scholarly journals Atlas of the Global Burden of Stroke (1990-2013): The GBD 2013 Study

2015 ◽  
Vol 45 (3) ◽  
pp. 230-236 ◽  
Author(s):  
Valery L. Feigin ◽  
George A. Mensah ◽  
Bo Norrving ◽  
Christopher J.L. Murray ◽  
Gregory A. Roth ◽  
...  

Background: World mapping is an important tool to visualize stroke burden and its trends in various regions and countries. Objectives: To show geographic patterns of incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke and hemorrhagic stroke in the world for 1990-2013. Methodology: Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated following the general approach of the Global Burden of Disease (GBD) 2010 with several important improvements in methods. Data were updated for mortality (through April 2014) and stroke incidence, prevalence, case fatality and severity through 2013. Death was estimated using an ensemble modeling approach. A new software package, DisMod-MR 2.0, was used as part of a custom modeling process to estimate YLDs. All rates were age-standardized to new GBD estimates of global population. All estimates have been computed with 95% uncertainty intervals. Results: Age-standardized incidence, mortality, prevalence and DALYs/YLDs declined over the period from 1990 to 2013. However, the absolute number of people affected by stroke has substantially increased across all countries in the world over the same time period, suggesting that the global stroke burden continues to increase. There were significant geographical (country and regional) differences in stroke burden in the world, with the majority of the burden borne by low- and middle-income countries. Conclusions: Global burden of stroke has continued to increase in spite of dramatic declines in age-standardized incidence, prevalence, mortality rates and disability. Population growth and aging have played an important role in the observed increase in stroke burden.

2015 ◽  
Vol 45 (3) ◽  
pp. 203-214 ◽  
Author(s):  
Suzanne Barker-Collo ◽  
Derrick A. Bennett ◽  
Rita V. Krishnamurthi ◽  
Priya Parmar ◽  
Valery L. Feigin ◽  
...  

Background: Accurate information on stroke burden in men and women are important for evidence-based healthcare planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality rates were greater in men. However, sex differences in various metrics of stroke burden on a global scale have not been a subject of comprehensive and comparable assessment for most regions of the world, nor have sex differences in stroke burden been examined for trends over time. Methods: Stroke incidence, prevalence, mortality, disability-adjusted life years (DALYs) and healthy years lost due to disability were estimated as part of the Global Burden of Disease (GBD) 2013 Study. Data inputs included all available information on stroke incidence, prevalence and death and case fatality rates. Analysis was performed separately by sex and 5-year age categories for 188 countries. Statistical models were employed to produce globally comprehensive results over time. All rates were age-standardized to a global population and 95% uncertainty intervals (UIs) were computed. Findings: In 2013, global ischemic stroke (IS) and hemorrhagic stroke (HS) incidence (per 100,000) in men (IS 132.77 (95% UI 125.34-142.77); HS 64.89 (95% UI 59.82-68.85)) exceeded those of women (IS 98.85 (95% UI 92.11-106.62); HS 45.48 (95% UI 42.43-48.53)). IS incidence rates were lower in 2013 compared with 1990 rates for both sexes (1990 male IS incidence 147.40 (95% UI 137.87-157.66); 1990 female IS incidence 113.31 (95% UI 103.52-123.40)), but the only significant change in IS incidence was among women. Changes in global HS incidence were not statistically significant for males (1990 = 65.31 (95% UI 61.63-69.0), 2013 = 64.89 (95% UI 59.82-68.85)), but was significant for females (1990 = 64.892 (95% UI 59.82-68.85), 2013 = 45.48 (95% UI 42.427-48.53)). The number of DALYs related to IS rose from 1990 (male = 16.62 (95% UI 13.27-19.62), female = 17.53 (95% UI 14.08-20.33)) to 2013 (male = 25.22 (95% UI 20.57-29.13), female = 22.21 (95% UI 17.71-25.50)). The number of DALYs associated with HS also rose steadily and was higher than DALYs for IS at each time point (male 1990 = 29.91 (95% UI 25.66-34.54), male 2013 = 37.27 (95% UI 32.29-45.12); female 1990 = 26.05 (95% UI 21.70-30.90), female 2013 = 28.18 (95% UI 23.68-33.80)). Interpretation: Globally, men continue to have a higher incidence of IS than women while significant sex differences in the incidence of HS were not observed. The total health loss due to stroke as measured by DALYs was similar for men and women for both stroke subtypes in 2013, with HS higher than IS. Both IS and HS DALYs show an increasing trend for both men and women since 1990, which is statistically significant only for IS among men. Ongoing monitoring of sex differences in the burden of stroke will be needed to determine if disease rates among men and women continue to diverge. Sex disparities related to stroke will have important clinical and policy implications that can guide funding and resource allocation for national, regional and global health programs.


