Background
Severe periodontitis is one of the most prevalent diseases and a global public health problem due to its high incidence and prevalence. However, there are few studies on the burden of ...periodontitis in different regions of the world.
Methods
We extracted data on the incidence, prevalence, and disability‐adjusted life years (DALYs) from the Global Burden of Disease study as severe periodontitis burden measures. We also explored the global burden of severe periodontitis according to 21 world regions and Socio‐Demographic Index (SDI) quintiles. The joinpoint model was used to analyze temporal trends of major regions from 1990 to 2019, and the age‐period‐cohort model was used to estimate age, period, and cohort trends in severe periodontitis.
Results
Globally, the age‐standardized incidence rate (ASIR), age‐standardized prevalence rate (ASPR), and disability‐adjusted life years (DALYs) rate increased from 1990 to 2019 (percentage change: 5.77%, 7.78%, and 8.01%, respectively), with average annual percent changes of 0.2%, 0.3%, and 0.3%, respectively. The region with the highest DALY rate was western sub‐Saharan Africa with a value of 142.5 (95% uncertainty interval: 56.3, 303.7) per 100,000 in 2019. For the ASIR, ASPR, and DALY, the age effect of severe periodontitis showed an increase followed by a decrease, the period effect showed an upward trend, the cohort effect showed an overall decreasing trend, and the cohort relative risk for incidence for some SDI quintiles showed a slight increase in recent years.
Conclusions
Oral health varies significantly across regions, and it is essential to address inequalities in oral health between countries. Effective measures to prevent severe periodontitis risk factors should also be taken in regions with low SDI.
Environmental waters (EW) substantially lend to the transmission of Helicobacter pylori (Hp). But the increase in Hp infections and antimicrobial resistance is often attributed to socioeconomic ...status. The connection between socioeconomic status and Hp prevalence in EW is however yet to be investigated. This study aimed to assess the impacts of socioeconomic indices (SI: continent, world bank region (WBR), world bank income (WBI), WHO region, Socio-demographic Index (SDI quintile), Sustainable Development Index (SuDI), and Human Development Index (HDI)) on the prevalence of Hp in EW. Hp-EW data were fitted to a generalized linear mixed-effects model and SI-guided meta-regression models with a 1000-resampling test. The worldwide prevalence of Hp in EW was 21.76% 95% confidence interval CI: 10.29–40.29, which declined significantly from 59.52% 43.28–74.37 in 1990–99 to 19.36% 3.99–58.09 in 2010–19 and with increasing trend in 2020–22 (33.33%, 22.66–45.43). Hp prevalence in EW was highest in North America (45.12%, 17.07–76.66), then Europe (22.38%, 5.96–56.74), South America (22.09%, 13.76–33.49), Asia (2.98%, 0.02–85.17), and Africa (2.56%, 0.00–99.99). It was negligibly different among sampling settings, WBI, and WHO regions demonstrating highest prevalence in rural location 42.62%, 3.07–94.56, HIEs 32.82%, 13.19–61.10, and AMR 39.43%, 19.92–63.01, respectively. However, HDI, sample size, and microbiological method robustly predict Hp prevalence in EW justifying 26.08%, 21.15%, and 16.44% of the true difference, respectively. In conclusion, Hp is highly prevalence in EW across regional/socioeconomic strata and thus challenged the uses of socioeconomic status as surrogate for hygienic/sanitary practices in estimating Hp infection prevalence.
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•Environmental waters (EW) add to H. pylori (Hp) spread via (in)direct pathways.•Global Hp prevalence in EW was 21.76% 95%CI: 10.29 – 40.29.•Human development index, sample size, & methods robustly predict Hp prevalence in EW.•Hp is highly prevalence in EW dismissing regional socioeconomic strength.
