahabi; Ataollah Shahbandi; Fariba Shahraki-Sanavi; Masood Ali Shaikh; Elaheh Shaker; Mehran Shams-Beyranvand; Mohd Shanawaz; Mohammed Shannawaz; Mequannent Melaku Sharew Sharew; Neeraj Sharma; Bereket Beyene Shashamo; Maryam Shayan; Rahim Ali Sheikhi; Jiabin Shen; B. Suresh Kumar Shetty; Pavanchand H. Shetty; Jae Il Shin; Nebiyu Aniley Shitaye; K.M. Shivakumar; Parnian Shobeiri; Seyed Afshin Shorofi; Sunil Shrestha; Soraya Siabani; Negussie Boti Sidemo; Wudneh Simegn; Ehsan Sinaei; Paramdeep Singh; Robert Sinto; Md Shahjahan Siraj; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; David A. Sleet; S.N. Chandan; Bogdan Socea; Marco Solmi; Yonatan Solomon; Yi Song; Raúl A.R.C. Sousa; Ireneous N. Soyiri; Mark A. Stokes; Muhammad Suleman; Rizwan Suliankatchi Abdulkader; Jing Sun; Rafael TabarÃ©s-Seisdedos; Seyyed Mohammad Tabatabaei; Mohammad Tabish; Ensiyeh Taheri; Moslem Taheri Soodejani; Mircea Tampa; KerKan Tan; Ingan Ukur Tarigan; Md Tariqujjaman; Nathan Y. Tat; Vivian Y. Tat; Arash Tavakoli; Belay Negash Tefera; Yibekal Manaye Tefera; Gebremaryam Temesgen; Mohamad-Hani Temsah; Pugazhenthan Thangaraju; Rekha Thapar; Nikhil Kenny Thomas; Jansje Henny Vera Ticoalu; Marius Belmondo Tincho; Amir Tiyuri; Munkhsaikhan Togtmol; Marcos Roberto Tovani-Palone; Mai Thi Ngoc Tran; Sana Ullah; Saif Ullah; Irfan Ullah; Srikanth Umakanthan; Bhaskaran Unnikrishnan; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R. Valdez; Tommi Juhani Vasankari; Siavash Vaziri; Massimiliano Veroux; Dominique Vervoort; Francesco S. Violante; Vasily Vlassov; Linh Gia Vu; Yasir Waheed; Yanzhong Wang; Yuan-Pang Wang; Cong Wang; Taweewat Wiangkham; Nuwan Darshana Wickramasinghe; Abay Tadesse Woday; Ai-Min Wu; Gahin Abdulraheem Tayib Yahya; Seyed Hossein Yahyazadeh Jabbari; Lin Yang; Sanni Yaya; Arzu Yigit; Vahit Yigit; Eshetu Yisihak; Naohiro Yonemoto; Yuyi You; Mustafa Z. Younis; Chuanhua Yu; Ismaeel Yunusa; Hossein Yusefi; Mazyar Zahir; Sojib Bin Zaman; Iman Zare; Kourosh Zarea; Mikhail Sergeevich Zastrozhin; Zhi-Jiang Zhang; Yunquan Zhang; Arash Ziapour; Sanjay Zodpey; Mohammad Zoladl; George C. Patton; Rebecca Q. Ivers
Background: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades. Methods: Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10–14, 15–19, and 20–24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. Findings: In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10–24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010–19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010–19. Interpretation: As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low–middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury. 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
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
Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019 A Systematic Analysis for the Global Burden of Disease Study 2019
(American Medical Association, 2022) Jonathan M. Kocarnik; Kelly Compton; Frances E. Dean; Weijia Fu; Brian L. Gaw; James D. Harvey; Hannah Jacqueline Henrikson; Dan Lu; Alyssa Pennini; Rixing Xu; Emad Ababneh; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Sherief M. Abd-Elsalam; Amir Abdoli; Aidin Abedi; Hassan Abidi; Hassan Abolhassani; Isaac Akinkunmi Adedeji; Qorinah Estiningtyas Sakilah Adnani; Shailesh M. Advani; Muhammad Sohail Afzal; Mohammad Aghaali; Bright Opoku Ahinkorah; Sajjad Ahmad; Tauseef Ahmad; Ali Ahmadi; Sepideh Ahmadi; Tarik Ahmed Rashid; Yusra Ahmed Salih; Gizachew Taddesse Akalu; Addis Aklilu; Tayyaba Akram; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Ziyad Al-Aly; Saqib Ali; Yousef Alimohamadi; Vahid Alipour; Syed Mohamed Aljunid; Motasem Alkhayyat; Amir Almasi-Hashiani; Nihad A. Almasri; Sadeq Ali Ali Al-Maweri; Sami Almustanyir; Nivaldo Alonso; Nelson Alvis-Guzman; Hubert Amu; Etsay Woldu Anbesu; Robert Ancuceanu; Fereshteh Ansari; Alireza Ansari-Moghaddam; Maxwell Hubert Antwi; Davood Anvari; Anayochukwu Edward Anyasodor; Muhammad Aqeel; Jalal Arabloo; Morteza Arab-Zozani; Olatunde Aremu; Hany Ariffin; Timur Aripov; Muhammad Arshad; Al Artaman; Judie Arulappan; Zatollah Asemi; Mohammad Asghari Jafarabadi; Tahira Ashraf; Prince Atorkey; Avinash Aujayeb; Marcel Ausloos; Atalel Fentahun Awedew; Beatriz Paulina Ayala Quintanilla; Temesgen Ayenew; Mohammed A. Azab; Sina Azadnajafabad; Amirhossein Azari Jafari; Ghasem Azarian; Ahmed Y. Azzam; Ashish D. Badiye; Saeed Bahadory; Atif Amin Baig; Jennifer L. Baker; Senthilkumar Balakrishnan; Maciej Banach; Till Winfried Bärnighausen; Francesco Barone-Adesi; Fabio Barra; Amadou Barrow; Masoud Behzadifar; Uzma Iqbal Belgaumi; Woldesellassie M. Mequanint Bezabhe; Yihienew Mequanint Bezabih; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Sadia Bibi; Ali Bijani; Antonio Biondi; Catherine Bisignano; Tone Bjorge; Archie Bleyer; Oleg Blyuss; Obasanjo Afolabi Bolarinwa; Srinivasa Rao Bolla; Dejana Braithwaite; Amanpreet Brar; Hermann Brenner; Maria Teresa Bustamante-Teixeira; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano dos Santos; Yin Cao; Giulia Carreras; Ferrán Catalá-López; Francieli Cembranel; Ester Cerin; Achille Cernigliaro; Raja Chandra Chakinala; Soosanna Kumary Chattu; Vijay Kumar Chattu; Pankaj Chaturvedi; Odgerel Chimed-Ochir; Daniel Youngwhan Cho; Devasahayam J. Christopher; Dinh-Toi Chu; Michael T. Chung; Joao Conde; Sanda Cortés; Paolo Angelo Cortesi; Vera Marisa Costa; Amanda Ramos Cunha; Omid Dadras; Amare Belachew Dagnew; Saad M.A. Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Aso Mohammad Darwesh; José das Neves; Fernando Pio De la Hoz; Asmamaw Bizuneh Demis; Edgar Denova-Gutiérrez; Deepak Dhamnetiya; Mandira Lamichhane Dhimal; Meghnath Dhimal; Mostafa Dianatinasab; Daniel Diaz; Shirin Djalalinia; Huyen Phuc Do; Saeid Doaei; Fariba Dorostkar; Francisco Winter dos Santos Figueiredo; Tim Robert Driscoll; Hedyeh Ebrahimi; Sahar Eftekharzadeh; Maha El Tantawi; Hassan El-Abid; Iffat Elbarazi; Hala Rashad Elhabashy; Muhammed Elhadi; Shaimaa I. El-Jaafary; Babak Eshrati; Sharareh Eskandarieh; Firooz Esmaeilzadeh; Arash Etemadi; Sayeh Ezzikouri; Mohammed Faisaluddin; Emerito Jose A. Faraon; Jawad Fares; Farshad Farzadfar; Abdullah Hamid Feroze; Simone Ferrero; Lorenzo Ferro Desideri; Irina Filip; Florian Fischer; James L. Fisher; Masoud Foroutan; Takeshi Fukumoto; Peter Andras Gaal; Mohamed M. Gad; Muktar A. Gadanya; Silvano Gallus; Mariana Gaspar Fonseca; Abera Getachew Obsa; Mansour Ghafourifard; Ahmad Ghashghaee; Nermin Ghith; Maryam Gholamalizadeh; Syed Amir Gilani; Themba G. Ginindza; Abraham Tamirat T. Gizaw; James C. Glasbey; Mahaveer Golechha; Pouya Goleij; Ricardo Santiago Gomez; Sameer Vali Gopalani; Giuseppe Gorini; Houman Goudarzi; Giuseppe Grosso; Mohammed Ibrahim Mohialdeen Gubari; Maximiliano Ribeiro Guerra; Avirup Guha; D. Sanjeeva Gunasekera; Bhawna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Reyna Alma Gutiérrez; Nima Hafezi-Nejad; Mohammad Rifat Haider; Arvin Haj-Mirzaian; Rabih Halwani; Randah R. Hamadeh; Sajid Hameed; Samer Hamidi; Asif Hanif; Shafiul Haque; Netanja I. Harlianto; Josep Maria Haro; Ahmed I. Hasaballah; Soheil Hassanipour; Roderick J. Hay; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Mohammad Heidari; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Kamal Hezam; Ramesh Holla; Md Mahbub Hossain; Mohammad Bellal Hossain Hossain; Mohammad-Salar Hosseini; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Mohamed Hsairi; Junjie Huang; Fernando N. Hugo; Rabia Hussain; Nawfal R. Hussein; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Fidelia Ida; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Lalu Muhammad Irham; Jessica Y. Islam; Rakibul M. Islam; Sheikh Mohammed Shariful Islam; Nahlah Elkudssiah Ismail; Gaetano Isola; Masao Iwagami; Louis Jacob; Vardhmaan Jain; Mihajlo B. Jakovljevic; Tahereh Javaheri; Shubha Jayaram; Seyed Behzad Jazayeri; Ravi Prakash Jha; Jost B. Jonas; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Mikk Jürisson; Ali Kabir; Danial Kahrizi; Leila R. Kalankesh; Rohollah Kalhor; Feroze Kaliyadan; Yogeshwar Kalkonde; Ashwin Kamath; Nawzad Kameran Al-Salihi; Himal Kandel; Neeti Kapoor; André Karch; Ayele Semachew Kasa; Srinivasa Vittal Katikireddi; Joonas H. Kauppila; Taras Kavetskyy; Sewnet Adem Kebede; Pedram Keshavarz; Mohammad Keykhaei; Yousef Saleh Khader; Rovshan Khalilov; Gulfaraz Khan; Maseer Khan; Md Nuruzzaman Khan; Moien A.B. Khan; Young-Ho Khang; Amir M. Khater; Maryam Khayamzadeh; Gyu Ri Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Katarzyna Kissimova-Skarbek; Jacek A. Kopec; Rajasekaran Koteeswaran; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Burcu Kucuk Bicer; Nuworza Kugbey; G. Anil Kumar; Narinder Kumar; Nithin Kumar; Om P. Kurmi; Tezer Kutluk; Carlo La Vecchia; Faris Hasan Lami; Iván Landires; Paolo Lauriola; Sang-Woong Lee; Shaun Wen Huey Lee; Wei-Chen Lee; Yo Han Lee; James Leigh; Elvynna Leong; Jiarui Li; Ming-Chieh Li; Xuefeng Liu; Joana A. Loureiro; Raimundas Lunevicius; Muhammed Magdy Abd El Razek; Azeem Majeed; Alaa Makki; Shilpa Male; Ahmad Azam Malik; Mohammad Ali Mansournia; Santi Martini; Seyedeh Zahra Masoumi; Prashant Mathur; Martin McKee; Ravi Mehrotra; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; Mohamed Kamal Mesregah; Tomislav Mestrovic; Junmei Miao Jonasson; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Ted R. Miller; Hamed Mirzaei; Hamid Reza Mirzaei; Sanjeev Misra; Prasanna Mithra; Masoud Moghadaszadeh; Karzan Abdulmuhsin Mohammad; Yousef Mohammad; Mokhtar Mohammadi; Seyyede Momeneh Mohammadi; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Nagabhishek Moka; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Mohammad Ali Moni; Mohammad Amin Moosavi; Yousef Moradi; Paula Moraga; Joana Morgado-Da-Costa; Shane Douglas Morrison; Abbas Mosapour; Sumaira Mubarik; Lillian Mwanri; Ahamarshan Jayaraman Nagarajan; Shankar Prasad Nagaraju; Chie Nagata; Mukhammad David Naimzada; Vinay Nangia; Atta Abbas Naqvi; Sreenivas Narasimha Swamy; Rawlance Ndejjo; Sabina O. Nduaguba; Ionut Negoi; Serban Mircea Negru; Sandhya Neupane Kandel; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Robina Khan Niazi; Chukwudi A. Nnaji; Nurulamin M. Noor; Virginia Nunez-Samudio; Chimezie Igwegbe Nzoputam; Bogdan Oancea; Chimedsuren Ochir; Oluwakemi Ololade Odukoya; Felix Akpojene Ogbo; Andrew T. Olagunju; Babayemi Oluwaseun Olakunde; Emad Omar; Ahmed Omar Bali; Abidemi E. Emmanuel Omonisi; Sokking Ong; Obinna E. Onwujekwe; Hans Orru; Doris V. Ortega-Altamirano; Nikita Otstavnov; Stanislav S. Otstavnov; Mayowa O. Owolabi; Mahesh P A; Jagadish Rao Padubidri; Keyvan Pakshir; Adrian Pana; Demosthenes Panagiotakos; Songhomitra Panda-Jonas; Shahina Pardhan; Eun-Cheol Park; Eun-Kee Park; Fatemeh Pashazadeh Kan; Harsh K. Patel; Jenil R. Patel; Siddhartha Pati; Sanjay M. Pattanshetty; Uttam Paudel; David M. Pereira; Renato B. Pereira; Arokiasamy Perianayagam; Julian David Pillay; Saeed Pirouzpanah; Farhad Pishgar; Indrashis Podder; Maarten J. Postma; Hadi Pourjafar; Akila Prashant; Liliana Preotescu; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Raghu Anekal Radhakrishnan; Venkatraman Radhakrishnan; Ata Rafiee; Fakher Rahim; Shadi Rahimzadeh; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Nazanin Rajai; Aashish Rajesh; Ivo Rakovac; Pradhum Ram; Kiana Ramezanzadeh; Kamal Ranabhat; Priyanga Ranasinghe; Chythra R. Rao; Sowmya J. Rao; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Andre M.N. Renzaho; Negar Rezaei; Nima Rezaei; Aziz Rezapour; Thomas J. Roberts; Jefferson Antonio Buendia Rodriguez; Peter Rohloff; Michele Romoli; Luca Ronfani; Gholamreza Roshandel; Godfrey M. Rwegerera; S. Manjula; Siamak Sabour; Basema Saddik; Umar Saeed; Amirhossein Sahebkar; Harihar Sahoo; Sana Salehi; Marwa Rashad Salem; Hamideh Salimzadeh; Mehrnoosh Samaei; Abdallah M. Samy; Juan Sanabria; Senthilkumar Sankararaman; Milena M. Santric-Milicevic; Yaeesh Sardiwalla; Arash Sarveazad; Brijesh Sathian; Monika Sawhney; Mete Saylan; Ione Jayce Ceola Schneider; Mario Sekerija; Allen Seylani; Omid Shafaat; Zahra Shaghaghi; Masood Ali Shaikh; Erfan Shamsoddin; Mohammed Shannawaz; Rajesh Sharma; Aziz Sheikh; Sara Sheikhbahaei; Adithi Shetty; Jeevan K. Shetty; Pavanchand H. Shetty; Kenji Shibuya; Reza Shirkoohi; K.M. Shivakumar; Velizar Shivarov; Soraya Siabani; Sudeep K. Siddappa Malleshappa; Diego Augusto Santos Silva; Jasvinder A. Singh; Yitagesu Sintayehu; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Matthew J. Soeberg; Ahmad Sofi-Mahmudi; Houman Sotoudeh; Paschalis Steiropoulos; Kurt Straif; Ranjeeta Subedi; Mu'awiyyah Babale Sufiyan; Iyad Sultan; Saima Sultana; Daniel Sur; Viktória Szerencsés; Miklós Szócska; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Hooman Tadbiri; Amir Taherkhani; Ken Takahashi; Iman M. Talaat; Ker-Kan Tan; Vivian Y. Tat; Bemnet Amare A. Tedla; Yonas Getaye Tefera; Arash Tehrani-Banihashemi; Mohamad-Hani Temsah; Fisaha Haile Tesfay; Gizachew Assefa Tessema; Rekha Thapar; Aravind Thavamani; Viveksandeep Thoguluva Chandrasekar; Nihal Thomas; Hamid Reza Tohidinik; Mathilde Touvier; Marcos Roberto Tovani-Palone; Eugenio Traini; Bach Xuan Tran; Khanh Bao Tran; Mai Thi Ngoc Tran; Jaya Prasad Tripathy; Biruk Shalmeno Tusa; Irfan Ullah; Saif Ullah; Krishna Kishore Umapathi; Bhaskaran Unnikrishnan; Era Upadhyay; Marco Vacante; Maryam Vaezi; Sahel Valadan Tahbaz; Diana Zuleika Velazquez; Massimiliano Veroux; Francesco S. Violante; Vasily Vlassov; Bay Vo; Victor Volovici; Giang Thu Vu; Yasir Waheed; Richard G. Wamai; Paul Ward; Yi Feng Wen; Ronny Westerman; Andrea Sylvia Winkler; Lalit Yadav; Seyed Hossein Yahyazadeh Jabbari; Lin Yang; Sanni Yaya; Taklo Simeneh Yazie Yazie; Yigizie Yeshaw; Naohiro Yonemoto; Mustafa Z. Younis; Zabihollah Yousefi; Chuanhua Yu; Deniz Yuce; Ismaeel Yunusa; Vesna Zadnik; Fariba Zare; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Jianrong Zhang; Chenwen Zhong; Linghui Zhou; Cong Zhu; Arash Ziapour; Ivan R. Zimmermann; Christina Fitzmaurice; Christopher J.L. Murray; Lisa M. Force
IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world. © 2022 American Medical Association. All rights reserved.