2021 ◽  
Author(s):  
DEEPAK DHAMNETIYA ◽  
Ravi Prakash Jha ◽  
Shalini . ◽  
Krittika Bhattacharyya

Abstract Visceral leishmaniasis (VL) is a neglected tropical disease which contributes to the mortality and morbidity significantly in India and Brazil. This study was planned to compare the trends of incidence, prevalence, death and disability-adjusted life years (DALY) of VL burden in India and Brazil from 1990 to 2019 using Global burden of disease study (GBD) data. The metrics are presented as age-standardized rates per 100,000 inhabitants with their respective uncertainty intervals (95%UI) and relative percentages of change. The decline in the Incidence rate is more in case of India (16.82 cases per 100,000 in 1990 to 0.60cases in 2019) as compared to Brazil (3.12 cases per 100,000 in 1990 to 2.65 cases in 2019). The annualized rate of change in number of prevalent cases for India is -0.95 (95% UI, -0.98 to -0.91) whereas for Brazil it is -0.06 (95% UI, -0.41 to 0.52). The annualized rate of change in number of DALY for India is -0.94 (95% UI, -0.96 to -0.92) whereas for Brazil it is -0.09 (95% UI, -0.25 to 0.28). The annualized rate of change in number of deaths for India is -0.93 (95% UI, -0.95 to -0.92) whereas for Brazil it is increasing i.e. 0.04 (95% UI, -0.12 to 0.51). India achieves significant reduction in the age standardized incidence, prevalence, mortality and DALY of VL as compare to Brazil during the period of 1990 to 2019. A multi-centric study is required to assess bottleneck in the existing strategies of VLSCP in Brazil.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jean Wilguens Lartigue ◽  
Olaoluwa Ezekiel Dada ◽  
Makinah Haq ◽  
Sarah Rapaport ◽  
Lorraine Arabang Sebopelo ◽  
...  

Background: Worldwide, neurological disorders are the leading cause of disability-adjusted life years lost and the second leading cause of death. Despite global health capacity-building efforts, each year, 22.6 million individuals worldwide require neurosurgeon's care due to diseases such as traumatic brain injury and hydrocephalus, and 13.8 million of these individuals require surgery. It is clear that neurosurgical care is indispensable in both national and international public health discussions. This study highlights the role neurosurgeons can play in supporting the global health agenda, national surgical plans, and health strengthening systems (HSS) interventions.Methods: Guided by a literature review, the authors discuss key topics such as the global burden of neurosurgical diseases, the current state of neurosurgical care around the world and the inherent benefits of strong neurosurgical capability for health systems.Results: Neurosurgical diseases make up an important part of the global burden of diseases. Many neurosurgeons possess the sustained passion, resilience, and leadership needed to advocate for improved neurosurgical care worldwide. Neurosurgical care has been linked to 14 of the 17 Sustainable Development Goals (SDGs), thus highlighting the tremendous impact neurosurgeons can have upon HSS initiatives.Conclusion: We recommend policymakers and global health actors to: (i) increase the involvement of neurosurgeons within the global health dialogue; (ii) involve neurosurgeons in the national surgical system strengthening process; (iii) integrate neurosurgical care within the global surgery movement; and (iv) promote the training and education of neurosurgeons, especially those residing in Low-and middle-income countries, in the field of global public health.


