There is no reliable estimate of burden of snakebite-envenoming (SBE) in Sub-Saharan Africa (SSA). We derived from a meta-analysis the burden of SBE related deaths, amputations and Post-Traumatic ...Stress Disorder (PTSD) in 41 countries in SSA. The annual burden was estimated at 1.03 million DALYs (95% Confidence Interval: 0.80–1.28 million DALYs). This is similar to or higher than the burden of many Neglected Tropical Diseases (NTDs) and the finding advocates for a commensurate resources allocation towards control of SBE.
•The burden of snakebite envenoming (SBE) in sub-Saharan Africa is considerable.•In addition to mortality, amputations and post-traumatic stress disorder account for a sizable proportion of the burden.•The total annual burden is estimated at 1.03 million DALYs (95% Confidence Interval: 0.80 - 1.28 million DALYs).•The burden of SBE surpasses that of many other Neglected Tropical Diseases and requires more resources for control.
Background
Diabetes places a significant burden on personal and public health. However, a comprehensive assessment of the burden of diabetes in older adults is lacking. We aimed to estimate the ...global burden of diabetes and explore trends for the population aged ≥70 from 1990 to 2019.
Methods
Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, the prevalence, mortality, and disability‐adjusted life‐years (DALYs) of diabetes among people aged ≥70 were estimated by sex and age group in 2019. We also assessed the epidemiological trend of diabetes from 1990 to 2019.
Results
In 2019, 110.1 million (95% uncertainty interval UI: 101.2–119.4) people aged ≥70 years were living with diabetes (types 1 and 2 combined) with a global prevalence of 23.7% (21.8%–25.8%). Worldwide, 181.9 deaths (163.0–194.7) per 100,000 population and 4512.3 DALYs (3861.3–5264.2) per 100,000 population occurred due to diabetes. In 2019, minor sex‐related disparities in the burden of diabetes were identified among specific age and sex groups. From 1990 to 2019, the prevalence of diabetes increased by 39.7% (37.7%–41.7%), and the related mortality and DALY rates also increased (16.4% 9.43%–22.9% and 22.3% 17.2%–27.0%, respectively).
Conclusion and Relevance
The global burden of diabetes in adults aged ≥70 has increased markedly from 1990 to 2019. As the population continues to age, there is an urgent need to combat the increasing disease burden.
In view of the high incidence and mortality of esophageal cancer, the latest statistical data on the disease burden of esophageal cancer can provide strategies for cancer screening, early detection ...and treatment, and help to rationally allocate health resources. This study provides an analysis of the global disease burden and risk factors of esophageal cancer from 1990 to 2019.
Using the 2019 Global Burden of Disease, Injury and Risk Factor (GBD) data, we present the incidence, mortality and disability-adjusted life years (DALY) of esophageal cancer in 21 regions and 204 countries and different sociodemographic index (SDI) regions from 1990 to 2019. The age-period-cohort model was used to estimate the age, period, and cohort trend of esophageal cancer in different SDI regions. The estimated proportion of DALY attributable to each risk factor from 1990 to 2019.
From 1990 to 2019, the number of new cases of esophageal cancer, the number of deaths and DALY increased by 67.07%, 55.97% and 42.13%, respectively, but age standardized incidence rate (ASIR), age standardized mortality rate (ASMR) and age standardized DALY rate (ASDR) decreased by 19.28%, 25.32% and 88.22%, respectively. Overall, the results of the age-period-cohort model showed that the incidence, mortality, and DALY rates in countries and regions with higher SDI levels showed a downward trend over time and with the passage of time. Conversely, there were no significant changes in incidence and mortality in countries and regions with low SDI levels. In the past 30 years, the incidence and death of esophageal cancer in the world has gradually changed to people over 80 years old, but the population aged 60-79 still accounts for the largest proportion. The global DALY in esophageal cancer is mainly attributable to smoking, followed by alcohol consumption and occupational exposure.