Development of CD163 receptor-based enzyme-linked immunosorbent assay for diagnosis of porcine reproductive and respiratory syndrome virus
(Springer Science and Business Media Deutschland GmbH, 2022) Rajib Deb; Ajay Kumar Yadav; Gyanendra Singh Sengar; Joyshikh Sonowal; D. Lalita; Seema Rani Pegu; Indra Singh; Ningthoukhongjam Linda; Pranab Jyoti Das; Satish Kumar; Prasanna Pal; Souvik Paul; Swaraj Rajkhowa; Vivek Kumar Gupta
Porcine reproductive and respiratory syndrome (PRRS) is an important economical disease in the global swine industry. The accurate detection of the PRRS virus (PRRSV) antigen is essential for the disease control and prevention programme. In this study, an indirect enzyme-linked immunosorbent test (PRRSVCD163-iELISA) was developed for the detection of the PRRSV antigen in samples of post-mortem swine tissue using the recombinant pig CD163 receptor protein as the capture ligand. The test was found to be specific for PRRSV, with no cross-reactions with other prevalent pig viral pathogens. The assay was validated by testing 217 post-mortem porcine tissue samples and the results were found to be satisfactory with a relative accuracy of 88.88%. Our assay is also quite precise, with intra- and inter-assay CVs of 6% and 10%, respectively. These findings imply that the PRRSVCD163-iELISA developed is capable of detecting the PRRSV antigen in swine post-mortem tissue samples. This research showed that porcine CD163, the PRRSV cellular receptor, can be exploited to build a diagnostic technique for the detection of PRRSV antigen. © 2022, King Abdulaziz City for Science and Technology.
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
Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Emma Nichols; Jaimie D. Steinmetz; Stein Emil Vollset; Kai Fukutaki; Julian Chalek; Foad Abd-Allah; Amir Abdoli; Ahmed Abualhasan; Eman Abu-Gharbieh; Tayyaba Tayyaba Akram; Hanadi Al Hamad; Fares Alahdab; Fahad Mashhour Alanezi; Vahid Alipour; Sami Almustanyir; Hubert Amu; Iman Ansari; Jalal Arabloo; Tahira Ashraf; Thomas Astell-Burt; Getinet Ayano; Jose L. Ayuso-Mateos; Atif Amin Baig; Anthony Barnett; Amadou Barrow; Bernhard T. Baune; Yannick Béjot; Woldesellassie M. Mequanint Bezabhe; Yihienew Mequanint Bezabih; Akshaya Srikanth Bhagavathula; Sonu Bhaskar; Krittika Bhattacharyya; Ali Bijani; Atanu Biswas; Srinivasa Rao Bolla; Archith Boloor; Carol Brayne; Hermann Brenner; Katrin Burkart; Richard A. Burns; Luis Alberto Cámera; Chao Cao; Felix Carvalho; Luis F.S. Castro-De-Araujo; Ferrán Catalá-López; Ester Cerin; Prachi P. Chavan; Nicolas Cherbuin; Dinh-Toi Chu; Vera Marisa Costa; Rosa A.S. Couto; Omid Dadras; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Vanessa De la Cruz-Góngora; Deepak Dhamnetiya; Diana Dias da Silva; Daniel Diaz; Abdel Douiri; David Edvardsson; Michael Ekholuenetale; Iman El Sayed; Shaimaa I. El-Jaafary; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Jawad Fares; Andre Faro; Umar Farooque; Valery L. Feigin; Xiaoqi Feng; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Pietro Ferrara; Irina Filip; Howard Fillit; Florian Fischer; Shilpa Gaidhane; Lucia Galluzzo; Ahmad Ghashghaee; Nermin Ghith; Alessandro Gialluisi; Syed Amir Gilani; Ionela-Roxana Glavan; Elena V. Gnedovskaya; Mahaveer Golechha; Rajeev Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Mohammad Rifat Haider; Brian J. Hall; Samer Hamidi; Asif Hanif; Graeme J. Hankey; Shafiul Haque; Risky Kusuma Hartono; Ahmed I. Hasaballah; M. Tasdik Hasan; Amr Hassan; Simon I. Hay; Khezar Hayat; Mohamed I. Hegazy; Golnaz Heidari; Reza Heidari-Soureshjani; Claudiu Herteliu; Mowafa Househ; Rabia Hussain; Bing-Fang Hwang; Licia Iacoviello; Ivo Iavicoli; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Seyed Sina Naghibi Irvani; Hiroyasu Iso; Masao Iwagami; Roxana Jabbarinejad; Louis Jacob; Vardhmaan Jain; Sathish Kumar Jayapal; Ranil Jayawardena; Ravi Prakash Jha; Jost B. Jonas; Nitin Joseph; Rizwan Kalani; Amit Kandel; Himal Kandel; André Karch; Ayele Semachew Kasa; Gizat M. Kassie; Pedram Keshavarz; Moien A.B. Khan; Mahalaqua Nazli Khatib; Tawfik Ahmed Muthafer Khoja; Jagdish Khubchandani; Min Seo Kim; Yun Jin Kim; Adnan Kisa; Sezer Kisa; Mika Kivimäki; Walter J. Koroshetz; Ai Koyanagi; G. Anil Kumar; Manasi Kumar; Hassan Mehmood Lak; Matilde Leonardi; Bingyu Li; Stephen S. Lim; Xuefeng Liu; Yuewei Liu; Giancarlo Logroscino; Stefan Lorkowski; Giancarlo Lucchetti; Ricardo Lutzky Saute; Francesca Giulia Magnani; Ahmad Azam Malik; João Massano; Man Mohan Mehndiratta; Ritesh G. Menezes; Atte Meretoja; Bahram Mohajer; Norlinah Mohamed Ibrahim; Yousef Mohammad; Arif Mohammed; Ali H. Mokdad; Stefania Mondello; Mohammad Ali Moni; Md Moniruzzaman; Tilahun Belete Mossie; Gabriele Nagel; Muhammad Naveed; Vinod C. Nayak; Sandhya Neupane Kandel; Trang Huyen Nguyen; Bogdan Oancea; Nikita Otstavnov; Stanislav S. Otstavnov; Mayowa O. Owolabi; Songhomitra Panda-Jonas; Fatemeh Pashazadeh Kan; Maja Pasovic; Urvish K. Patel; Mona Pathak; Mario F.P. Peres; Arokiasamy Perianayagam; Carrie B. Peterson; Michael R. Phillips; Marina Pinheiro; Michael A. Piradov; Constance Dimity Pond; Michele H. Potashman; Faheem Hyder Pottoo; Sergio I. Prada; Amir Radfar; Alberto Raggi; Fakher Rahim; Mosiur Rahman; Pradhum Ram; Priyanga Ranasinghe; David Laith Rawaf; Salman Rawaf; Nima Rezaei; Aziz Rezapour; Stephen R. Robinson; Michele Romoli; Gholamreza Roshandel; Ramesh Sahathevan; Amirhossein Sahebkar; Mohammad Ali Sahraian; Brijesh Sathian; Davide Sattin; Monika Sawhney; Mete Saylan; Silvia Schiavolin; Allen Seylani; Feng Sha; Masood Ali Shaikh; K.S. Shaji; Mohammed Shannawaz; Jeevan K. Shetty; Mika Shigematsu; Jae Il Shin; Rahman Shiri; Diego Augusto Santos Silva; Joao Pedro Silva; Renata Silva; Jasvinder A. Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Amanda E. Smith; Sergey Soshnikov; Emma Elizabeth Spurlock; Dan J. Stein; Jing Sun; Rafael Tabarés-Seisdedos; Bhaskar Thakur; Binod Timalsina; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Gebiyaw Wudie Tsegaye; Sahel Valadan Tahbaz; Pascual R. Valdez; Narayanaswamy Venketasubramanian; Vasily Vlassov; Giang Thu Vu; Linh Gia Vu; Yuan-Pang Wang; Anders Wimo; Andrea Sylvia Winkler; Lalit Yadav; Seyed Hossein Yahyazadeh Jabbari; Kazumasa Yamagishi; Lin Yang; Yuichiro Yano; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Siddhesh Zadey; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Christopher J.L. Murray; Theo Vos
Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. Methods: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. Findings: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4–65·1) million cases globally in 2019 to 152·8 (130·8–175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [–7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64–1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52–1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41–67]) and western Europe (74% [58–90]), and the largest in north Africa and the Middle East (367% [329–403]) and eastern sub-Saharan Africa (357% [323–395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Interpretation: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. Funding: Bill & Melinda Gates Foundation and Gates Ventures. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Austin E. Schumacher; Hmwe Hmwe Kyu; Amirali Aali; Cristiana Abbafati; Jaffar Abbas; Rouzbeh Abbasgholizadeh; Madineh Akram Abbasi; Mohammadreza Abbasian; Samar Abd ElHafeez; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab; Mohammad Abdollahi; Meriem Abdoun; Auwal Abdullahi; Ame Mehadi Abdurehman; Mesfin Abebe; Aidin Abedi; Armita Abedi; Tadesse M. Abegaz; Roberto Ariel Abeldaño Zuñiga; E.S. Abhilash; Olugbenga Olusola Abiodun; Richard Gyan Aboagye; Hassan Abolhassani; Mohamed Abouzid; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Michael R.M. Abrigo; Dariush Abtahi; Samir Abu Rumeileh; Niveen M.E. Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Juan Manuel Acuna; Tim Adair; Isaac Yeboah Addo; Oladimeji M. Adebayo; Oyelola A. Adegboye; Victor Adekanmbi; Bashir Aden; Abiola Victor Adepoju; Charles Oluwaseun Adetunji; Temitayo Esther Adeyeoluwa; Olorunsola Israel Adeyomoye; Rishan Adha; Amin Adibi; Wirawan Adikusuma; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Abel Afework; Aanuoluwapo Adeyimika Afolabi; Ali Afraz; Shadi Afyouni; Saira Afzal; Pradyumna Agasthi; Shahin Aghamiri; Antonella Agodi; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Tauseef Ahmad; Keivan Ahmadi; Amir Mahmoud Ahmadzade; Mohadese Ahmadzade; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Olufemi Ajumobi; Gizachew Taddesse Akalu; Essona Matatom Akara; Karolina Akinosoglou; Sreelatha Akkala; Samuel Akyirem; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Ammar Al Homsi; Mohammad Al Qadire; Moein Ala; Timothy Olukunle Aladelusi; Tareq Mohammed Ali Al-Ahdal; Samer O. Alalalmeh; Ziyad Al-Aly; Khurshid Alam; Manjurul Alam; Zufishan Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Mohammed Albashtawy; Mohammad T. AlBataineh; Robert W. Aldridge; Sharifullah Alemi; Ayman Al-Eyadhy; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Khaled Al-Hanawi; Abid Ali; Akhtar Ali; Beriwan Abdulqadir Ali; Hassam Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Zahid Ali; Shohreh Alian Samakkhah; Gianfranco Alicandro; Sheikh Mohammad Alif; Mohammad Aligol; Rasoul Alimi; Ahmednur Adem Aliyi; Adel Al-Jumaily; Syed Mohamed Aljunid; Wael Almahmeed; Sabah Al-Marwani; Sadeq Ali Ali Al-Maweri; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Omar Almidani; Mahmoud A. Alomari; Nivaldo Alonso; Jaber S. Alqahtani; Ahmed Yaseen Alqutaibi; Salman Khalifah Al-Sabah; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Farrukh Jawad Alvi; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Karem H. Alzoubi; Azmeraw T. Amare; Edward Kwabena Ameyaw; Abebe Feyissa Amhare; Tarek Tawfik Amin; Alireza Amindarolzarbi; Javad Aminian Dehkordi; Sohrab Amiri; Hubert Amu; Dickson A. Amugsi; Jimoh Amzat; Robert Ancuceanu; Deanna Anderlini; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Dhanalakshmi Angappan; Abhishek Anil; Afifa Anjum; Catherine M. Antony; Ernoiz Antriyandarti; Iyadunni Adesola Anuoluwa; Sumadi Lukman Anwar; Anayochukwu Edward Anyasodor; Seth Christopher Yaw Appiah; Muhammad Aqeel; Jalal Arabloo; Razman Arabzadeh Bahri; Morteza Arab-Zozani; Mosab Arafat; Ana Margarida Araújo; Aleksandr Y. Aravkin; Abdulfatai Aremu; Hany Ariffin; Timur Aripov; Benedetta Armocida; Mahwish Arooj; Anton A. Artamonov; Kurnia Dwi Artanti; Judie Arulappan; Idowu Thomas Aruleba; Raphael Taiwo Aruleba; Ashokan Arumugam; Malke Asaad; Saeed Asgary; Mubarek Yesse Ashemo; Muhammad Ashraf; Marvellous O. Asika; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Alok Atreya; Sameh Attia; Avinash Aujayeb; Abolfazl Avan; Adedapo Wasiu Awotidebe; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Getnet Melaku Ayele; Jose L. Ayuso-Mateos; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Gulrez Shah Azhar; Shahkaar Aziz; Ahmed Y. Azzam; Mina Babashahi; Abraham Samuel Babu; Muhammad Badar; Alaa Badawi; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Sulaiman Bah; Saeed Bahadorikhalili; Jianjun Bai; Ruhai Bai; Jennifer L. Baker; Shankar M. Bakkannavar; Abdulaziz T. Bako; Senthilkumar Balakrishnan; Saliu A. Balogun; Ovidiu Constantin Baltatu; Kiran Bam; Maciej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Hansi Bansal; Shirin Barati; Martina Barchitta; Mainak Bardhan; Suzanne Lyn Barker-Collo; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Ronald D. Barr; Lope H. Barrero; Zarrin Basharat; Asma'u I.J. Bashir; Hameed Akande Bashiru; Pritish Baskaran; Buddha Basnyat; Quique Bassat; João Diogo Basso; Saurav Basu; Kavita Batra; Ravi Batra; Bernhard T. Baune; Mohsen Bayati; Nebiyou Simegnew Bayileyegn; Thomas Beaney; Neeraj Bedi; Tahmina Begum; Emad Behboudi; Amir Hossein Behnoush; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Uzma Iqbal Belgaumi; Michelle L. Bell; Aminu K. Bello; Muhammad Bashir Bello; Olorunjuwon Omolaja Bello; Luis Belo; Apostolos Beloukas; Salaheddine Bendak; Derrick A. Bennett; Isabela M. Bensenor; Habib Benzian; Zombor Berezvai; Adam E. Berman; Amiel Nazer C. Bermudez; Paulo J.G. Bettencourt; Habtamu B. Beyene; Kebede A. Beyene; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Dinesh Bhandari; 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; Nada Binmadi; Bagas Suryo Bintoro; Antonio Biondi; Catherine Bisignano; Francesca Bisulli; Atanu Biswas; Raaj Kishore Biswas; Saeid Bitaraf; Tone Bjørge; Archie Bleyer; Mary Sefa Boampong; Virginia Bodolica; Aadam Olalekan Bodunrin; Obasanjo Afolabi Bolarinwa; Milad Bonakdar Hashemi; Aime Bonny; Kaustubh Bora; Berrak Bora Basara; Safiya Bala Borodo; Rohan Borschmann; Alejandro Botero Carvajal; Souad Bouaoud; Sofiane Boudalia; Edward J. Boyko; Nicola Luigi Bragazzi; Dejana Braithwaite; Hermann Brenner; Gabrielle Britton; Annie J. Browne; Andre R. Brunoni; Norma B. Bulamu; Lemma N. Bulto; Danilo Buonsenso; Katrin Burkart; Richard A. Burns; Sharath Burugina Nagaraja; Reinhard Busse; Yasser Bustanji; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Tianji Cai; Daniela Calina; Luis Alberto Cámera; Luciana Aparecida Campos; Ismael R. Campos-Nonato; Chao Cao; Carlos Alberto Cardenas; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Juan J. Carrero; Andrea Carugno; Felix Carvalho; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Ferrán Catalá-López; Alberico L. Catapano; Maria Sofia Cattaruzza; Arthur Caye; Christopher R. Cederroth; Francieli Cembranel; Muthia Cenderadewi; Kelly M. Cercy; Ester Cerin; Muge Cevik; Pamela R. Chacón-Uscamaita; Yaacoub Chahine; Chiranjib Chakraborty; Jeffrey Shi Kai Chan; Chin-Kuo Chang; Periklis Charalampous; Jaykaran Charan; Vijay Kumar Chattu; Victoria Chatzimavridou-Grigoriadou; Malizgani Paul Chavula; Huzaifa Ahmad Cheema; An-Tian Chen; Haowei Chen; Lingxiao Chen; Meng Xuan Chen; Simiao Chen; Nicolas Cherbuin; Derek S. Chew; Gerald Chi; Jesus Lorenzo Chirinos-Caceres; Abdulaal Chitheer; So Mi Jemma Cho; William C.S. Cho; Bryan Chong; Hitesh Chopra; Rahul Choudhary; Rajiv Chowdhury; Dinh-Toi Chu; Isaac Sunday Chukwu; Eric Chung; Eunice Chung; Sheng-Chia Chung; Karly I. Cini; Cain C.T. Clark; Kaleb Coberly; Alyssa Columbus; Haley Comfort; Joao