Assessing antiretroviral therapy success in HIV/AIDS morbidity and mortality trends in Brazil, 1990–2017: an interrupted time series study

2020 ◽  
pp. 095646242095298
Author(s):  
Augusto Cesar Lara de Sousa ◽  
Tatiana de Araujo Eleuterio ◽  
José Victor Afonso Coutinho ◽  
Raphael Mendonça Guimarães
Keyword(s):  
Time Series ◽  
Antiretroviral Therapy ◽  
Burden Of Disease ◽  
Interrupted Time Series ◽  
People Living With Hiv ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Impact ◽  
Hiv Aids

To describe the trends of HIV/AIDS metrics related to the burden of disease for Brazil between 1990 and 2017 we conducted a timeseries analysis for HIV/AIDS indicators by extracting data from the Global Burden of Disease study. We calculated traditional prevalence, incidence and mortality rates, the number of years lost by HIV-related deaths (YLL) and disability (YLD), and disability-adjusted life years (DALY). We estimated time series models and assessed the impact of highly active antiretroviral therapy (HAART) on the same indicators. In the set of disability-adjusted life years (DALY), the highest weight of its magnitude was due to YLL. There was a decline, especially after 1996, of DALY, mortality and YLL for HIV/AIDS. However, YLD, incidence, and prevalence increased over the same period. Also, the analysis of interrupted time series showed that the introduction of HAART into health policy had a significant impact on indicators, especially for DALY and YLL. We need to assess the quality of life of people living with HIV, especially among older adults. In addition, we need to focus on primary prevention, emphasizing methods to avoid infection and public policies should reflect this.

scholarly journals How do world and European standard populations impact burden of disease studies? A case study of disability-adjusted life years (DALYs) in Scotland

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Grant M. A. Wyper ◽  
Ian Grant ◽  
Eilidh Fletcher ◽  
Gerry McCartney ◽  
Colin Fischbacher ◽  
...  
Keyword(s):  
Burden Of Disease ◽  
Rank Order ◽  
Disability Adjusted Life Years ◽  
European Standard ◽  
Standard Population ◽  
Disability Adjusted Life ◽  
Life Years ◽  
European Standard Population ◽  
Causes Of Disease ◽  
The Impact

Abstract Background Disability-Adjusted Life Years (DALYs) are an established method for quantifying population health needs and guiding prioritisation decisions. Global Burden of Disease (GBD) estimates aim to ensure comparability between countries and over time by using age-standardised rates (ASR) to account for differences in the age structure of different populations. Different standard populations are used for this purpose but it is not widely appreciated that the choice of standard may affect not only the resulting rates but also the rankings of causes of DALYs. We aimed to evaluate the impact of the choice of standard, using the example of Scotland. Methods DALY estimates were derived from the 2016 Scottish Burden of Disease (SBoD) study for an abridged list of 68 causes of disease/injury, representing a three-year annual average across 2014–16. Crude DALY rates were calculated using Scottish national population estimates. DALY ASRs standardised using the GBD World Standard Population (GBD WSP) were compared to those using the 2013 European Standard Population (ESP2013). Differences in ASR and in rank order within the cause list were summarised for all-cause and for each individual cause. Results The ranking of causes by DALYs were similar using crude rates or ASR (ESP2013). All-cause DALY rates using ASR (GBD WSP) were around 26% lower. Overall 58 out of 68 causes had a lower ASR using GBD WSP compared with ESP2013, with the largest falls occurring for leading causes of mortality observed in older ages. Gains in ASR were much smaller in absolute scale and largely affected causes that operated early in life. These differences were associated with a substantial change to the ranking of causes when GBD WSP was used compared with ESP2013. Conclusion Disease rankings based on DALY ASRs are strongly influenced by the choice of standard population. While GBD WSP offers international comparability, within-country analyses based on DALY ASRs should reflect local age structures. For European countries, including Scotland, ESP2013 may better guide local priority setting by avoiding large disparities occurring between crude and age-standardised results sets, which could potentially confuse non-technical audiences.

scholarly journals 1442The burden of COVID-19 in Australia in 2020

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Lynelle Moon ◽  
Anna Reynolds ◽  
Michelle Gourley
Keyword(s):  
Burden Of Disease ◽  
Disease Burden ◽  
Years Of Life Lost ◽  
Disability Adjusted Life Years ◽  
Australian Population ◽  
Healthy Life ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Years Lived With Disability ◽  
The Impact

Abstract Background During 2020, there were nearly 28,500 cases of COVID-19 in Australia. Burden of disease estimates for COVID-19 have not been calculated for the Australian population. Burden of disease data on COVID-19 provide valuable information on the impact of the disease, including both fatal and non-fatal effects. Methods Burden of disease is measured using the summary measure disability-adjusted life years (DALYs). One DALY is 1 year of ‘healthy life’ lost due to illness (Years Lived with Disability) and/or death (Years of Life Lost)—the more DALYs associated with a disease or injury, the greater the burden. The analysis draws on Australian deaths, incidence and severity, as well as methods and other inputs developed in other countries reflecting current understanding about this new disease. Results There were over 8,300 DALYs lost due to COVID-19 in 2020 in Australia; 97% of the disease burden arose from fatal cases. Males lost an average of 10.7 years, and females 8.1 years, due to dying from COVID-19, using an aspirational life expectancy. The burden of disease estimates for Australia for COVID-19 are much lower than the leading diseases causing burden. Conclusions The relatively low burden for COVID-19 in Australia in 2020 compared to other diseases and other countries reflects the success Australia had in containing the virus. Key messages Most of the burden due to COVID-19 in Australia was fatal. Burden of disease estimates for COVID-19 in Australia for 2020 are much lower than the leading diseases.

