Does national expenditure on research and development influence stroke outcomes?

2017 ◽  
Vol 12 (8) ◽  
pp. 827-834
Author(s):  
Young Dae Kim ◽  
Yo Han Jung ◽  
Bo Norrving ◽  
Bruce Ovbiagele ◽  
Gustavo Saposnik
Keyword(s):  
Mortality Rate ◽  
Research And Development ◽  
Multivariable Analysis ◽  
Case Fatality ◽  
Population Based ◽  
World Health ◽  
Absolute Amount ◽  
Stroke Mortality ◽  
Stroke Outcomes ◽  
The World

Background Expenditure on research and development is a macroeconomic indicator representative of national investment. International organizations use this indicator to compare international research and development activities. Aim We investigated whether differences in expenditures on research and development at the country level may influence the incidence of stroke and stroke mortality. Methods We compared stroke metrics with absolute amount of gross domestic expenditure on R&D (GERD) per-capita adjusted for purchasing power parity (aGERD) and relative amount of GERD as percent of gross domestic product (rGERD). Sources included official data from the UNESCO, the World Health Organization, the World Bank, and population-based studies. We used correlation analysis and multivariable linear regression modeling. Results Overall, data on stroke mortality rate and GERD were available from 66 countries for two periods (2002 and 2008). Age-standardized stroke mortality rate was associated with aGERD (r = −0.708 in 2002 and r = −0.730 in 2008) or rGERD (r = −0.545 in 2002 and r = −0.657 in 2008) (all p < 0.001). Multivariable analysis showed a lower aGERD and rGERD were independently and inversely associated with higher stroke mortality (all p < 0.05). The estimated prevalence of hypertension, diabetes, or obesity was higher in countries with lower aGERD. The analysis of 27 population-based studies showed consistent inverse associations between aGERD or rGERD and incident risk of stroke and 30-day case fatality. Conclusions There is higher stroke mortality among countries with lower expenditures in research and development. While this study does not prove causality, it suggests a potential area to focus efforts to improve global stroke outcomes.

Countries with women inequalities have higher stroke mortality

2017 ◽  
Vol 12 (8) ◽  
pp. 869-874 ◽  
Author(s):  
Young Dae Kim ◽  
Yo Han Jung ◽  
Valeria Caso ◽  
Cheryl D Bushnell ◽  
Gustavo Saposnik
Keyword(s):  
Mortality Rate ◽  
Gender Inequality ◽  
Women's Rights ◽  
World Health ◽  
Women’S Rights ◽  
Stroke Mortality ◽  
Inequality Index ◽  
Stroke Outcomes ◽  
Country Level ◽  
Mortality Ratio

Background Stroke outcomes can differ by women’s legal or socioeconomic status. Aim We investigated whether differences in women’s rights or gender inequalities were associated with stroke mortality at the country-level. Methods We used age-standardized stroke mortality data from 2008 obtained from the World Health Organization. We compared female-to-male stroke mortality ratio and stroke mortality rates in women and men between countries according to 50 indices of women’s rights from Women, Business and the Law 2016 and Gender Inequality Index from the Human Development Report by the United Nations Development Programme. We also compared stroke mortality rate and income at the country-level. Results In our study, 176 countries with data available on stroke mortality rate in 2008 and indices of women’s rights were included. There were 46 (26.1%) countries where stroke mortality in women was higher than stroke mortality in men. Among them, 29 (63%) countries were located in Sub-Saharan African region. After adjusting by country income level, higher female-to-male stroke mortality ratio was associated with 14 indices of women’s rights, including differences in getting a job or opening a bank account, existence of domestic violence legislation, and inequalities in ownership right to property. Moreover, there was a higher female-to-male stroke mortality ratio among countries with higher Gender Inequality Index (r = 0.397, p < 0.001). Gender Inequality Index was more likely to be associated with stroke mortality rate in women than that in men (p < 0.001). Conclusions Our study suggested that the gender inequality status is associated with women’s stroke outcomes.

scholarly journals Quasi-Simpson paradox in estimating the expected mortality rate from the SARS-CoV-2

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110096
Author(s):  
Yair Y Shaki
Keyword(s):  
Mortality Rate ◽  
Case Fatality ◽  
World Health ◽  
High Infection Rate ◽  
Confounding Variable ◽  
Global Pandemic ◽  
High Infection ◽  
The World ◽  
Health Organization ◽  
Expected Mortality

On January 30, 2020, the World Health Organization (WHO) declared SARS-CoV-2 a global pandemic, based on a high infection rate and a high case fatality rate (CFR). The combination of these two points led WHO to forecast a high expected mortality rate of approximately 2% of the population. The phenomenon of Simpson’s paradox teaches us that we should be careful when we combine two variables together. Indeed, despite the high mortality rate in several places, this forecast seems to have collapsed. We believe one of the reasons for the erroneous forecasts is that combining the above points ignored a confounding variable – many of the virus carriers are asymptomatic and therefore not diagnosed.