Conde; Sara Conti; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Richard G. Cowden; Michael H. Criqui; Natália Cruz-Martins; Garland T. Culbreth; Patricia Cullen; Matthew Cunningham; Daniel da Silva E Silva; Sriharsha Dadana; Omid Dadras; Zhaoli Dai; Koustuv Dalal; Lachlan L. Dalli; Giovanni Damiani; Emanuele D'Amico; Sara Daneshvar; Aso Mohammad Darwesh; Jai K. Das; Saswati Das; Nihar Ranjan Dash; Mohsen Dashti; Claudio Alberto Dávila-Cervantes; Nicole Davis Weaver; Kairat Davletov; Diego De Leo; Aklilu Tamire Debele; Louisa Degenhardt; Reza Dehbandi; Lee Deitesfeld; Ivan Delgado-Enciso; Laura Delgado-Ortiz; Daniel Demant; Berecha Hundessa Demessa; Andreas K. Demetriades; Xinlei Deng; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Hardik Dineshbhai Desai; Rupak Desai; Keshab Deuba; Vinoth Gnana Chellaiyan Devanbu; Sourav Dey; Arkadeep Dhali; Kuldeep Dhama; Mandira Lamichhane Dhimal; Meghnath Dhimal; Sameer Dhingra; Diana Dias Da Silva; Daniel Diaz; Adriana Dima; Delaney D. Ding; M. Ashworth Dirac; Abhinav Dixit; Shilpi Gupta Dixit; Thanh Chi Do; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Masoud Dodangeh; Klara Georgieva Dokova; Christiane Dolecek; E Ray Dorsey; Wendel Mombaque dos Santos; Rajkumar Doshi; Leila Doshmangir; Abdel Douiri; Robert Kokou Dowou; Tim Robert Driscoll; Haneil Larson Dsouza; John Dube; Samuel C. Dumith; Susanna J. Dunachie; Bruce B. Duncan; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Sulagna Dutta; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Oluwakemi Ebenezer; Ejemai Eboreime; Alireza Ebrahimi; Chidiebere Peter Echieh; Abdelaziz Ed-Dra; Hisham Atan Edinur; David Edvardsson; Kristina Edvardsson; Defi Efendi; Ferry Efendi; Shayan Eghdami; Terje Andreas Eikemo; Ebrahim Eini; Michael Ekholuenetale; Emmanuel Ekpor; Temitope Cyrus Ekundayo; Rabie Adel El Arab; Doaa Abdel Wahab El Morsi; Maysaa El Sayed Zaki; Maha El Tantawi; Iffat Elbarazi; Noha Mousaad Elemam; Frank J. Elgar; Islam Y. Elgendy; Ghada Metwally Tawfik ElGohary; Hala Rashad Elhabashy; Muhammed Elhadi; Omar Abdelsadek Abdou Elmeligy; Mohammed Elshaer; Ibrahim Elsohaby; Amir Emami Zeydi; Mehdi Emamverdi; Theophilus I. Emeto; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Tesfahun C. Eshetie; Sharareh Eskandarieh; Juan Espinosa-Montero; Kara Estep; Farshid Etaee; Ugochukwu Anthony Eze; Natalia Fabin; Adewale Oluwaseun Fadaka; Adeniyi Francis Fagbamigbe; Saman Fahimi; Luca Falzone; Carla Sofia E Sá Farinha; MoezAlIslam Ezzat Mahmoud Faris; Mohsen Farjoud Kouhanjani; Andre Faro; Hossein Farrokhpour; Ali Fatehizadeh; Hamed Fattahi; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Ginenus Fekadu; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Daniela Ferrante; Pietro Ferrara; Nuno Ferreira; Getahun Fetensa; Irina Filip; Florian Fischer; Joanne Flavel; Abraham D. Flaxman; Luisa S. Flor; Bobirca Teodor Florin; Morenike Oluwatoyin Folayan; Kristen Marie Foley; Artem Alekseevich Fomenkov; Lisa M. Force; Carla Fornari; Behzad Foroutan; Matteo Foschi; Kate Louise Francis; Richard Charles Franklin; Alberto Freitas; Joseph Friedman; Sara D. Friedman; Takeshi Fukumoto; John E. Fuller; Peter Andras Gaal; Muktar A. 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Gnedovskaya; Laszlo Göbölös; Amit Goel; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Arefeh Golestanfar; Davide Golinelli; Philimon N. Gona; Houman Goudarzi; Amir Hossein Goudarzian; Anmol Goyal; Scott Greenhalgh; Michal Grivna; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Avirup Guha; Stefano Guicciardi; Damitha Asanga Gunawardane; Sasidhar Gunturu; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Indarchand Ratanlal Gupta; Rajat Das Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Reyna Alma Gutiérrez; Farrokh Habibzadeh; Parham Habibzadeh; Vladimir Hachinski; Mohammad Haddadi; Rasool Haddadi; Nils Haep; Adel Hajj Ali; Esam S. Halboub; Sobia Ahsan Halim; Brian J. Hall; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Kanaan Hamagharib Abdullah; Samer Hamidi; Mohammad Hamiduzzaman; Ahmad Hammoud; Nasrin Hanifi; Graeme J. Hankey; Md Abdul Hannan; Md Nuruzzaman Haque; Harapan Harapan; Josep Maria Haro; Ahmed I. 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Ikuta; Mehran Ilaghi; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Leeberk Raja Inbaraj; Arnaud Iradukunda; Farideh Iravanpour; Kenneth Chukwuemeka Iregbu; Md Rabiul Islam; Mohammad Mainul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Nahlah Elkudssiah Ismail; Gaetano Isola; Masao Iwagami; Chidozie C.D. Iwu; Chinwe Juliana Iwu-Jaja; Mahalaxmi Iyer; Linda Merin; Jalil Jaafari; Louis Jacob; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Morteza Jafarinia; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Mihajlo Jakovljevic; Reza Jalilzadeh Yengejeh; Elham Jamshidi; Chinmay T. Jani; Mark M. Janko; Abubakar Ibrahim Jatau; Sathish Kumar Jayapal; Shubha Jayaram; Jayakumar Jeganathan; Alelign Tasew Jema; Digisie Mequanint Jemere; Wonjeong Jeong; Anil K. Jha; Ravi Prakash Jha; John S. 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Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. 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 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. 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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 Burden of Cardiovascular Diseases and Risks, 1990-2022
(Elsevier Inc., 2023) George A. Mensah; Valentin Fuster; Christopher J.L. Murray; Gregory A. Roth; George A. Mensah; Yohannes Habtegiorgis Abate; Mohammadreza Abbasian; Foad Abd-Allah; Ashkan Abdollahi; Mohammad Abdollahi; Deldar Morad Abdulah; Auwal Abdullahi; Ayele Mamo Abebe; Aidin Abedi; Armita Abedi; Olugbenga Olusola Abiodun; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Niveen M.E. Abu-Rmeileh; Salahdein Aburuz; Abdelrahman I. Abushouk; Ahmed Abu-Zaid; Tigist Demssew Adane; Nicola J. Adderley; Oladimeji M. Adebayo; Bashir Aden; Temitayo Esther Adeyeoluwa; Olorunsola Israel Adeyomoye; Qorinah Estiningtyas Sakilah Adnani; Fatemeh Afrashteh; Shadi Afyouni; Saira Afzal; Pradyumna Agasthi; Antonella Agodi; Constanza Elizabeth Aguilera Arriagada; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Ayman Ahmed; Haroon Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Karolina Akinosoglou; Moein Ala; Tareq Mohammed Ali AL-Ahdal; Samer O. Alalalmeh; Ziyad Al-Aly; Nazmul Alam; Rasmieh Mustafa Al-Amer; Alaa Alashi; Mohammed Albashtawy; Mohammad T. AlBataineh; Haileselasie Berhane Alema; Sharifullah Alemi; Yihun Mulugeta Alemu; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Gianfranco Alicandro; Reyhaneh Alikhani; Syed Mohamed Aljunid; François Alla; Wael Almahmeed; Sabah Al-Marwani; Jordi Alonso; Rajaa M. Al-Raddadi; Farrukh Jawad Alvi; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Hassan Alwafi; Hany Aly; Prince M. Amegbor; Tarek Tawfik Amin; Alireza Amindarolzarbi; Mostafa Amini-Rarani; Sohrab Amiri; Enrico Ammirati; Tanu Anand; Robert Ancuceanu; Deanna Anderlini; Abhishek Anil; Golnoosh Ansari; Philip Emeka Anyanwu; Anayochukwu Edward Anyasodor; Geminn Louis Carace Apostol; Jalal Arabloo; Mosab Arafat; Aleksandr Y. Aravkin; Olatunde Aremu; Benedetta Armocida; Johan Ärnlöv; Oluwaseyi Olalekan Arowosegbe; Anton A. Artamonov; Kurnia Dwi Artanti; Judie Arulappan; Idowu Thomas Aruleba; Ashokan Arumugam; Zahra Aryan; Mohammad Asghari-Jafarabadi; Thomas Astell-Burt; Mahshid Ataei; Mohammad Athar; Alok Atreya; Avinash Aujayeb; Adedapo Wasiu Awotidebe; Amdehiwot A. Aynalem; Zahra Azizi; Ahmed Y. Azzam; Abraham Samuel Babu; Muhammad Badar; Feras Bader; Ashish D. Badiye; Arvind Bagga; Sara Bagherieh; Farshad Bahrami Asl; Ruhai Bai; Jennifer L. Baker; Shankar M. Bakkannavar; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Saliu A. Balogun; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Kannu Bansal; Hamid Reza Baradaran; Franca Barbic; Martina Barchitta; Mainak Bardhan; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Francesco Barone-Adesi; Sandra Barteit; Lingkan Barua; Azadeh Bashiri; Mohsen Bayati; Nebiyou Simegnew Bayileyegn; Emad Behboudi; Amir Hossein Behnoush; Yannick Béjot; Sefealem Assefa Belay; Melaku Ashagrie Belete; Uzma Iqbal Belgaumi; Michelle L. Bell; Luis Belo; Salaheddine Bendak; Bright Benfor; Derrick A. Bennett; Isabela M. Bensenor; Catherine P. Benziger; Azizullah Beran; Adam E. Berman; Amiel Nazer C. Bermudez; Gregory J. Bertolacci; Habtamu B. Beyene; Kebede A. Beyene; Akshaya Srikanth Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Boris Bikbov; Andras Bikov; Marina G. Birck; Bijit Biswas; Saeid Bitaraf; Aadam Olalekan Bodunrin; Eyob Ketema Bogale; Kassawmar Angaw Bogale; Archith Boloor; Milad Bonakdar Hashemi; Hamed Borhany; Edward J. Boyko; Dejana Braithwaite; Luisa C. Brant; Michael Brauer; Susanne Breitner; Andrey Briko; Lemma N. Bulto; Yasser Bustanji; Zahid A. Butt; Daniela Calina; Fan Cao; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Juan J. Carrero; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Maria Sofia Cattaruzza; Luca Cegolon; Ester Cerin; Yaacoub Chahine; Jeffrey Shi Kai Chan; Mei Yen Chan; Raymond N.C. Chan; Periklis Charalampous; Jaykaran Charan; Vijay Kumar Chattu; An-Tian Chen; Catherine S. Chen; Haowei Chen; Suma Sri Chennapragada; Derek S. Chew; Gerald Chi; Patrick R. Ching; Abdulaal Chitheer; So Mi Jemma Cho; William C.S. Cho; Bryan Chong; Hitesh Chopra; Rahul Choudhary; Enayet Karim Chowdhury; Rajiv Chowdhury; Dinh-Toi Chu; Isaac Sunday Chukwu; Arrigo Francesco Giuseppe Cicero; Zinhle Cindi; Iolanda Cioffi; Kaleb Coberly; Sean Coffey; Alyssa Columbus; Joao Conde; Sara Conti; Barbara Corso; Sandra Cortés; Paolo Angelo Cortesi; Vera Marisa Costa; Rosa A.S. Couto; Emma Johnson Cowart; Michael H. Criqui; Jessica A. Cruz; Sriharsha Dadana; Omid Dadras; Xiaochen Dai; Zhaoli Dai; Maxwell Ayindenaba Dalaba; Albertino Antonio Moura Damasceno; Giovanni Damiani; Emanuele D'Amico; Saswati Das; Subasish Das; Mohsen Dashti; Mohammad Dashtkoohi; Maedeh Dastmardi; Kairat Davletov; Aklilu Tamire Debele; Shayom Debopadhaya; Nicole K. DeCleene; Ivan Delgado-Enciso; Juana Maria Delgado-Saborit; Berecha Hundessa Demessa; Andreas K. Demetriades; Xinlei Deng; Edgar Denova-Gutiérrez; Nebiyu Dereje Dereje; Awoke Masrie Asrat Derese; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Syed Masudur Rahman Dewan; Sourav Dey; Vishal R. Dhulipala; Daniel Diaz; Michael J. Diaz; Delaney D. Ding; Ricardo Jorge Dinis-Oliveira; Thanh Chi Do; Thao Huynh Phuong Do; Saeid Doaei; Sushil Dohare; Wanyue Dong; Mario D'Oria; Wendel Mombaque Dos Santos; Abdel Douiri; Robert Kokou Dowou; Ashel Chelsea Dsouza; Haneil Larson Dsouza; Viola Dsouza; Mi Du; Andre Rodrigues Duraes; Oyewole Christopher Durojaiye; Sulagna Dutta; Arkadiusz Marian Dziedzic; Alireza Ebrahimi; Defi Efendi; Ferry Efendi; Diyan Ermawan Effendi; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Maha El Tantawi; Iffat Elbarazi; Frank J. Elgar; Islam Y. Elgendy; Muhammed Elhadi; Waseem El-Huneidi; Mehdi Emamverdi; Theophilus I. Emeto; Ryenchindorj Erkhembayar; Tesfahun C. Eshetie; Juan Espinosa-Montero; Farshid Etaee; Natalia Fabin; Ibtihal Fadhil; Adeniyi Francis Fagbamigbe; Luca Falzone; Carla Sofia E Sá Farinha; MoezAlIslam Ezzat Mahmoud Faris; Andre Faro; Mithila Faruque; Medhat Farwati; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Pooria Fazeli; Valery L. Feigin; Xiaoqi Feng; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Pietro Ferrara; Nuno Ferreira; Irina Filip; Laura Fleszar; David Flood; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Diogo A. Fonseca; Carla Fornari; Matteo Foschi; Richard Charles Franklin; Takeshi Fukumoto; Blima Fux; Peter Andras Gaal; Muktar A. Gadanya; Shilpa Gaidhane; Abduzhappar Gaipov; Emmanuela Gakidou; Yaseen Galali; Silvano Gallus; Aravind P. Gandhi; Balasankar Ganesan; Rupesh K. Gautam; Miglas W.W. Gebregergis; Kahsu Gebrekirstos Gebrekidan; Johanna M. Geleijnse; Urge Gerema; Alireza Ghajar; Seyyed-Hadi Ghamari; Mohammad Reza Ghasemi; Ghazal Ghasempour Dabaghi; Afsaneh Ghasemzadeh; Ramy Mohamed Ghazy; Maryam Gholamalizadeh; Arun Digambarrao Ghuge; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Elena V. Gnedovskaya; Ali Golchin; Pouya Goleij; Giuseppe Gorini; Alessandra C. Goulart; Anmol Goyal; Kashish Goyal; Shi-Yang Guan; Giovanni Guarducci; Mesay Dechasa Gudeta; Avirup Guha; Stefano Guicciardi; David Gulisashvili; Damitha Asanga Gunawardane; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Indarchand Ratanlal Gupta; Kartik Gupta; Mohak Gupta; Rajat Das Gupta; Rajeev Gupta; Renu Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Lami Gurmessa; Reyna Alma Gutiérrez; Farrokh Habibzadeh; Mostafa Hadei; Helia Sadat Haeri Boroojeni; Aram Halimi; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Nadia M. Hamdy; Samer Hamidi; Chieh Han; Qiuxia Han; Graeme J. Hankey; Md. Abdul Hannan; Arief Hargono; Josep Maria Haro; Faizul Hasan; Ikramul Hasan; Hamidreza Hasani; Maryam Hashemian; Md Saquib Hasnain; Amr Hassan; Ikrama Hassan; Johannes Haubold; Rasmus J. Havmoeller; Simon I. Hay; Khezar Hayat; Youssef Hbid; Omar E. Hegazi; Tadele Yohannes Hegena; Mohammad Heidari; Bartosz Helfer; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Hamed Hesami; Kamran Hessami; Keyvan Heydari; Kamal Hezam; Yuta Hiraike; Nguyen Quoc Hoan; Ramesh Holla; Md Mahbub Hossain; Md. Belal Hossain; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Junjie Huang; Michael Hultström; Hong-Han Huynh; Bing-Fang Hwang; Khalid S. Ibrahim; Oluwatope Olaniyi Idowu; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Leeberk Raja Inbaraj; Muhammad Iqhrammullah; Sheikh Mohammed Shariful Islam; Faisal Ismail; Nahlah Elkudssiah Ismail; Gaetano Isola; Masao Iwagami; J. Linda Merin; Jalil Jaafari; Louis Jacob; Abdollah Jafarzadeh; Khushleen Jaggi; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Mihajlo Jakovljevic; Roland Dominic G. Jamora; Nilofer Javadi; Sathish Kumar Jayapal; Shubha Jayaram; Rime Jebai; Rebuma Sorsa Jeben; Sun Ha Jee; Anil K. Jha; Ravi Prakash Jha; Vivekanand Jha; Heng Jiang; Yinzi Jin; Yash B. Jobanputra; Catherine Owens Johnson; Mohammad Jokar; Tamas Joo; Abel Joseph; Nitin Joseph; Charity Ehimwenma Joshua; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Zubair Kabir; Vidya Kadashetti; Farima Kahe; Rizwan