Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Comparative management of Chilo suppressalis (Walker) (Lepidoptera: Crambidae) by convenient pesticides and non-chemical practices in a double rice cropping system

The inclination of rice growers towards double cropping system in north of Iran has raised new concerns about the excessive release of broad-spectrum pesticides, particularly organophosphates, in the environment. In this study, the efficiency of three insecticides and an integrated pest management (IPM) program for management of the striped rice stem borer, Chilo suppressalis (Walker) (Lep: Crambidae), in double cropping system was investigated under field condition. According to the results, one accurate application of hexaflumuron EC 10% (1.5 L/ha) or diazinon EC 60% (1.5 L/ha) for each generation of the pest resulted in significant reduction in dead heart and white head damage and increase in yield performance when compared with one application of fipronil G 0.2%, diazinon G 10% and diazinon EC 60% + diazinon G 10% as well as two application of diazinon EC 60% + diazinon G 10%. Additionally, considerable effect of IPM programs (mechanical, physical, and biological practices) on suppression of pest damage and improvement of yield performance was also observed. Given the environmental problems associated with excessive application of diazinon and fipronil, hexaflumuron, as an insect growth regulator with specific mode of action, can be efficiently integrated with other non-chemical methods for successful management of Ch suppressalis in double cropping systems

Diazinon resistance in different selected strains of Chilo suppressalis (Lepidoptera: Crambidae) in northern Iran

Asiatic rice borer, Chilo suppressalis (Walker) (Lepidoptera: Crambidae), is a cosmopolitan and destructive pest in rice fields of the world. This pest was reported in 1973 in Iran, and it has since spread widely in rice, Oryza sativa L., fields throughout the country. In this study, we tried to evaluate comparative toxicity of diazinon in five colonies of C. suppressalis, collected from Babol (Ba), Amol (Am) of Mazandaran Province and Rasht (Ra), Sheikhmahale (Sh), and Gourabzarmikh (Go) of Guilan Province, northern Iran. The LD 50 values were compared. We also evaluated the general esterases, alkaline phosphatase (ALP), glutathione transferase (GST), and acetylcholinesterase (AChE) activities from the five populations. The LD 50 values of Ra, Ba, Am, and Sh (12.64, 11.4, 7.17, and 3.71 μg/mg larva-1) were 13.67-, 12.33-, 7.75-, and 4.02-fold higher than Go population (0.924 μg/mg larva-1). Using α-naphthyl acetate as substrate, the general esterase activities in Ra, Ba, Am, and Sh colonies were, respectively, 1.81-, 1.68-, 1.75-, and 1.35-fold more than those in Go population. When β-naphthyl acetate was used as the substrate, activity ratio was measured 1.98-, 2.58-, 1.25-, and 1.24-fold compared with the Go population. Glutathione transferase activities in Ra, Ba, Am, and Sh populations were 1.27-, 1.68-, 0.98-, and 1.7-fold more than those in Go, when l-chloro-2,4-dinitrobenzene was used as the substrate. When 1,2-dichloro-4- nitro-benzene was used as the substrate, activity ratio was measured 1.14-, 1.42-, 0.56-, and 0.95-fold compared with Go population. The ALP activity demonstrated a significant difference among these populations and in Ra, Ba, Am, and Sh larvae were 3.54-, 4.62-, 3.84-, and 2.18-fold more than Go. The AChE inhibition or I50 value was 0.19, 0.22, 0.31, 0.19, and 0.26 mM in Ra, Ba, Am, Sh and Go populations, respectively. However, the results showed no significant differences in studied colonies. These biochemical characterizations of general esterases ALP, GST, and AChE were consistent with diazinon bioassay in the five populations. It is inferred from increased esterase, alkaline phosphatase and glutathione transferase, activities that might play an important role in the increasing resistance in C. suppressalis to diazinon among these five populations

Water ferns Azolla spp. (Azollaceae) as new host plants for the small China-mark moth, Cataclysta lemnata (Linnaeus, 1758) (Lepidoptera, Crambidae, Acentropinae)

Water ferns (Azolla spp., Azollaceae) are reported for the first time as host plants for the larvae of the small China-mark moth Cataclysta lemnata (Linnaeus) (Lepidoptera: Crambidae: Acentropinae) in rice fields and waterways of northern Iran. Cataclysta lemnata is a semi-aquatic species that has been recorded to feed on Lemnaceae and a few other aquatic plants. However, it has not been reported before on Azolla spp. Larvae use water fern as food source and shelter and, at high population density in the laboratory, they completely wiped water fern from the water surface. Feeding was confirmed after rearing more than eight continual generations of C. lemnata on water fern in the laboratory. Adults obtained this way are darker and have darker fuscous markings in both sexes compared with specimens previously reported and the pattern remains unchanged after several generations

Enhanced resistance to two stem borers in an aromatic rice containing a synthetic cryIA(b) gene

Rice cultivars of isozyme group V include high-quality, aromatic rices that are difficult to improve by traditional methods because of the loss of quality characters upon sexual hybridization. Their low-tillering plant type predisposes them to economic loss from attack by stem borers, a group of insects to which they are susceptible. We report here the enhancement of stem borer resistance in cv. Tarom Molaii through transformation by microprojectile bombardment. Embryogenic calli derived from mature seeds were bombarded with gold particles coated with plasmid pCIB4421, carrying a synthetic truncated toxin gene based on the cryIA(b) gene from Bacillus thuringiensis, and plasmid pHygII, carrying the hygromycin phosphotransferase (hpt) selectable marker gene. Inclusion of 50 mg/l hygromycin B in culture media from bombardment through to rooting of plantlets eliminated escapes. The procedure generated three independent hpt transformants of which two also contained the cryIA(b) gene. One such line (No. 827) produced truncated (67 kDa) CryIA(b) protein equivalent to about 0.1% of total soluble protein. The cryIA(b) gene was controlled by the promoter of the maize C<SUB>4</SUB> PEP carboxylase gene and was expressed in leaf blades but was not expressed to a detectable level in dehulled mature grain. Line 827 contained about 3 copies of the cryIA(b) gene which segregated as a single dominant Mendelian locus in the second (T<SUB>1</SUB>) and third (T<SUB>2</SUB>) generations and co-segregated with enhanced resistance to first-instar larvae of striped stem borer (Chilo suppressalis) and yellow stem borer (Scirpophaga incertulas). T<SUB>2</SUB> line 827-6 homozygous for the cryIA(b) gene showed no dead hearts or whiteheads after infestation with stem borers, whereas T<SUB>2</SUB> line 827-25 lacking the gene averaged 7 dead hearts per plant and 2.25 whiteheads per plant. These results establish that transformation of high-quality rices of group V is a feasible alternative to sexual hybridization