scholarly journals Burden of disease among the world’s poorest billion people: An expert-informed secondary analysis of Global Burden of Disease estimates

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0253073
Author(s):  
Matthew M. Coates ◽  
Majid Ezzati ◽  
Gisela Robles Aguilar ◽  
Gene F. Kwan ◽  
Daniel Vigo ◽  
...  

Background The health of populations living in extreme poverty has been a long-standing focus of global development efforts, and continues to be a priority during the Sustainable Development Goal era. However, there has not been a systematic attempt to quantify the magnitude and causes of the burden in this specific population for almost two decades. We estimated disease rates by cause for the world’s poorest billion and compared these rates to those in high-income populations. Methods We defined the population in extreme poverty using a multidimensional poverty index. We used national-level disease burden estimates from the 2017 Global Burden of Disease Study and adjusted these to account for within-country variation in rates. To adjust for within-country variation, we looked to the relationship between rates of extreme poverty and disease rates across countries. In our main modeling approach, we used these relationships when there was consistency with expert opinion from a survey we conducted of disease experts regarding the associations between household poverty and the incidence and fatality of conditions. Otherwise, no within-country variation was assumed. We compared results across multiple approaches for estimating the burden in the poorest billion, including aggregating national-level burden from the countries with the highest poverty rates. We examined the composition of the estimated disease burden among the poorest billion and made comparisons with estimates for high-income countries. Results The composition of disease burden among the poorest billion, as measured by disability-adjusted life years (DALYs), was 65% communicable, maternal, neonatal, and nutritional (CMNN) diseases, 29% non-communicable diseases (NCDs), and 6% injuries. Age-standardized DALY rates from NCDs were 44% higher in the poorest billion (23,583 DALYs per 100,000) compared to high-income regions (16,344 DALYs per 100,000). Age-standardized DALY rates were 2,147% higher for CMNN conditions (32,334 DALYs per 100,000) and 86% higher for injuries (4,182 DALYs per 100,000) in the poorest billion, compared to high-income regions. Conclusion The disease burden among the poorest people globally compared to that in high income countries is highly influenced by demographics as well as large disparities in burden from many conditions. The comparisons show that the largest disparities remain in communicable, maternal, neonatal, and nutritional diseases, though NCDs and injuries are an important part of the “unfinished agenda” of poor health among those living in extreme poverty.

2020 ◽  
Vol 29 ◽  
Author(s):  
Jiayuan Wu ◽  
Jie Liu ◽  
Shasha Li ◽  
Huan Ma ◽  
Yufeng Wang

Abstract Aim Eating disorders have increasingly become a public health concern globally. This study aimed to reveal the burden of eating disorders at the global, regional and national levels using the Global Burden of Disease (GBD) Study 2017 data. Methods We extracted the age-standardised rates (ASRs) of prevalence and disability-adjusted life years (DALYs) and their 95% uncertainty intervals (UIs) of eating disorders, including anorexia nervosa and bulimia nervosa, between 1990 and 2017 from the GBD 2017 data. The estimated annual percentage changes (EAPCs) were calculated to quantify the secular trends of the burden of eating disorders. Results The ASRs of prevalence and the DALYs of eating disorders continuously increased worldwide from 1990 to 2017 by an average of 0.65 (95% UI: 0.59–0.71) and 0.66 (95% UI: 0.60–0.72), respectively. The burden of eating disorders was higher in females than in males, but the increment in ASRs was greater in males than in females over time. In 2017, the highest burden of eating disorders was observed in the high sociodemographic index (SDI) regions, especially Australasia (ASR of prevalence = 807.13, 95% UI: 664.20–982.30; ASR of DALYs = 170.74, 95% UI: 113.43–244.14, per 100 000 population), Western Europe and high-income North America. However, the most significant increment of the burden of eating disorders was observed in East Asia (EAPC for prevalence = 2.23, 95% UI: 2.14–2.32; EAPC for DALYs = 2.22, 95% UI: 2.13–2.31), followed by South Asia. An increasing trend in the burden of eating disorders at the national level was observed among most countries or territories. The countries with the top three highest increasing trends were Equatorial Guinea, Bosnia and Herzegovina and China. Positive associations were found between the burden estimates and the SDI levels in almost all geographic regions during the observed 28-year period. We also found that the human development indexes in 2017 were positively correlated with the EAPCs of the ASRs of prevalence (ρ = 0.222, P = 0.002) and DALYs (ρ = 0.208, P = 0.003). Conclusion The highest burden of eating disorders remains in the high-income western countries, but an increasing trend was observed globally and in all SDI-quintiles, especially in Asian regions that were highly populous. These results could help governments worldwide formulate suitable medical and health policies for the prevention and early intervention of eating disorders.