Kalani; Laleh R. Kalankesh; Farnaz Kalantar; Yogeshwar Kalkonde; Sanjay Kalra; Ashwin Kamath; Sagarika Kamath; Arun Kamireddy; Tanuj Kanchan; Himal Kandel; Arun R. Kanmanthareddy; Kehinde Kazeem Kanmodi; Sushil Kumar Kansal; Daniel John Kapner; Sitanshu Sekhar Kar; Paschalis Karakasis; Prabin Karki; Faizan Zaffar Kashoo; Hengameh Kasraei; Eskeziaw Abebe Kassahun; Nicholas J. Kassebaum; Patrick D.M.C. Katoto; Neda Kaydi; Foad Kazemi; Sina Kazemian; Sara Kazeminia; Jessica A. Kerr; Emmanuelle Kesse-Guyot; Mohammad Keykhaei; Mohamad Mehdi Khadembashiri; Mohammad Amin Khadembashiri; Morteza Abdullatif Khafaie; Himanshu Khajuria; Amirmohammad Khalaji; Nauman Khalid; Alireza Khalilian; Rovshan Khalilov; Asaduzzaman Khan; Ejaz Ahmad Khan; Junaid Khan; M. Nuruzzaman Khan; Maseer Khan; Mohammad Jobair Khan; Muhammad Shahzeb Khan; Yusra H. Khan; Mahammed Ziauddin Khan Suheb; Shaghayegh Khanmohammadi; Khaled Khatab; Sorour Khateri; Hamid Reza Khayat Kashani; Khalid A. Kheirallah; Feriha Fatima Khidri; Saeid Kian; Zemene Demelash Kifle; Ruth W. Kimokoti; Adnan Kisa; Sezer Kisa; Ali-Asghar Kolahi; Farzad Kompani; Gerbrand Koren; Ashwin Laxmikant Kotnis; Parvaiz A. Koul; Ai Koyanagi; Kewal Krishan; Hare Krishna; Vijay Krishnamoorthy; Yuvaraj Krishnamoorthy; Md Abdul Kuddus; Mohammed Kuddus; Mukhtar Kulimbet; Vishnutheertha Kulkarni; Akshay Kumar; Ashish Kumar; Naveen Kumar; Nithin Kumar; Rahul Kumar; Netsanet Bogale Kumsa; Kunle Rotimi Kunle; Dian Kusuma; Ilias Kyriopoulos; Carlo La Vecchia; Ben Lacey; Muhammad Awwal Ladan; Lucie Laflamme; Chandrakant Lahariya; Arista Lahiri; Daphne Teck Ching Lai; Tea Lallukka; Qing Lan; Iván Landires; Francesco Lanfranchi; Bagher Larijani; Anders O. Larsson; Savita Lasrado; Kamaluddin Latief; Kaveh Latifinaibin; Jerrald Lau; Paolo Lauriola; Khuong Le; Long Khanh Dao Le; Nhi Huu Hanh Le; Thao Thi Thu Le; Trang Diep Thanh Le; Trang Thi Bich Le; Caterina Ledda; Munjae Lee; Paul H. Lee; Seung Won Lee; Wei-Chen Lee; Yo Han Lee; Kate E. LeGrand; Mall Leinsalu; Matilde Leonardi; Temesgen L. Lerango; An Li; Ming-Chieh Li; Wei Li; Xiaopan Li; Yichong Li; Lee-Ling Lim; Stephen S. Lim; Ro-Ting Lin; Megan Lindstrom; Shai Linn; Gang Liu; Simin Liu; Xiaofeng Liu; Xuefeng Liu; Katherine M. Livingstone; Erand Llanaj; Platon D. Lopukhov; Arianna Maever Loreche; László Lorenzovici; Stefan Lorkowski; Paulo A. Lotufo; Giancarlo Lucchetti; Alessandra Lugo; Zheng Feei Ma; Farzan Madadizadeh; Ralph Maddison; Javier A. Magaña Gómez; Julien Magne; D.R. Mahadeshwara Prasad; Mehrdad Mahalleh; Mansour Adam Mahmoud; Elham Mahmoudi; Behnaz Mahmoudvand; Omar Mohamed Makram; Elaheh Malakan Rad; Reza Malekzadeh; Kashish Malhotra; Iram Malik; Muhammad Sajeel Ahmed Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Aseer Manilal; Yosef Manla; Yasaman Mansoori; Borhan Mansouri; Pejman Mansouri; Mohammad Ali Mansournia; Hamid Reza Marateb; Mirko Marino; Daniela Martini; Santi Martini; Sharmeen Maryam; Roy Rillera Marzo; Alireza Masoudi; Sahar Masoudi; Clara N. Matei; Yasith Mathangasinghe; Elezebeth Mathews; Manu Raj Mathur; Jishanth Mattumpuram; Richard James Maude; Andrea Maugeri; Mahsa Mayeli; Mohsen Mazidi; John J. McGrath; Steven M. McPhail; Enkeleint A. Mechili; John Robert Carabeo Medina; Jitendra Kumar Meena; Kamran Mehrabani-Zeinabad; Max Alberto Mendez Mendez-Lopez; Walter Mendoza; Ritesh G. Menezes; Belayneh Mengist; Sultan Ayoub Meo; Haftu Asmerom Meresa; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Kukulege Chamila Dinushi Mettananda; Sachith Mettananda; Laurette Mhlanga; Tianyue Mi; Junmei Miao Jonasson; Tomasz Miazgowski; Irmina Maria Michalek; Ted R. Miller; Le Huu Nhat Minh; Neema W. Minja; Pouya Mir Mohammad Sadeghi; Niloofar Mirdamadi; Andreea Mirica; Erkin M. Mirrakhimov; Moonis Mirza; Mohammad Mirza-Aghazadeh-Attari; Prasanna Mithra; Zahra Moghimi; Jama Mohamed; Mouhand F.H. Mohamed; Nouh Saad Mohamed; Soheil Mohammadi; Hussen Mohammed; Mustapha Mohammed; Salahuddin Mohammed; Shafiu Mohammed; Nagabhishek Moka; Ali H. Mokdad; Hossein Molavi Vardanjani; Sara Momtazmanesh; Lorenzo Monasta; Fateme Montazeri; AmirAli Moodi Ghalibaf; Yousef Moradi; Paula Moraga; Lidia Morawska; Negar Morovatdar; Shane Douglas Morrison; Jakub Morze; Ebrahim Mostafavi; Amirmahdi Mostofinejad; Vincent Mougin; Parsa Mousavi; Seyed Ehsan Mousavi; Dariush Mozaffarian; Ahmed Msherghi; Lorenzo Muccioli; Ulrich Otto Mueller; Sumoni Mukherjee; Kavita Munjal; Efrén Murillo-Zamora; Ghulam Mustafa; Sathish Muthu; Julius C. Mwita; Woojae Myung; Ahamarshan Jayaraman Nagarajan; Shankar Prasad Nagaraju; Ganesh R. Naik; Gurudatta Naik; Tapas Sadasivan Nair; Mohammad Sadeq Najafi; Noureddin Nakhostin Ansari; Vinay Nangia; Sreenivas Narasimha Swamy; Shumaila Nargus; Bruno Ramos Nascimento; Gustavo G. Nascimento; Hadis Nasoori; Zuhair S. Natto; Javaid Nauman; Muhammad Naveed; Biswa Prakash Nayak; Vinod C. Nayak; Hadush Negash; Ionut Negoi; Ruxandra Irina Negoi; Reza Nejad Shahrokh Abadi; Seyed Aria Nejadghaderi; Chakib Nejjari; Mohammad Hadi Nematollahi; Samata Nepal; Nawi Ng; Dang H. Nguyen; Phat Tuan Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Shawn S. Nijjar; Muhammad A. Nizam; Efaq Ali Noman; Shuhei Nomura; Mamoona Noreen; Bo Norrving; Jean Jacques Noubiap; Chisom Adaobi Nri-Ezedi; Mpiko Ntsekhe; Dieta Nurrika; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Kehinde O. Obamiro; Martin James O'Donnell; Onome Bright Oghenetega; Ayodipupo Sikiru Oguntade; James Odhiambo Oguta; Sylvester Reuben Okeke; Akinkunmi Paul Okekunle; Lawrence Okidi; Osaretin Christabel Okonji; Patrick Godwin Okwute; Andrew T. Olagunju; Muideen Tunbosun Olaiya; Matifan Dereje Olana; Matthew Idowu Olatubi; Gláucia Maria Moraes Oliveira; Abdulhakeem Abayomi Olorukooba; Isaac Iyinoluwa Olufadewa; Yinka Doris Oluwafemi; Gideon Olamilekan Oluwatunase; Goran Latif Omer; Mohammad Mehdi Ommati; Kanyin Liane Ong; Sokking Ong; Kenneth Ikenna Onyedibe; Michal Ordak; Doris V. Ortega-Altamirano; Alberto Ortiz; Esteban Ortiz-Prado; Wael M.S. Osman; Uchechukwu Levi Osuagwu; Adrian Otoiu; Stanislav S. Otstavnov; Mayowa O. Owolabi; P.A. Mahesh Padukudru; Alicia Padron-Monedero; Jagadish Rao Padubidri; Mahsa Pahlavikhah Varnosfaderani; Tamás Palicz; Raffaele Palladino; Feng Pan; Hai-Feng Pan; Seithikurippu R. Pandi-Perumal; Paraskevi Papadopoulou; Seoyeon Park; Roberto Passera; Jay Patel; Shankargouda Patil; Dimitrios Patoulias; Venkata Suresh Patthipati; Shrikant Pawar; Amy E. Peden; Paolo Pedersini; Minjin Peng; Veincent Christian Filipino Pepito; Emmanuel K. Peprah; Marcos Pereira; Maria Odete Pereira; Mario F.P. Peres; Arokiasamy Perianayagam; Norberto Perico; Fanny Emily Petermann-Rocha; Hoang Tran Pham; Anil K. Philip; David M. Pigott; Thomas Pilgrim; Michael A. Piradov; Evgenii Plotnikov; Dimitri Poddighe; Roman V. Polibin; Ramesh Poluru; Ghazaleh Pourali; Akram Pourshams; Pranil Man Singh Pradhan; Manya Prasad; Elton Junio Sady Prates; Bharathi M. Purohit; Jagadeesh Puvvula; Ibrahim Qattea; Gangzhen Qian; Maryam Faiz Qureshi; Mehrdad Rabiee Rad; Amir Radfar; Seyedeh Niloufar Rafiei Alavi; Ibrar Rafique; Alberto Raggi; Fakher Rahim; Md Jillur Rahim; Mehran Rahimi; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Bita Rahmani; Shayan Rahmani; Vahid Rahmanian; Pramila Rai; Sathish Rajaa; Ali Rajabpour-Sanati; Prashant Rajput; Pradhum Ram; Prasanna Ram; Sudha Ramalingam; Shakthi Kumaran Ramasamy; Sheena Ramazanu; Pushkal Sinduvadi Ramesh; Juwel Rana; Kritika Rana; Chhabi Lal Ranabhat; Nemanja Rancic; Amey Rane; Shubham Ranjan; Annemarei Ranta; Indu Ramachandra Rao; Mithun Rao; Sowmya J. Rao; Sina Rashedi; Vahid Rashedi; Ahmed Mustafa Rashid; Azad Rasul; Zubair Ahmed Ratan; Giridhara Rathnaiah Babu; Nakul Ravikumar; Salman Rawaf; Iman Razeghian-Jahromi; Christian Razo; Murali Mohan Rama Krishna Reddy; Elrashdy Moustafa Mohamed Redwan; Giuseppe Remuzzi; Luis Felipe Reyes; Nazila Rezaei; Mohsen Rezaeian; Antonio Luiz P. Ribeiro; Daniela Ribeiro; Reza Rikhtegar; Leonardo Roever; Debby Syahru Romadlon; Luca Ronfani; Himanshu Sehar Sekhar Rout; Nitai Roy; Priyanka Roy; Andrzej Rynkiewicz; Aly M.A. Saad; Zahra Saadatian; Siamak Sabour; Simona Sacco; Rajesh Sachdeva; Basema Saddik; Erfan Sadeghi; Umar Saeed; Fahimeh Safaeinejad; Fatemeh Saheb Sharif-Askari; Narjes Saheb Sharif-Askari; Amirhossein Sahebkar; Soumya Swaroop Sahoo; Seyed Aidin Sajedi; Mirza Rizwan Sajid; Joseph W. Sakshaug; Nasir Salam; Afeez Abolarinwa Salami; Mohamed A. Saleh; Sana Salehi; Marwa Rashad Salem; Mohammed Z.Y. Salem; Sara Samadzadeh; Saad Samargandy; Vijaya Paul Samuel; Abdallah M. Samy; Juan Sanabria; Rama Krishna Sanjeev; Milena M. Santric-Milicevic; Muhammad Arif Nadeem Saqib; Made Ary Sarasmita; Aswini Saravanan; Yaser Sarikhani; Tanmay Sarkar; Rodrigo Sarmiento-Suárez; Gargi Sachin Sarode; Sachin C. Sarode; Thirunavukkarasu Sathish; Anudeep Sathyanarayan; Monika Sawhney; Mehdi Sayyah; Benedikt Michael Schaarschmidt
[No abstract available]
Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019
(Elsevier Ltd, 2023) Sara Momtazmanesh; Sahar Saeedi Moghaddam; Seyyed-Hadi Ghamari; Elaheh Malakan Rad; Negar Rezaei; Parnian Shobeiri; Amirali Aali; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Michael Abdelmasseh; Meriem Abdoun; Deldar Morad Abdulah; Abu Yousuf Md Abdullah; Aidin Abedi; Hassan Abolhassani; Zahra Abrehdari-Tafreshi; Basavaprabhu Achappa; Denberu Eshetie Adane Adane; Tigist Demssew Adane; Isaac Yeboah Addo; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Sajjad Ahmad; Ali Ahmadi; Keivan Ahmadi; Ali Ahmed; Ayman Ahmed; Tarik Ahmed Rashid; Hanadi Al Hamad; Fares Alahdab; Astawus Alemayehu; Sheikh Mohammad Alif; Syed Mohamed Aljunid; Sami Almustanyir; Khalid A Altirkawi; Nelson Alvis-Guzman; Javad Aminian Dehkordi; Mehrdad Amir-Behghadami; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Catherine M Antony; Anayochukwu Edward Anyasodor; Jalal Arabloo; Judie Arulappan; Tahira Ashraf; Seyyed Shamsadin Athari; Engi F Attia; Meshesha Tsegazeab Ayele; Sina Azadnajafabad; Abraham Samuel Babu; Sara Bagherieh; Ovidiu Constantin Baltatu; MacIej Banach; Mainak Bardhan; Francesco Barone-Adesi; Amadou Barrow; Saurav Basu; Nebiyou Simegnew Bayileyegn; Isabela M Bensenor; Nikha Bhardwaj; Pankaj Bhardwaj; Ajay Nagesh Bhat; Krittika Bhattacharyya; Souad Bouaoud; Dejana Braithwaite; Michael Brauer; Muhammad Hammad Butt; Zahid A Butt; Daniela Calina; Luis Alberto Cámera; Gashaw Sisay Chanie; Periklis Charalampous; Vijay Kumar Chattu; Odgerel Chimed-Ochir; Dinh-Toi Chu; Aaron J Cohen; Natália Cruz-Martins; Omid Dadras; Aso Mohammad Darwesh; Saswati Das; Sisay Abebe Debela; Laura Delgado-Ortiz; Diriba Dereje; Mostafa Dianatinasab; Nancy Diao; Daniel Diaz; Lankamo Ena Digesa; Gebisa Dirirsa; Paul Narh Doku; Deepa Dongarwar; Abdel Douiri; Haneil Larson Dsouza; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Ahmed Elabbas Mustafa Elagali; Muhammed Elhadi; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Farshid Etaee; Adeniyi Francis Fagbamigbe; Andre Faro; Ali Fatehizadeh; Ginenus Fekadu; Irina Filip; Florian Fischer; Masoud Foroutan; Richard Charles Franklin; Peter Andras Gaal; Santosh Gaihre; Abduzhappar Gaipov; Mesfin Gebrehiwot; Urge Gerema; Motuma Erena Getachew; Tamiru Getachew; Mansour Ghafourifard; Reza Ghanbari; Ahmad Ghashghaee; Ali Gholami; Artyom Urievich Gil; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Habtamu Alganeh Guadie; Bhawna Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Mostafa Hadei; Rabih Halwani; Asif Hanif; Arief Hargono; Mehdi Harorani; Risky Kusuma Hartono; Hamidreza Hasani; Abdiwahab Hashi; Simon I Hay; Mohammad Heidari; Merel E Hellemons; Claudiu Herteliu; Ramesh Holla; Nobuyuki Horita; Mohammad Hoseini; Mehdi Hosseinzadeh; Junjie Huang; Salman Hussain; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Sufyan Ibrahim; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mustapha Immurana; Nahlah Elkudssiah Ismail; Linda Merin J; Mihajlo Jakovljevic; Elham Jamshidi; Manthan Dilipkumar Janodia; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Ravi Prakash Jha; Olatunji Johnson; Tamas Joo; Nitin Joseph; Jacek Jerzy Jozwiak; Vaishali Kraghuabr; Billingsley Kaambwa; Zubair Kabir; Laleh R Kalankesh; Rohollah Kalhor; Himal Kandel; Shama D Karanth; Ibraheem M Karaye; Bekalu Getnet Kassa; Gizat M Kassie; Leila Keikavoosi-Arani; Mohammad Keykhaei; Himanshu Khajuria; Imteyaz A Khan; Moien A B Khan; Yusra H Khan; Haneen Khreis; Min Seo Kim; Adnan Kisa; Sezer Kisa; Luke D Knibbs; Pavel Kolkhir; Somayeh Komaki; Farzad Kompani; Hamid Reza Koohestani; Ali Koolivand; Oleksii Korzh; Ai Koyanagi; Kewal Krishan; Kris J Krohn; Naveen Kumar; Nithin Kumar; Om P Kurmi; Ambily Kuttikkattu; Carlo La Vecchia; Judit Lám; Qing Lan; Savita Lasrado; Kamaluddin Latief; Paolo Lauriola; Sang-Woong Lee; Yo Han Lee; Samson Mideksa Legesse; Jacopo Lenzi; Ming-Chieh Li; Ro-Ting Lin; Gang Liu; Wei Liu; Chun-Han Lo; László Lorenzovici; Yifei Lu; Soundarya Mahalingam; Elham Mahmoudi; Narayan B Mahotra; Mohammad-Reza Malekpour; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Borhan Mansouri; Elezebeth Mathews; Sazan Qadir Maulud; Enkeleint A Mechili; Entezar Mehrabi Nasab; Ritesh G Menezes; Dechasa Adare Mengistu; Alexios-Fotios A Mentis; Mahboobeh Meshkat; Tomislav Mestrovic; Ana Carolina Micheletti Gomide Nogueira De Sá; Erkin M Mirrakhimov; Awoke Misganaw; Prasanna Mithra; Javad Moghadasi; Esmaeil Mohammadi; Mokhtar Mohammadi; Marita Mohammadshahi; Shafiu Mohammed; Syam Mohan; Nagabhishek Moka; Lorenzo Monasta; Mohammad Ali Moni; Md Moniruzzaman; Fateme Montazeri; Maryam Moradi; Ebrahim Mostafavi; Christine Mpundu-Kaambwa; Efrén Murillo-Zamora; Christopher J L Murray; Tapas Sadasivan Nair; Vinay Nangia; Sreenivas Narasimha Swamy; Aparna Ichalangod Narayana; Zuhair S Natto; Biswa Prakash Nayak; Wogene Wogene Negash; Evangelia Nena; Sandhya Neupane Kandel; Robina Khan Niazi; Antonio Tolentino Nogueira De Sá; Ali Nowroozi; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Rahman Md Obaidur; Oluwakemi Ololade Odukoya; Hassan Okati-Aliabad; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Ahmed Omar Bali; Sergej M Ostojic; P.A. Mahesh; Alicia Padron-Monedero; Jagadish Rao Padubidri; Mohammad Taha Pahlevan Fallahy; Tamás Palicz; Adrian Pana; Eun-Kee Park; Jay Patel; Rajan Paudel; Uttam Paudel; Paolo Pedersini; Marcos Pereira; Renato B