Helicobacter pylori (Hp) transmission dynamics via drinking water (DW) has a far much higher direct and indirect public health disease burden than previously thought. This study aimed to assess the ...global prevalence of Hp in DW, distributions across regions and socioeconomic indices (continent, world bank income, Human Development Index (HDI), Sustainable Development Index (SuDI), Socio-Demographic Index (SDI) quintile, and WHO regions). Hp-DW related data mined from five databases until 10/12/2022 according to PRISMA standard were quality-appraised and fitted to a generalized linear mixed-effects model. Sub-group analysis and meta-regression-modelling coupled with a 1000-permutation test (⁎) were conducted. The global prevalence of Hp in DW was 15.7% (95% confidence interval CI: 7.98–27.5), which varied significantly by sampling methods (Moore swabbing (61.0% 0.00–100.0) vs. grab sampling (13.68%6.99–25.04)) and detection technique (non-culture (21.35%9.13–42.31) vs. cultured-based methods (Psubgroup < 0.01)). The period 1990–99 had the highest prevalence (41.24% 0.02–99.97). Regarding regional designations, Hp prevalence in DW was significantly different being highest in North America (61.82% 41.03–79.02) by continents, AMR (42.66% 20.81–67.82) by WHO group, high HDI (24.64% 10.98–46.43) by HDI group and North America (61.90% 2.79–98.93) by world bank region (Psubgroup < 0.01). Generally, sample preparation, SuDI grouping, and detection/confirmation techniques, have significant effects on the detection/prevalence of Hp in DW (Psubgroup < 0.01). Hp prevalence in DW was not significantly different among rural and urban DW (Psubgroup = 0.90), world bank income groups (Psubgroup = 0.15), and SDI quintiles (Psubgroup = 0.07). Among the predictors examined, only sample size (p < 0.1, R∗2(coefficient of determinant) = 15.29%), continent (p∗val = 0.04), HDI (p∗val = 0.02), HDI group (p∗val = 0.05), and microbiological methods (p < 0.1; R∗2=28.09 %) predicted Hp prevalence in DW robustly. In conclusion, Hp prevalence is still endemic in DW regardless of the regional designations/improve DW supplies.
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•H. pylori (Hp) transmission via drinking water (DW) has higher disease burden.•This study assessed global prevalence of Hp in DW via meta-regression modelling.•Global prevalence of Hp in DW was 15.7 % (95 % CI: 7.98–27.5).•DW sampling, microbiological & detection techniques affect Hp accurate detection.•Hp prevalence is still endemic in DW regardless of regional & setting designations.
This study aimed to investigate global, regional, and national trends in osteoarthritis disability-adjusted life years (DALYs) from 1990 to 2019, identify the burden of osteoarthritis in different ...age groups, and assess age, period, and cohort effects on osteoarthritis DALYs.
A comprehensive analysis of the Global Burden of Disease Study 2019 data, covering 204 countries and territories.
We conducted a comprehensive analysis using data from the Global Burden of Disease Study 2019, encompassing 204 countries and territories. Age-standardized DALY rates were calculated, and the age-period-cohort model was employed to examine the age, period, and cohort effects on osteoarthritis DALYs. The annual percentage change (APC) and average annual percentage change (AAPC) were estimated to evaluate trends in DALYs.
Globally, osteoarthritis DALYs increased by 114.48 % between 1990 and 2019, with an age-standardized DALY rate growth of 3.3 %. The largest relative growth in DALYs occurred in Middle and Low-middle Socio-Demographic Index (SDI) regions. DALYs increased significantly in almost all age-specific groups, particularly among 45–74 years old age groups. Age, period, and cohort effects analysis revealed a general increase in osteoarthritis DALYs risk over time, with some variations by SDI quintiles and sex. The steepest increase in DALYs occurred in the 30–34 years age group, and the trend attenuated with increasing age. Males showed significantly slower DALYs growth than females in age groups with non-overlapping 95 % confidence intervals. Age effects were consistently higher in females, especially in high-SDI countries. Period and cohort effects generally demonstrated a climbing risk of osteoarthritis DALYs across different SDI quintiles, with more pronounced increases in lower-SDI regions.
Our findings highlight the substantial and increasing burden of osteoarthritis at global, regional, and national levels from 1990 to 2019, with significant variations by age, period, and cohort. These results underscore the importance of developing targeted public health strategies and interventions to address the growing impact of osteoarthritis, particularly in lower-SDI regions and among older populations.