2018 ◽  
Vol 38 (02) ◽  
pp. 208-211 ◽  
Author(s):  
Mira Katan ◽  
Andreas Luft

AbstractStroke is the second leading cause of death and a major cause of disability worldwide. Its incidence is increasing because the population ages. In addition, more young people are affected by stroke in low- and middle-income countries. Ischemic stroke is more frequent but hemorrhagic stroke is responsible for more deaths and disability-adjusted life-years lost. Incidence and mortality of stroke differ between countries, geographical regions, and ethnic groups. In high-income countries mainly, improvements in prevention, acute treatment, and neurorehabilitation have led to a substantial decrease in the burden of stroke over the past 30 years. This article reviews the epidemiological and clinical data concerning stroke incidence and burden around the globe.


2020 ◽  
Vol 30 (11) ◽  
pp. 1688-1693 ◽  
Author(s):  
Dominique Vervoort ◽  
Marcelo Cardarelli

AbstractBackground:CHDs are one of the most frequent congenital malformations, affecting one in hundred live births. In total, 70% will require treatment in the first year of life, but over 90% of cases in low- and middle-income countries receive no treatment or suboptimal treatment. As a result, CHDs are responsible for 66% of preventable deaths due to congenital malformations in low- and middle-income countries. This study examines the unmet need of congenital cardiac care around the world based on the global burden of disease.Materials and methods:CHD morbidity and mortality data for 2006, 2011, and 2016 were collected from the Institute for Health Metrics and Evaluation Global Burden of Disease Results Tool and analysed longitudinally to assess trends in excess morbidity and mortality.Results:Between 2006 and 2016, a 20.7% reduction in excess disability-adjusted life years and 20.6% reduction in excess deaths due to CHDs were observed for children under 15. In 2016, excess global morbidity and mortality due to CHDs remained high with 14,788,418.7 disability-adjusted life years and 171,761.8 paediatric deaths, respectively. In total, 90.2% of disability-adjusted life years and 91.2% of deaths were considered excess.Conclusion:This study illustrates the unmet need of congenital cardiac care around the world. Progress has been made to reduce morbidity and mortality due to CHDs but remains high and largely treatable around the world. Limited academic attention for global paediatric cardiac care magnifies the lack of progress in this area.


2021 ◽  
Author(s):  
Deepa Kumari Bhatta ◽  
Kreeti Budhathoki ◽  
Kiran Paudel ◽  
Shishir Paudel ◽  
Sujan Babu Marhatta ◽  
...  

Objectives: This study aims to describe the burden of depressive and anxiety disorders in Nepal in terms of incidence, prevalence, YLDs, and DALYs by age and sex. Design: An ecological study on disease burden. Methods: We used the publicly available Global Burden of Disease (GBD) data from 1990 to 2017. The age and sex-specific incidence, prevalence rate, Years Lived with Disability (YLDs), and Disability Adjusted Life Years (DALYs) were examined among per 100,000 populations. Results: Females had a higher prevalence of depressive 4094.4 (95% uncertainty interval [UI]: 3761.9-4470.3 per 100,000) and anxiety 4496.8 (95% UI: 4171.9-4837.9 per 100,000) disorders. The prevalence of major depressive disorders was comparatively higher in females (2766.7) than males (1822.9). Females also had higher YLDs for both depressive and anxiety disorders. In 2017, higher DALYs of anxiety disorder were found in the females of 45-49 years (630.1). Childhood sexual abuse was found to be the main risk factor for depressive disorder, contributing to 32.5 DALYs in both sexes. Bullying, victimization had contributed to 26.7 DALYs of anxiety. Conclusions: The high burden of disorders in females would support in identifying major mental health challenges in Nepal and develop plans and various preventive, curative, and rehabilitative strategies.