Pereira; Ionela-Roxana Petcu; Majid Pirestani; Maarten J Postma; Akila Prashant; Mohammad Rabiee; Amir Radfar; Sima Rafiei; Fakher Rahim; Mohammad Hifz Ur Rahman; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Shayan Rahmani; Vahid Rahmanian; Prashant Rajput; Juwel Rana; Chythra R Rao; Sowmya J Rao; Sina Rashedi; Mohammad-Mahdi Rashidi; Zubair Ahmed Ratan; David Laith Rawaf; Salman Rawaf; Lal Rawal; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Maryam Rezaei; Nazila Rezaei; Nima Rezaei; Mohsen Rezaeian; Mónica Rodrigues; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; David Rojas-Rueda; Kristina E Rudd; Aly M A Saad; Siamak Sabour; Basema Saddik; Erfan Sadeghi; Masoumeh Sadeghi; Umar Saeed; Maryam Sahebazzamani; Amirhossein Sahebkar; Harihar Sahoo; Mirza Rizwan Sajid; Sateesh Sakhamuri; Sana Salehi; Abdallah M Samy; Milena M Santric-Milicevic; Bruno Piassi Sao Jose; Brijesh Sathian; Maheswar Satpathy; Ganesh Kumar Saya; Subramanian Senthilkumaran; Allen Seylani; Saeed Shahabi; Masood Ali Shaikh; Mohd Shanawaz; Mohammed Shannawaz; Rahim Ali Sheikhi; Shashank Shekhar; Migbar Mekonnen Sibhat; Colin R Simpson; Jasvinder A Singh; Paramdeep Singh; Surjit Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Mohammad Sadegh Soltani-Zangbar; Suhang Song; Ireneous N Soyiri; Paschalis Steiropoulos; Leo Stockfelt; Jing Sun; Ken Takahashi; Iman M Talaat; Ker-Kan Tan; Nathan Y Tat; Vivian Y Tat; Birhan Tsegaw Taye; Pugazhenthan Thangaraju; Rekha Thapar; Friedrich Thienemann; Amir Tiyuri; Mai Thi Ngoc Tran; Jaya Prasad Tripathy; Lorainne Tudor Car; Biruk Shalmeno Tusa; Irfan Ullah; Sana Ullah; Marco Vacante; Pascual R Valdez; Rohollah Valizadeh; Job F M Van Boven; Tommi Juhani Vasankari; Siavash Vaziri; Francesco S Violante; Bay Vo; Ning Wang; Melissa Y Wei; Ronny Westerman; Nuwan Darshana Wickramasinghe; Suowen Xu; Xiaoyue Xu; Lalit Yadav; Yazachew Yismaw; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Yong Yu; Ismaeel Yunusa; Mazyar Zahir; Moein Zangiabadian; Zahra Zareshahrabadi; Armin Zarrintan; Mikhail Sergeevich Zastrozhin; Zelalem Banjaw Zegeye; Yunquan Zhang; Mohsen Naghavi; Bagher Larijani; Farshad Farzadfar
Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries. Funding: Bill & Melinda Gates Foundation. © 2023 The Authors
Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Natalia V. Bhattacharjee; Austin E. Schumacher; Amirali Aali; Yohannes Habtegiorgis Abate; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Sherief Abd-Elsalam; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Olumide Abiodun; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Michael R.M. Abrigo; Dariush Abtahi; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen M.E. Abu-Rmeileh; Tadele Girum Girum Adal; Mesafint Molla Adane; Oluwafemi Atanda Adeagbo Adeagbo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Bashir Aden; Abiola Victor Adepoju; Olatunji O. Adetokunboh; Juliana Bunmi Adetunji; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Rotimi Felix Afolabi; Shadi Afyouni; Muhammad Sohail Afzal; Saira Afzal; Shahin Aghamiri; Antonella Agodi; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Austin J. Ahlstrom; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Sajjad Ahmad; Tauseef Ahmad; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Meqdad Saleh Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Gizachew Taddesse Akalu; Hossein Akbarialiabad; Rufus Olusola Akinyemi; Mohammed Ahmed Akkaif; Sreelatha Akkala; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Mohammad Al Qadire; Tareq Mohammed Ali AL-Ahdal; Samer O. Alalalmeh; Tariq A. Alalwan; Ziyad Al-Aly; Khurshid Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Almaza Albakri; Mohammed Albashtawy; Mohammad T. AlBataineh; Hediyeh Alemi; Sharifullah Alemi; Yihun Mulugeta Alemu; Ayman Al-Eyadhy; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Noora Alhajri; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Abid Ali; Beriwan Abdulqadir Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Sheikh Mohammad Alif; Mohammad Aligol; Mehran Alijanzadeh; Mohammad A.M. Aljasir; Syed Mohamed Aljunid; Sabah Al-Marwani; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jaber S. Alqahtani; Ahmed Yaseen Alqutaibi; Rajaa M. Al-Raddadi; Salman Khalifah Al-Sabah; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Farrukh Jawad Alvi; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Mostafa Amini-Rarani; Sohrab Amiri; Irene Gyamfuah Ampomah; Dickson A. Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Abhishek Anil; Sneha Anil; Adnan Ansar; Alireza Ansari-Moghaddam; Catherine M. Antony; Ernoiz Antriyandarti; Saeid Anvari; Saleha Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Jalal Arabloo; Razman Arabzadeh Bahri; Elshaimaa A. Arafa; Mosab Arafat; Ana Margarida Araujo; Aleksandr Y. Aravkin; Abdulfatai Aremu; Timur Aripov; Mesay Arkew; Benedetta Armocida; Johan Ärnlöv; Mahwish Arooj; Anton A. Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Ashokan Arumugam; Mohsen Asadi-Lari; Zatollah Asemi; Saeed Asgary; Mona Asghariahmadabad; Mohammad Asghari-Jafarabadi; Mubarek Yesse Ashemo; Muhammad Ashraf; Tahira Ashraf; Marvellous O. Asika; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Amlaku Mulat Aweke; Getnet Melaku Ayele; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Rui M.S. Azevedo; Ahmed Y. Azzam; Muhammad Badar; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Najmeh Bahmanziari; Ruhai Bai; Atif Amin Baig; Jennifer L. Baker; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Madhan Balasubramanian; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Hansi Bansal; Mehmet Firat Baran; Martina Barchitta; Mainak Bardhan; Erfan Bardideh; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Sandra Barteit; Zarrin Basharat; Asma'u I.J. Bashir; Hameed Akande Bashiru; Afisu Basiru; Joao Diogo Basso; Sanjay Basu; Abdul-Monim Mohammad Batiha; Kavita Batra; Bernhard T. Baune; Mohsen Bayati; Tahmina Begum; Emad Behboudi; Amir Hossein Behnoush; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Alehegn Bekele; Sefealem Assefa Belay; Uzma Iqbal Belgaumi; Michelle L. Bell; Olorunjuwon Omolaja Bello; Apostolos Beloukas; Isabela M. 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Castañeda-Orjuela; Giulio Castelpietra; Maria Sofia Cattaruzza; Arthur Caye; Luca Cegolon; Francieli Cembranel; Ester Cerin; Joshua Chadwick; Yaacoub Chahine; Chiranjib Chakraborty; Julian Chalek; Jeffrey Shi Kai Chan; Periklis Charalampous; Vijay Kumar Chattu; Sarika Chaturvedi; Malizgani Paul Chavula; An-Tian Chen; Haowei Chen; Simiao Chen; Gerald Chi; Fatemeh Chichagi; Ju-Huei Chien; Patrick R. Ching; William C.S. Cho; Sungchul Choi; Bryan Chong; Hitesh Chopra; Sonali Gajanan Choudhari; Devasahayam J. Christopher; Dinh-Toi Chu; Isaac Sunday Chukwu; Eric Chung; Sheng-Chia Chung; Zinhle Cindi; Iolanda Cioffi; Raffaela Ciuffreda; Rafael M. Claro; Kaleb Coberly; Alyssa Columbus; Haley Comfort; Joao Conde; Michael H. Criqui; Natalia Cruz-Martins; Silvia Magali Cuadra-Hernández; Sriharsha Dadana; Omid Dadras; Tukur Dahiru; Zhaoli Dai; Bronte Dalton; Giovanni Damiani; Aso Mohammad Darwesh; Jai K. Das; Saswati Das; Mohsen Dashti; Anna Dastiridou; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Aklilu Tamire Debele; Shayom Debopadhaya; Somayeh Delavari; Ivan Delgado-Enciso; Dessalegn Demeke; Berecha Hundessa Demessa; Xinlei Deng; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Arkadeep Dhali; Kuldeep Dhama; Meghnath Dhimal; Vishal R. Dhulipala; Diana Dias Da Silva; Daniel Diaz; Michael J. Diaz; Adriana Dima; Delaney D. Ding; M. Ashworth Dirac; Thanh Chi Do; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Sushil Dohare; Wanyue Dong; Mario D'Oria; Wendel Mombaque Dos Santos; Leila Doshmangir; Robert Kokou Dowou; Ashel Chelsea Dsouza; Haneil Larson Dsouza; Viola Dsouza; John Dube; Joe Duprey; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Sulagna Dutta; Laura Dwyer-Lindgren; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Alireza Ebrahimi; Hisham Atan Edinur; Kristina Edvardsson; Ferry Efendi; Terje Andreas Eikemo; Michael Ekholuenetale; Maha El Tantawi; Noha Mousaad Elemam; Ghada Metwally Tawfik ElGohary; Muhammed Elhadi; Legesse Tesfaye Elilo; Omar Abdelsadek Abdou Elmeligy; Mohamed A. Elmonem; Mohammed Elshaer; Ibrahim Elsohaby; Amir Emami Zeydi; Luchuo Engelbert Bain; Sharareh Eskandarieh; Francesco Esposito; Kara Estep; Farshid Etaee; Natalia Fabin; Adeniyi Francis Fagbamigbe; Saman Fahimi; Aliasghar Fakhri-Demeshghieh; Luca Falzone; Ali Faramarzi; MoezAlIslam Ezzat Mahmoud Faris; Sam Farmer; Andre Faro; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Pietro Ferrara; Nuno Ferreira; Getahun Fetensa; Irina Filip; Florian Fischer; Joanne Flavel; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Behzad Foroutan; Matteo Foschi; Kayode Raphael Fowobaje; Kate Louise Francis; Alberto Freitas; Takeshi Fukumoto; John E. Fuller; Blima Fux; Peter Andras Gaal; Muktar A. Gadanya; Abhay Motiramji Gaidhane; Yaseen Galali; Silvano Gallus; Aravind P. Gandhi; Balasankar Ganesan; Mohammad Arfat Ganiyani; M.A. Garcia-Gordillo; Naval Garg; Rupesh K. Gautam; Federica Gazzelloni; Semiu Olatunde Gbadamosi; Miglas W. Gebregergis; Mesfin Gebrehiwot; Tesfay Brhane Gebremariam; Teferi Gebru Gebremeskel; Yohannes Fikadu Geda; Simona Roxana Georgescu; Urge Gerema; Habtamu Geremew; Motuma Erena Getachew; Peter W. Gething; MohammadReza Ghasemi; Ghazal Ghasempour Dabaghi; Afsaneh Ghasemzadeh; Fariba Ghassemi; Ramy Mohamed Ghazy; Sailaja Ghimire; Asadollah Gholamian; Ali Gholamrezanezhad; Mahsa Ghorbani; Aloke Gopal Ghoshal; Arun Digambarrao Ghuge; Artyom Urievich Gil; Tiffany K. Gill; Matteo Giorgi; Alem Girmay; James C. Glasbey; Laszlo Göbölös; Amit Goel; Ali Golchin; Mahaveer Golechha; Pouya Goleij; Sameer Vali Gopalani; Houman Goudarzi; Alessandra C. Goulart; Anmol Goyal; Simon Matthew Graham; Michal Grivna; Shi-Yang Guan; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Stefano Guicciardi; Snigdha Gulati; David Gulisashvili; Damitha Asanga Gunawardane; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Manoj Kumar Gupta; Mohak Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Annie Haakenstad; Farrokh Habibzadeh; Najah R. Hadi; Nils Haep; Ramtin Hajibeygi; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Nadia M. Hamdy; Sajid Hameed; Samer Hamidi; Qiuxia Han; Alexis J. Handal; Graeme J. Hankey; Md Nuruzzaman Haque; Josep Maria Haro; Ahmed I. Hasaballah; Ikramul Hasan; Mohammad Jahid Hasan; S.M. Mahmudul Hasan; Hamidreza Hasani; Md Saquib Hasnain; Amr Hassan; Ikrama Hassan; Soheil Hassanipour; Hadi Hassankhani; Simon I. Hay; Jeffrey J. Hebert; Omar E. Hegazi; Mohammad Heidari; Bartosz Helfer; Mehdi Hemmati; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Kamran Hessami; Kamal Hezam; Yuta Hiraike; Nguyen Quoc Hoan; Ramesh Holla; Nobuyuki Horita; Md Mahbub Hossain; Mohammad Bellal Hossain Hossain; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Vivian Chia-Rong Hsieh; Chengxi Hu; Junjie Huang; M. Mamun Huda; Ayesha Humayun; Javid Hussain; Nawfal R. Hussein; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Pulwasha Maria Iftikhar; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Leeberk Raja Inbaraj; Afrin Iqbal; Md. Rabiul Islam; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Masao Iwagami; Mahalaxmi Iyer; J. Linda Merin; Jalil Jaafari; Louis Jacob; Farhad Jadidi-Niaragh; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Mihajlo Jakovljevic; Elham Jamshidi; Sabzali Javadov; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Sun Ha Jee; Jayakumar Jeganathan; Anil K. Jha; Ravi Prakash Jha; Heng Jiang; Mohammad Jokar; Jost B. Jonas; Tamas Joo; Nitin Joseph; Charity Ehimwenma Joshua; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; K. Vaishali; Billingsley Kaambwa; Abdulkareem Kabir; Ali Kabir; Hannaneh Kabir; Zubair Kabir; Rizwan Kalani; Leila R. Kalankesh; Feroze Kaliyadan; Sanjay Kalra; Rajesh Kamath; Sagarika Kamath; Tanuj Kanchan; Edmund Wedam Kanmiki; Kehinde Kazeem Kanmodi; S. Suthanthira Kannan; Sushil Kumar Kansal; Rami S. Kantar; Neeti Kapoor; Mehrdad Karajizadeh; Manoochehr Karami; Ibraheem M. Karaye; Faizan Zaffar Kashoo; Hengameh Kasraei; Nicholas J. Kassebaum; Molly B. Kassel; Joonas H. Kauppila; Foad Kazemi; Sara Kazeminia; John H. Kempen; Evie Shoshannah Kendal; Kamyab Keshtkar; Mohammad Keykhaei; Himanshu Khajuria; Amirmohammad Khalaji; Nauman Khalid; Anees Ahmed Khalil; Alireza Khalilian; Faham Khamesipour; Ajmal Khan; Asaduzzaman Khan; Ikramullah Khan; M. Nuruzzaman Khan; Maseer Khan; Mohammad Jobair Khan; Moien A.B. Khan; Young-Ho Khang; Shaghayegh Khanmohammadi; Khaled Khatab; Armin Khavandegar; Hamid Reza Khayat Kashani; Feriha Fatima Khidri; Moein Khormali; Mohammad Ali Khosravi; Mahmood Khosrowjerdi; Wondwosen Teklesilasie Kidane; Zemene Demelash Kifle; Julie Sojin Kim; Min Seo Kim; Ruth W. Kimokoti; Kasey E. Kinzel; Girmay Tsegay Kiross; Adnan Kisa; Sezer Kisa; Ali-Asghar Kolahi; Farzad Kompani; Gerbrand Koren; Oleksii Korzh; Soewarta Kosen; Sindhura Lakshmi Koulmane Laxminarayana; Kewal Krishan; Varun Krishna; Vijay Krishnamoorthy; Barthelemy Kuate Defo; Connor M. Kubeisy; Burcu Kucuk Bicer; Md Abdul Kuddus; Mohammed Kuddus; Ilari Kuitunen; Mukhtar Kulimbet; Harish Kumar; Satyajit Kundu; Kunle Rotimi Kunle; Om P. Kurmi; Asep Kusnali; Dian Kusuma; Evans F. Kyei; Ilias Kyriopoulos; Carlo La Vecchia; Ben Lacey; Muhammad Awwal Ladan; Lucie Laflamme; Chandrakant Lahariya; Daphne Teck Ching Lai; Dharmesh Kumar Lal; Ratilal Lalloo; Judit Lám; Demetris Lamnisos; Ivan Landires; Francesco Lanfranchi; Berthold Langguth; Ariane Laplante-Lévesque; Heidi Jane Larson; Anders O. Larsson; Savita Lasrado; Kamaluddin Latief; Kaveh Latifinaibin; Long Khanh Dao Le; Nhi Huu Hanh Le; Trang Diep Thanh Le; Caterina Ledda; Munjae Lee; Paul H. Lee; Seung Won Lee; Yo Han Lee; Gebretsadik Kiros Lema; Elvynna Leong; Temesgen L. Lerango; An Li; Ming-Chieh Li; Shanshan Li; Wei Li; Xiaopan Li; Virendra S. Ligade; Stephen S. Lim; Ro-Ting Lin; Paulina A. Lindstedt; Stefan Listl; Gang Liu; Jue Liu; Xiaofeng Liu; Xuefeng Liu; Yuewei Liu; Erand Llanaj; Ruben López-Bueno; Platon D. Lopukhov; Laszlo Lorenzovici; Paulo A. Lotufo; Jailos Lubinda; Giancarlo Lucchetti; Alessandra Lugo; Raimundas Lunevicius; Hengliang Lv; Zheng Feei Ma; Kelsey Lynn Maass; Monika MacHoy; Áurea M. Madureira-Carvalho; Mohammed Magdy Abd El Razek; Azzam A. Maghazachi; Soleiman Mahjoub; Mansour Adam Mahmoud; Azeem Majeed; Jeadran N. Malagón-Rojas; Elaheh Malakan Rad; Kashish Malhotra; Ahmad Azam Malik; Iram Malik; Deborah Carvalho Malta; Abdullah A. Mamun; Yosef Manla; Yasaman Mansoori; Ali Mansour; Borhan Mansouri; Zeinab Mansouri; Mohammad Ali Mansournia; Joemer C. Maravilla; Mirko Marino; Abdoljalal Marjani; Gabriel Martinez; Ramon Martinez-Piedra; Francisco Rogerlandio Martins-Melo; Miquel Martorell; Sharmeen Maryam; Roy Rillera Marzo; Alireza Masoudi; Jishanth Mattumpuram; Richard James Maude; Andrea Maugeri; Erin A. May; Mahsa Mayeli; Maryam Mazaheri; John J. McGrath; Martin McKee; Anna Laura Wensel McKowen; Susan A. McLaughlin; Steven M. 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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
