Impacts D’une Technique De Restauration De Terre Dégradée Sur La Survie Et La Croissance Des Plants De Quatre Espèces De Combretaceae En Zone Sahélienne Du Niger

Les banquettes sylvopastorales constituent l’une des techniques les plus utilisées au Niger pour restaurer les terres dégradées de plateaux. La présente expérimentation a été réalisée sur un plateau dégradé de Simiri dans l’Ouest nigérien où des banquettes sylvopastorales ont été installées. L’objectif est d’évaluer la survie et la croissance des plants de quatre essences locales de Combretaceae, Combretum glutinosum, Combretum micranthum, Combretum nigricans et Guiera senegalensis. Les méthodes utilisées ont consisté d’abord à délimiter un espace sur le plateau dégradé où 40 banquettes sont confectionnées et un autre espace sans banquette pour servir de témoin. Dans les banquettes, 200 plants de chaque espèce ont été plantés à raison de 20 plants/banquette. Deux mois après la plantation un suivi périodique de l’humidité du sol et des paramètres dendrométriques des plants a été effectué durant 30 mois. Les paramètres dendrométriques mesurés sont le taux de survie, la hauteur et le diamètre au collet du grand axe caulinaire, le nombre de rejets et de feuilles. Les résultats obtenus ont montré d’une part que les banquettes améliorent les conditions hydriques du sol de 18,19 % par rapport à la zone non traitée (sans banquette) et d’autre part que les meilleurs taux de survie et de croissance ont été observés au niveau des espèces Guiera senegalensis, Combretum. glutinosum et Combretum. micranthum. Ainsi, les espèces Guiera senegalensis, Combretum glutinosum et Combretum micranthum peuvent être utilisées dans le reboisement de sites aménagés avec des banquettes sylvopastorales pour restaurer les terres de plateaux au Niger Silvopastoral banquettes are one of the techniques mostly used in Niger to restore degraded plateau lands. The present experiment was carried out on a degraded Simiri plateau in western Niger where silvopastoral banquettes have been installed. The objective is to assess the survival and growth of plants of four local species of Combretaceae, Combretum glutinosum, Combretum micranthum, Combretum nigricans, and Guiera senegalensis. The methods used consisted first of delimiting a space on the degraded plateau where 40 banquettes are made and another space without a banquette to serve as a control zone. In the banquettes, 200 plants of each species were planted at 20 plants/banquette. Two months after planting, periodic monitoring of soil moisture and dendrometric parameters of the plants was carried out for 30 months. The dendrometric parameters measured are the survival rate, the height and the collar diameter of the stem axis, the number of suckers and leaves. The results obtained showed on the one hand that the banquettes improve the water conditions of the soil by 18.19% compared to the untreated zone (without banquettes) and on the other hand that the best survival and growth rates were observed at the level of the species Guiera senegalensis, Combretum. glutinosum and Combretum. micranthum. Thus, Guiera senegalensis, Combretum glutinosum, and Combretum micranthum species can be used in the reforestation of sites developed with silvopastoral banquettes to restore plateau lands in Niger

