Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.
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ABSTRACT:
SUBMITTER: GBD 2019 Diseases and Injuries Collaborators
PROVIDER: S-EPMC7567026 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
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Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.
Lancet (London, England) 20201001 10258
<h4>Background</h4>In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseas ...[more]
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Project description:Bladder cancer (BCa) poses a significant medical burden worldwide. However, the epidemiological pattern of the global smoking-induced BCa burden is unclear. Our analysis of the 2019 Global Burden of Disease (GBD) database showed a significant increase in the number of BCa cases worldwide from 1990 to 2019, with a clear upward trend in both age-standardized prevalence and incidence. In contrast, age-standardized rates of mortality (ASMR) and disability-adjusted life-years (ASDR) showed a downward trend, despite an increase in the absolute number of death and disability-adjusted life years. The burden of BCa caused by smoking is greater in males, middle-aged and older adults, and people in countries with high-middle socio-demographic indices (SDI). The study highlights the continuing global health challenge posed by smoking-related BCa. Targeted health policies and interventions are critical, especially in areas with high smoking rates and low socioeconomic status.
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Project description:BackgroundLead hazards are ubiquitous in the environment, and lead exposure has been proved to damage human health. Nevertheless, there is limited data on the global burden of diseases attributable to lead exposure. In this study, we evaluated the temporal-spatial trend of disease burden caused by lead exposure in 204 countries and territories from 1990 to 2019.MethodsBased on Global Burden of Disease (GBD) Study 2019, deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR) and DALYs rate (ASDR) were estimated by region, country, sex and age. The estimated annual percentage change (EAPC) was calculated to assess the temporal trends of ASMR and ASDR between 1990 and 2019.ResultsGlobal deaths increased from 0.53 (95% UI: 0.31, 0.77) to 0.90 (95% UI: 0.55, 1.29) million, and the number of DALYs increased from 16.02 (95% UI: 10.32, 22.17) to 21.68 (95% UI: 13.81, 30.30) million between 1990 and 2019. China, India and Bangladesh were top three countries with the largest number of deaths and DALYs in 2019. The ASMR (per 100,000 population) decreased from 14.47 (95% UI: 8.40, 21.43) to 11.48 (95% UI: 7.00, 16.49) with EAPC of -0.75 (95% UI: -0.87, -0.64), and the ASDR (per 100,000 population) decreased from 378.01 (95% UI: 240.55, 524.18) to 267.52 (95% UI: 170.57, 373.44) with EAPC of -1.19 (95% UI: -1.32, -1.07). Most of disease burden of lead exposure occurred in the men and elderly population. Stroke and ischemic heart disease were two key sources of disease burden of lead exposure. Also, a negative association between sociodemographic index (SDI) and disease burden of lead exposure was observed.ConclusionsLead exposure poses a significant disease burden globally, and is still a great threat to public health. Primary prevention measures of reducing lead exposure in the environment are essential.
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Project description:BackgroundThe sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic.MethodsTo estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0).FindingsIn 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1-38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78-0·91) per female living with HIV in 2019, 0·99 male infections (0·91-1·10) for every female infection, and 1·02 male deaths (0·95-1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58-35·43, and a 39·66% decrease in deaths, 36·49-42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05-0·06) and the global incidence-to-mortality ratio was 1·94 (1·76-2·12). No regions met suggested thresholds for progress.InterpretationSub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics.FundingThe Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH.
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Project description:BackgroundCancers are leading causes of mortality and morbidity, with smoking being recognized as a significant risk factor for many types of cancer. We aimed to report the cancer burden attributable to tobacco smoking by sex, age, socio-demographic index (SDI), and cancer type in 204 countries and territories from 1990 to 2019.MethodsThe burden of cancers attributable to smoking was reported between 1990 and 2019, based upon the Comparative Risk Assessment approach used in the Global Burden of Disease (GBD) study 2019.ResultsGlobally, in 2019 there were an estimated 2.5 million cancer-related deaths (95% UI: 2.3 to 2.7) and 56.4 million DALYs (51.3 to 61.7) attributable to smoking. The global age-standardized death and DALY rates of cancers attributable to smoking per 100,000 decreased by 23.0% (-29.5 to -15.8) and 28.6% (-35.1 to -21.5), respectively, over the period 1990-2019. Central Europe (50.4 [44.4 to 57.6]) and Western Sub-Saharan Africa (6.7 [5.7 to 8.0]) had the highest and lowest age-standardized death rates, respectively, for cancers attributable to smoking. In 2019, the age-standardized DALY rate of cancers attributable to smoking was highest in Greenland (2224.0 [1804.5 to 2678.8]) and lowest in Ethiopia (72.2 [51.2 to 98.0]). Also in 2019, the global number of DALYs was highest in the 65-69 age group and there was a positive association between SDI and the age-standardized DALY rate.ConclusionsThe results of this study clearly illustrate that renewed efforts are required to increase utilization of evidence-based smoking cessation support in order to reduce the burden of smoking-related diseases.
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Project description:BackgroundAnemia is a common disease which affects around 40% of children and 30% of reproductive age women and can have major health consequences. The present study reports the global, regional and national burden of anemia and its underlying causes between 1990 and 2019, by age, sex and socio-demographic index (SDI).MethodsPublicly available data on the point prevalence and years lived with disability (YLDs) were retrieved from the global burden of disease (GBD) 2019 study for 204 countries and territories between 1990 and 2019. The point prevalence, YLD counts and rates per 100,000 population were presented, along with their corresponding 95% uncertainty intervals.ResultsIn 2019, the global age-standardized point prevalence and YLD rates for anemia were 23,176.2 (22,943.5-23,418.6) and 672.4 (447.2-981.5) per 100,000 population, respectively. Moreover, the global age-standardized point prevalence and YLD rate decreased by 13.4% (12.1-14.5%) and 18.8% (16.9-20.8%), respectively, over the period 1990-2019. The highest national point prevalences of anemia were found in Zambia [49327.1 (95% UI: 46,838.5-51,700.1)], Mali [46890.1 (95% UI: 44,301.1-49,389.8)], and Burkina Faso [46117.2 (95% UI: 43,640.7-48,319.2)]. In 2019, the global point prevalence of anemia was highest in the 15-19 and 95+ age groups in females and males, respectively. Also, the burden of anemia was lower in regions with higher socio-economic development. Globally, most of the prevalent cases were attributable to dietary iron deficiency, as well as hemoglobinopathies and hemolytic anemias.ConclusionsAnemia remains a major health problem, especially among females in less developed countries. The implementation of preventive programs with a focus on improving access to iron supplements, early diagnosis and the treatment of hemoglobinopathies should be taken into consideration.
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