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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 age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier Ltd, 2024) Jorge R. Ledesma; Jianing Ma; Meixin Zhang; Ann V. L. Basting; Huong Thi Chu; Avina Vongpradith; Amanda Novotney; Kate E. LeGrand; Yvonne Yiru Xu; Xiaochen Dai; Sneha Ingle Nicholson; Lauryn K. Stafford; Austin Carter; Jennifer M. Ross; Hedayat Abbastabar; Meriem Abdoun; Deldar Morad Abdulah; Richard Gyan Aboagye; Hassan Abolhassani; Woldu Aberhe Abrha; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Salahdein Aburuz; Isaac Yeboah Addo; Abiola Victor Adepoju; Kishor Adhikari; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Abel Afework; Shahin Aghamiri; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Danish Ahmad; Sajjad Ahmad; Amir Mahmoud Ahmadzade; Haroon Ahmed; Mohammed Ahmed; Ayman Ahmed; Karolina Akinosoglou; Tareq Mohammed Ali Al-Ahdal; Nazmul Alam; Mohammed Albashtawy; Mohammad T. AlBataineh; Adel Ali Saeed Al-Gheethi; Abid Ali; Endale Alemayehu Ali; Liaqat Ali; Zahid Ali; Syed Shujait Shujait Ali; Kasim Allel; Awais Altaf; Jaffar A. Al-Tawfiq; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Reza Amani; Ganiyu Adeniyi Amusa; Jimoh Amzat; Jason R. Andrews; Abhishek Anil; Razique Anwer; Aleksandr Y. Aravkin; Damelash Areda; Anton A. Artamonov; Raphael Taiwo Aruleba; Mulusew A. Asemahagn; Sachin R. Atre; Avinash Aujayeb; Davood Azadi; Sina Azadnajafabad; Ahmed Y. Azzam; Muhammad Badar; Ashish D. Badiye; Sara Bagherieh; Saeed Bahadorikhalili; Atif Amin Baig; Maciej Banach; Biswajit Banik; Mainak Bardhan; Hiba Jawdat Barqawi; Zarrin Basharat; Pritish Baskaran; Saurav Basu; Maryam Beiranvand; Melaku Ashagrie Belete; Makda Abate Belew; Uzma Iqbal Belgaumi; Apostolos Beloukas; Paulo J. G. Bettencourt; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Ashish Bhargava; Vivek Bhat; Jasvinder Singh Bhatti; Gurjit Kaur Bhatti; Boris Bikbov; Veera R. Bitra; Vesna Bjegovic-Mikanovic; Danilo Buonsenso; Katrin Burkart; Yasser Bustanji; Zahid A. Butt; Paulo Camargos; Yu Cao; Sinclair Carr; Felix Carvalho; Luca Cegolon; Muthia Cenderadewi; Muge Cevik; Yaacoub Chahine; Vijay Kumar Chattu; Patrick R. Ching; Hitesh Chopra; Eunice Chung; Mareli M. Claassens; Kaleb Coberly; Natália Cruz-Martins; Bashir Dabo; Sriharsha Dadana; Omid Dadras; Isaac Darban; Jiregna Darega Gela; Aso Mohammad Darwesh; Mahmood Dashti; Berecha Hundessa Demessa; Biniyam Demisse; Solomon Demissie; Awoke Masrie Asrat Derese; Kebede Deribe; Hardik Dineshbhai Desai; Vinoth Gnana Chellaiyan Devanbu; Arkadeep Dhali; Kuldeep Dhama; Sameer Dhingra; Thao Huynh Phuong Do; Deepa Dongarwar; Haneil Larson Dsouza; John Dube; Arkadiusz Marian Dziedzic; Abdelaziz Ed-Dra; Ferry Efendi; Diyan Ermawan Effendi; Aziz Eftekharimehrabad; Nopryan Ekadinata; Temitope Cyrus Ekundayo; Muhammed Elhadi; Legesse Tesfaye Elilo; Theophilus I. Emeto; Luchuo Engelbert Bain; Adeniyi Francis Fagbamigbe; Ayesha Fahim; Alireza Feizkhah; Getahun Fetensa; Florian Fischer; Abduzhappar Gaipov; Aravind P. Gandhi; Rupesh K. Gautam; Miglas W. Gebregergis; Mesfin Gebrehiwot; Kahsu Gebrekirstos Gebrekidan; Kazem Ghaffari; Fariba Ghassemi; Ramy Mohamed Ghazy; Amador Goodridge; Anmol Goyal; Shi-Yang Guan; Mesay Dechasa Gudeta; Rashid Abdi Guled; Novianti Br Gultom; Veer Bala Gupta; Vivek Kumar Gupta; Sapna Gupta; Hailey Hagins; Semira Goitom Hailu; Wase Benti Hailu; Samer Hamidi; Asif Hanif; Harapan Harapan; Rumina Syeda Hasan; Shoaib Hassan; Johannes Haubold; Kamal Hezam; Sung Hwi Hong; Nobuyuki Horita; Md Belal Hossain; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Hong-Han Huynh; Segun Emmanuel Ibitoye; Kevin S. Ikuta; Irena M. Ilic; Milena D. Ilic; Md Rabiul Islam; Nahlah Elkudssiah Ismail; Faisal Ismail; Abdollah Jafarzadeh; Mihajlo Jakovljevic; Mahsa Jalili; Manthan Dilipkumar Janodia; Nabi Jomehzadeh; Jost B. Jonas; Nitin Joseph; Charity Ehimwenma Joshua; Zubair Kabir; Bhushan Dattatray Kamble; Tanuj Kanchan; Himal Kandel; Kehinde Kazeem Kanmodi; Rami S. Kantar; Ibraheem M. Karaye; Arman Karimi Behnagh; Gebrehiwot G. Kassa; Rimple Jeet Kaur; Navjot Kaur; Himanshu Khajuria; Faham Khamesipour; Yusra H. Khan; M. Nuruzzaman Khan; Mahammed Ziauddin Khan Suheb; Khaled Khatab; Fatemeh Khatami; Min Seo Kim; Soewarta Kosen; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Kewal Krishan; Burcu Kucuk Bicer; Md Abdul Kuddus; Mukhtar Kulimbet; Nithin Kumar; Dharmesh Kumar Lal; Iván Landires; Kamaluddin Latief; Trang Diep Thanh Le; Thao Thi Thu Le; Caterina Ledda; Munjae Lee; Seung Won Lee; Temesgen L. Lerango; Stephen S. Lim; Chaojie Liu; Xuefeng Liu; Platon D. Lopukhov; Hong Luo; Hengliang Lv; Preetam Bhalchandra Mahajan; Amir Ali Mahboobipour; Azeem Majeed; Elaheh Malakan Rad; Kashish Malhotra; Muhammad Sajeel Ahmed Malik; Lesibana Anthony Malinga; Tauqeer Hussain Mallhi; Aseer Manilal; Bernardo Alfonso Martinez-Guerra; Francisco Rogerlândio Martins-Melo; Roy Rillera Marzo; Hossein Masoumi-Asl; Vasundhara Mathur; Richard James Maude; Ravi Mehrotra; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Muayad Aghali Merza; Tomislav Mestrovic; Laurette Mhlanga; Sanjeev Misra; Arup Kumar Misra; Prasanna Mithra; Babak Moazen; Hussen Mohammed; Ali H. Mokdad; Lorenzo Monasta; Catrin E. Moore; Parsa Mousavi; Francesk Mulita; Fungai Musaigwa; Raman Muthusamy; Ahamarshan Jayaraman Nagarajan; Pirouz Naghavi; Ganesh R. Naik; Gurudatta Naik; Sanjeev Nair; Tapas Sadasivan Nair; Zuhair S. Natto; Biswa Prakash Nayak; Hadush Negash; Dang H. Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Chukwudi A. Nnaji; Lawrence Achilles Nnyanzi; Efaq Ali Noman; Shuhei Nomura; Bogdan Oancea; Kehinde O. Obamiro; Ismail A. Odetokun; Daniel Bogale Odo Odo; Oluwakemi Ololade Odukoya; In-Hwan Oh; Chukwuma O. Okereke; Osaretin Christabel Okonji; Eyal Oren; Edgar Ortiz-Brizuela; Uchechukwu Levi Osuagwu; Amel Ouyahia; P.A. Mahesh Padukudru; Pragyan Paramita Parija; Romil R. Parikh; Seoyeon Park; Ashwaghosha Parthasarathi; Shankargouda Patil; Shrikant Pawar; Minjin Peng; Veincent Christian Filipino Pepito; Prince Peprah; João Perdigão; Norberto Perico; Hoang Tran Pham; Maarten J. Postma; Attur Ravindra Attur Prabhu; Manya Prasad; Akila Prashant; Elton Junio Sady Prates; Fakher Rahim; Mosiur Rahman; Muhammad Aziz Rahman; Masoud Rahmati; Sathish Rajaa; Shakthi Kumaran Ramasamy; Indu Ramachandra Rao; Sowmya J. Rao; Deepthi Rapaka; Ahmed Mustafa Rashid; Zubair Ahmed Ratan; Nakul Ravikumar; Salman Rawaf; Murali Mohan Rama Krishna Reddy; Elrashdy Moustafa Mohamed Redwan; Giuseppe Remuzzi; Luis Felipe Reyes; Nazila Rezaei; Mohsen Rezaeian; Omid Rezahosseini; Mónica Rodrigues; Priyanka Roy; Guilherme de Andrade Ruela; Siamak Sabour; Basema Saddik; Umar Saeed; Sher Zaman Safi; Narjes Saheb Sharif-Askari; Fatemeh Saheb Sharif-Askari; Amirhossein Sahebkar; Biniyam Sahiledengle; Soumya Swaroop Sahoo; Nasir Salam; Afeez Abolarinwa Salami; Samreen Saleem; Mohamed A. Saleh; Hossein Samadi Kafil; Sara Samadzadeh; Yoseph Leonardo Samodra; Rama Krishna Sanjeev; Aswini Saravanan; Susan M. Sawyer; Siddharthan Selvaraj; Sabyasachi Senapati; Subramanian Senthilkumaran; Pritik A. Shah; Samiah Shahid; Masood Ali Shaikh; Sunder Sham; Mohammad Ali Shamshirgaran; Mohd Shanawaz; Medha Sharath; Samendra P. Sherchan; Ranjitha S. Shetty; Hesamaddin Shirzad-Aski; Aminu Shittu; Emmanuel Edwar Siddig; João Pedro Silva; Surjit Singh; Paramdeep Singh; Harpreet Singh; Jasvinder A. Singh; Md Shahjahan Siraj; Siswanto Siswanto; Ranjan Solanki; Yonatan Solomon; Joan B. Soriano; Chandrashekhar T. Sreeramareddy; Vijay Kumar Srivastava; Paschalis Steiropoulos; Chandan Kumar Swain; Takahiro Tabuchi; Mircea Tampa; Jacques J. L. Lukenze Tamuzi; Nathan Y. Tat; Razieh Tavakoli Oliaee; Gebrehiwot Teklay; Edosa Geta Tesfaye; Belay Tessema; Pugazhenthan Thangaraju; Rekha Thapar; Chern Choong Chern Thum; Jansje Henny Vera Ticoalu; Imad M. Tleyjeh; Ruoyan Tobe-Gai; Temesgen Mohammed Toma; Khai Hoan Tram; Aniefiok John Udoakang; Tungki Pratama Umar; Chukwuma David Umeokonkwo; Seyed Mohammad Vahabi; Asokan Govindaraj Vaithinathan; Job F. M. van Boven; Shoban Babu Varthya; Ziyue Wang; Muktar S. A. Warsame; Ronny Westerman; Tewodros Eshete Wonde; Sajad Yaghoubi; Siyan Yi; Vahit Yigit; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Fathiah Zakham; Moein Zangiabadian; Francis Zeukeng; Haijun Zhang; Yang Zhao; Peng Zheng; Magdalena Zielinska; Joshua A. Salomon; Robert C. Reiner; Mohsen Naghavi; Theo Vos; Simon I. Hay; Christopher J. L. Murray; Hmwe Hmwe Kyu
Background: Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to 2021, and to report on age-specific progress between 2015 and 2020. Methods: We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021) analytical framework to compute age-specific tuberculosis mortality and incidence estimates for 204 countries and territories (1990–2021 inclusive). We quantified tuberculosis mortality among individuals without HIV co-infection using 22 603 site-years of vital registration data, 1718 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, 680 site-years of mortality surveillance data, and 9 site-years of minimally invasive tissue sample (MITS) diagnoses data as inputs into the Cause of Death Ensemble modelling platform. Age-specific HIV and tuberculosis deaths were established with a population attributable fraction approach. We analysed all available population-based data sources, including prevalence surveys, annual case notifications, tuberculin surveys, and tuberculosis mortality, in DisMod-MR 2.1 to produce internally consistent age-specific estimates of tuberculosis incidence, prevalence, and mortality. We also estimated age-specific tuberculosis mortality without HIV co-infection that is attributable to the independent and combined effects of three risk factors (smoking, alcohol use, and diabetes). As a secondary analysis, we examined the potential impact of the COVID-19 pandemic on tuberculosis mortality without HIV co-infection by comparing expected tuberculosis deaths, modelled with trends in tuberculosis deaths from 2015 to 2019 in vital registration data, with observed tuberculosis deaths in 2020 and 2021 for countries with available cause-specific mortality data. Findings: We estimated 9·40 million (95% uncertainty interval [UI] 8·36 to 10·5) tuberculosis incident cases and 1·35 million (1·23 to 1·52) deaths due to tuberculosis in 2021. At the global level, the all-age tuberculosis incidence rate declined by 6·26% (5·27 to 7·25) between 2015 and 2020 (the WHO End TB strategy evaluation period). 15 of 204 countries achieved a 20% decrease in all-age tuberculosis incidence between 2015 and 2020, eight of which were in western sub-Saharan Africa. When stratified by age, global tuberculosis incidence rates decreased by 16·5% (14·8 to 18·4) in children younger than 5 years, 16·2% (14·2 to 17·9) in those aged 5–14 years, 6·29% (5·05 to 7·70) in those aged 15–49 years, 5·72% (4·02 to 7·39) in those aged 50–69 years, and 8·48% (6·74 to 10·4) in those aged 70 years and older, from 2015 to 2020. Global tuberculosis deaths decreased by 11·9% (5·77 to 17·0) from 2015 to 2020. 17 countries attained a 35% reduction in deaths due to tuberculosis between 2015 and 2020, most of which were in eastern Europe (six countries) and central Europe (four countries). There was variable progress by age: a 35·3% (26·7 to 41·7) decrease in tuberculosis deaths in children younger than 5 years, a 29·5% (25·5 to 34·1) decrease in those aged 5–14 years, a 15·2% (10·0 to 20·2) decrease in those aged 15–49 years, a 7·97% (0·472 to 14·1) decrease in those aged 50–69 years, and a 3·29% (–5·56 to 9·07) decrease in those aged 70 years and older. Removing the combined effects of the three attributable risk factors would have reduced the number of all-age tuberculosis deaths from 1·39 million (1·28 to 1·54) to 1·00 million (0·703 to 1·23) in 2020, representing a 36·5% (21·5 to 54·8) reduction in tuberculosis deaths compared to those observed in 2015. 41 countries were included in our analysis of the impact of the COVID-19 pandemic on tuberculosis deaths without HIV co-infection in 2020, and 20 countries were included in the analysis for 2021. In 2020, 50 900 (95% CI 49 700 to 52 400) deaths were expected across all ages, compared to an observed 45 500 deaths, corresponding to 5340 (4070 to 6920) fewer deaths; in 2021, 39 600 (38 300 to 41 100) deaths were expected across all ages compared to an observed 39 000 deaths, corresponding to 657 (–713 to 2180) fewer deaths. Interpretation: Despite accelerated progress in reducing the global burden of tuberculosis in the past decade, the world did not attain the first interim milestones of the WHO End TB Strategy in 2020. The pace of decline has been unequal with respect to age, with older adults (ie, those aged >50 years) having the slowest progress. As countries refine their national tuberculosis programmes and recalibrate for achieving the 2035 targets, they could consider learning from the strategies of countries that achieved the 2020 milestones, as well as consider targeted interventions to improve outcomes in older age groups. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019