Although ASIR, ASMR and ASDR have decreased significantly, esophageal cancer is still the main factor causing the disease burden worldwide. Public health administrators in low SDI and low-middle SDI countries are high-risk areas for esophageal cancer, and preventive control measures should be implemented to raise awareness, screening, and treatment of esophageal cancer in these areas. Tobacco and alcohol control and reduction of occupational hazards are key steps in reducing the burden of esophageal cancer.
Objective
We aimed to report the burden of bulimia nervosa (BN) in the Middle East and North Africa (MENA) region by age, sex, and sociodemographic index (SDI), for the period 1990–2019.
Methods
...Estimates of the prevalence, incidence, and disability‐adjusted life‐years (DALYs) attributable to BN were retrieved from the Global Burden of Disease study 2019, between 1990 and 2019, for the 21 countries in the MENA region. The counts and age‐standardized rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals.
Results
In 2019, the estimated regional age‐standardized point prevalence and incidence rates of BN were 168.3 (115.0–229.6) and 178.6 (117.0–255.6) per 100,000, which represented 22.0% (17.5–27.2) and 10.4% (7.1–14.7) increases, respectively, since 1990. Moreover, in 2019 the regional age‐standardized DALY rate was 35.5 (20.6–55.5) per 100,000, which was 22.2% (16.7–28.2) higher than in 1990. In 2019, Qatar (58.6 34.3–92.5) and Afghanistan (18.4 10.6–29.2) had the highest and lowest age‐standardized DALY rates, respectively. Regionally, the age‐standardized point prevalence of BN peaked in the 30–34 age group and was more prevalent among women. In addition, there was a generally positive association between SDI and the burden of BN across the measurement period.
Discussion
In the MENA region, the burden of BN has increased over the last three decades. Cost‐effective preventive measures are needed in the region, especially in the high SDI countries.
Public Significance
This study reports the estimated burden of BN in the MENA region and shows that its burden has increased over the last three decades.
Background
Data on the incidence, mortality, and other burden of oral cancer as well as their secular trends are necessary to provide policy‐makers with the information needed to allocate resources ...appropriately. The purpose of this study was to use the Global Burden of Disease (GBD) 2017 results to estimate the incidence, mortality, and disability‐adjusted life years (DALYs) for oral cancer from 1990 to 2017.
Methods
We collected detailed data on oral cancer from 1990 to 2017 from the GBD 2017. The global incidence, mortality, and DALYs attributable to oral cancer as well as the corresponding age‐standardized rates (ASRs) were calculated. The estimated annual percentage changes in the ASRs of incidence (ASRI) and mortality (ASRM) and age‐standardized DALYs of oral cancer were also calculated according to regions and countries to quantify the secular trends in these rates.
Results
We tracked the incidence, mortality, and DALYs of oral cancer in 195 countries/territories over 28 years. Globally, the incidence, mortality, and DALYs of oral cancer increased by about 1.0‐fold from 1990 to 2017. The ASRI of oral cancer showed a similar trend, increasing from 4.41 to 4.84 per 100,000 person‐years during the study period. The ASRM remained approximately stable at about 2.4 per 100,000 from 1990 to 2017, as did the age‐standardized DALYs, at about 64.0 per 100,000 person‐years. ASRI was highest in Pakistan (27.03/100,000, 95% CI = 22.13‐32.75/100,000), followed by Taiwan China, and lowest in Iraq (0.96/100,000, 95% CI = 0.86‐1.06/100,000). ASRM was highest in Pakistan (16.85/100,000, 95% CI = 13.92‐20.17/100,000) and lowest in Kuwait (0.51/100,000, 95% CI = 0.45‐0.58/100,000).
Conclusions
The ASRI of oral cancer has increased slightly worldwide, while the ASRM and age‐standardized DALY have remained stable. However, these characteristics vary between countries, suggesting that current prevention strategies should be reoriented, and much more targeted and specific strategies should be established in some countries to forestall the increase in oral cancer.