Rheumatology ◽  
2020 ◽  
Author(s):  
Saeid Safiri ◽  
Ali Asghar Kolahi ◽  
Marita Cross ◽  
Kristin Carson-Chahhoud ◽  
Amir Almasi-Hashiani ◽  
...  

Abstract Objectives To describe the level and trends of point prevalence, deaths and disability-adjusted life years (DALYs) for other musculoskeletal (MSK) disorders, i.e. those not covered by specific estimates generated for RA, OA, low back pain, neck pain and gout, from 1990 to 2017 by age, sex and sociodemographic index. Methods Publicly available modelled estimates from the Global Burden of Disease (GBD) 2017 study were extracted and reported as counts and age-standardized rates per 100 000 population for 195 countries and territories between 1990 and 2017. Results Globally, the age-standardized point prevalence estimates and deaths rates of other MSK disorders in 2017 were 4151.1 and 1.0 per 100 000. This was an increase of 3.4% and 7.2%, respectively. The age-standardized DALY rate in 2017 was 380.2, an increase of 3.4%. The point prevalence estimate was higher among females and increased with age. This peaked in the 65–69 year age group for both females and males in 2017, followed by a decreasing trend for both sexes. At the national level, the highest age-standardized point prevalence estimates in 2017 were seen in Bangladesh, India and Nepal. The largest increases in age-standardized point prevalence estimates were observed in Romania, Croatia and Armenia. Conclusion The burden of other MSK disorders is proven to be substantial and increasing worldwide, with a notable intercountry variation. Data pertaining to specific diseases within this overarching category are required for future GBD MSK estimates. This would enable policymakers to better allocate resources and provide interventions appropriately.


2016 ◽  
Vol 39 (3) ◽  
pp. 464-475 ◽  
Author(s):  
A. Prüss-Ustün ◽  
J. Wolf ◽  
C. Corvalán ◽  
T. Neville ◽  
R. Bos ◽  
...  

Abstract Background The update of the global burden of disease attributable to the environment is presented. The study focuses on modifiable risks to show the potential health impact from environmental interventions. Methods Systematic literature reviews on 133 diseases and injuries were performed. Comparative risk assessments were complemented by more limited epidemiological estimates, expert opinion and information on disease transmission pathways. Population attributable fractions were used to calculate global deaths and global disease burden from environmental risks. Results Twenty-three percent (95% CI: 13–34%) of global deaths and 22% (95% CI: 13–32%) of global disability adjusted life years (DALYs) were attributable to environmental risks in 2012. Sixty-eight percent of deaths and 56% of DALYs could be estimated with comparative risk assessment methods. The global disease burden attributable to the environment is now dominated by noncommunicable diseases. Susceptible ages are children under five and adults between 50 and 75 years. Country level data are presented. Conclusions Nearly a quarter of global disease burden could be prevented by reducing environmental risks. This analysis confirms that eliminating hazards and reducing environmental risks will greatly benefit our health, will contribute to attaining the recently agreed Sustainable Development Goals and will systematically require intersectoral collaboration to be successful.


2021 ◽  
Vol 12 ◽  
Author(s):  
Zhitao Li ◽  
Lili Wang ◽  
Haixia Guan ◽  
Cheng Han ◽  
Peng Cui ◽  
...  

Background: Eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN), are complex mental disorders. A better understanding of the burden of eating disorders is essential for improving their management. Information about the burden of eating disorders at the national level in China remains unclear.Methods: This is a systematic analysis of the Global Burden of Disease Study (GBD) 2019. The sex- and age-specific prevalence, incidence, and disability-adjusted life years (DALYs) of eating disorders in China were estimated by systematically reviewing all available epidemiological data and inputting these data into a Bayesian meta-regression tool (DisMod-MR 2.0). Trends in the age-standardized prevalence, incidence, and DALYs due to AN and BN were assessed from 1990 to 2019.Results: The age-standardized incidence rate (ASIR), prevalence rate (ASPR), and DALY rate per 100,000 population were estimated to be 13.22 (95% UI, 9.35–18.23), 38.08 (95% UI: 26.37–55.73), and 8.38 (95% UI, 4.87–13.35) for AN and 130.05 (95% UI, 84.02–187.13), 75.21 (95% UI, 48.52–105.97), and 16.16 (95% UI, 9.23–25.40) for BN, respectively, in 2019. The prevalence, incidence, and DALY rate of AN peaked at 15–19 years old. The prevalence and DALY rate of BN peaked at 30–34 years old. Females had a higher burden of AN and a lower burden of BN than males. The ASIR, ASPR, and DALY significantly increased by 1.3% (95% CI: 1.3–1.4%), 1.6% (95% CI, 1.5–1.6%), and 1.6% (95% CI, 1.5–1.7%) for AN and 1.4% (95% CI: 1.4–1.4%), 2.0% (95% CI, 2.0–2.1%), and 2.0% (95% CI, 2.0–2.1%) for BN, respectively, from 1990 to 2019 in China. In addition, the increments in all the age-standardized measures of BN were higher in males than in females.Conclusions: The burden of eating disorders in China showed unexpected patterns that varied by sex and age, with increasing trends of AN and BN from 1990 to 2019. More attention should be given to improving the burden of BN in males in China.


2020 ◽  
Author(s):  
Di Lu ◽  
Jintao Zhan ◽  
Xiguang Liu ◽  
Xiaoying Dong ◽  
Siyang Feng ◽  
...  

Abstract Background: Esophageal cancer is the 7th leading cancer globally and the 10th leading cancer in the United States. However, it is has received limited attention over more common malignancies. Only a few studies have comprehensively assessed disease burden from esophageal cancer in the United States (US). Methods: Using states-categorized data on incidence, mortality, and Disability-adjusted Life Years (DALYs), this study analyzed the current trends in esophageal cancer disease burden. Data and risk factor indicators were obtained from Global Burden of Disease (GBD) online resource and used to determine annual relative change. Results: We report here that between 1990 and 2017, the number of esophageal cancer new cases, deaths and DALYs in the US increased significantly, while the Age-standardized Rate (ASR) of disease incidence remained constant. During the same time, disease burden from esophageal cancer in males was higher than that in females. Economically stronger states trend to had lesser disease burden from esophageal cancer. Smoking and alcohol use contributed most of the burden while influence of high body-mass index and diet low in fruits grew largely. Conclusions: This study provided an analysis of esophageal cancer disease burden in the United States that will inform the design of targeted strategies for disease prevention tailored to different states.


2021 ◽  
Vol 8 ◽  
Author(s):  
Wenwen Cai ◽  
Qingle Zeng ◽  
Xingxing Zhang ◽  
Weiqing Ruan

Background: Non-Hodgkin lymphoma is a common hematologic malignancy. This article aimed to estimate the trends of non-Hodgkin lymphoma (NHL) globally from 1990 to 2019.Methods: Data on the NHL burden were explored from the Global Burden of Disease study 2019. The trends of NHL burden were estimated using age-standardized rate (ASR) and estimated annual percentage change (EAPC).Results: The ASR of NHL incidence showed an increasing trend worldwide from 1990 to 2019, with an EAPC of.56 [95% CI: 0.45–0.66]. Meanwhile, increasing trends were observed in both sexes and in most geographic regions, particularly East Asia (EAPC = 3.57, 95% CI: 3.29–3.86). The most pronounced increasing trends were seen in Georgia (EAPC = 4.7, 95% CI: 4.20–5.21), followed by Belarus and Uzbekistan. However, death and disability-adjusted life years (DALYs) caused by NHL showed decreasing trends globally, in which the respective EAPCs were −0.09 (95% CI: −0.17 to −0.02) and −0.28 (95% CI: −0.35 to −0.22). Decreasing trends were mainly seen in high and high-middle sociodemographic index (SDI) areas. At the national level, the largest increasing trends of death and DALYs were observed in Georgia, in which the respective EAPCs were 4.54 (95% CI: 4.01–5.07) and 4.97 (95% CI: 4.42–5.52).Conclusions: Decreasing trends of death and DALYs caused by NHL were observed worldwide from 1990 to 2019, but NHL remains a substantial challenge globally. The findings would inform the strategies for reducing the burden of NHL.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xingxing Zhang ◽  
Qingle Zeng ◽  
Wenwen Cai ◽  
Weiqing Ruan

Abstract Background Cervical cancer is an important global health problem. In this study we aimed to analyze trends in cervical cancer at the global, regional, and national levels from 1990 to 2019, to inform health service decision-making. Methods Data on cervical cancer was extracted from the Global Burden of Disease study, 2019. Trends in cervical cancer burden were assessed based on estimated annual percentage change (EAPC) and age-standardized rate (ASR). Results Globally, decreasing trends were observed in incidence, death, and disability adjusted life years (DALYs) of cervical cancer from 1990 to 2019, with respective EAPCs of − 0.38 (95% confidence interval [CI]: − 0.41 to − 0.34), − 0.93 (95%CI: − 0.98 to − 0.88), and − 0.95 (95 CI%: − 1.00 to − 0.90). Meanwhile, decreasing trends were detected in most sociodemographic index (SDI) areas and geographic regions, particularly death and DALYs in Central Latin America, with respective EAPCs of − 2.61 (95% CI: − 2.76 to − 2.46) and − 2.48 (95% CI: − 2.63 to − 2.32); hhowever, a pronounced increasing trend in incidence occurred in East Asia (EAPC = 1.33; 95% CI: 1.12 to 1.55). At the national level, decreasing trends in cervical cancer were observed in most countries/territories, particularly DALYs in the Maldives (EAPC = − 5.06; 95% CI: − 5.40 to − 4.72), Whereas increasing trends were detected in Lesotho, Zimbabwe, and Bulgaria. Conclusions Slowly decreasing trends in cervical cancer were detected worldwide from 1990 to 2019. Cervical cancer remains a substantial health problem for women globally, requiring more effective prevention and control strategies.


2019 ◽  
Vol 4 (5) ◽  
pp. e001500 ◽  
Author(s):  
Fridolin Steinbeis ◽  
Dzintars Gotham ◽  
Peter von Philipsborn ◽  
Jan M Stratil

BackgroundThe major shifts in the global burden of disease over the past decades are well documented, but how these shifts have affected global inequalities in health remains an underexplored topic. We applied comprehensive inequality measures to data from the Global Burden of Disease (GBD) study.MethodsBetween-country relative inequality was measured by the population-weighted Gini Index, between-country absolute inequality was calculated using the population-weighted Slope Inequality Index (SII). Both were applied to country-level GBD data on age-standardised disability-adjusted life years.FindingsAbsolute global health inequality measured by the SII fell notably between 1990 (0.68) and 2017 (0.42), mainly driven by a decrease of disease burden due to communicable, maternal, neonatal and nutritional diseases (CMNN). By contrast, relative inequality remained essentially unchanged from 0.21 to 0.19 (1990–2017), with a peak of 0.23 (2000–2008). The main driver for the increase of relative inequality 1990–2008 was the HIV epidemic in Sub-Saharan Africa. Relative inequality increased 1990–2017 within each of the three main cause groups: CMNNs; non-communicable diseases (NCDs); and injuries.ConclusionsDespite considerable reductions in disease burden in 1990–2017 and absolute health inequality between countries, absolute and relative international health inequality remain high. The limited reduction of relative inequality has been largely due to shifts in disease burden from CMNNs and injuries to NCDs. If progress in the reduction of health inequalities is to be sustained beyond the global epidemiological transition, the fight against CMNNs and injuries must be joined by increased efforts for NCDs.


2021 ◽  
Vol 6 (1) ◽  
pp. e004145
Author(s):  
Iain James Marshall ◽  
Veline L'Esperance ◽  
Rachel Marshall ◽  
James Thomas ◽  
Anna Noel-Storr ◽  
...  

IntroductionIdeally, health conditions causing the greatest global disease burden should attract increased research attention. We conducted a comprehensive global study investigating the number of randomised controlled trials (RCTs) published on different health conditions, and how this compares with the global disease burden that they impose.MethodsWe use machine learning to monitor PubMed daily, and find and analyse RCT reports. We assessed RCTs investigating the leading causes of morbidity and mortality from the Global Burden of Disease study. Using regression models, we compared numbers of actual RCTs in different health conditions to numbers predicted from their global disease burden (disability-adjusted life years (DALYs)). We investigated whether RCT numbers differed for conditions disproportionately affecting countries with lower socioeconomic development.ResultsWe estimate 463 000 articles describing RCTs (95% prediction interval 439 000 to 485 000) were published from 1990 to July 2020. RCTs recruited a median of 72 participants (IQR 32–195). 82% of RCTs were conducted by researchers in the top fifth of countries by socio-economic development. As DALYs increased for a particular health condition by 10%, the number of RCTs in the same year increased by 5% (3.2%–6.9%), but the association was weak (adjusted R2=0.13). Conditions disproportionately affecting countries with lower socioeconomic development, including respiratory infections and tuberculosis (7000 RCTs below predicted) and enteric infections (9700 RCTs below predicted), appear relatively under-researched for their disease burden. Each 10% shift in DALYs towards countries with low and middle socioeconomic development was associated with a 4% reduction in RCTs (3.7%–4.9%). These disparities have not changed substantially over time.ConclusionResearch priorities are not well optimised to reduce the global burden of disease. Most RCTs are produced by highly developed countries, and the health needs of these countries have been, on average, favoured.


2021 ◽  
Author(s):  
Xingxing Zhang ◽  
Danfeng Yu ◽  
Wenwen Cai ◽  
Weiqing Ruan

Abstract Background Cervical cancer remains an important global health problem. This article aims to analysis the trend of cervical cancer at global, regional, and national level from 1990 to 2019, which would inform the health decision-making. Methods Data on cervical cancer was extracted from the Global Burden of Disease study 2019. The trends of cervical cancer burden were estimated using estimated annual percentage change (EAPC) and age-standardized rate (ASR). Results Globally, the decreasing trends in incidence, death, and disability adjusted life years (DALYs) of cervical cancer were observed worldwide from 1990 to 2019, with the respective EAPCs were − 0.38 (95% confidence interval [CI]: -0.41 to -0.34), -0.93 (95%CI: -0.98 to -0.88), and − 0.95 (95CI%: -1.00 to -0.90). Meanwhile, decreasing trends were also seen in most sociodemographic index (SDI) areas and geographic regions, particularly the trends of death and DALYs in Central Latin America, in which the respective EAPCs were − 2.61 (95%CI: -2.76 to -2.46) and − 2.48 (95%CI: -2.63 to -2.32). However, pronounced increasing trends occurred in the incidence in East Asia (EAPC = 1.33; 95%CI: 1.12 to 1.55). At the national level, the decreasing trends of cervical cancer were observed in most countries/territories, particularly the DALYs in Maldives (EAPC=-5.06; 95%CI: -5.40 to -4.72). Whereas increasing trend were seen in Lesotho, Zimbabwe, and Bulgaria. Conclusions Slowly decreasing trends of cervical cancer were demonstrated worldwide from 1990 to 2019. Cervical cancer remains a substantial health problem globally, which required the more effective prevention and control strategies.


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