2015 ◽  
Vol 45 (3) ◽  
pp. 190-202 ◽  
Author(s):  
Rita V. Krishnamurthi ◽  
Andrew E. Moran ◽  
Valery L. Feigin ◽  
Suzanne Barker-Collo ◽  
Bo Norrving ◽  
...  

Background: Recent evidence suggests that stroke is increasing as a cause of morbidity and mortality in younger adults, where it carries particular significance for working individuals. Accurate and up-to-date estimates of stroke burden are important for planning stroke prevention and management in younger adults. Objectives: This study aims to estimate prevalence, mortality and disability-adjusted life years (DALYs) and their trends for total, ischemic stroke (IS) and hemorrhagic stroke (HS) in the world for 1990-2013 in adults aged 20-64 years. Methodology: Stroke prevalence, mortality and DALYs were estimated using the Global Burden of Disease (GBD) 2013 methods. All available data on rates of stroke incidence, excess mortality, prevalence and death were collected. Statistical models were used along with country-level covariates to estimate country-specific stroke burden. Stroke-specific disability weights were used to compute years lived with disability and DALYs. Means and 95% uncertainty intervals (UIs) were calculated for prevalence, mortality and DALYs. The median of the percent change and 95% UI were determined for the period from 1990 to 2013. Results: In 2013, in younger adults aged 20-64 years, the global prevalence of HS was 3,725,085 cases (95% UI 3,548,098-3,871,018) and IS was 7,258,216 cases (95% UI 6,996,272-7,569,403). Globally, between 1990 and 2013, there were significant increases in absolute numbers and prevalence rates of both HS and IS for younger adults. There were 1,483,707 (95% UI 1,340,579-1,658,929) stroke deaths globally among younger adults but the number of deaths from HS (1,047,735 (95% UI 945,087-1,184,192)) was significantly higher than the number of deaths from IS (435,972 (95% UI 354,018-504,656)). There was a 20.1% (95% UI -23.6 to -10.3) decline in the number of total stroke deaths among younger adults in developed countries but a 36.7% (95% UI 26.3-48.5) increase in developing countries. Death rates for all strokes among younger adults declined significantly in developing countries from 47 (95% UI 42.6-51.7) in 1990 to 39 (95% UI 35.0-43.8) in 2013. Death rates for all strokes among younger adults also declined significantly in developed countries from 33.3 (95% UI 29.8-37.0) in 1990 to 23.5 (95% UI 21.1-26.9) in 2013. A significant decrease in HS death rates for younger adults was seen only in developed countries between 1990 and 2013 (19.8 (95% UI 16.9-22.6) and 13.7 (95% UI 12.1-15.9)) per 100,000). No significant change was detected in IS death rates among younger adults. The total DALYs from all strokes in those aged 20-64 years was 51,429,440 (95% UI 46,561,382-57,320,085). Globally, there was a 24.4% (95% UI 16.6-33.8) increase in total DALY numbers for this age group, with a 20% (95% UI 11.7-31.1) and 37.3% (95% UI 23.4-52.2) increase in HS and IS numbers, respectively. Conclusions: Between 1990 and 2013, there were significant increases in prevalent cases, total deaths and DALYs due to HS and IS in younger adults aged 20-64 years. Death and DALY rates declined in both developed and developing countries but a significant increase in absolute numbers of stroke deaths among younger adults was detected in developing countries. Most of the burden of stroke was in developing countries. In 2013, the greatest burden of stroke among younger adults was due to HS. While the trends in declining death and DALY rates in developing countries are encouraging, these regions still fall far behind those of developed regions of the world. A more aggressive approach toward primary prevention and increased access to adequate healthcare services for stroke is required to substantially narrow these disparities.


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