(John Wiley and Sons Inc, 2023) Youn Ho Shin; Jimin Hwang; Rosie Kwon; Seung Won Lee; Min Seo Kim; Jae Il Shin; Dong Keon Yon; Yohannes Habtegiorgis Abate; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Michael Abdelmasseh; Deldar Morad Abdulah; Richard Gyan Aboagye; Hassan Abolhassani; Elissa M. Abrams; Yonas Derso Abtew; Eman Abu-Gharbieh; Denberu Eshetie Adane Adane; Tigist Demssew Adane; Isaac Yeboah Addo; Rishan Adha; Amin Adibi; Qorinah Estiningtyas Sakilah Adnani; Anurag Agrawal; Sohail Ahmad; Ali Ahmadi; Ali Ahmed; Ayman Ahmed; Sayer Al-Azzam; Fadwa Alhalaiqa Naji Alhalaiqa; Sheikh Mohammad Alif; Vahid Alipour; Zaid Altaany; Khalid A. Altirkawi; Nelson Alvis-Guzman; Hany Aly; Adnan Ansar; Judie Arulappan; Mohammad Asghari-Jafarabadi; Tahira Ashraf; Seyyed Shamsadin Athari; Daniel Atlaw; Avinash Aujayeb; Sina Azadnajafabad; Mahsa Babaei; Hassan Babamohamadi; Alaa Badawi; Nayereh Baghcheghi; Sara Bagherieh; Khuloud Bajbouj; Maciej Banach; Mainak Bardhan; Francesco Barone-Adesi; Amadou Barrow; Azadeh Bashiri; Nebiyou Simegnew Bayileyegn; Isabela M. Bensenor; Alemshet Yirga Berhie; Kebede A. Beyene; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Ajay Nagesh Bhat; Vijayalakshmi S. Bhojaraja; Ali Bijani; Andras Bikov; Jiao Cai; Paulo Camargos; Josip Car; Sinclair Carr; Andrea Carugno; Promit Ananyo Chakraborty; Jeffrey Shi Kai Chan; Periklis Charalampous; Mohammadreza Chashmyazdan; Vijay Kumar Chattu; Mohiuddin Ahsanul Kabir Chowdhury; Dinh-Toi Chu; Barbara Corso; Natália Cruz-Martins; Omid Dadras; Xiaochen Dai; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; Dessalegn Demeke; Biniyam Demisse; Daniel Diaz; Mengistie Diress; Deepa Dongarwar; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Muhammed Elhadi; Omar Abdelsadek Abdou Elmeligy; Habtamu Esubalew; Farshid Etaee; Azin Etemadimanesh; Adeniyi Francis Fagbamigbe; Ildar Ravisovich Fakhradiyev; Ali Fatehizadeh; Syeda Anum Fatima Fatima; Xiaoqi Feng; Mohammad Fereidouni; Nuno Ferreira; Getahun Fetensa; Florian Fischer; Masoud Foroutan; Takeshi Fukumoto; Abduzhappar Gaipov; Yibeltal Yismaw Gela; Abera Getachew Obsa; Fataneh Ghadirian; Seyyed-Hadi Ghamari; Sherief Ghozy; Richard F. Gillum; Abraham Tamirat Gizaw; Admasu Belay AB Gizaw; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Sapna Gupta; Vivek Kumar Gupta; Arvin Haj-Mirzaian; Rabih Halwani; Samer Hamidi; Md Abdul Hannan; Ahmed I. Hasaballah; Hamidreza Hasani; Abdiwahab Hashi; Mohammed Bheser Hassen; Behzad Heibati; Golnaz Heidari; Mohammad Heidari; Mahsa Heidari-Foroozan; Ramesh Holla; Nobuyuki Horita; Md Shakhaoat Hossain; Salman Hussain; Bing-Fang Hwang; Irena M. Ilic; Milena D. Ilic; Rana Irilouzadian; Nahlah Elkudssiah Ismail; Zhanat Bakhitovna I. Z. B. Ispayeva; Chidozie C. D. Iwu; Linda Merin J; Maziar Jajarmi; Elham Jamshidi; Manthan Dilipkumar Janodia; Shubha Jayaram; Rime Jebai; Jost B. Jonas; Nitin Joseph; Billingsley Kaambwa; Zubair Kabir; Feroze Kaliyadan; Himal Kandel; Rami S. Kantar; Ibraheem M. Karaye; Hanie Karimi; Harkiran Kaur; Leila Keikavoosi-Arani; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Imteyaz A. Khan; Maseer Khan; Moien A. B. Khan; Saval Khanal; Moawiah Mohammad Khatatbeh; Jagdish Khubchandani; Biruk Getahun Kibret; Adnan Kisa; Sezer Kisa; Pavel Kolkhir; Farzad Kompani; Hamid Reza Koohestani; Oleksii Korzh; Parvaiz A. Koul; Ai Koyanagi; Kewal Krishan; Claudia E. Kuehni; G. Anil Kumar; Om P. Kurmi; L. V. Simhachalam Kutikuppala; Ambily Kuttikkattu; Judit Lám; Bagher Larijani; Kamaluddin Latief; Paolo Lauriola; Thao Thi Thu Le; Yo Han Lee; Jacopo Lenzi; Ming-Chieh Li; Shanshan Li; Virendra S. Ligade; Stephen S. Lim; Gang Liu; Wei Liu; Xuefeng Liu; Chun-Han Lo; Graciliana Lopes; Soundarya Mahalingam; Sandeep B. Maharaj; Mansour Adam Mahmoud; Azeem Majeed; Mohammad-Reza Malekpour; Ahmad Azam Malik; Tauqeer Hussain Mallhi; Deborah Carvalho Malta; Abdullah A. Mamun; Seyedeh Zahra Masoumi; Andrea Maugeri; John Robert Carabeo Medina; Ritesh G. Menezes; George A. Mensah; Alexios-Fotios A. Mentis; Tomislav Mestrovic; Irmina Maria Michalek; Le Huu Nhat Minh; Erkin M. Mirrakhimov; Awoke Misganaw; Manish Mishra; Shafiu Mohammed; Ali H. Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Md Moniruzzaman; Temesgen Mulugeta; Daniel Munblit; Efrén Murillo-Zamora; Ghulam Mustafa; Tapas Sadasivan Nair; Vinay Nangia; Sreenivas Narasimha Swamy; Hasan Nassereldine; Zuhair S. Natto; Biswa Prakash Nayak; Javad Nazari; Tze Pin Ng; Dang H. Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Hasti Nouraei; Ogochukwu Janet Nzoputam; Bogdan Oancea; Rahman Md Obaidur; Hassan Okati-Aliabad; Osaretin Christabel Okonji; Patrick Godwin Okwute; Andrew T. Olagunju; Isaac Iyinoluwa Olufadewa; Hans Orru; P.A. Mahesh; Jagadish Rao Padubidri; Anamika Pandey; Shahina Pardhan; Eun-Kee Park; Jay Patel; Shankargouda Patil; Venkata Suresh Patthipati; Uttam Paudel; Marcos Pereira; Renato B. Pereira; Ionela-Roxana Petcu; Indrashis Podder; Vivek Podder; Arash Pour Mohammad; Ibrahim Qattea; Navid Rabiee; Mehran Rahimi; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Shayan Rahmani; Vahid Rahmanian; Prashant Rajput; Pradhum Ram; Premkumar Ramasubramani; Indu Ramachandra Rao; Ahmed Mustafa Rashid; Zubair Ahmed Ratan; Nakul Ravikumar; Salman Rawaf; Lal Rawal; Elrashdy Moustafa Mohamed Redwan; Aavishkar Raj Regmi; Nazila Rezaei; Negar Rezaei; Nima Rezaei; Saeid Rezaei; Mohsen Rezaeian; Jefferson Antonio Buendia Rodriguez; Leonardo Roever; Esperanza Romero-Rodríguez; Luca Ronfani; Aly M. A. Saad; Basema Saddik; Umar Saeed; Dominic Sagoe; Fatemeh Saheb Sharif-Askari; Amirhossein Sahebkar; Harihar Sahoo; Mirza Rizwan Sajid; Joseph W. Sakshaug; Saina Salahi; Sana Salehi; Abdallah M. Samy; Milena M. Santric-Milicevic; Made Ary Sarasmita; Maryam Sarkhosh; Ganesh Kumar Saya; Subramanian Senthilkumaran; Humaira Shah; Masood Ali Shaikh; Mohd Shanawaz; Aziz Sheikh; Shashank Shekhar; Mika Shigematsu; Parnian Shobeiri; Seyed Afshin Shorofi; Migbar Mekonnen Sibhat; Colin R. Simpson; Jasvinder A. Singh; Paramdeep Singh; Surjit Singh; Virendra Singh; Md Shahjahan Siraj; Anna Aleksandrovna Skryabina; Yonatan Solomon; Suhang Song; Sergey Soshnikov; Ireneous N. Soyiri; Paschalis Steiropoulos; Mindy D. Szeto; Iman M. Talaat; Jacques J. L. Lukenze Tamuzi; Ker-Kan Tan; Nathan Y. Tat; Mohamad-Hani Temsah; Dufera Rikitu Terefa; Riki Tesler; Pugazhenthan Thangaraju; Jansje Henny Vera Ticoalu; Tala Tillawi; Mai Thi Ngoc Tran; Biruk Shalmeno Tusa; Irfan Ullah; Saif Ullah; Sana Ullah; Era Upadhyay; Seyed Mohammad Vahabi; Job F. M. van Boven; Tommi Juhani Vasankari; Georgios-Ioannis Verras; Rafael José Vieira; Francesco S. Violante; Theo Vos; Ronny Westerman; Nuwan Darshana Wickramasinghe; Hywel C. Williams; Dereje Y. Yada; Yazachew Yismaw; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mazyar Zahir; Heather J. Zar; Iman Zare; Mikhail Sergeevich Zastrozhin; Mohammad A. Zeineddine; Getachew Assefa Zenebe; Zhi-Jiang Zhang; Hanqing Zhao; Mohammad Zoladl
Background: Asthma and atopic dermatitis (AD) are chronic allergic conditions, along with allergic rhinitis and food allergy and cause high morbidity and mortality both in children and adults. This study aims to evaluate the global, regional, national, and temporal trends of the burden of asthma and AD from 1990 to 2019 and analyze their associations with geographic, demographic, social, and clinical factors. Methods: Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019, we assessed the age-standardized prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of both asthma and AD from 1990 to 2019, stratified by geographic region, age, sex, and socio-demographic index (SDI). DALYs were calculated as the sum of years lived with disability and years of life lost to premature mortality. Additionally, the disease burden of asthma attributable to high body mass index, occupational asthmagens, and smoking was described. Results: In 2019, there were a total of 262 million [95% uncertainty interval (UI): 224–309 million] cases of asthma and 171 million [95% UI: 165–178 million] total cases of AD globally; age-standardized prevalence rates were 3416 [95% UI: 2899–4066] and 2277 [95% UI: 2192–2369] per 100,000 population for asthma and AD, respectively, a 24.1% [95% UI: −27.2 to −20.8] decrease for asthma and a 4.3% [95% UI: 3.8–4.8] decrease for AD compared to baseline in 1990. Both asthma and AD had similar trends according to age, with age-specific prevalence rates peaking at age 5–9 years and rising again in adulthood. The prevalence and incidence of asthma and AD were both higher for individuals with higher SDI; however, mortality and DALYs rates of individuals with asthma had a reverse trend, with higher mortality and DALYs rates in those in the lower SDI quintiles. Of the three risk factors, high body mass index contributed to the highest DALYs and deaths due to asthma, accounting for a total of 3.65 million [95% UI: 2.14–5.60 million] asthma DALYs and 75,377 [95% UI: 40,615–122,841] asthma deaths. Conclusions: Asthma and AD continue to cause significant morbidity worldwide, having increased in total prevalence and incidence cases worldwide, but having decreased in age-standardized prevalence rates from 1990 to 2019. Although both are more frequent at younger ages and more prevalent in high-SDI countries, each condition has distinct temporal and regional characteristics. Understanding the temporospatial trends in the disease burden of asthma and AD could guide future policies and interventions to better manage these diseases worldwide and achieve equity in prevention, diagnosis, and treatment. © 2023 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Rajesh Sharma; Mohsen Abbasi-Kangevari; Rami Abd-Rabu; Hassan Abidi; Eman Abu-Gharbieh; Juan Manuel Acuna; Sangeet Adhikari; Shailesh M. Advani; Muhammad Sohail Afzal; Mohamad Aghaie Meybodi; Bright Opoku Ahinkorah; Sajjad Ahmad; Ali Ahmadi; Sepideh Ahmadi; Haroon Ahmed; Luai A. Ahmed; Muktar Beshir Ahmed; Hanadi Al Hamad; Fares Alahdab; Fahad Mashhour Alanezi; Turki M. Alanzi; Fadwa Alhalaiqa Naji Alhalaiqa; Yousef Alimohamadi; Vahid Alipour; Syed Mohamed Aljunid; Motasem Alkhayyat; Sami Almustanyir; Rajaa M. Al-Raddadi; Saba Alvand; Nelson Alvis-Guzman; Saeed Amini; Robert Ancuceanu; Amir Anoushiravani; Ali Arash Anoushirvani; Alireza Ansari-Moghaddam; Jalal Arabloo; Armin Aryannejad; Mohammad Asghari Jafarabadi; Seyyed Shamsadin Athari; Floriane Ausloos; Marcel Ausloos; Atalel Fentahun Awedew; Mamaru Ayenew Awoke; Tegegn Mulatu Ayana; Sina Azadnajafabad; Hiva Azami; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Ashish D. Badiye; Sara Bagherieh; Saeed Bahadory; Atif Amin Baig; Jennifer L. Baker; Maciej Banach; Amadou Barrow; Alemshet Yirga Berhie; Sima Besharat; Devidas S. Bhagat; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Sadia Bibi; Ali Bijani; Antonio Biondi; Tone Bjørge; Belay Boda Abule Bodicha; Dejana Braithwaite; Hermann Brenner; Daniela Calina; Chao Cao; Yin Cao; Giulia Carreras; Felix Carvalho; Ester Cerin; Raja Chandra Chakinala; William C.S. Cho; Dinh-Toi Chu; Joao Conde; Vera Marisa Costa; Natália Cruz-Martins; Omid Dadras; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Anna Danielewicz; Feleke Mekonnen Demeke; Getu Debalkie Demissie; Rupak Desai; Deepak Dhamnetiya; Mostafa Dianatinasab; Daniel Diaz; Mojtaba Didehdar; Saeid Doaei; Linh Phuong Doan; Milad Dodangeh; Fatemeh Eghbalian; Debela Debela Ejeta; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Muhammed Elhadi; Daniel Berhanie Enyew; Tahir Eyayu; Rana Ezzeddini; Ildar Ravisovich Fakhradiyev; Umar Farooque; Hossein Farrokhpour; Farshad Farzadfar; Ali Fatehizadeh; Hamed Fattahi; Nima Fattahi; Masood Fereidoonnezhad; Eduarda Fernandes; Getahun Fetensa; Irina Filip; Florian Fischer; Masoud Foroutan; Peter Andras Gaal; Mohamed M. Gad; Silvano Gallus; Tushar Garg; Tamiru Getachew; Seyyed-Hadi Ghamari; Ahmad Ghashghaee; Nermin Ghith; Maryam Gholamalizadeh; Jamshid Gholizadeh Navashenaq; Abraham Tamirat Gizaw; James C. Glasbey; Mahaveer Golechha; Pouya Goleij; Kebebe Bekele Gonfa; Giuseppe Gorini; Avirup Guha; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Rasool Haddadi; Nima Hafezi-Nejad; Arvin Haj-Mirzaian; Rabih Halwani; Shafiul Haque; Sanam Hariri; Ahmed I. Hasaballah; Soheil Hassanipour; Simon I. Hay; Claudiu Herteliu; Ramesh Holla; Mohammad-Salar Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Mowafa Househ; Junjie Huang; Ayesha Humayun; Ivo Iavicoli; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Farhad Islami; Masao Iwagami; Mohammad Ali Jahani; Mihajlo Jakovljevic; Tahereh Javaheri; Ranil Jayawardena; Rime Jebai; Ravi Prakash Jha; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Ali Kabir; Rohollah Kalhor; Ashwin Kamath; Neeti Kapoor; Ibraheem M. Karaye; Amirali Karimi; Joonas H. Kauppila; Asma Kazemi; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Rovshan Khalilov; Javad Khanali; Maryam Khayamzadeh; Mahmoud Khodadost; Hanna Kim; Min Seo Kim; Adnan Kisa; Sezer Kisa; Ali-Asghar Kolahi; Hamid Reza Koohestani; Jacek A. Kopec; Rajasekaran Koteeswaran; Ai Koyanagi; Yuvaraj Krishnamoorthy; G. Anil Kumar; Manoj Kumar; Vivek Kumar; Carlo La Vecchia; Faris Hasan Lami; Iván Landires; Caterina Ledda; Sang-Woong Lee; Wei-Chen Lee; Yeong Yeh Lee; Elvynna Leong; Bingyu Li; Stephen S. Lim; Stany W. Lobo; Joana A. Loureiro; Raimundas Lunevicius; Farzan Madadizadeh; Ata Mahmoodpoor; Azeem Majeed; Mohammad-Reza Malekpour; Reza Malekzadeh; Ahmad Azam Malik; Fariborz Mansour-Ghanaei; Lorenzo Giovanni Mantovani; Miquel Martorell; Sahar Masoudi; Prashant Mathur; Jitendra Kumar Meena; Entezar Mehrabi Nasab; Walter Mendoza; Alexios-Fotios A. Mentis; Tomislav Mestrovic; Junmei Miao Jonasson; Bartosz Miazgowski; Tomasz Miazgowski; Gelana Fekadu Worku Mijena; Seyyedmohammadsadeq Mirmoeeni; Mohammad Mirza-Aghazadeh-Attari; Hamed Mirzaei; Sanjeev Misra; Karzan Abdulmuhsin Mohammad; Esmaeil Mohammadi; Saeed Mohammadi; Seyyede Momeneh Mohammadi; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Teroj Abdulrahman Mohammed; Nagabhishek Moka; Ali H. Mokdad; Zeinab Mokhtari; Mariam Molokhia; Sara Momtazmanesh; Lorenzo Monasta; Ghobad Moradi; Rahmatollah Moradzadeh; Paula Moraga; Joana Morgado-Da-Costa; Sumaira Mubarik; Francesk Mulita; Mohsen Naghavi; Mukhammad David Naimzada; Hae Sung Nam; Zuhair S. Natto; Biswa Prakash Nayak; Javad Nazari; Ehsan Nazemalhosseini-Mojarad; Ionut Negoi; Cuong Tat Nguyen; Son Hoang Nguyen; Nurulamin M. Noor; Maryam Noori; Seyyed Mohammad Ali Noori; Virginia