scholarly journals How do World and European Standard Populations impact Burden of Disease studies? A case study of Disability-Adjusted Life Years in Scotland

2019 ◽  
Author(s):  
Grant MA Wyper ◽  
Ian Grant ◽  
Eilidh Fletcher ◽  
Gerry McCartney ◽  
Colin Fischbacher ◽  
...  
Keyword(s):  
Burden Of Disease ◽  
Rank Order ◽  
Disability Adjusted Life Years ◽  
European Standard ◽  
Standard Population ◽  
Disability Adjusted Life ◽  
Life Years ◽  
European Standard Population ◽  
Causes Of Disease ◽  
The Impact

AbstractBackgroundDisability-Adjusted Life Years (DALYs) are an established method for quantifying population health needs and guiding prioritisation decisions. Global Burden of Disease (GBD) estimates aim to ensure comparability between countries and over time by using age-standardised rates (ASR) to account for differences in the age structure of different populations. Different standard populations are used for this purpose but it is not widely appreciated that the choice of standard may affect not only the resulting rates but also the rankings of causes of DALYs. We aimed to evaluate the impact of the choice of standard, using the example of Scotland.MethodsDALY estimates were derived from the 2016 Scottish Burden of Disease (SBOD) study for an abridged list of 68 causes of disease/injury, representing a three-year annual average across 2014-16. Crude DALY rates were calculated using Scottish national population estimates. DALY ASRs standardised using the GBD World Standard Population (GBD WSP) were compared to those using the 2013 European Standard Population (ESP2013). Differences in ASR and in rank order within the cause list were summarised across all-causes and for each individual cause.ResultsThe ranking of causes by DALYs were similar using crude rates or ASR (ESP2013). As expected, all-cause DALY rates using ASR (GBD WSP) were around 26% lower. Overall 58 out of 68 causes had a lower ASR using GBD WSP compared with ESP2013, with the largest falls occurring for leading causes of mortality observed in older ages. Gains in ASR were much smaller in scale and largely affected causes that operated early in life. These differences were associated with a substantial change to the ranking of causes when GBD WSP was used compared with ESP2013.ConclusionDisease rankings based on DALY ASRs are strongly influenced by the choice of standard population. While GBD WSP offers international comparability, within-country analyses based on DALY ASRs should reflect local age structures. For European countries including Scotland, ESP2013 may better guide local priority setting.

Examination of incidence, mortality and disability-adjusted life years and risk factors of breast cancer in 49 Asian countries, 1990–2019: estimates from Global Burden of Disease Study 2019

2021 ◽  
Author(s):  
Rajesh Sharma
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Mortality Rate ◽  
Burden Of Disease ◽  
Global Burden ◽  
Disability Adjusted Life Years ◽  
Asian Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Standardized Mortality Rate

Abstract Background This study presents an up-to-date, comprehensive and comparative examination of breast cancer’s temporal patterns in females in Asia in last three decades. Methods The estimates of incidence, mortality, disability-adjusted-life-years and risk factors of breast cancer in females in 49 Asian countries were retrieved from Global Burden of Disease 2019 study. Results In Asia, female breast cancer incidence grew from 245 045[226 259–265 260] in 1990 to 914 878[815 789–1025 502] in 2019 with age-standardized incidence rate rising from 21.2/100 000[19.6–22.9] to 35.9/100 000[32.0–40.2] between 1990 and 2019. The death counts more than doubled from 136 665[126 094–148 380] to 337 822[301 454–375 251]. The age-standardized mortality rate rose marginally between 1990 and 2019 (1990: 12.1[11.0–13.1]; 2019: 13.4[12.0–14.9]). In 2019, age-standardized incidence rate varied from 17.2/100 000[13.95–21.4] in Mongolia to 122.5[92.1–160.7] in Lebanon and the age-standardized mortality rate varied 4-fold from 8.0/100 000 [7.2–8.8] in South Korea to 51.9[39.0–69.8] in Pakistan. High body mass index (5.6%), high fasting plasma glucose (5.6%) and secondhand smoke (3.5%) were the main contributory risk factors to all-age disability-adjusted-life-years due to breast cancer in Asia. Conclusion With growing incidence, escalating dietary and behavioural risk factors and lower survival rates due to late-disease presentation in low- and medium-income countries of Asia, breast cancer has become a significant public health threat. Its rising burden calls for increasing breast cancer awareness, preventive measures, early-stage detection and cost-effective therapeutics in Asia.

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