Trends in drowning mortality in Portugal from 1992 to 2019: comparing Global Burden of Disease and national data

2021 ◽  
pp. injuryprev-2021-044415
Author(s):  
Ana Catarina Queiroga ◽  
Rui Seabra ◽  
Richard Charles Franklin ◽  
Amy E Peden

IntroductionImprecise data systems hinder understanding of drowning burden, even in high-income countries like Portugal, that have a well-implemented death certificate system. Consequently, national studies on drowning mortality are scarce. We aimed to explore drowning mortality in Portugal using national data and to compare these to Global Burden of Disease (GBD) estimates.MethodsData were obtained from the National Institute of Statistics (INE) for 1992–2019, using International Classification of Diseases (ICD)-9 and ICD-10 codes, by sex, age group and cause (unintentional; water transport and intentional). GBD unintentional drowning data were obtained online. Age-standardised drowning rates were calculated and compared.ResultsINE data showed 6057 drowning deaths, 4327 classified as unintentional (75.2% male; 36.7% 35–64 years; 31.5% 65+years; 15.2% 0–19 years). Following 2001, an increase in accidental drowning mortality and corresponding decrease in undetermined intent was observed, coincident with Portugal’s ICD-10 implementation. GBD modelled estimates followed a downward trend at an overall rate of decrease of −0.41/decade (95% CI (−0.45 to –0.37); R2adj=0.94; p<0.05). Conversely, INE data showed an increase in the rate of drowning deaths over the last decade (0.35/decade; 95% CI (−0.18 to 0.89)). GBD estimates were significantly different from the INE dataset (alpha=0.05), either underestimating as much as 0.567*INE in 1996 or overestimating as much as 1.473*INE in 2011.ConclusionsWhile GBD mortality data estimates are valuable in the absence of routinely collected data, they smooth variations, concealing key advocacy opportunities. Investment in country-level drowning registries enables in-depth analysis of incident circumstances. Such data are essential to informing National Water Safety Plans.

2020 ◽  
Vol 26 (Supp 1) ◽  
pp. i83-i95 ◽  
Author(s):  
Richard Charles Franklin ◽  
Amy E Peden ◽  
Erin B Hamilton ◽  
Catherine Bisignano ◽  
Chris D Castle ◽  
...  

BackgroundDrowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study’s objective is to describe unintentional drowning using GBD estimates from 1990 to 2017.MethodsUnintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning.ResultsGlobally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes.ConclusionsThere has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries.


2019 ◽  
Vol 99 (2) ◽  
pp. 143-151 ◽  
Author(s):  
M. Du ◽  
R. Nair ◽  
L. Jamieson ◽  
Z. Liu ◽  
P. Bi

The worldwide incidence trends of the lip, oral cavity, and pharyngeal cancers (LOCPs) need to be updated. This study aims to examine the temporal incidence trends of LOCPs from 1990 to 2017, using the latest Global Burden of Disease (GBD) study data to explore sex, age, and regional differences. GBD incidence data for LOCPs were driven by population cancer registries and were estimated from mortality data. Age-standardized incidence rates (ASIRs) were directly extracted from the 2017 GBD database to calculate the estimated annual percentage change (EAPC) over the study period. Incidence trends are mapped and compared separately by sex (females vs. males), age groups (15–49, 50–69, and 70+ y), regions (21 geographical and 5 sociodemographic regions), and countries. Among 678,900 incident cases of LOCPs notified in 2017, more than half were lip and oral cavity cancers. From 1990 to 2017, the estimated global incidence for nasopharyngeal cancers decreased dramatically (EAPC = −1.52; 95% confidence interval [CI], –1.70 to −1.34), while the incidence for lip and oral cavity cancers (EAPC = 0.26; 95% CI, 0.16–0.37) and other pharyngeal cancers (EAPC = 0.62; 95% CI, 0.54–0.71) increased. Higher ASIRs were observed among males than females across all age groups. However, females had larger EAPC variation when compared to males. Population groups aged 15 to 49 y presented the lowest ASIRs, with larger values of EAPC than those aged 50 to 69 and 70+ y. While high-income countries had higher ASIRs with little EAPC variation, ASIRs varied across low/middle-income regions with larger EAPC variations. South Asia and East Asia had the highest ASIRs and EAPC for lip and oral cavity cancers, respectively. In conclusion, the global incidence of LOCPs has increased among females, those aged 15 to 49 y, and people from low/middle-income countries over the study period, excepting nasopharyngeal cancers, which had a decreasing worldwide trend.


2015 ◽  
Vol 45 (3) ◽  
pp. 152-160 ◽  
Author(s):  
Thomas Truelsen ◽  
Lars-Henrik Krarup ◽  
Helle K. Iversen ◽  
George A. Mensah ◽  
Valery L. Feigin ◽  
...  

