Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Pomegranate seed oil rich in conjugated linolenic acids reduces in vitro methane production

The objective of this study was to determine the effect of pomegranate (Punica granatum L.) seed oil (PSO) on gas and methane (CH4) production, ruminal fermentation and microbial populations under in vitro conditions. Three treatments consisting of a control diet containing 10 mg tallow (CON); the control diet with 5 mg PSO + 5 mg tallow (MPSO) and the control diet containing 10 mg PSO (HPSO) were compared. Ten mg of the experimental fat/oil samples were inserted into a gas-tight 100 mL plastic syringe containing 30 mL of an incubation inoculum and 250 mg of a basic substrate of a hay/concentrate (1/1, w/w) mixture. In vitro gas production was recorded over 0, 2, 4, 6, 8, 10, 12 and 24 h of incubation. After 24 hours, incubation was stopped, and methane production, pH, volatile fatty acids (VFAs) and microbial counts were measured in the inoculant. Gas production at 4, 6, 8, 10, 12 and 24 h incubation, metabolizable energy and in vitro organic matter disappearance increased linearly and quadratically as level of PSO increased. Furthermore, the 10 mg PSO (HPSO) decreased CH4 production by 21.0% compared with the control (CON) group. There were no significant differences in total and individual VFA concentrations between different levels of PSO, except for butyric acid. After 24 h of incubation, methanogenesis decreased in the HPSO compared with the MPSO and CON treatments. In addition, total bacteria and protozoa counts increased with rising PSO levels, while population methanogenesis declined significantly. These results suggested that PSO could reduce methane emissions, which might be beneficial to nutrient utilization and growth in ruminants

Dietary supplementation with papaya (Carica papaya L.) leaf affects abundance of rumen methanogens, fermentation characteristics and blood plasma fatty acid composition in goats

The objective of this study was to test the effect of feeding papaya leaf (PL) on rumen microbial population, fermentation characteristics, blood fatty acid composition and antioxidant activity in goats. Three rumen fistulated male goats were assigned in a 3×3 latin square design using three levels of PL: no addition of PL in basal diet (control, CON, 50% concentrate + 50% alfalfa hay), 25% of alfalfa hay in basal diet replaced by PL (medium PL, MPL) and 50% of alfalfa hay in basal diet replaced by PL (high PL, HPL). Rumen fluid and blood plasma were sampled from the animals at the end of feeding trial (third week). Papaya leaf treatments (MPL and HPL) showed significant differences (p<0.05) in terms of rumen fermentation parameters as compared to the CON group at different times of measurement. The concentration of methanogenic archaea (log10cell/L) decreased (p<0.05) in both PL treatment groups as compared with CON group at all sampling times. The concentration of α-linolenic acid and total conjugated linoleic acid (CLA) were also higher (p<0.05) in the blood of goats fed PL especially HPL, compared to the CON. Blood plasma malondialdehyde concentration (mM/mL) of PL treatment groups showed a significant reduction as compared with CON. Supplementation of PL allowed the modulation of rumen characteristics which might represent a feeding strategy to reduce methane emission by directly inhibiting methanogens while improving the health benefits of ruminant products

Dietary supplementation with papaya (Carica papaya L.) leaf affects abundance of rumen methanogens, fermentation characteristics and blood plasma fatty acid composition in goats

The objective of this study was to test the effect of feeding papaya leaf (PL) on rumen microbial population, fermentation characteristics, blood fatty acid composition and antioxidant activity in goats. Three rumen fistulated male goats were assigned in a 3×3 latin square design using three levels of PL: no addition of PL in basal diet (control, CON, 50% concentrate + 50% alfalfa hay), 25% of alfalfa hay in basal diet replaced by PL (medium PL, MPL) and 50% of alfalfa hay in basal diet replaced by PL (high PL, HPL). Rumen fluid and blood plasma were sampled from the animals at the end of feeding trial (third week). Papaya leaf treatments (MPL and HPL) showed significant differences (p<0.05) in terms of rumen fermentation parameters as compared to the CON group at different times of measurement. The concentration of methanogenic archaea (log10cell/L) decreased (p<0.05) in both PL treatment groups as compared with CON group at all sampling times. The concentration of α-linolenic acid and total conjugated linoleic acid (CLA) were also higher (p<0.05) in the blood of goats fed PL especially HPL, compared to the CON. Blood plasma malondialdehyde concentration (mM/mL) of PL treatment groups showed a significant reduction as compared with CON. Supplementation of PL allowed the modulation of rumen characteristics which might represent a feeding strategy to reduce methane emission by directly inhibiting methanogens while improving the health benefits of ruminant products

