Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019

BACKGROUND: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. METHODS: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. FINDINGS: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6-4.3) with a prevalence of 454.6 million cases (417.4-499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4-225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9-3.6) deaths. With 262.4 million (224.1-309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. INTERPRETATION: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries

Global burden of chronic respiratory diseases and risk factors, 1990–2019 : an update from the Global Burden of Disease Study 2019

Acknowledgments S Aljunid acknowledges the International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Community Medicine, School of Medicine, International Medical University, Malaysia for the approval and support to participate in this research project. A Cohen was supported by the Health Effects Institute, Boston, MA, USA. D Dereje acknowledges the research team. A Douiri acknowledges support by King's Health Partners / Guyâs and St Thomas Charity MLTC Challenge Fund (grant number EIC180702) and the NIHR Applied Research Collaboration (ARC) South London at King’s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. T Ekundayo thanks the African-German Network of Excellence in Science, the Federal Ministry of Education and Research and the Alexander von Humboldt Foundation for financial support. R Erkhembayar is partially funded by the WHO. A Fatehizadeh acknowledges support from the Department of Environmental Health Engineering of Isfahan University of Medical Sciences, Isfahan, Iran. S Gahre acknowledges the Institute of Applied Health Sciences (IAHS), School of Medicine, Medical Sciences and Nutrition (SMMSN), University of Aberdeen for their institutional support for this work. V K Gupta acknowledges funding support from NHMRC (National Health and Medical Research) Australia. R Hartono thanks IHME who provide the GBD Data. C Herteliu is partially supported by a grant of the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. S Hussain was supported from Operational Programme Research, Development and Education Project, Postdoc2MUNI(No. CZ.02.2.69/0.0/0.0/18_053/0016952). BF Hwang was partially supported by China Medical University (CMU111-MF-55). M Jakovlievic declares that the serbian part of this GBD contribution was co-funded through Grant OI 175 014 of the Ministry of Education Technological Development and Science of the Republic of Serbia. T Joo acknowledges support from the National Research, Development and Innovation Office in Hungary (RRF-2.3.1-21-2022-00006, Data-Driven Health Division of National Laboratory for Health Security). N Joseph thanks the Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India for encouraging research activities. H Kandel is supported by the Kornhauser Research Fellowship at The University of Sydney. M Khan is the recipient of College of Medicine and Health Sciences research grant, Grant numbers G00003634, G00003569 and UAEU Sustainable Development Goals Grant, Grant number 1976. K Krishan acknowledges Non-financial support from UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. K Latief acknowledges Taipei Medical University. MC Li was supported by the National Science and Technology Council in Taiwan (NSTC 111-2410-H-003-100-SSS). G Liu was supported by a CREATE scientific fellowship from Lung Foundation Australia. T H Malihi would like to acknowledge the support and encouragement from Deanship of Scientific Research at Jouf University, Saudi Arabia to actively Participate in this project. D Malta acknowledges CNPQ - Conselho Nacional de Desenvolvimento Cientifico e Tecnologico. E Mathews is supported by a Clinical and Public Health Early Career Fellowship (grant number IA/CPHE/17/1/503345) from the DBT India Alliance/Wellcome Trust†Department of Biotechnology, India Alliance. AF A Mentis would like to acknowledge Anna Gkika for her continuous moral support during this study. L Monasta was supported by the Italian Ministry of Health, through a contribution given to the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. M Moniruzzaman was supported by The University of Queensland Postdoctoral Fellowship. J R Padubidri acknowledges Kasturba Medical College, Mangalore and Manipal Academy of Higher Education, Manipal for their constant support towards collaborative research. P Pedersini declares support and funding by the Italian Ministry of Health - Ricerca Corrente 2022. S Rahmani acknowledges the primary investigator for all their support. M Rodrigues acknowledges support from the Portuguese Council for Health and Environment. K E Rudd is supported by NIH/NIGMS grant 1K23GM141463-02. U Saeed acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad Pakistan. A M Samy acknowledges the support from Ain Shams University and the Egyptian Fulbright Mission Program F Thienemann is supported by the European Union (grant number RIA2017T-2004-StatinTB). X Xu is supported by Scientia Program at the University of New South Wales, Australia. This study was solely funded by the Bill & Melinda Gates Foundation. The funders of the study had no role in study design; collection, analysis, and interpretation of data; or writing of the report. The corresponding author had full access to the data and had responsibility for final submission of the manuscript. Funding Bill & Melinda Gates FoundationPeer reviewedPublisher PD

Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019.

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6-4.3) with a prevalence of 454.6 million cases (417.4-499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4-225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9-3.6) deaths. With 262.4 million (224.1-309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries.Bill & Melinda Gates Foundation.S

Diseases in Chronic Non-infective Diarrhea

Background: Chronic diarrhea is common in Indonesia. The chronic non-infective diarrhea cases seem to be increasing recently. The aim of this study is to reveal the pattern of diseases that can cause chronic non-infective diarrhea. Methods: We examined all patients suffering from chronic non-infective diarrhea over a six years period. The patients underwent physical examination and performed laboratory tests, colon enema X-ray, colonoscopy, ileoscopy, upper gastrointestnal endoscopy and small bowel X-ray. Result: Chronic non-infective diarrhea was observed in 107 (51.7%) cases from 207 chronic diarrhea cases respectively. The frequently found abnormalities that had caused chronic non-infective diarrhea were carbohydrate maldigestion (62.61%), colorectal cancer (14.01%), Crohn's disease (11.21%), ulcerative colitis (9.34%), irritable bowel syndrome (8.41%), colorectal polyp (8.41%) etc. Conclusion: The most frequent abnormality found in chronic non-infective diarrhea was maldigestion