scholarly journals Morbidity and Mortality Pattern of Neonates Admitted to Neonatal Care Unit.Central Teaching Pediatric Hospital Baghdad

2020 ◽  
Vol 16 (1) ◽  
pp. 38-48
Author(s):  
Riyadh M Ibrahim
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Child Death ◽  
Case Fatality ◽  
Neonatal Care ◽  
Morbidity And Mortality ◽  
World Health ◽  
Bacterial Sepsis ◽  
Related Condition ◽  
The World

Background; Neonatal period is a very vulnerable period of life due to many problems, In spite of advances in perinatal and neonatal care still, the mortality rate of neonate high especially in developing country The World Health Organization estimates that globally four million neonatal deaths per year, Developing countries account for around 99% of the neonatal mortality in the world, In Iraq. Neonatal mortality rate about 19 per 1000 live births which represent 56% of child death below 5 years age in 2012. .Objectives The aims of the study were to determine the institutional new-born case fatality rate and the cause of admission and death in the neonatal care unit.Method; Across-section study was carried out of the Neonatal Care Unit of Central Teaching Hospital of Pediatric in Baghdad Al-krakh Health DirectorateResult; During 2015, 1977 neonates were admitted, Mortality rate was 9%, Four main causes of death were identified; Respiratory related condition, Bacterial sepsis, premature neonate (Disorder related to short gestational and low birth weight not relayed to elsewhere classification) and congenital malformation 37.5%, 33.3%, 7.1% and 7.1% respectively , The main causes of morbidity were Neonatal jaundice, Respiratory related condition, Bacterial sepsis 37.5%, 35.2%. 14.1% respectively Conclusions: The majority of neonatal morbidity and mortality can be prevented by appropriate interventions

Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

2020 ◽  
Author(s):  
Ahmed Youssef Kada
Keyword(s):  
Case Fatality Rate ◽  
Doubling Time ◽  
Case Fatality ◽  
World Health ◽  
Fatality Rate ◽  
Therapeutic Protocol ◽  
First Case ◽  
The World ◽  
The Impact ◽  
At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

scholarly journals Infectious disease outbreaks in the African region: overview of events reported to the World Health Organization in 2018

2019 ◽  
Vol 147 ◽  
Author(s):  
F. Mboussou ◽  
P. Ndumbi ◽  
R. Ngom ◽  
Z. Kassamali ◽  
O. Ogundiran ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Disease Onset ◽  
Disease Outbreaks ◽  
Case Fatality ◽  
World Health ◽  
African Region ◽  
Regional Office ◽  
Member States ◽  
Infectious Disease Outbreaks ◽  
The World

Abstract The WHO African region is characterised by the largest infectious disease burden in the world. We conducted a retrospective descriptive analysis using records of all infectious disease outbreaks formally reported to the WHO in 2018 by Member States of the African region. We analysed the spatio-temporal distribution, the notification delay as well as the morbidity and mortality associated with these outbreaks. In 2018, 96 new disease outbreaks were reported across 36 of the 47 Member States. The most commonly reported disease outbreak was cholera which accounted for 20.8% (n = 20) of all events, followed by measles (n = 11, 11.5%) and Yellow fever (n = 7, 7.3%). About a quarter of the outbreaks (n = 23) were reported following signals detected through media monitoring conducted at the WHO regional office for Africa. The median delay between the disease onset and WHO notification was 16 days (range: 0–184). A total of 107 167 people were directly affected including 1221 deaths (mean case fatality ratio (CFR): 1.14% (95% confidence interval (CI) 1.07%–1.20%)). The highest CFR was observed for diseases targeted for eradication or elimination: 3.45% (95% CI 0.89%–10.45%). The African region remains prone to outbreaks of infectious diseases. It is therefore critical that Member States improve their capacities to rapidly detect, report and respond to public health events.

scholarly journals Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mortality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Day Case ◽  
Fatality Risk ◽  
E Coli ◽  
Factors Associated ◽  
Case Fatality Risk ◽  
Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

scholarly journals Antibiotic Pipeline Coordinators

2018 ◽  
Vol 46 (S1) ◽  
pp. 25-31 ◽  
Author(s):  
Enrico Baraldi ◽  
Olof Lindahl ◽  
Miloje Savic ◽  
David Findlay ◽  
Christine Årdal
Keyword(s):  
Research And Development ◽  
World Health ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Priority List ◽  
Non Profit ◽  
Global Priority ◽  
The World ◽  
New Antibiotics ◽  
Health Organization

The World Health Organization (WHO) has published a global priority list of antibiotic-resistant bacteria to guide research and development (R&D) of new antibiotics. Every pathogen on this list requires R&D activity, but some are more attractive for private sector investments, as evidenced by the current antibacterial pipeline. A “pipeline coordinator” is a governmental/non-profit organization that closely tracks the antibacterial pipeline and actively supports R&D across all priority pathogens employing new financing tools.

scholarly journals Literature Review The Relationship Of Antenatal Class Towards Mothers’ Knowledge Of DangerousSign During Pregnancy