Mortality effects of exposure to air pollution and other environmental hazards are often described by the estimated number of “premature” or “attributable” deaths and the economic value of a ...reduction in exposure as the product of an estimate of “statistical lives saved” and a “value per statistical life.” These terms can be misleading because the number of deaths advanced by exposure cannot be determined from mortality data alone, whether from epidemiology or randomized trials (it is not statistically identified). The fraction of deaths “attributed” to exposure is conventionally derived as the hazard fraction (R – 1)/R, where R is the relative risk of mortality between high and low exposure levels. The fraction of deaths advanced by exposure (the “etiologic” fraction) can be substantially larger or smaller: it can be as large as one and as small as 1/e (≈0.37) times the hazard fraction (if the association is causal and zero otherwise). Recent literature reveals misunderstanding about these concepts. Total life years lost in a population due to exposure can be estimated but cannot be disaggregated by age or cause of death. Economic valuation of a change in exposure‐related mortality risk to a population is not affected by inability to know the fraction of deaths that are etiologic. When individuals facing larger or smaller changes in mortality risk cannot be identified, the mean change in population hazard is sufficient for valuation; otherwise, the economic value can depend on the distribution of risk reductions.
Background and objective
Chronic obstructive pulmonary disease (COPD) is the most prevalent chronic respiratory disease. This study investigated the global, regional and country burden of COPD based ...on gender, age and socio‐demographic indices (SDIs) in the last 30‐year period from 1990 to 2019.
Methods
The COPD data, including incidence, mortality and disability‐adjusted life years (DALYs), were obtained from the 2019 Global Burden of Disease Study. If age‐standardized incidence rate (ASIR) or death rate (ASDR) remains almost constant or decreases, the number of cases will still increase as the global population increases substantially. Estimated annual percentage change (EAPC) was calculated to assess incidence, mortality and DALY trends.
Results
The incidence of COPD increased by 85.89% from 8,722,966 cases in 1990 to 16,214,828 cases in 2019, and the ASIR decreased from 216.48/100,000 persons in 1990 (95%UI, 204.56–227.33) to 200.49 per 100,000 persons (95%UI, 188.63–212.57) in 2019. The ASIR increased (EAPC = 0.05, 95%CI, 0.01–0.10) in the low SDI region, was stable in the high SDI region, and fell in the other three SDI regions. Men had a higher ASIR than women over the past 30 years, and there were differences in the incidence rates for different age groups. Male mortality and DALYs were higher than female mortality. ASDR decreased by 2.13% (95%CI, −2.23% to −2.02%) per year and the annual age‐standardized DALY rate decreased by 1.97% (95%CI, −2.05% to −1.89%).
Conclusions
The ASIR, ASDR and age‐standardized DALY rate of COPD declined overall in the last 30 years, and were highest in the low‐middle SDI region.
Over the last 30 years, the absolute number of COPD‐associated deaths and DALYs increased significantly worldwide, but the ASIR, ASDR and age‐standardized DALY rate of COPD declined. Health authorities and policymakers must take these differences into account to make better use of limited resources.
See related Editorial
Objectives
Increasing life expectancy and decreasing mortality in patients with HIV infection are well documented. However, details of how many of the years of healthy life are damaged by HIV ...infection vs. good health have not been understood. We conducted this study to provide a comprehensive assessment of the levels and trends of the global burden, as measured by disability‐adjusted life years (DALYs), of HIV infection.
Methods
Data on HIV‐related DALY were obtained from the Global Burden of Disease Study 2019. The absolute numbers and age‐standardised rates of DALYs due to HIV were reported between 1990 and 2019. Estimated annual percentage changes in age‐standardised rates by sex, region and nation were calculated to quantify the temporal trends in HIV burden.
Results
Global HIV infection caused 47.63 million DALYs in 2019, presenting a 1.28‐fold increase from 1990 to 2019. In 2019, years of life lost contributed to most of the total DALYs, but the increases in HIV‐related years lived with disability have outpaced increases in years of life lost. The age‐standardised rates of HIV‐related DALYs in 2019 decreased as the sociodemographic indexes increased. The highest age‐standardised rates were observed in sub‐Saharan Africa, and the greatest increments over time were detected in Oceania.