Prevalence of disability according to multimorbidity and disease clustering: a population-based study

Background: The prevalence of chronic diseases has increased with population ageing, and research has attempted to elucidate the correlation between chronic diseases and disability. However, most studies in older populations have focused on the effect of single disabling conditions, even though most older adults have more than one chronic disease (multimorbidity). Objective: The aims of this study were to evaluate the association of disability with disease, in terms of multimorbidity and specified pairs of diseases, in a population-based study of older adults. Materials and Methods: Using the Kungsholmen Project, we estimated the prevalence of disability by the number of chronic diseases, disease status by organ systems, and in specific pairs of chronic conditions, in a Swedish population (n=1,099; ≥77 years). Disability was defined as need of assistance in at least one activity of daily living (Katz index). Results: Functional disability was seen in 17.9% of participants. It increased as the number of chronic diseases increased. The prevalence of disability varied greatly amongst specific pairs of diseases: from 6.7% in persons affected by hypertension and atrial fibrillation to 82.4% in persons affected by dementia and hip fracture. In multivariate logistic regression models, the disease pairs that were significantly associated with the highest increased relative odds of disability contained dementia (dementia–hip fracture, dementia–CVD, and dementia–depression). Conclusions: Our findings suggest specific pairs of diseases are much more highly associated with disability than others, particularly diseases coupled with dementia. This knowledge may improve prevention of disablement and planning of resource distribution.Journal of Comorbidity 2011;1(1):11–1

Chronic cough due to occupational factors

Within the large variety of subtypes of chronic cough, either defined by their clinical or pathogenetic causes, occupational chronic cough may be regarded as one of the most preventable forms of the disease. Next to obstructive airway diseases such as asthma or chronic obstructive pulmonary disease, which are sometimes concomitant with chronic cough, this chronic airway disease gains importance in the field of occupational medicine since classic fiber-related occupational airway diseases will decrease in the future. Apart from acute accidents and incidental exposures which may lead to an acute form of cough, there are numerous sources for the development of chronic cough within the workplace. Over the last years, a large number of studies has focused on occupational causes of respiratory diseases and it has emerged that chronic cough is one of the most prevalent work-related airway diseases. Best-known examples of occupations related to the development of cough are coal miners, hard-rock miners, tunnel workers, or concrete manufacturing workers. As chronic cough is often based on a variety of non-occupational factors such as tobacco smoke, a distinct separation into either occupational or personally -evoked can be difficult. However, revealing the occupational contribution to chronic cough and to the symptom cough in general, which is the commonest cause for the consultation of a physician, can significantly lead to a reduction of the socioeconomic burden of the disease

Leading Causes of Death in Vietnam

Vietnam is currently facing a public health crisis. Rates of chronic and preventable diseases are climbing, in addition to mortality rates from these diseases. If nothing is done to halt these rising rates, the health of the Vietnamese people will only continue to decline. Although there may be many factors contributing to these high death rates due to chronic diseases, risky health behaviors, such as smoking, and the state of the healthcare system can be considered two main contributors to the leading causes of death in Vietnam. The high smoking rates and high costs of healthcare are hindering the health of Vietnam, and may be related to the top causes of death, including stroke, ischemic heart disease, chronic obstructive pulmonary disease (COPD), and lower respiratory infections (World Health Organization and UN partners, 2015). Implementing government programs, including smoking cessation, smoking education, tobacco taxes, healthcare education, and continued work toward universal healthcare coverage, will hopefully help decrease the rising rates of chronic diseases and the high mortality rates they cause.https://jdc.jefferson.edu/cwicposters/1033/thumbnail.jp

An investigation to identify potential risk factors associated with common chronic diseases among the older population in India

© 2017 Indian Journal of Community Medicine. Background: In India, chronic diseases are the leading cause of death and their prevalence has constantly increased over the last decade. Objective: This study aimed to identify risk factors associated with common chronic diseases among people aged 50 years and over in India. Materials and Methods: Data from Wave 1 of the 2007/2008 Indian Study on Global Ageing and Adult Health (SAGE) was used to investigate the association between lifestyle choices and chronic diseases using logistic regression. Result: The fully adjusted model showed that significant independent risk factors for angina included area of residence, being diagnosed with diabetes, chronic lung disease (CLD) [highest odds ratio (OR) 4.77, 95% confidence interval (CI): 2.95-7.70] and arthritis. For arthritis, risk factors included having underlying diabetes, CLD diagnosis, or angina (highest OR 2.32, 95% CI: 1.63-3.31). Risk factors associated with CLD included arthritis, angina (highest OR 4.76, 95% CI: 2.94-7.72), alcohol use, and tobacco use. Risk factors associated with diabetes included level of education, area of residence, socioeconomic status, angina (highest OR 3.59, 95% CI: 2.44-5.29), CLD, arthritis, stroke, and vegetable consumption. Finally, risk factors associated with stroke included diabetes and angina (highest OR 3.34, 95% CI: 1.72-6.50). The presence of any other comorbidity was significantly associated with all five chronic diseases studied. Conclusion: The results show that within the older population, the contribution of lifestyle risk factors to the common chronic diseases investigated in this study was limited. Our findings showed that the major health issue within the study population was multimorbidity