116 research outputs found
Cathepsin K induces platelet dysfunction and affects cell signaling in breast cancer - molecularly distinct behavior of cathepsin K in breast cancer
- Author
- Andrade Sheila Siqueira
- Campos Antonio Hugo J. F. M.
- Castro Eloisa Dognani
- da Silva Ismael D. C. G.
- de Paula Claudia A. A.
- Facina Gil
- Girao Manoel J. B. C.
- Gouvea Iuri Estrada
- Juliano Maria
- Okamoto Debora
- Oliva Maria Luiza V.
- Oliveira Lilian
- Ottaiano Tatiana
- Paredes-Gamero Edgar Julian
- Peres Giovani Bravin
- Pinto Nazario Afonso Celso
- Silva Mariana Cristina C.
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2016
- Field of study
Background: Breast cancer comprises clinically and molecularly distinct tumor subgroups that differ in cell histology and biology and show divergent clinical phenotypes that impede phase III trials, such as those utilizing cathepsin K inhibitors. Here we correlate the epithelial-mesenchymal-like transition breast cancer cells and cathepsin K secretion with activation and aggregation of platelets. Cathepsin K is up-regulated in cancer cells that proteolyze extracellular matrix and contributes to invasiveness. Although proteolytically activated receptors (PARs) are activated by proteases, the direct interaction of cysteine cathepsins with PARs is poorly understood. In human platelets, PAR-1 and -4 are highly expressed, but PAR-3 shows low expression and unclear functions. Methods: Platelet aggregation was monitored by measuring changes in turbidity. Platelets were immunoblotted with anti-phospho and total p38, Src-Tyr-416, FAK-Tyr-397, and TGF beta monoclonal antibody. Activation was measured in a flow cytometer and calcium mobilization in a confocal microscope. Mammary epithelial cells were prepared from the primary breast cancer samples of 15 women with Luminal-B subtype to produce primary cells. Results: We demonstrate that platelets are aggregated by cathepsin K in a dose-dependent manner, but not by other cysteine cathepsins. PARs-3 and -4 were confirmed as the cathepsin K target by immunodetection and specific antagonists using a fibroblast cell line derived from PARs deficient mice. Moreover, through co-culture experiments, we show that platelets activated by cathepsin K mediated the up-regulation of SHH, PTHrP, OPN, and TGF beta in epithelial-mesenchymal-like cells from patients with Luminal B breast cancer. Conclusions: Cathepsin K induces platelet dysfunction and affects signaling in breast cancer cells.Associacao Beneficente de Coleta de Sangue (Colsan)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Univ Fed Sao Paulo, Dept Gynecol, BR-04024002 Sao Paulo, SP, BrazilCOLSAN, Charitable Assoc Blood Collect, BR-04080006 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Biophys, BR-04024002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Biochem, BR-04024002 Sao Paulo, SP, BrazilAntonio Prudente Fdn, AC Camargo Canc Ctr, AC Camargo Hosp Biobank, Dept Pathol, BR-01509010 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Cellular Gynecol Lab, Dept Gynecol, Rua Napoleao Barros 608, BR-04024002 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Gynecol, BR-04024002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Biophys, BR-04024002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Biochem, BR-04024002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Cellular Gynecol Lab, Dept Gynecol, Rua Napoleao Barros 608, BR-04024002 Sao Paulo, BrazilFAPESP: 2012/19780-3FAPESP: 2012/19851-8FAPESP: 2009/53766-5Web of Scienc
Cathepsin K induces platelet dysfunction and affects cell signaling in breast cancer - molecularly distinct behavior of cathepsin K in breast cancer
- Author
- A Mazharian
- AB Jensen
- Afonso Celso Pinto Nazário
- Antonio Hugo J. F. M. Campos
- B Chen
- C Gall Le
- C Medina
- Cláudia A. A. de Paula
- D Bromme
- D Bromme
- D Musil
- Debora Okamoto
- E Candia De
- E Nery Del
- Edgar Julian Paredes-Gamero
- Eloísa Dognani Castro
- F Lecaille
- F Schaffner
- G Caliendo
- Gil Facina
- Giovani Bravin Peres
- H Ishihara
- H Kennecke
- HS Kuznetsov
- I Podgorski
- Ismael D. C. G. da Silva
- Iuri Estrada Gouvea
- J Reiser
- J Trejo
- JH Lindeman
- JN McLaughlin
- JS Isenberg
- K Brix
- K Brix
- KV Honn
- L Burnier
- LD Cupit
- LE Sanman
- Lilian Oliveira
- LJ Gay
- M Canault
- M Fonovic
- M Holinstat
- M Jonathan
- M Labelle
- M Nakanishi-Matsui
- Manoel J. B. C. Girão
- Maria Juliano
- Maria Luiza V. Oliva
- Mariana Cristina C. Silva
- MJ Ludeman
- ML Kahn
- MT Harper
- P Clezardin
- PC Almeida
- PF Angelo
- R Bar-Shavit
- R Ramachandran
- S Das
- S Valastyan
- Sheila Siqueira Andrade
- SS Andrade
- T Goerge
- Tatiana Ottaiano
- TJ Scase
- V Almendro
- V Evangelista
- VA Schmidt
- VB Reddy
- VB Reddy
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).