Impacts des banquettes dans la récupération des terres dégradées au Niger

Objectifs : Le département de Ouallam au Niger est soumis au phénomène de dégradation des terres. La présente étude, conduite sur le plateau dégradé de Sini Bangou dans la Commune de Simiri, a pourobjectif d’évaluer l’efficacité du dispositif des banquettes anti-érosives sur l’amélioration de la couverture végétale et de la qualité du sol.Méthodologie et résultats : Le dispositif expérimental de collecte des données est un site de récupération des terres où des banquettes ont été réalisées, plantées et ensemencées. La méthodologie a consisté à une analyse diachronique de l’occupation du sol à l’aide des images Landsat, une analyse granulométrique, des tests d’infiltration de l’eau et des relevés phytosociologiques. Les résultats montrentune amélioration du couvert végétal de 17,24 ha, soit 11,50% de la superficie du site, l’apparition d’une végétation spontanée de 69 espèces dont 11 ligneuses appartenant à 7 familles et 58 herbacées réparties dans 15 familles dominées par la famille des Poaceae (31,88%) et les types biologiques Thérophytes (69,01%).Les espèces à distribution Soudano-Zambéziennes (33,21%)etSoudano-Zambéziennes-Sahariennes-Sindiennes(31,15%) sont les types phytogéographiques les plus dominants de la flore globale à l’échelle africaine. La vitesse de l’infiltration relativement lente enregistrée pendant les dix premières minutes (≤ 10 cm/mn), a progressé au rythme d’une moyenne de 1 cm/mn en profondeur pour s’arrêter aubout de 30 minutes au profit d’une infiltration latérale. L’épaisseur des dépôts de sédiments varie entre 9 et 15 cm selon les banquettes et la teneur en matière organique fluctuant entre 0,36 à 1,43%, quoique faible, reste plus importante au niveau des horizons de surface de 0-20 cm que ceux de profondeur 20-40 cm. Ces effets associés au caractère dominant sableux du sol ont permis l’amélioration de l’état structural et textural de ce dernier et l’augmentation de l’infiltration et du stockage de l’eau qui aurait résulté au développement quantitatif et qualitatif du couvert végétal.Conclusion et application des résultats : Cette étude montre que les banquettes constituent une méthode efficace pour régénérer le capital productif d’un écosystème dégradé. Cependant, la pérennité des services écosystémiques de l’aménagement devrait être garantie par des modes de gestion rationnelle. Objectives: The department of Ouallam in Niger is subject to land degradation. The study was conducted on the degraded area of Sini Bangou in the district of Simiri with the aim to assess the effectiveness of the anti-erosion terraces system on improving plant cover and soil quality.Methodology and results: Experimental data collection design was a degraded land site where terraces have been made with tree plantation and herbaceous seeds sown. The methodology consisted of a diachronic analysis of land use using Landsat images, a granulometric analysis, water infiltration tests and phytosociological surveys. Results show an improvement in the plant cover of 17.24 ha, or 11.50% of the site area, a spontaneous vegetation of 69 species made up of 11 woody ones belonging to 7 families and 58 herbaceous ones distributed into 15 families dominated by the family of Poaceae (31.88%) and the biological types of Therophytes (69.01%). Soudano-Zambezian (33.21%) and Soudano-Zambezian-Saharan-Sindian (31.15%) species are the most dominant phytogeographic types of the overall flora on anafrican scale. The relatively slow infiltration speed recorded during the first ten minutes (≤ 10 cm / min), increased at the rate of an average of 1 cm / min in depth to stop after 30 minutes in favour of a lateral infiltration. Sediment deposits thickness varied between 9 and 15 cm depending on the terraces and the organic matter content fluctuating between 0.36 to 1.43%, although low, remains greater at the level of the surface horizons of 0-20 cm than those of 20-40 cm deep. These effects associated with the dominant sandy character of the soil allowed the structural and textural soil state improvement and the increase inthe water infiltration and storage which would have resulted in the quantitative and qualitative development of the plant cover.Conclusion and application of findings: The study shows that terraces are an effective method forregenerating the productive capital of a degraded ecosystem. However, the sustainability of the ecosystem services of the treated area should be guaranteed by rational management methods

Cartographie et dynamique spatio-temporelle des formations végétales de la forêt protégée de Baban Rafi (Niger)

n Niger, protected areas lose several hectares of their land each year under the combined effects of anthropogenic pressure and climate change. To understand this continuous degradation of the plant cover, a study was carried out in the protected forest of Baban Rafi. The main objective of this study is to highlight the spatio-temporal dynamics of forest formations between 1996 and 2016 by means of remote sensing and Geographic Information Systems (GIS). For this purpose, an exploitation of Landsat LT05 type satellite images from 1996, Landsat LE07 from 2005 and Sentinel T32PKV for 2016 coupled with ground truth using GPS including 17 visited points. This made it possible to identify 8 types of land use: the riparian belt, the tree savannah, the shrub savannah, the rainfed crops, the fallow, the inhabited area, the bare soils and the ravine. The cartographic results also reveal a regression in forest cover in the order of 171.8 ha / year between 1996 and 2016. This regression was in favor of cultivated areas which increased by 3,450 ha. These results suggest the implementation of an effective strategy for the sustainable management of the Baban Rafi protected forest to avoid its disappearance in the long term. Keywords: Degradation, remote sensing, dynamic, sustainable management, Baban Rafi forest, NigerAu Niger, les aires protégées perdent chaque année plusieurs hectares de leurs étendues sous les effets conjugués de la pression anthropique et des changements climatiques. Pour appréhender cette dégradation continue du couvert végétal, une étude a été menée dans la forêt protégée de Baban Rafi. Cette étude a pour objectif principal de mettre en évidence la dynamique spatio-temporelle des formations forestières entre 1996 et 2016 au moyen de la télédétection et des Systèmes d’information géographique (SIG). Pour ce faire, une exploitation des images satellitaires de type Landsat LT05 de l’année 1996, Landsat LE07 de l’année 2005 et Sentinelle T32PKV pour l’année 2016 couplée avec la vérité terrain à l’aide du GPS dont 17 points visités a été faite. Ceci a permis d’identifier 8 types d’occupation des terres que sont le cordon ripicole, la savane arborée, la savane arbustive, les cultures pluviales, la jachère, la zone habitée, les sols nus et le ravin. Les résultats cartographiques révèlent également une régression de la couverture forestière de l’ordre de 171,8 ha/an entre 1996 et 2016. Cette régression s’est faite au profit des zones de culture qui ont augmenté de 3 450 ha. Ces résultats suggèrent la mise en place d’une stratégie efficace de gestion durable de la forêt protégée de Baban Rafi pour éviter sa disparition à long terme. Mots clés: Dégradation, télédétection, dynamique, gestion durable, Forêt protégée de Baban Rafi, Nige