Background: Stroke mortality estimates in the Global Burden of Disease (GBD) study are based on routine mortality statistics and redistribution of ill-defined codes that cannot be a cause of death, the so-called ‘garbage codes' (GCs). This study describes the contribution of these codes to stroke mortality estimates. Methods: All available mortality data were compiled and non-specific cause codes were redistributed based on literature review and statistical methods. Ill-defined codes were redistributed to their specific cause of disease by age, sex, country and year. The reassignment was done based on the International Classification of Diseases and the pathology behind each code by checking multiple causes of death and literature review. Results: Unspecified stroke and primary and secondary hypertension are leading contributing ‘GCs' to stroke mortality estimates for hemorrhagic stroke (HS) and ischemic stroke (IS). There were marked differences in the fraction of death assigned to IS and HS for unspecified stroke and hypertension between GBD regions and between age groups. Conclusions: A large proportion of stroke fatalities are derived from the redistribution of ‘unspecified stroke' and ‘hypertension' with marked regional differences. Future advancements in stroke certification, data collections and statistical analyses may improve the estimation of the global stroke burden.


Author(s):  
Vanessa Machado ◽  
João Botelho ◽  
João Albernaz Neves ◽  
Luís Proença ◽  
Ricardo Alves ◽  
...  

Background: The progression of periodontal diseases at national Portuguese level and its public awareness are of great interest, mainly due to the high burden of periodontitis. Objectives: To evaluate the prevalence progression of periodontal diseases in Portugal and correspondent public awareness, between 2004 and 2017, by using data from the Global Burden of Disease (GBD), Directorate-General of Health (DGH) and Google&reg; Trends (GT). Methods: For the period 2004-2017, Portuguese national data of periodontal diseases prevalence were searched in the Institute for Health Metrics and Evaluation of GBD and DGH and for public awareness, GT comparison tool between Portuguese words for &ldquo;Periodontitis&rdquo;, &ldquo;Gingivitis&rdquo;, &ldquo;Gums&rdquo; and &ldquo;Periodontal disease&rdquo; trends was used. Results: For the period 2004-2017, the overall prevalence of periodontitis slightly increased from 11.3% to 11.7%. During that period the GT search term &ldquo;Gums&rdquo; (&ldquo;Gengivas&rdquo;) was the most relevant. It increased steadily over time while the search term &ldquo;Periodontal disease&rdquo; (&ldquo;Doen&ccedil;a periodontal&rdquo;) decreased, being these search trends significantly correlated (


2019 ◽  
Vol 4 (2) ◽  
pp. e000733 ◽  
Author(s):  
Junaid Razzak ◽  
Mohammad Farooq Usmani ◽  
Zulfiqar A Bhutta

ObjectiveThere are currently no metrics for measuring population-level burden of emergency medical diseases (EMDs). This study presents an analysis of the burden of EMDs using two metrics: the emergency disease mortality rate (EDMR) and the emergency disease burden (EDB) per 1000 population at the national, regional and global levels.MethodsWe used the 1990 and 2015 Global Burden of Disease Study for morbidity and mortality data on 249 medical conditions in 195 countries. Thirty-one diseases were classified as ‘emergency medical diseases’ based on earlier published work. We developed two indicators, one focused on mortality (EDMR) and the other on burden (EDB). We compared the EDMR and EDB across countries, regions and income groups and compared these metrics from 1990 to 2015.ResultsIn 2015, globally, there were 28.3 million deaths due to EMDs. EMDs contributed to 50.7% of mortality and 41.5% of all burden of diseases. The EDB in low-income countries is 4.4 times that of high-income countries. The EDB in the African region is 273 disability-adjusted life years (DALYs) per 1000 compared with 100 DALYs per 1000 in the European region. There has been a 6% increase in overall mortality due to EMDs from 1990 to 2015. Globally, injuries (22%), ischaemic heart disease (17%), lower respiratory infections (11%) and haemorrhagic strokes (7%) made up about 60% of EMDs in 2015.ConclusionGlobally, EMDs contributed to more than half of all years of life lost. There is a significant disparity between the EDMR and EDB between regions and socioeconomic groups at the global level.


Author(s):  
Breidge Boyle ◽  
Marie-Claude Addor ◽  
Larraitz Arriola ◽  
Ingeborg Barisic ◽  
Fabrizio Bianchi ◽  
...  

ObjectiveTo validate the estimates of Global Burden of Disease (GBD) due to congenital anomaly for Europe by comparing infant mortality data collected by EUROCAT registries with the WHO Mortality Database, and by assessing the significance of stillbirths and terminations of pregnancy for fetal anomaly (TOPFA) in the interpretation of infant mortality statistics.Design, setting and outcome measuresEUROCAT is a network of congenital anomaly registries collecting data on live births, fetal deaths from 20 weeks’ gestation and TOPFA. Data from 29 registries in 19 countries were analysed for 2005–2009, and infant mortality (deaths of live births at age <1 year) compared with the WHO Mortality Database. Eight EUROCAT countries were excluded from further analysis on the basis that this comparison showed poor ascertainment of survival status.ResultsAccording to WHO, 17%–42% of infant mortality was attributed to congenital anomaly. In 11 EUROCAT countries, average infant mortality with congenital anomaly was 1.1 per 1000 births, with higher rates where TOPFA is illegal (Malta 3.0, Ireland 2.1). The rate of stillbirths with congenital anomaly was 0.6 per 1000. The average TOPFA prevalence was 4.6 per 1000, nearly three times more prevalent than stillbirths and infant deaths combined. TOPFA also impacted on the prevalence of postneonatal survivors with non-lethal congenital anomaly.ConclusionsBy excluding TOPFA and stillbirths from GBD years of life lost (YLL) estimates, GBD underestimates the burden of disease due to congenital anomaly, and thus declining YLL over time may obscure lack of progress in primary, secondary and tertiary prevention.


Author(s):  
Azin Nahvijou

Background: Cancer with 13% of all deaths is the third leading cause of mortality in Iran. We aimed to assess the burden of cancer in Iran by acquiring data from the Global Burden of Disease (GBD) study. Methods: This study was conducted on the DALY approach to examine the cancer burden in Iran from 1990 to 2016. A list of all cancers was extracted using the International Classification of Disease, tenth revision (ICD-10). Then, the cancer burden was assessed based on the type of cancer. The Percentage change (PC) by Daly’s number and age-standardized DALY rate (ASDR) was estimated. The cause of PC on the DALYs number from cancer was analyzed, and the share of every variable was determined. Results: In 2016, cancer caused 781.5 and 564 thousand DALYs for men and women, respectively. In all years, the DALYs number of cancer is higher in men than women. From 1990 to 2016, leukemia, stomach, tracheal, bronchus and lung (TBL) cancers were among the leading causes of cancer burden in Iran. The highest increase in PC of cancer DALYs from 1990 to 2016 happened by multiple myeloma with 302.4% and breast with 283.7%. The lowest increase occurred by Hodgkin lymphoma (-2.1%) and leukemia (18.2%). Conclusion: Cancers have grown more than doubled in terms of DALYs from 1990 to 2016. The majority of DALYs were due to Years of Life Lost, suggesting the need for prevention, early detection, and screening programs.


2020 ◽  
Author(s):  
Alessandro Bigoni ◽  
Amanda Ramos da Cunha ◽  
José Leopoldo Ferreira Antunes

Abstract Background The reliability of mortality data is a critical aspect of epidemiological studies on cancer. The under-registration of deaths, a high proportion of deaths classified as due to unspecified causes,4 and inadequate report of immediate or mediate conditions as the underlying cause of death are the main problems affecting the reliability of mortality data. Several statistical techniques to correct this problem were reported, resulting in a variety of methods for the same purpose. This study aims to discuss the impact on the magnitude and temporal trends of mortality of four different strategies of redistribution that have been used to assess cancer mortality in Brazil. Methods This study used anonymized georeferenced provided by the Brazilian Ministry of Health. Four different approaches were used to perform the redistribution of ill-defined deaths and garbage codes. Age-standardized mortality rates used the world population as reference. Prais-Winsten autoregression allowed calculating trends for each region, sex and cancer type. Results Death rates increased considerably in all regions after performing the redistribution. Overall, the Elisabeth B. França and World Health Organization methods had a milder impact on trends and magnitudes of rates when compared to the method used in the Global Burden of Disease 2010 study. This study also observed that when the Brazilian Ministry of Health dealt with the problem of redistributing ill-defined deaths, the results were similar to those obtained by the Global Burden of Disease method. The redistribution methods also influenced the assessment of trends; however, differences in the annual percent change were less pronounced. Conclusions Given the impossibility of developing a gold standard method for comparison, the matching of global techniques with those that consider the local reality may be an alternative for methodology selection. In the present study, the compatibility of the findings suggests the validity of the Global Burden of Disease method as concerning the Brazilian context. However, caution is needed in this interpretation. Future studies should assess the impact of these methods as applied to the redistribution of deaths to type-specific neoplasms.


2020 ◽  
Vol 26 (Supp 1) ◽  
pp. i125-i153
Author(s):  
Spencer L James ◽  
Chris D Castle ◽  
Zachary V Dingels ◽  
Jack T Fox ◽  
Erin B Hamilton ◽  
...  

BackgroundWhile there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.MethodsIn this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced.ResultsGBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes.ConclusionsGBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.


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