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- Aaroe H.
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- Abdel-Qader M.
- Abdelrahman H.
- Abdul A.
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- Abe M. (Masatake)
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- Winnik S.
- Wirdby A.
- Wisaratapong T.
- Wiswedel H.
- Woehrer C.
- Wojewoda P.
- Wojnowski L.
- Wolf T.
- Wollaert B.
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- Wong S. W.
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- Wongtheptien W.
- Woo J. J.
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- Wozakowska-Kaplon B.
- Wozniak-Skowerska I
- Wright D.
- Wrobel M.
- Wu R. N.
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- Wurziger J.
- Wutthimanop A.
- Xhaet O.
- Xie Q.
- Xiong L. G.
- Xu R. Y.
- Xue L.
- Yagensky A.
- Yakupov E.
- Yamada T.
- Yamagishi T.
- Yamaguchi H.
- Yamamoto K.
- Yamamoto K. (Kenichi)
- Yamamoto K. (Kentaro)
- Yamamoto K. (Kunihiko)
- Yamamoto T.
- Yamasawa M.
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- Yan X. W.
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- Yasui K.
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- Yeter E.
- Yildirim E.
- Yildirim R.
- Yilmaz F.
- Yilmaz M. B.
- Yilmaz O.
- Yim K. H.
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- Yokoyama Y.
- Yong R.
- Yoo K. M.
- Yoon E. J.
- Yoon J. H.
- Yorgun H.
- Yoshida H.
- Yoshida K.
- Yoshida T. (Tetsuro)
- Yoshida T. (Tomoki)
- Yoshimura A.
- Yoshizawa N.
- Yousef G.
- Yu H. Y.
- Yu J. H.
- Yu T.
- Yuksekdag V
- Yun S. Y.
- Yunis M. E.
- Zaatout E.
- Zaidi S. M. A.
- Zaitsu R.
- Zak J.
- Zakutynska-Kowalczyk K.
- Zaluska R.
- Zaman K.
- Zanolin D.
- Zapata G.
- Zateyshchikov D.
- Zateyshchikova A.
- Zauzig H-D
- Zauzig H.
- Zecca C.
- Zemlianskaia O.
- Zhai H.
- Zhan Q.
- Zhang G. S.
- Zhang H. Q.
- Zhang Q.
- Zhang R.
- Zhang Y.
- Zhao R. P.
- Zhao Y. S.
- Zheng W. Y.
- Zhirov I
- Zhou B.
- Zhou Z. H.
- Zhu X. Y.
- Zhuravleva E.
- Zhurba S.
- Zidek M.
- Zidkova E.
- Ziefle S.
- Zika J.
- Zillo M.
- Zimmett L.
- Zimny H-H
- Zincke S.
- Zinka E.
- Zotova I
- Zrazhevskiy K.
- Zubeeva G.
- Zuber M.
- Zurbrigk F. J.
- Zutz S.
- Zyczynska-Szmon M.
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2018
- Field of study
Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)
Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.
- Author
- A. Abd El-Aziz
- A. Abdul
- A. Agakhanyan
- A. Aggarwala
- A. Agrawal
- A. Al Mulla
- A. Al Naeemi
- A. Alfieri
- A. Ali
- A. Altun
- A. Alvarez D'Amelio
- A. Andersson
- A. Argena
- A. Austria
- A. Aydinlar
- A. Babyesiza
- A. Barai
- A. Barreau
- A. Barszcz
- A. Bartes
- A. Bazzoni Ruiz
- A. Beattie
- A. Bianchi
- A. Biernacka
- A. Black
- A. Blenkhorn
- A. Branjovich Tijuan
- A. Bremmelgaard
- A. Brown
- A. Browne
- A. Capucci
- A. Caspar
- A. Catanchin
- A. Chmielowski
- A. Choi
- A. Cieszynska
- A. Conde Y Bolado
- A. Connelly
- A. Cortada Cabrera
- A. Davids
- A. De Blasio
- A. De Wolf
- A. Dickerson
- A. Domenech Borras
- A. Dumikyan
- A. Edin
- A. Egilsson
- A. El-Etreby
- A. Elbahry
- A. Elorriaga Madariaga
- A. Espallargas
- A. Ewert
- A. Fearon
- A. Fedorowsky
- A. Ferreira-Jardim
- A. Ferrer
