340 research outputs found

    Mapping child growth failure across low- and middle-income countries

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    Childhood malnutrition is associated with high morbidity and mortality globally1. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood2. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0Ăąïżœïżœ59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards3Ăąïżœïżœ5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health OrganizationĂąïżœïżœs median growth reference standards for a healthy population6. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)7; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes8. Building from our previous work mapping CGF in Africa9, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99 of affected children live1, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40 and wasting to less than 5 by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications. © 2020, The Author(s)

    Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

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    BackgroundHuman immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico.MethodsWe performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017.ResultsAll countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries-apart from Ecuador-across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups-the median age group among decedents ranged from 30 to 45years of age at the municipality level in Brazil, Colombia, and Mexico in 2017.ConclusionsOur subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.Peer reviewe

    Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

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    Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US,2020US, 2020 US per capita, purchasing-power parity-adjusted USpercapita,andasaproportionofgrossdomesticproduct.Weusedvariousmodelstogeneratefuturehealthspendingto2050.FindingsIn2019,healthspendinggloballyreached per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached 8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or 1132(1119−1143)perperson.Spendingonhealthvariedwithinandacrossincomegroupsandgeographicalregions.Ofthistotal,1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, 40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that 54.8billionindevelopmentassistanceforhealthwasdisbursedin2020.Ofthis,54.8 billion in development assistance for health was disbursed in 2020. Of this, 13.7 billion was targeted toward the COVID-19 health response. 12.3billionwasnewlycommittedand12.3 billion was newly committed and 1.4 billion was repurposed from existing health projects. 3.1billion(22.43.1 billion (22.4%) of the funds focused on country-level coordination and 2.4 billion (17.9%) was for supply chain and logistics. Only 714.4million(7.7714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to 1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

    The performance of the jet trigger for the ATLAS detector during 2011 data taking

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    The performance of the jet trigger for the ATLAS detector at the LHC during the 2011 data taking period is described. During 2011 the LHC provided proton–proton collisions with a centre-of-mass energy of 7 TeV and heavy ion collisions with a 2.76 TeV per nucleon–nucleon collision energy. The ATLAS trigger is a three level system designed to reduce the rate of events from the 40 MHz nominal maximum bunch crossing rate to the approximate 400 Hz which can be written to offline storage. The ATLAS jet trigger is the primary means for the online selection of events containing jets. Events are accepted by the trigger if they contain one or more jets above some transverse energy threshold. During 2011 data taking the jet trigger was fully efficient for jets with transverse energy above 25 GeV for triggers seeded randomly at Level 1. For triggers which require a jet to be identified at each of the three trigger levels, full efficiency is reached for offline jets with transverse energy above 60 GeV. Jets reconstructed in the final trigger level and corresponding to offline jets with transverse energy greater than 60 GeV, are reconstructed with a resolution in transverse energy with respect to offline jets, of better than 4 % in the central region and better than 2.5 % in the forward direction

    Measurement of the View the tt production cross-section using eÎŒ events with b-tagged jets in pp collisions at √s = 13 TeV with the ATLAS detector

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    This paper describes a measurement of the inclusive top quark pair production cross-section (σttÂŻ) with a data sample of 3.2 fb−1 of proton–proton collisions at a centre-of-mass energy of √s = 13 TeV, collected in 2015 by the ATLAS detector at the LHC. This measurement uses events with an opposite-charge electron–muon pair in the final state. Jets containing b-quarks are tagged using an algorithm based on track impact parameters and reconstructed secondary vertices. The numbers of events with exactly one and exactly two b-tagged jets are counted and used to determine simultaneously σttÂŻ and the efficiency to reconstruct and b-tag a jet from a top quark decay, thereby minimising the associated systematic uncertainties. The cross-section is measured to be: σttÂŻ = 818 ± 8 (stat) ± 27 (syst) ± 19 (lumi) ± 12 (beam) pb, where the four uncertainties arise from data statistics, experimental and theoretical systematic effects, the integrated luminosity and the LHC beam energy, giving a total relative uncertainty of 4.4%. The result is consistent with theoretical QCD calculations at next-to-next-to-leading order. A fiducial measurement corresponding to the experimental acceptance of the leptons is also presented

    Search for dark matter produced in association with a hadronically decaying vector boson in pp collisions at sqrt (s) = 13 TeV with the ATLAS detector

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    A search is presented for dark matter produced in association with a hadronically decaying W or Z boson using 3.2 fb−1 of pp collisions at View the MathML sources=13 TeV recorded by the ATLAS detector at the Large Hadron Collider. Events with a hadronic jet compatible with a W or Z boson and with large missing transverse momentum are analysed. The data are consistent with the Standard Model predictions and are interpreted in terms of both an effective field theory and a simplified model containing dark matter

    Search for resonances in the mass distribution of jet pairs with one or two jets identified as b-jets in proton–proton collisions at √s=13TeV with the ATLAS detector

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    Searches for high-mass resonances in the dijet invariant mass spectrum with one or two jets identi-fied as b-jets are performed using an integrated luminosity of 3.2fb−1of proton–proton collisions with a centre-of-mass energy of √s=13TeVrecorded by the ATLAS detector at the Large Hadron Collider. Noevidence of anomalous phenomena is observed in the data, which are used to exclude, at 95%credibility level, excited b∗quarks with masses from 1.1TeVto 2.1TeVand leptophobic Z bosons with masses from 1.1TeVto 1.5TeV. Contributions of a Gaussian signal shape with effective cross sections ranging from approximately 0.4 to 0.001pb are also excluded in the mass range 1.5–5.0TeV

    Measurement of the double-differential high-mass Drell-Yan cross section in pp collisions at √s = 8 TeV with the ATLAS detector

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    This paper presents a measurement of the double-differential cross section for the Drell-Yan Z/γ∗ → ℓ+ℓ− and photon-induced γγ → ℓ+ℓ− processes where ℓ is an electron or muon. The measurement is performed for invariant masses of the lepton pairs, mℓℓ, between 116 GeV and 1500 GeV using a sample of 20.3 fb−1 of pp collisions data at centre-of-mass energy of √s = 8 TeV collected by the ATLAS detector at the LHC in 2012. The data are presented double differentially in invariant mass and absolute dilepton rapidity as well as in invariant mass and absolute pseudorapidity separation of the lepton pair. The single-differential cross section as a function of mℓℓ is also reported. The electron and muon channel measurements are combined and a total experimental precision of better than 1% is achieved at low mℓℓ. A comparison to next-to-next-to-leading order perturbative QCD predictions using several recent parton distribution functions and including next-to-leading order electroweak effects indicates the potential of the data to constrain parton distribution functions. In particular, a large impact of the data on the photon PDF is demonstrated

    Charged-particle distributions in √s=13 TeV pp interactions measured with the ATLAS detector at the LHC

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    Charged-particle distributions are measured in proton–proton collisions at a centre-of-mass energy of 13 TeV, using a data sample of nearly 9 million events, corresponding to an integrated luminosity of 170 ÎŒb−1170 ÎŒb−1, recorded by the ATLAS detector during a special Large Hadron Collider fill. The charged-particle multiplicity, its dependence on transverse momentum and pseudorapidity and the dependence of the mean transverse momentum on the charged-particle multiplicity are presented. The measurements are performed with charged particles with transverse momentum greater than 500 MeV and absolute pseudorapidity less than 2.5, in events with at least one charged particle satisfying these kinematic requirements. Additional measurements in a reduced phase space with absolute pseudorapidity less than 0.8 are also presented, in order to compare with other experiments. The results are corrected for detector effects, presented as particle-level distributions and are compared to the predictions of various Monte Carlo event generators

    Measurement of W± and Z-boson production cross sections in pp collisions at √s=13 TeV with the ATLAS detector

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    See paper for full list of authors - 17 pages plus author list + cover pages (34 pages total), 5 figures, 3 tables, submitted to Phys. Lett. B, All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2015-03/International audienceMeasurements of the W±→ℓ±ΜW^{\pm} \rightarrow \ell^{\pm} \nu and Z→ℓ+ℓ−Z \rightarrow \ell^+ \ell^- production cross sections (where ℓ±=e±,Ό±\ell^{\pm}=e^{\pm},\mu^{\pm}) in proton-proton collisions at s=13\sqrt{s}=13 TeV are presented using data recorded by the ATLAS experiment at the Large Hadron Collider, corresponding to a total integrated luminosity of 81 pb−1^{-1}. The total inclusive W±W^{\pm}-boson production cross sections times the single-lepton-flavour branching ratios are σW+tot=11.78±0.02(stat)±0.32(sys)±0.59(lumi)\sigma_{W^+}^{tot}= 11.78 \pm 0.02 (stat) \pm 0.32 (sys) \pm 0.59 (lumi) nb and σW−tot=8.75±0.02(stat)±0.24(sys)±0.44(lumi)\sigma_{W^-}^{tot} = 8.75 \pm 0.02 (stat) \pm 0.24 (sys) \pm 0.44 (lumi) nb for W+W^+ and W−W^-, respectively. The total inclusive ZZ-boson production cross section times leptonic branching ratio, within the invariant mass window 66<mℓℓ<11666 < m_{\ell\ell} < 116 GeV, is σZtot=1.97±0.01(stat)±0.04(sys)±0.10(lumi)\sigma_{Z}^{tot} = 1.97 \pm 0.01 (stat) \pm 0.04 (sys) \pm 0.10 (lumi) nb. The W+W^+, W−W^-, and ZZ-boson production cross sections and cross-section ratios within a fiducial region defined by the detector acceptance are also measured. The cross-section ratios benefit from significant cancellation of experimental uncertainties, resulting in σW+fid/σW−fid=1.295±0.003(stat)±0.010(sys)\sigma_{W^+}^{fid}/\sigma_{W^-}^{fid} = 1.295 \pm 0.003 (stat) \pm 0.010 (sys) and σW±fid/σZfid=10.31±0.04(stat)±0.20(sys)\sigma_{W^{\pm}}^{fid}/\sigma_{Z}^{fid} = 10.31 \pm 0.04 (stat) \pm 0.20 (sys). Theoretical predictions, based on calculations accurate to next-to-next-to-leading order for quantum chromodynamics and next-to-leading order for electroweak processes and which employ different parton distribution function sets, are compared to these measurements
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