EFFECT OF SOME OF ORGANIC AND BIO AND/OR MINERAL FERTILIZATION ON VEGETATIVE GROWTH AND CHEMICAL COMPOSITION OF DELONIX REGIA

This work wasexecuted during two successive seasons of 2018 and 2019 in the nursery and laboratory of Fac. Agric., Minia Univ., Egypt to investigate the response of vegetative and root growthand some chemical composition of Delonix regia seedlings to four percentages of humic acid (0, 1, 2 and 4%) and four bio- and/or mineral NPK fertilization treatments (control, 100% NPK, Minia Azotein and 75% NPK plus Minia Azotein), as well as, the interaction between them. All used three percentages of humic acid significantly increased vegetative growth (plant height, stem diameter, the aerial part dry weight), root growth (root number and roots dry weight) and chemical composition (photosynthetic pigments, NPK%, total phenolic and total flavonoids contents) over control. Humic acid at 4% more was effective treatment. All used bio-and/or mineral NPK fertilization treatments significantly increased all studied characters over control. The best treatments were 100% NPK or 75% NPK plus Minia Azotein. It could be recommended to add humic acid at 4% in combination with 100% NPK or 75% NPK plus Minia Azotein to improve growth of Delonix regia

Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019

BACKGROUND: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. METHODS: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. FINDINGS: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. INTERPRETATION: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. FUNDING: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38)

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019

Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38)

Global, regional, and national incidence of six major immune-mediated inflammatory diseases : findings from the global burden of disease study 2019

DATA SHARING STATEMENT : Data used for the analyses are publicly available from the Institute of Health Metrics and Evaluation (http://www.healthdata.org/; http:// ghdx.healthdata.org/gbd-results-tool).BACKGROUND : The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. METHODS : We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. FINDINGS : In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. INTERPRETATION : The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively.The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. Support from Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital; Shaqra University; the School of Pharmacy, University of Botswana; the Indian Council of Medical Research (ICMR); an Australian National Health and Medical Research Council (NHMRC) Investigator Fellowship; the Italian Center of Precision Medicine and Chronic Inflammation in Milan; the Department of Environmental Health Engineering of Isfahan University of Medical Sciences, Isfahan, Iran; National Health and Medical Research Council (NHMRC), Australia; Jazan University, Saudi Arabia; the Clinician Scientist Program of the Clinician Scientist Academy (UMEA) of the University Hospital Essen; AIMST University, Malaysia; the Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; a Kornhauser Research Fellowship at The University of Sydney; the National Research, Development and Innovation Office Hungary; Taipei Medical University; CREATE Hope Scientific Fellowship from Lung Foundation Australia; the National Institute for Health and Care Research Manchester Biomedical Research Centre and an NIHR Clinical Lectureship in Respiratory Medicine; Kasturba Medical College, Mangalore and Manipal Academy of Higher Education, Manipal; Author Gate Publications; the Cleveland Clinic Foundation and Nassau University Medical center; the Italian Ministry of Health (RRC); King Abdulaziz University (DSR), Jeddah, and King Abdulaziz City for Science & Technology (KACSAT), Saudi Arabia, Science & Technology Development Fund (STDF), and US-Egypt Science & Technology joint Fund: The Academy of Scientific Research and Technology (ASRT), Egypt; partially supported by the Centre of Studies in Geography and Spatial Planning; the International Center of Medical Sciences Research (ICMSR), Islamabad Pakistan; Ain Shams University and the Egyptian Fulbright Mission Program; the Belgian American Educational Foundation; Health Data Research UK; the Spanish Ministry of Science and Innovation, Institute of Health Carlos III, CIBERSAM, and INCLIVA; the Clinical Research Development Unit, Imam Reza Hospital, Mashhad University of Medical Sciences; Shaqra University; Saveetha Institute of Medical and Technical Sciences and SRM Institute of Science and Technology; University of Agriculture, Faisalabad-Pakistan; the Chinese University of Hong Kong Research Committee Postdoctoral Fellowship Scheme; the institutional support of the Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Egypt; the European (EU) and Developing Countries Clinical Trials Partnership, the EU Horizon 2020 Framework Programme, UK-National Institute for Health and Care Research, the Mahathir Science Award Foundation and EU-EDCTP.http://www.thelancet.comam2024School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein