scholarly journals Assessing the Impact of Salt Reduction Initiatives on the Chronic Disease Burden of Singapore

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1171
Author(s):  
Ken Wei Tan ◽  
Sharon Esi Duoduwa Quaye ◽  
Joel Ruihan Koo ◽  
Jue Tao Lim ◽  
Alex R. Cook ◽  
...  

Globally, many countries are facing an increasing burden of chronic disease due to ageing populations, of which cardiovascular disease forms a large proportion. Excess dietary sodium contributes to cardiovascular disease risk and requires intervention at a population level. This study aimed to quantify the impact of several salt reduction initiatives on population health over a 30-year horizon using GeoDEMOS, a population model from Singapore. Four interventions were modelled in four demographic groups in 2020 for a total of 16 intervention scenarios. The effect of 0.5, 2.0, and 4.0 g/day reductions in daily salt consumption, along with adherence to the World Health Organization guidelines of a maximum of 5.0 g of salt each day, was modelled in the entire population, including the overweight and obese, the elderly, and diabetics. In each scenario, the number of averted incident cases of acute myocardial infarction and stroke, along with the disability-adjusted life years up to 2050, was monitored. We found 4.0 g/day reductions in salt consumption were the most effective when implemented across the entire population, resulting in 24,000 averted incident cases of cardiovascular disease and 215,000 disability-adjusted life years over 30 years. This is a large figure when compared with the 29,200 projected annual incident cases of cardiovascular disease in 2050. When targeted at specific high-risk demographic groups, the largest effects were observed in the overweight and obese, with the same intervention yielding 10,500 averted incident cases of cardiovascular disease and 91,500 disability-adjusted life years. Quantifying the benefits of salt reduction initiatives revealed a significant impact when administered across the entire population or the overweight and obese. Health promotion efforts directed toward sustainably reducing salt consumption will help to lower the chronic disease burden on the healthcare system in years to come.

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Patrick J Sur ◽  
Ashkan Afshin

Introduction: While cardio-protective effects of fruits and vegetables are well-established, the impact of their suboptimal intake on the CVD burden across nations and levels of development has not been evaluated. Objective: To systematically quantify the burden of CVD attributable to low intake of fruits and low intake of vegetables in 195 countries by age, sex, country, and development status in 2015. Methods: We obtained data on consumption of fruits and vegetables from nationally or subnationally representative nutrition surveys and data on their national availability from the UN FAO. Etiologic effect sizes of fruits and vegetables on CVD endpoints were obtained from meta- analyses of prospective cohort studies. The optimal level of intakes for each was determined based on the levels associated with lowest risk of mortality in prospective observational studies. A comparative risk assessment analysis was conducted to quantify the proportion of disability- adjusted life years (DALYs) attributable to low intake of each. The variation of this burden was further evaluated across different levels of our newly developed socio-demographic index (SDI). Results: In 2015, low intake of fruits accounted for 57.3 (95% UI: 37.1- 78.4) million DALYs due to CVD globally (41.5% from IHD and 58.5% from stroke). Low intake of vegetable caused 44.6 (23.6- 68.8) million CVD DALYs (67.3% IHD and 32.7% stroke). The highest burden of CVD attributable to low intake of fruits and vegetables was seen in the middle and low-middle SDI quintiles (17.2 and 14.3% of total DALYs), while the lowest burden for each was seen in high and high-middle SDI quintiles (12.7 and 11.2%). At the country level, the attributable CVD burden ranged from 5.1% of total DALYs (Rwanda) to 23.2% (Bangladesh) for low intake of fruit and from 5.9% (North Korea) to 19.4% (Mongolia) for low intake of vegetable. Conclusion: Our findings suggest that population inventions to increase consumption of fruits and vegetables at population level could save millions of life years globally. Figure. Age-standardized proportion of disability-adjusted life years attributable to low intake of fruits (A) and vegetables (B) from cardiovascular disease among adults (> 25y) in 2015.


2020 ◽  
pp. 095646242095298
Author(s):  
Augusto Cesar Lara de Sousa ◽  
Tatiana de Araujo Eleuterio ◽  
José Victor Afonso Coutinho ◽  
Raphael Mendonça Guimarães

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.


2020 ◽  
Author(s):  
jefferson buendia ◽  
Fernando Polack ◽  
Juana Patricia Sanchez Villamil

Abstract BACKGROUND: Respiratory syncytial virus infection is the leading cause of bronchiolitis in Colombia. There is growing evidence about the impact of Respiratory syncytial virus on society in terms of years of life lost due to this condition. The objective of the present study is to determine the Disability-Adjusted Life Years for respiratory syncytial virus in children under 2 years in ColombiaMETHODS: Data from the national epidemiological surveillance system were used to estimate DALYs, calculated from the sum of years of life lost and years lived with disability due to RSV infection in Colombia. A bootstrapped method with 10000 iterations was used to estimate each statistical parameter using the package DALY calculator in R. RESULTS: In 2019, 260 873 years of life (CI95% 208 180- 347 023) were lost due to RSV bronchiolitis in Colombian children under 2 years. The estimated rate was 20 DALYs / 1000 person-year (95% CI 16 – 27).CONCLUSION: This is the first report estimating the impact of RSV bronchiolitis morbidity and mortality in Colombia. The findings of the present study suggest that the actual burden and cost of bronchiolitis due to RSV is high. Prevention strategies, such as RSV vaccination, to reduce morbidity associated with RSV infection should be encouraged in our country.


2020 ◽  
Author(s):  
Sanjay K Mohanty ◽  
Manisha Dubey ◽  
Udaya S Mishra ◽  
Umakanta Sahoo

AbstractIn a short span of four months, the COVID-19 pandemic has added over 0.4 million deaths worldwide, which are untimely, premature and unwarranted. The USA, Italy, Germany and Sweden are four worst affected countries, accounting to over 40% of COVID-19 deaths globally. The main objective of this study is to examine the impact of COVID-19 attributable deaths on longevity, years of potential life lost (YPLL) and disability adjusted life years (DALY) in USA, Italy, Germany and Sweden. Data from United Nation Population Projection, Statista and centre for disease control and prevention were used in the analyses. Life expectancy, YPLL and DALY were estimated under four scenarios; no COVID-19 deaths, actual number of COVID-19 death as of 22nd May, 2020 and anticipating COVID-19 death share of 6% and 10% respectively. The COVID-19 attributable deaths have lowered the life expectancy by 0.4 years each in USA and Sweden, 0.5 years in Italy and 0.1 years in Germany. The loss of YPLL was 1.5, 0.5, 0.1 and 0.5 million in USA, Italy, Germany and Sweden respectively. The DALY (per 1000 population) due to COVID-19 was 4 in USA, 6 in Italy, 1 each in Germany and Sweden. Compression in life expectancy and increase in YPLL and DALY may intensify further if death continues to soar. COVID-19 has a marked impact on mortality. Reduction in longevity premature mortality and loss of DALY is higher among elderly.


2020 ◽  
Author(s):  
Denny John ◽  
Narassima MS ◽  
Jaideep C Menon ◽  
Guru Rajesh Jammy

Abstract Background: The COVID-19 pandemic has had a huge impact on the global economy and stressed the health care systems worldwide. Measuring the burden of disease on health and economy is essential for system preparedness by way of allocation of funds and human resources.Methods: The present study estimates Disability-Adjusted Life Years (DALYs), Years of Potential Productive Life Lost (YPPLL) and Cost of Productivity Lost (CPL) due to premature mortality and absenteeism, secondary to COVID-19 in Kerala state, India. The impact of disease on various age-gender cohorts has been analyzed. Sensitivity Analysis has been conducted by adjusting six variables with a total of 21 scenarios. Results: Severity of infection and mortality were higher among older sub-group of patients, and male were more susceptible than female in most of the age groups. DALY for the baseline scenario was 15,924.24 and 8,669.32 for males and females respectively. The CPL due to premature mortality was 26,80,36,179 and 42,510,946 for males and females respectively. Conclusion: People aged more than 50 were disproportionately affected by the disease, with presence of comorbidities further raising vulnerability.


2021 ◽  
Vol 15 (8) ◽  
pp. e0009711
Author(s):  
Shuaibu Ahijo Abdullahi ◽  
Abdulrazaq Garba Habib ◽  
Nafiu Hussaini

A mathematical model is designed to assess the impact of some interventional strategies for curtailing the burden of snakebite envenoming in a community. The model is fitted with real data set. Numerical simulations have shown that public health awareness of the susceptible individuals on snakebite preventive measures could reduce the number of envenoming and prevent deaths and disabilities in the population. The simulations further revealed that if at least fifty percent of snakebite envenoming patients receive early treatment with antivenom a substantial number of deaths will be averted. Furthermore, it is shown using optimal control that combining public health awareness and antivenom treatment averts the highest number of snakebite induced deaths and disability adjusted life years in the study area. To choose the best strategy amidst limited resources in the study area, cost effectiveness analysis in terms of incremental cost effectiveness ratio is performed. It has been established that the control efforts of combining public health awareness of the susceptible individuals and antivenom treatment for victims of snakebite envenoming is the most cost effective strategy. Approximately the sum of US$72,548 is needed to avert 117 deaths or 2,739 disability adjusted life years that are recorded within 21 months in the study area. Thus, the combination of these two control strategies is recommended.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037505
Author(s):  
Gulfaraz Khan ◽  
Christina Fitzmaurice ◽  
Mohsen Naghavi ◽  
Luai A Ahmed

ObjectiveTo determine the global and regional burden of Epstein-Barr virus (EBV)-attributed malignancies.DesignAn international comparative study based on the Global Burden of Disease (GBD) Study estimates.SettingGlobal population by age, sex, region, demographic index and time.Methods and outcome measuresThe burden of EBV-attributed Burkitt lymphoma (BL), Hodgkin lymphoma (HL), nasopharyngeal carcinoma (NPC) and gastric carcinoma (GC) was estimated in a two-step process. In the first step, the fraction of each malignancy attributable to EBV was estimated based on published studies; this was then applied to the GBD estimates to determine the global and regional incidence, mortality and disability-adjusted life-years (DALYs) for each malignancy by age, sex, geographical region and social demographic index (SDI) from 1990 to 2017.ResultsThe combined global incidence of BL, HL, NPC and GC in 2017 was 1.442 million cases, with over 973 000 deaths. An estimated 265 000 (18%) incident cases and 164 000 (17%) deaths were due to the EBV-attributed fraction. This is an increase of 36% in incidence and 19% in mortality from 1990. In 2017, EBV-attributed malignancies caused 4.604 million DALYs, of which 82% was due to NPC and GC alone. The incidence of both of these malignancies was higher in high and middle-high SDI regions and peaked in adults aged between 50 and 70 years. All four malignancies were more common in males and the highest burden was observed in East Asia.ConclusionsThis study provides comprehensive estimates of the burden of EBV-attributed BL, HL, NPC and GC. The overall burden of EBV-related malignancies is likely to be higher since EBV is aetiologically linked to several other malignancies not included in this analysis. Increasing global population and life expectancy is expected to further raise this burden in the future. The urgency for developing an effective vaccine to prevent these malignancies cannot be overstated.


2020 ◽  
pp. 204748732094941
Author(s):  
Paolo A Cortesi ◽  
Carla Fornari ◽  
Fabiana Madotto ◽  
Sara Conti ◽  
Mohsen Naghavi ◽  
...  

Aims An exhaustive and updated estimation of cardiovascular disease burden and vascular risk factors is still lacking in European countries. This study aims to fill this gap assessing the global Italian cardiovascular disease burden and its changes from 1990 to 2017 and comparing the Italian situation with European countries. Methods All accessible data sources from the 2017 Global Burden of Disease study were used to estimate the cardiovascular disease prevalence, mortality and disability-adjusted life years and cardiovascular disease attributable risk factors burden in Italy from 1990 to 2017. Furthermore, we compared the cardiovascular disease burden within the 28 European Union countries. Results Since 1990, we observed a significant decrease of cardiovascular disease burden, particularly in the age-standardised prevalence (–12.7%), mortality rate (–53.8%), and disability-adjusted life years rate (–55.5%). Similar improvements were observed in the majority of European countries. However, we found an increase in all-ages prevalence of cardiovascular diseases from 5.75 m to 7.49 m Italian residents. Cardiovascular diseases still remain the first cause of death (34.8% of total mortality). More than 80% of the cardiovascular disease burden could be attributed to known modifiable risk factors such as high systolic blood pressure, dietary risks, high low density lipoprotein cholesterol, and impaired kidney function. Conclusions Our study shows a decline in cardiovascular mortality and disability-adjusted life years, which reflects the success in reducing disability, premature death and early incidence of cardiovascular diseases. However, the burden of cardiovascular diseases is still high. An approach that includes the cooperation and coordination of all stakeholders of the Italian National Health System is required to further reduce this burden.


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