- A. Filippi
- A. Fleck
- A. Flynn
- A. Forero
- A. Frankiewicz
- A. Fujisawa
- A. Gallagher
- A. Ganatra
- A. Gegenhuber
- A. Gieroba
- A. Gilliland
- A. Giombolini
- A. Gonzales Segovia
- A. Grande Ruiz
- A. Grau
- A. Grytzmann
- A. Gubanov
- A. Guerrero Molina
- A. Guinand
- A. Haideri
- A. Hajimirsadeghi
- A. Hallaråker
- A. Halpin
- A. Hay
- A. Heer
- A. Heyse
- A. Horak
- A. Hot-Bjelac
- A. Howitt
- A. Iglesias Garcia
- A. Ishihara
- A. Ivanov
- A. Iñiguez Romo
- A. Jackun-Podlesna
- A. Jaremczuk-Kaczmarczyk
- A. Jarzebowski
- A. Jefferies
- A. Jekthammer
- A. Jerzewski
- A. John Camm
- A. John Camm
- A. John Camm
- A. Jones
- A. Kaczmarzyk-Radka
- A. Karczmarczyk
- A. Katta
- A. Kemmel
- A. Khan
- A. Khokhlov
- A. Koch
- A. Kolesnikova
- A. Kolodzinska
- A. Komlo
- A. Konopka
- A. Kopf
- A. Krueger
- A. Krzesiak-Lodyga
- A. Lavoie
- A. Lawande
- A. Lee
- A. Lettenström
- A. Leyva Rendón
- A. Lindberg
- A. Lindh
- A. Lindourkova
- A. Lischka-Lindner
- A. Lo Buglio
- A. Lopes
- A. Lopez
- A. Lucassen
- A. Ludkova
- A. Lysek-Jozefowicz
- A. Mannermyr
- A. Manzanal Rey
- A. Mariani
- A. Markiewicz
- A. Marquand
- A. Martin Vila
- A. Martinelli
- A. Maselli
- A. Matoltsy
- A. Mauric
- A. Meirino
- A. Menezes Lorga Filho
- A. Merliss
- A. Metzgier-Gumiela
- A. Mielot
- A. Mirtl
- A. Miyashita
- A. Mizuno
- A. Mowafy
- A. Murray
- A. Naguib
- A. Nagy
- A. Nakagomi
- A. Nakata
- A. Navarro
- A. Negrete Palma
- A. Negri
- A. Niemirycz-Makurat
- A. Nowak
- A. Nygaard
- A. Ohanissian
- A. Ohlsson
- A. Olofsson
- A. Ortiz
- A. Osberg
- A. Ota
- A. Oto
- A. Ovsannikova
- A. Page
- A. Papp
- A. Parkhomenko
- A. Pawelska-Buczen
- A. Pedersen
- A. Phrommintikul
- A. Pinter
- A. Pizzini
- A. Plauskat
- A. Podczeck-Schweighofer
- A. Postolache
- A. Pronk
- A. Pustelnik
- A. Quick
- A. Quietzsch
- A. Quisi
- A. Raczynska
- A. Raisaro
- A. Ramdass
- A. Reda
- A. Rodrigues
- A. Ross
- A. Sabir
- A. Sage
- A. Said
- A. Salinas
- A. Sapatyi
- A. Sasaki
- A. Scaccianoce
- A. Seoane Blanco
- A. Sidor
- A. Singal
- A. Skein
- A. Soliman
- A. Soma
- A. Sossich
- A. Spyropoulos
- A. Srinivas
- A. Sriwichian
- A. Stallinga-de Vos
- A. Steffens
- A. Suissa
- A. Sulc
- A. Svilaas
- A. Sword
- A. Szczepanska
- A. Szilagyi
- A. Szulowska
- A. Taguchi
- A. Talkenberger
- A. Tangsirira
- A. Tetlak
- A. Thatcher
- A. Therkelsen
- A. Thomson
- A. Tomasello
- A. Ushakov
- A. Vandorpe
- A. Vertes
- A. Vishnevsky
- A. Vonbank
- A. Wakeman
- A. Waldman
- A. Warke
- A. Wassef
- A. Wierzbicka
- A. Williams
- A. Wilson
- A. Wirdby
- A. Wutthimanop
- A. Yagensky
- A. Yoshimura
- A. Zateyshchikova
- A. Østrem
- A.-B. Ekstrand
- A.-K. Ascoop
- A.-M. Barbuto
- A.-M. Ohlin
- A.A. Damonte
- A.A. Fernandez
- A.B. Lensebraaten
- A.C. Billiaux
- A.C. Ingaramo
- A.C. Rothwell
- A.C. Tovar Castaneda
- A.C.P. Barretto
- A.D. Hrabar
- A.G. Ravi Shankar
- A.J. Kleiban
- A.J. McLeod
- A.L. Baek
- A.L. Cappi
- A.L. Tufare
- A.M. Jackson
- A.P. Drummond Wainstein
- A.P. Macagnan
- A.R. Kelsall
- A.R. Park
- A.S. Pandey
- Ajay K. Kakkar
- Ajay K. Kakkar
- Alex Parkhomenko
- Alex Spyropoulos
- Alexander G.G. Turpie
- Ali Oto
- Antonio Carlos Pereira Barretto
- B. Allasia
- B. Alzand
- B. Ayres
- B. Chatlaong
- B. