Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990-2019: results from the Global Burden of Disease Study 2019.
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ABSTRACT:
SUBMITTER: GBD 2019 Tuberculosis Collaborators
PROVIDER: S-EPMC8799634 | biostudies-literature | 2022 Feb
REPOSITORIES: biostudies-literature
Publications
Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990-2019: results from the Global Burden of Disease Study 2019.
The Lancet. Infectious diseases 20210923 2
<h4>Background</h4>Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 ...[more]
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Project description:Objective To examine the incidence of cardiomyopathy including both alcoholic cardiomyopathy (AC) and other cardiomyopathy (OC) in 204 nations and regions over the 1990–2019 period. Methods The present study was conducted using data derived from the GBD 2019 study coordinated by the Institute for Health Metrics and Evaluation (IHME). The GBD 2019 study included epidemiological data pertaining to 369 diseases/injuries, 286 causes of death, and 87 risk factors in 204 nations and regions. For this study, we adopt published estimates pertaining to the prevalence rates, mortality rates, and disability-adjusted life years (DALYs) associated with cardiomyopathy. The Bayesian mixed-effects DisMod-MR 2.1 meta-regression tool, which was designed to analyze GBD data, was used to estimate the prevalence of OC and AC. The GBD data are subdivided into 21 global regions based on characteristics such as geographical proximity and epidemiological similarity. The overall burden of cardiomyopathy was assessed by combining AC- and OC-related data, 95% confidence intervals were calculated based on standardized error values determined based upon the width of the 95% UI divided by 1.96 × 2. Results Globally, there were an estimated 0.71 million (95% UI: 0.55–0.92) AC cases and 3.73 million (95% UI: 2.92–4.72) OC cases in 2019. The age-standardized cardiomyopathy, AC, and OC prevalence rates (per 100,000 persons) in 2019 were 56.0 (95% CI: 43.82–71.17), 8.51 (95% UI: 6.6–11.01), and 47.49 (95% UI: 37.22–60.16), respectively. In total, the respective numbers of global deaths attributed to AC and OC were 0.07 million (95% UI: 0.06–0.08) and 0.24 million (95% UI: 0.19–0.26). The age-standardized mortality rate for cardiomyopathy in 2019 was 3.97 (95% CI: 3.29–4.39), with respective mortality rates of 0.86 (95% UI: 0.72–0.99) and 3.11 (95% UI: 2.57–3.4) for AC and OC. At the global level in 2019, 2.44 million (95% UI: 2.04–2.78) DALYs were attributed to AC, while 5.72 million (95% UI: 4.89–6.33) DALYs were attributed to OC. From 1990 to 2019, cardiomyopathy age-standardized prevalence rates declined by −0.49% (95% CI: −0.57 to −0.41), with those for AC and OC having respectively declined by −0.32% (95% UI: −0.36 to −0.28) and −0.17% (95% UI: −0.21 to −0.13). The age-standardized AC and OC mortality rates declined by −0.36% (95% UI: −0.5 to −0.26) and −0.39% (95% UI: −0.44 to −0.29), despite 24.8 and 30.2% increases, respectively, in the numbers of AC- and OC-related deaths during the same period. Conclusion Previous studies have estimated the risk factors that influence the burden of multiple cardiovascular diseases (CVD). Among them, some studies related to the GBD database on cardiomyopathy data suggest that alcohol intake, gender are factors in the development of AC, and the burden of AC and OC is not limited to developed or less developed countries. Otherwise, this study mainly focused on cardiomyopathy, and analyzed multiple indicators from national, regional, and age-standard dimensions to identify potential risk factors including prevalence, deaths, years lived with Disability-adjusted life years (DALYs) that influence the development of AC and OC. To our knowledge, this study is the first to have systematically assessed the burden of AC and OC as of 2019 at the national, regional, and global levels and calculated DALYs to achieve a better evaluation of disease risk and quality of life of the population. The number of cases, deaths and DALYs of cardiomyopathy showed an overall increasing trend and obvious geographical differences in the past three decades. The burden of cardiomyopathy remains a persistent threat to global public health. These results provide an epidemiological foundation that can guide public health efforts and policymakers.
| S-EPMC9748073 | biostudies-literature
Project description:(1) Background: Understanding occurrence can help formulate effective preventative laws and regulations. However, the most recent global burden and road injuries (RIs) trends have not been reported. This study reports the burden of RIs globally from 1990 to 2019. (2) Methods: RIs data were downloaded from the Global Burden of Disease 2019. Incidence, deaths, and disability-adjusted life years (DALYs) described the trend and burden of RIs. We calculated age-standardized rates (ASRs) and estimated annual percentage change (EAPC) for the above indexes to evaluate the temporal trend of RIs. We evaluated the social-demographic index (SDI) with epidemiological RI parameters and reported proportions of age-standardized rates due to RI. (3) Results: In 2019, the global incidence of RIs reached 103.2 million. The EAPC of RI incidence increased, whereas deaths and DALYs decreased. Age-standardized incident rate (ASIR) was highest in low-middle SDI regions, age-standardized death rate (ASDR) was high in middle SDI regions, and age-standardized DALYs increased in low SDI regions. The highest accident rates were found in those aged 20-24 years old. Cyclist injuries were the leading RIs (34%), though pedestrian and motor vehicle accidents were the leading cause of death (37.4%, 37.6%) and DALYs (35.7%, 32.3%), respectively. (4) Conclusions: Over the past 30 years, RIs incidence increased annually, though death and DALY rates decreased. RIs places a considerable burden on public health in low SDI countries. Data should be used to develop and implement effective measures to reduce the burden of RIs.
| S-EPMC9779128 | biostudies-literature
Project description:AimsPancreatic cancer (PC) is a malignant tumor with a strong invasive nature and low survival rate. We aimed to estimate the PC burden at the global, regional, and national levels in 204 countries from 1990 to 2019.MethodsDetailed data, including the incidence, death, and disability-adjusted life years (DALYs), were analyzed from the Global Burden of Diseases Study 2019.ResultsGlobally, there were 530,297 (486,175-573,635) incident cases and 531,107 (491,948-566,537) deaths from PC in 2019. The age-standardized incidence rate (ASIR) was 6.6 (6-7.1), and the age-standardized mortality rate (ASMR) was 6.6 (6.1-7.1) per 100,000 person-years. PC caused 11,549,016 (10,777,405-12,338,912) DALYs, with an age-standardized rate of 139.6 (130.2-149.1) per 100,000 person-years. There were increases in estimated annual percentage changes (EAPCs) of ASIR (0.83; 0.78-0.87), ASMR (0.77; 0.73-0.81), and age-standardized DALYs rate (ASDR) (0.67; 0.63-0.71). The global number of incident cases increased by 168.7%, from 197,348 (188,604-203,971) to 530,297 (486,175-573,635); the number of deaths increased by 168.2% from 198,051 (189,329-204,763) to 531,107 (491,948-566,537); and total DALYs increased by 148.5% from 4,647,207 (4,465,440-4,812,129) to 11,549,016 (10,777,405-12,338,912). East Asia and China recorded the highest number of incident cases, deaths, and DALYs. The proportion of deaths was attributable to smoking (21.4%), elevated fasting glucose (9.1%), and high BMI (6%).ConclusionsOur study updated the epidemiological trends and risk factors for PC. PC remains a major hazard to the sustainability of health systems worldwide, with an increasing incidence rate and mortality from 1990 to 2019. More targeted strategies are required to prevent and treat PC.
| S-EPMC10215993 | biostudies-literature
Project description:IntroductionCancer is the leading cause of death among children.ObjectivesWe report on the latest estimates of the burden of cancer among children at the global, regional, and national levels from 1990 to 2019.MethodsBased on the Global Burden of Disease Study 2019, children's cancer data were analyzed by sex, age, year, and location. Age-standardized rates were used to compare the burdens among regions and nations. Joinpoint analysis was applied to assess the temporal trend of the global childhood cancer burden.ResultsIn 2019, 291,319 (95% uncertainty interval [UI], 254,239 to 331,993) new cases and 98,834 (86,124 to 113,581) deaths from childhood cancer were documented globally. Further, 8,302,464 (7,230,447 to 9,555,118) DALYs and 1,806,630 (1,567,808 to 2,089,668) prevalent cases were recorded in the same year. Age-standardized incidence and prevalence rates of childhood cancer were greatest in higher SDI settings and increased most significantly in Australasia and Southern Latin America over the last 30 years. However, although age-standardized death and DALY rates of childhood cancer have remarkably decreased in all regions since 1990, countries with a lower SDI showed the highest rates in 2019, particularly in countries in Eastern Sub-Saharan Africa. Among all cancers, leukemia has shown the largest decrease in burden since 1990. Despite this, leukemia was still the most common cancer and the leading cause of death among children in 2019, followed by brain and central nervous system cancer.ConclusionsOn a global scale, the childhood cancer burden has significantly fallen over the last 30 years, but is still higher in lower SDI countries. Effective interventions and collaborations among nations should be facilitated to improve healthcare among children with cancer in countries with lower SDI.
| S-EPMC9481947 | biostudies-literature
Project description:BackgroundWith the increase in the aging population worldwide, Alzheimer's disease has become a rapidly increasing public health concern. Monitoring the dementia disease burden will support health development strategies by providing scientific data.MethodsBased on the data obtained from the 2019 Global Burden of Disease (GBD) database, the numbers and age-standardized rates (ASRs) of incidence, prevalence, death, and disability-adjusted life-years (DALYs) of Alzheimer's disease and other dementias from 1990 to 2019 were analyzed. Calculated estimated annual percentage changes (EAPCs) and Joinpoint regression analyses were performed to evaluate the trends during this period. We also evaluated the correlations between the epidemiology and the sociodemographic index (SDI), an indicator to evaluate the level of social development in a country or region considering the education rate, economic situation, and total fertility rate.ResultsFrom 1990 to 2019, the incidence and prevalence of Alzheimer's disease and other dementias increased by 147.95 and 160.84%, respectively. The ASR of incidence, prevalence, death, and DALYs in both men and women consistently increased over the study period. All the ASRs in women were consistently higher than those in men, but the increases were more pronounced in men. In addition, the ASRs of incidence, prevalence, and DALYs were positively correlated with the SDI. Moreover, the proportion of patients over 70 years old with dementia was also positively correlated with the SDI level. Smoking was a major risk factor for the disease burden of dementia in men, while obesity was the major risk factor for women.ConclusionFrom 1990 to 2019, the Alzheimer's disease burden increased worldwide. This trend was more serious in high-SDI areas, especially among elderly populations in high-SDI areas, who should receive additional attention. Policy-makers should take steps to reverse this situation. Notably, women were at a higher risk for the disease, but the risk in men showed a faster increase. We should give attention to the aging population, attach importance to interventions targeting dementia risk factors, and formulate action plans to address the increasing incidence of dementia.
| S-EPMC9588915 | biostudies-literature
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.
| S-EPMC8491452 | biostudies-literature
Project description:BackgroundSyphilis is a sexually transmitted disease caused by Treponema pallidum, and the infection source is syphilis patients. This study aimed to estimate the incidence, mortality rate, and disability-adjusted life years (DALYs) of syphilis to improve the understanding of the current global situation of syphilis.MethodsThis study collected data on syphilis incidence, mortality, and DALYs from the 2019 Global Burden of Disease database.ResultsThe global number of incident cases and age-standardized incidence rate (ASIR) increased from 8,845,220 (95% UI: 6,562,510-11,588,860) in 1990 to 14,114,110 (95% UI: 10,648,490-18,415,970) in 2019 and 160.03/100,000 persons (95% UI: 120.66-208.1) to 178.48/100,000 persons (95% UI: 134.94-232.34), respectively. The estimated annual percentage change (EAPC) in the ASIR was 0.16 (95% CI: 0.07-0.26). The EAPC in the ASIR associated with high and high-middle sociodemographic indices increased. The ASIR increased among males but decreased among females, and the incidence peaked among males and females between the ages of 20 and 30 years. The EAPCs in the age-standardized death rate and age-standardized DALY rate decreased.ConclusionsThe incidence and ASIR of syphilis increased worldwide from 1990 to 2019. Only the regions with high and high-middle sociodemographic indices showed an increase in the ASIR. Moreover, the ASIR increased among males but decreased among females. The age-standardized death rate and DALY rate both declined worldwide. The increase in the global ASIR of syphilis is a challenge.