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Ayu Kurniati ◽  
Enny Fitriahadi
Keyword(s):  
Developing Countries ◽  
Mortality Rate ◽  
Literature Review ◽  
World Health ◽  
Live Births ◽  
Complication Risk ◽  
The World ◽  
Health Organization ◽  
Relationship Of ◽  
The Relationship

IN 2013, the World Health Organization, released data in the form of Maternal Mortality Rate (MMR) worldwide, and the number reached 289,000 per 100, 000 live births, which 99% of cases occurred in developing countries. Research aims to discover the relationship of antenatal class towards mothers’ knowledge of the dangerous sign during pregnancy. The result showed that there is a relationship of antenatal class towards mothers’ knowledge of dangerous sign during pregnancy, From this result, the researcher concludes that antenatal class could increase mothers’ knowledge of dangerous sign during pregnancy and may decrease the complication risk during the childbirth.

scholarly journals Determinants of Maternal Mortality Rate in The Kyrgyz Republic Regions

2017 ◽  
Author(s):  
Nurbek Madmarov ◽  
Metin Bayrak
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Women’S Health ◽  
Women's Health ◽  
Fixed Effects ◽  
World Health ◽  
Kyrgyz Republic ◽  
Maternal Mortality Rate ◽  
The World ◽  
Determinants Of Maternal Mortality

Population is an important factor in development of a country. As a constraint, not only the size of the population is important but also its quality in the development process. Women’s health is considered all over the world and the data about this aspect is published by the World Health Organization annually. Among others maternal mortality rate is one of the major problems affecting women’s health and population. Everyday 830 women die due to the problems related to pregnancy and childbirth in the world. While this number is relatively lower in the developed countries, it is higher in the underdeveloped and developing countries. In addition, the maternal mortality rate in the Caucasus and Central Asia ranks in the worst third in the world. In the Kyrgyz Republic, this rate is 82.083333 per 10000 live births which is the worst in the region. Therefore, it is among one of the countries where the maternal mortality should be reduced in the framework of the Millennium Development Goals. In this study, the determinants of maternal mortality rate are analyzed in the Kyrgyz Republic regions during 2000-2015 by using static panel data methods fixed effects and random effects. The findings show that there are significant decreasing effects of GDP, number of assistant physicians, births by skilled staff, improved sanitation facilities, and gender wage equality, there are significant increasing effects of health expenditures, medical facilities, and poverty among women on the maternal mortality.

scholarly journals Incidence of Acute Ischemic Stroke With Visible Arterial Occlusion

Stroke ◽  
2020 ◽  
Vol 51 (7) ◽  
pp. 2122-2130 ◽  
Author(s):  
Gauthier Duloquin ◽  
Mathilde Graber ◽  
Lucie Garnier ◽  
Valentin Crespy ◽  
Pierre-Olivier Comby ◽  
...  
Keyword(s):  
Arterial Occlusion ◽  
Population Based ◽  
Annual Incidence ◽  
World Health ◽  
Annual Incidence Rate ◽  
Anterior Circulation ◽  
The World ◽  
Health Organization ◽  
Proximal Occlusion ◽  
Population Based Registry

Background and Purpose: Because of several methodological limitations, previous studies focusing on the prevalence of large vessel occlusion in ischemic stroke (IS) patients provided conflicting results. We evaluated the incidence of IS with a visible arterial occlusion using a comprehensive population-based registry. Methods: Patients with acute IS were prospectively identified among residents of Dijon, France, using a population-based registry (2013–2017). All arterial imaging exams were reviewed to assess arterial occlusion. Annual incidence rates of IS (first-ever and recurrent events) and IS with a visible occlusion were calculated. Results: One thousand sixty cases of IS were recorded (mean age: 76.0±15.8 years, 53.9% women). Information about arterial imaging was available in 971 (91.6%) of them, and only preexisting dementia was independently associated with having missing information (odds ratio=0.34 [95% CI, 0.18–0.65], P =0.001). Among these patients, 284 (29.2%) had a visible arterial occlusion. Occlusion site was the anterior circulation in 226 patients (23.3% of overall patients with available data) and the posterior circulation in 58 patients (6.0%). A proximal occlusion of the anterior circulation was observed in 167 patients (17.2%). The crude annual incidence rate of total IS per 100 000 was 138 (95% CI, 129–146). Corresponding standardized rates were 66 (95% CI, 50–82) to the World Health Organization and 141 (95% CI, 118–164) to the 2013 European populations. The crude annual incidence rate of IS with a visible arterial occlusion per 100 000 was 37 (95% CI, 33–41) and that of IS with a proximal occlusion of the anterior circulation was 22 (95% CI, 18–25). Corresponding standardized rates were 18 (95% CI, 10–26) and 10 (95% CI, 8–13) to the World Health Organization population, and 38 (95% CI, 26–50) and 23 (95% CI, 19–26) to the 2013 European population, respectively. Conclusions: These results will be helpful to plan the need for thrombectomy-capable stroke center resources.

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