Conclusions
Globally, HIV continues to cause enormous healthy life loss. The first and foremost strategy for controlling the HIV burden is still the reduction of premature deaths, and much effort needs to be exerted to mitigate the harm of comorbidities.
From a health prospective, it is critical to provide a comprehensive model which integrates all the parameters involved in virus transmission and its consequences on human body. In order to estimate ...the health risks, for workers and residents, associated with an exposure airborne viruses emitted from a wastewater treatment (WWTP), the concentration levels of viruses in emitted bioaerosols over a twelve-month period were measured by real-time polymerase chain reaction (RT-PCR). A combined Gaussian plum dispersion model and quantitative microbial risk assessment (QMRA) with Monte-Carlo simulation served as suitable explanatory tools to estimate the risk of acquiring gastrointestinal illness (GI) due to exposure to air containing Rotavirus (RoV) and Norovirus (NoV) bioaerosols. Additionally, DALY metric was applied to quantify the disability and mortality for workers and residents. RoV and NoV were detected above aeration tank with annual mean concentration 27 and 3099 (Viruses/m3.h), respectively. The medium calculated DALY indicator based on viral loads in contaminant source (RoV:5.76 × 10−2 and NoV:1.23 × 10−1) and estimated in different distances away (300–1000 m) (RoV:2.87 × 10−2- 2.75 × 10−2 and NoV:1.14 × 10−1-1.13 × 10−1) were markedly higher than the threshold values recommended by US EPA (10−4 DALY pppy) and WHO (10−6 DALY pppy). The sensitivity analysis highlighted dose exposure and disease burden per case (DBPC) as two most influential factors for both workers and residents following exposure to two pathogens of concern. Due to high resistance and high concentration in the environment, the presence of RoV and NoV can intensify the consequences of diarrhea especially for children under five years of age; A comprehensible and transparent presentation of DALYs and QMRA can help decision makers and responsibilities to justify the priorities of exposure to wastewater in comparison with other risks of daily life.
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•RoV and NoV were monitored with annual mean concentration 27 and 3099 (Viruses/m3h), respectively.•Pinf for RoV(8.3 × 10−3-2.3 × 10−3) and NoV(9.8 × 10−2-9.4 × 10−2) decreased at distances 300–1000 m.•The medium DALY for workers for exposure to RoV and NoV were 5.7 × 10−2 and1.2 × 10−1.
Capsule: Proposing a comprehensive model for measured RoV and NoV in WWTP air and their atmospheric dispersion to calculate corresponding QMRA and DALY for workers and residents.
Understanding the spatiotemporal variation in the household air pollution from solid fuels (HAP)‐related ischemic heart disease (IHD) burden on a global scale from 1990 to 2019 is essential to reduce ...IHD burden, as well as control HAP exposure. Based on the Global Burden of Disease Study 2019, the numbers and age‐standardized rates of IHD mortality and disability‐adjusted life years (DALYs) (ASMR and ASDR) attributed to HAP were analyzed by sex and age at global, regional, and national levels. The estimated annual percentage change was calculated to evaluate the temporal trend in burden rates. In 2019, IHD attributed to HAP resulted in 511 170 deaths and 13.18 million DALYs globally. The corresponding ASMR and ASDR were higher in males, increased with age peaking at about 80–94 years, and varied greatly across the world. Despite a remarkable decline in HAP‐related IHD was achieved across the world over the past decades, an undesirable increase could be observed in some low‐income but with high‐burden countries. Sustained and comprehensive efforts are needed to control HAP and reduce the IHD burden, especially in countries and territories with a heavy or increasing burden, such as the Solomon Islands, Vanuatu, Afghanistan, Philippines, Zimbabwe, Lesotho, and Somalia.
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