| S-EPMC10124004 | biostudies-literature
Project description:AimsAnxiety disorders are widespread across the world. A systematic understanding of the disease burden, temporal trend and risk factors of anxiety disorders provides the essential foundation for targeted public policies on mental health at the national, regional, and global levels.MethodsThe estimation of anxiety disorders in the Global Burden of Disease Study 2019 using systematic review was conducted to describe incidence, prevalence and disability-adjusted life years (DALYs) in 204 countries and regions from 1990 to 2019. We calculated the estimated annual percentage change (EAPC) to quantify the temporal trends in anxiety disorders burden by sex, region and age over the past 30 years and analysed the impact of epidemiological and demographic changes on anxiety disorders.ResultsGlobally, 45.82 [95% uncertainty interval (UI): 37.14, 55.62] million incident cases of anxiety disorders, 301.39 million (95% UI: 252.63, 356.00) prevalent cases and 28.68 (95% UI: 19.86, 39.32) million DALYs were estimated in 2019. Although the overall age-standardised burden rate of anxiety disorders remained stable over the past three decades, the latest absolute number of anxiety disorders increased by 50% from 1990. We observed huge disparities in both age-standardised burden rate and changing trend of anxiety disorders in sex, country and age. In 2019, 7.07% of the global DALYs due to anxiety disorders were attributable to bullying victimisation, mainly among the population aged 5-39 years, and the proportion increased in almost all countries and territories compared with 1990.ConclusionAnxiety disorder is still the most common mental illness in the world and has a striking impact on the global burden of disease. Controlling potential risk factors, such as bullying, establishing effective mental health knowledge dissemination and diversifying intervention strategies adapted to specific characteristics will reduce the burden of anxiety disorders.
| S-EPMC8157816 | biostudies-literature
Project description:BackgroundCombating 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.MethodsThe 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.FindingsIn 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.InterpretationThe 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.FundingBill & Melinda Gates Foundation.
| S-EPMC9349325 | biostudies-literature
Project description:Background: We aimed to estimate the incidence, mortality, disability-adjusted life years (DALYs) for chronic obstructive pulmonary disease (COPD) in 204 countries and territories. We examined the variations in these trends by country, gender, age group, and sociodemographic index (SDI). Methods: We calculated the estimated annual percentage changes (EAPCs) to assess temporal trends in the age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALYs of COPD from 1990 to 2019. Results: From 1990 to 2019, the COPD incidence and COPD-associated deaths and DALYs increased worldwide by 86%, 30%, and 26%, respectively. From 1990 to 2019, the global age-standardized incidence rate (EAPC, -0.11; 95% confidence interval (CI), -0.25 to 0.04), age-standardized mortality rate (EAPC, -2.10; 95% CI, -2.19 to -2.00), and age-standardized DALYs (EAPC, -1.87; 95% CI, -1.94 to -1.81) of COPD decreased. The age-standardized incidence of COPD increased most in areas with high SDI (EAPC 0.56). The largest increases in the age-standardized incidence rate of COPD were recorded in High-income North America (EAPC, 1.41), Southern Latin America (EAPC, 0.29), and North Africa and the Middle East (EAPC, 0.09). The three countries that recorded the largest increases in COPD incidence from 1990 to 2019 were the United States of America (EAPC, 1.51), Saudi Arabia (EAPC, 1.17), and Oman (EAPC, 1.10). Conclusion: Despite the decreased burden of COPD globally from 1990 to 2019, the age-standardized incidence rate of COPD increased in areas with high SDI, High-income North America, Southern Latin America, North Africa, and the Middle East.
| S-EPMC9396373 | biostudies-literature