Nuñez-Samudio; Chimezie Igwegbe Nzoputam; Bogdan Oancea; Oluwakemi Ololade Odukoya; Ayodipupo Sikiru Oguntade; Hassan Okati-Aliabad; Andrew T. Olagunju; Tinuke O. Olagunju; Sokking Ong; Samuel M. Ostroff; Alicia Padron-Monedero; Reza Pakzad; Adrian Pana; Anamika Pandey; Fatemeh Pashazadeh Kan; Urvish K. Patel; Uttam Paudel; Renato B. Pereira; Navaraj Perumalsamy; Richard G. Pestell; Zahra Zahid Piracha; Richard Charles G. Pollok; Akram Pourshams; Naeimeh Pourtaheri; Akila Prashant; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Sima Rafiei; Mosiur Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Nazanin Rajai; Aashish Rajesh; Vajiheh Ramezani-Doroh; Kiana Ramezanzadeh; Kamal Ranabhat; Sina Rashedi; Amirfarzan Rashidi; Mahsa Rashidi; Mohammad-Mahdi Rashidi; Mandana Rastegar; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Andre M.N. Renzaho; Negar Rezaei; Nima Rezaei; Saeid Rezaei; Mohsen Rezaeian; Sahba Rezazadeh-Khadem; Gholamreza Roshandel; Maha Mohamed Saber-Ayad; Bahar Saberzadeh-Ardestani; Basema Saddik; Hossein Sadeghi; Umar Saeed; Maryam Sahebazzamani; Amirhossein Sahebkar; Amir Salek Farrokhi; Amir Salimi; Hamideh Salimzadeh; Pouria Samadi; Mehrnoosh Samaei; Abdallah M. Samy; Juan Sanabria; Milena M. Santric-Milicevic; Muhammad Arif Nadeem Saqib; Arash Sarveazad; Brijesh Sathian; Maheswar Satpathy; Ione Jayce Ceola Schneider; Mario Šekerija; Sadaf G. Sepanlou; Allen Seylani; Feng Sha; Sayed Mohammad Shafiee; Zahra Shaghaghi; Saeed Shahabi; Elaheh Shaker; Maedeh Sharifian; Javad Sharifi-Rad; Sara Sheikhbahaei; Jeevan K. Shetty; Reza Shirkoohi; Parnian Shobeiri; Sudeep K. Siddappa Malleshappa; Diego Augusto Santos Silva; Guilherme Silva Julian; Achintya Dinesh Singh; Jasvinder A. Singh; Md Shahjahan Siraj; Gholam Reza Sivandzadeh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Bogdan Socea; Marco Solmi; Mohammad Sadegh Soltani-Zangbar; Suhang Song; Viktória Szerencsés; Miklós Szócska; Rafael Tabarés-Seisdedos; Elnaz Tabibian; Majid Taheri; Yasaman Taheri Abkenar; Amir Taherkhani; Iman M. Talaat; Ker-Kan Tan; Abdelghani Tbakhi; Bekele Tesfaye; Amir Tiyuri; Daniel Nigusse Tollosa; Mathilde Touvier; Bach Xuan Tran; Biruk Shalmeno Tusa; Irfan Ullah; Saif Ullah; Marco Vacante; Sahel Valadan Tahbaz; Massimiliano Veroux; Bay Vo; Theo Vos; Cong Wang; Ronny Westerman; Melat Woldemariam; Seyed Hossein Yahyazadeh Jabbari; Lin Yang; Fereshteh Yazdanpanah; Chuanhua Yu; Deniz Yuce; Ismaeel Yunusa; Vesna Zadnik; Mazyar Zahir; Iman Zare; Zhi-Jiang Zhang; Mohammad Zoladi
Background: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods: Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990–2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. Findings: Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408–868 574) to 2·17 million (2·00–2·34), and deaths increased from 518 126 (493 682–537 877) to 1·09 million (1·02–1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3–23·0) per 100 000 to 26·7 (24·6–28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5–14·9) per 100 000 to 13·7 (12·6–14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7–320·7) per 100 000 to 295·5 (275·2–313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9–80·0] per 100 000), Monaco (60·7 [48·5–73·6] per 100 000), and Andorra (56·6 [42·8–71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0–37·1] per 100 000), Brunei (30·3 [26·6–34·1] per 100 000), and Hungary (28·6 [23·6–34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019. Interpretation: The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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 osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier Ltd, 2023) Jaimie D. Steinmetz; Garland T. Culbreth; Lydia M. Haile; Quinn Rafferty; Justin Lo; Kai Glenn Fukutaki; Jessica A. Cruz; Amanda E. Smith; Stein Emil Vollset; Peter M. Brooks; Marita Cross; Anthony D. Woolf; Hailey Hagins; Mohsen Abbasi-Kangevari; Aidin Abedi; Ilana N. Ackerman; Hubert Amu; Benny Antony; Jalal Arabloo; Aleksandr Y. Aravkin; Ayele Mamo Argaw; Anton A. Artamonov; Tahira Ashraf; Amadou Barrow; Lindsay M. Bearne; Isabela M. Bensenor; Alemshet Yirga Berhie; Nikha Bhardwaj; Pankaj Bhardwaj; Vijayalakshmi S. Bhojaraja; Ali Bijani; Paul Svitil Briant; Andrew M. Briggs; Nadeem Shafique Butt; Jaykaran Charan; Vijay Kumar Chattu; Flavia M. Cicuttini; Kaleb Coberly; Omid Dadras; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Katie de Luca; Edgar Denova-Gutiérrez; Samath Dhamminda Dharmaratne; Meghnath Dhimal; Mostafa Dianatinasab; Karsten E. Dreinhoefer; Muhammed Elhadi; Umar Farooque; Hamid Reza Farpour; Irina Filip; Florian Fischer; Marisa Freitas; Balasankar Ganesan; Belete Negese Belete Gemeda; Tamiru Getachew; Seyyed-Hadi Ghamari; Ahmad Ghashghaee; Tiffany K. Gill; Mahaveer Golechha; Davide Golinelli; Bhawna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Rasool Haddadi; Nima Hafezi-Nejad; Rabih Halwani; Samer Hamidi; Asif Hanif; Netanja I. Harlianto; Josep Maria Haro; Jan Hartvigsen; Simon I. Hay; Jeffrey J. Hebert; Golnaz Heidari; Mohammad-Salar Hosseini; Mehdi Hosseinzadeh; Alexander Kevin Hsiao; Irena M. Ilic; Milena D. Ilic; Louis Jacob; Ranil Jayawardena; Ravi Prakash Jha; Jost B. Jonas; Nitin Joseph; Himal Kandel; Ibraheem M. Karaye; Md Jobair Khan; Yun Jin Kim; Ali-Asghar Kolahi; Oleksii Korzh; Rajasekaran Koteeswaran; Vijay Krishnamoorthy; G. Anil Kumar; Narinder Kumar; Sang-Woong Lee; Stephen S. Lim; Stany W. Lobo; Giancarlo Lucchetti; Mohammad-Reza Malekpour; Ahmad Azam Malik; Luiz Garcia Garcia Mandarano-Filho; Santi Martini; Alexios-Fotios A. Mentis; Mohamed Kamal Mesregah; Tomislav Mestrovic; Erkin M. Mirrakhimov; Awoke Misganaw; Reza Mohammadpourhodki; Ali H. Mokdad; Sara Momtazmanesh; Shane Douglas Morrison; Christopher J.L. Murray; Hasan Nassereldine; Henok Biresaw Netsere; Sandhya Neupane Kandel; Mayowa O. Owolabi; Songhomitra Panda-Jonas; Anamika Pandey; Shrikant Pawar; Paolo Pedersini; Jeevan Pereira; Amir Radfar; Mohammad-Mahdi Rashidi; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Seyed-Mansoor Rayegani; Daniela Ribeiro; Leonardo Roever; Basema Saddik; Amirhossein Sahebkar; Sana Salehi; Lidia Sanchez Riera; Francesco Sanmarchi; Milena M. Santric-Milicevic; Saeed Shahabi; Masood Ali Shaikh; Elaheh Shaker; Mohammed Shannawaz; Rajendra Sharma; Saurab Sharma; Jeevan K. Shetty; Rahman Shiri; Parnian Shobeiri; Diego Augusto Santos Silva; Ambrish Singh; Jasvinder A. Singh; Surjit Singh; Søren T. Skou; Helen Slater; Mohammad Sadegh Soltani-Zangbar; Antonina V. Starodubova; Arash Tehrani-Banihashemi; Sahel Valadan Tahbaz; Pascual R. Valdez; Bay Vo; Linh Gia Vu; Yuan-Pang Wang; Seyed Hossein Yahyazadeh Jabbari; Naohiro Yonemoto; Ismaeel Yunusa; Lyn M. March; Kanyin Liane Ong; Theo Vos; Jacek A. Kopec
Background: Osteoarthritis is the most common form of arthritis in adults, characterised by chronic pain and loss of mobility. Osteoarthritis most frequently occurs after age 40 years and prevalence increases steeply with age. WHO has designated 2021–30 the decade of healthy ageing, which highlights the need to address diseases such as osteoarthritis, which strongly affect functional ability and quality of life. Osteoarthritis can coexist with, and negatively effect, other chronic conditions. Here we estimate the burden of hand, hip, knee, and other sites of osteoarthritis across geographies, age, sex, and time, with forecasts of prevalence to 2050. Methods: In this systematic analysis for the Global Burden of Disease Study, osteoarthritis prevalence in 204 countries and territories from 1990 to 2020 was estimated using data from population-based surveys from 26 countries for knee osteoarthritis, 23 countries for hip osteoarthritis, 42 countries for hand osteoarthritis, and US insurance claims for all of the osteoarthritis sites, including the other types of osteoarthritis category. The reference case definition was symptomatic, radiographically confirmed osteoarthritis. Studies using alternative definitions from the reference case definition (for example self-reported osteoarthritis) were adjusted to reference using regression models. Osteoarthritis severity distribution was obtained from a pooled meta-analysis of sources using the Western Ontario and McMaster Universities Arthritis Index. Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLDs). Prevalence was forecast to 2050 using a mixed-effects model. Findings: Globally, 595 million (95% uncertainty interval 535–656) people had osteoarthritis in 2020, equal to 7·6% (95% UI 6·8–8·4) of the global population, and an increase of 132·2% (130·3–134·1) in total cases since 1990. Compared with 2020, cases of osteoarthritis are projected to increase 74·9% (59·4–89·9) for knee, 48·6% (35·9–67·1) for hand, 78·6% (57·7–105·3) for hip, and 95·1% (68·1–135·0) for other types of osteoarthritis by 2050. The global age-standardised rate of YLDs for total osteoarthritis was 255·0 YLDs (119·7–557·2) per 100 000 in 2020, a 9·5% (8·6–10·1) increase from 1990 (233·0 YLDs per 100 000, 109·3–510·8). For adults aged 70 years and older, osteoarthritis was the seventh ranked cause of YLDs. Age-standardised prevalence in 2020 was more than 5·5% in all world regions, ranging from 5677·4 (5029·8–6318·1) per 100 000 in southeast Asia to 8632·7 (7852·0–9469·1) per 100 000 in high-income Asia Pacific. Knee was the most common site for osteoarthritis. High BMI contributed to 20·4% (95% UI –1·7 to 36·6) of osteoarthritis. Potentially modifiable risk factors for osteoarthritis such as recreational injury prevention and occupational hazards have not yet been explored in GBD modelling. Interpretation: Age-standardised YLDs attributable to osteoarthritis are continuing to rise and will lead to substantial increases in case numbers because of population growth and ageing, and because there is no effective cure for osteoarthritis. The demand on health systems for care of patients with osteoarthritis, including joint replacements, which are highly effective for late stage osteoarthritis in hips and knees, will rise in all regions, but might be out of reach and lead to further health inequity for individuals and countries unable to afford them. Much more can and should be done to prevent people getting to that late stage. Funding: Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health. © 2023 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 prevalence and mortality burden of sickle cell disease, 2000–2021: a systematic analysis from the Global Burden of Disease Study 2021
(Elsevier Ltd, 2023) Azalea M. Thomson; Theresa A. McHugh; Assaf P. Oron; Corey Teply; Nikhil Lonberg; Victor M. Vilchis Tella; Lauren B. Wilner; Kia Fuller; Hailey Hagins; Richard Gyan Aboagye; Melka Biratu Aboye; Eman Abu-Gharbieh; Ahmed Abu-Zaid; Isaac Yeboah Addo; Bright Opoku Ahinkorah; Aqeel Ahmad; Saif Aldeen S. AlRyalat; Hubert Amu; Aleksandr Y. Aravkin; Judie Arulappan; Maha Moh'd Wahbi Atout; Ashish D. Badiye; Sara Bagherieh; MacIej Banach; Morteza Banakar; Mainak Bardhan; Amadou Barrow; Deriba Abera Bedane; Isabela M. Bensenor; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Ajay Nagesh Bhat; Zulfiqar A. Bhutta; Mariah Malak Bilalaga; Jessica Devin Bishai; Saeid Bitaraf; Archith Boloor; Muhammad Hammad Butt; Vijay Kumar Chattu; Dinh-Toi Chu; Omid Dadras; Xiaochen Dai; Bardia Danaei; Anh Kim Dang; Fitsum Wolde Demisse; Meghnath Dhimal; Daniel Diaz; Shirin Djalalinia; Deepa Dongarwar; Muhammed Elhadi; Mohamed A. Elmonem; Christopher Imokhuede Esezobor; Farshid Etaee; Oghenowede Eyawo; Adeniyi Francis Fagbamigbe; Ali Fatehizadeh; Lisa M. Force; William M. Gardner; Kazem Ghaffari; Paramjit Singh Gill; Mahaveer Golechha; Pouya Goleij; Vivek Kumar Gupta; Hamidreza Hasani; Treska S. Hassan; Mohammed Bheser Hassen; Segun Emmanuel Ibitoye; Adalia I. Ikiroma; Chidozie C.D. Iwu; Peter Bai James; Shubha Jayaram; Rime Jebai; Ravi Prakash Jha; Nitin Joseph; Farnaz Kalantar; Himal Kandel; Ibraheem M. Karaye; Woldeteklehaymanot Dagne Kassahun; Imteyaz A. Khan; Shaghayegh Khanmohammadi; Adnan Kisa; Farzad Kompani; Kewal Krishan; Iván Landires; Stephen S. Lim; Preetam Bhalchandra Mahajan; Soleiman Mahjoub; Azeem Majeed; Bishnu P. Marasini; Haftu Asmerom Meresa; Tomislav Mestrovic; Sonica Minhas; Awoke Misganaw; Ali H. Mokdad; Lorenzo Monasta; Ghulam Mustafa; Tapas Sadasivan Nair; Sreenivas Narasimha Swamy; Hasan Nassereldine; Zuhair S. Natto; Muhammad Naveed; Biswa Prakash Nayak; Jean Jacques Noubiap; Taylor Noyes; Chisom Adaobi Nri-Ezedi; Vincent Ebuka Nwatah; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Osaretin Christabel Okonji; Adeyinka Omoniyi Onikan; Mayowa O. Owolabi; Jay Patel; Siddhartha Pati; Shrikant Pawar; Ionela-Roxana Petcu; Frédéric B. Piel; Ibrahim Qattea; Mehran Rahimi; Mosiur Rahman; Salman Rawaf; Elrashdy Moustafa Mohamed Redwan; Nazila Rezaei; Basema Saddik; Umar Saeed; Fatemeh Saheb Sharif-Askari; Abdallah M. Samy; Austin E. Schumacher; Elaheh Shaker; Adithi Shetty; Migbar Mekonnen Sibhat; Jasvinder A. Singh; Muhammad Suleman; Dev Ram Sunuwar; Mindy D. Szeto; Jacques J.L. Lukenze Tamuzi; Nathan Y. Tat; Birhan Tsegaw Taye; Mohamad-Hani Temsah; Muhammad Umair; Sahel Valadan Tahbaz; Cong Wang; Nuwan Darshana Wickramasinghe; Arzu Yigit; Vahit Yigit; Ismaeel Yunusa; Burhan Abdullah Zaman; Moein Zangiabadian; Peng Zheng; Simon I. Hay; Mohsen Naghavi; Christopher J.L. Murray; Nicholas J. Kassebaum
Background: Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021. Methods: We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures—borrowing strength from predictive covariates and across age, time, and geography—and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs). Findings: Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13·7% (95% uncertainty interval 11·1–16·5), to 515 000 (425 000–614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41·4% (38·3–44·9), from 5·46 million (4·62–6·45) in 2000 to 7·74 million (6·51–9·2) in 2021. We estimated 34 400 (25 000–45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000–467 000). In children younger than 5 years, there were 81 100 (58 800–108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021. Interpretation: Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease. Funding: Bill & Melinda Gates Foundation. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license