Feeding oil palm (Elaeis guineensis, Jacq.) fronds alters rumen protozoal population and ruminal fermentation pattern in goats

Oil palm fronds (OPF), normally available all the year round, may provide a sustainable ruminant feed for livestock industry in tropical regions. A feeding trial was conducted to study the effects of feeding OPF on the rumen protozoal population, rumen fermentation and fatty acid profiles of rumen fluid in goats. Twentyfour five-month-old Kacang crossbred male goats were individually housed and fed for 100 d with concentrate diets supplemented with oil palm (Elaeis guineensis Jacq.) frond pellets. The treatments were: CON (100% concentrate), MOPF (75% concentrate + 25% OPF, w/w) and HOPF (50% concentrate + 50% OPF, w/w). The diets were adjusted to be isocaloric. The pH of rumen fluid was in the order of HOPF (5.90)&gt;MOPF (5.74)&gt;CON (5.62). Both HOPF (17.75x104/mL) and MOPF (17.13x104/mL) had significantly (P&lt;0.05) higher population of Entodinium sp. than CON (14.88x104/mL). Although populations of Holotrichs and total protozoa among the three groups did not show any significant difference (P&gt;0.05), populations were in the numerical order of HOPF&gt;MOPF&gt;CON. The molar proportions of acetate were significantly higher (P&lt;0.05) in HOPF animals compared to MOPF and CON. The altered status in the rumen environment due to supplementation of OPF in the diets resulted in the highest (P&lt;0.05) amount of unsaturated fatty acids (UFA) in the rumen of animals receiving HOPF and MOPF diet. These results were suggestive of a decreased biohydrogenation in the rumen, resulting in higher levels of UFA available for hindgut absorption, and hence their increased incorporation in the plasma and edible tissues of the HOPF animals

Changes in nutritional parameters in diploid and triploid African catfish Clarias gariepinus following chlorpyrifos exposure

There is a paucity of information about the influence of ploidy status on physiological parameters in organisms following contaminant stress. Also, little is known about the changes in nutritional values of fishes in response to the exposure to contaminants. Full-sibling juvenile Clarias gariepinus were exposed to 3 levels (mean measured 8.9, 17.5, or 28.0 µg l-1) of chlorpyrifos for 21 d. The levels of 3 fatty acids (FAs) in the muscle were significantly different between unexposed diploid and triploid fish. In the chlorpyrifos-exposed fish, the levels of most amino acids (AAs), some FAs, protein, and moisture content were affected in the muscle of diploids, while the levels of some FAs and ash content were changed in the muscle of triploid fish. This work represents the first study of changes in FAs and proximate composition in triploid animals in response to environmental stressors. Fewer changes of nutritional values in triploid C. gariepinus under chlorpyrifos exposure may indicate higher adaptability of triploids than diploids towards environmental stressors. Significant changes in the muscle protein content and AA and FA compositions in diploid Clarias gariepinus in response to chlorpyrifos exposure suggest their application as sensitive indicators of aquatic environmental pollution

Changes in nutritional values induced by butachlor in juvenile diploid and triploid Clarias gariepinus

© 2017, Islamic Azad University (IAU). There is a paucity of information about the effects of environmental stressors on nutritional values in fish. This study investigated the effects of the organochlorine pesticide, butachlor, on key indicators of nutritional value in both diploid and triploid African catfish (Clarias gariepinus). Amino acids (AA), fatty acids (FA), and the proximate composition (protein, lipid, moisture, and ash content) in the white muscle of full-sibling juvenile fish were measured following a 21-day exposure to graded butachlor concentrations [mean measured: 26.3, 48.4, and 66.1 µg/L]. No significant differences in AAs, FAs, protein, lipid, moisture, or ash content were observed between unexposed diploid and triploid fish. In diploids, exposure to butachlor significantly altered the concentrations of some of the AAs and FAs, and protein content, when compared to the control group. In triploid fish, however, butachlor treatments had no effect on the AA or proximate composition, but significantly changed the concentration of two individual FAs in the muscle. Butachlor treatments showed fewer changes in the nutritional values of triploid fish. This research is the first to study the nutritional values in any polyploid animals following the exposure to a contaminant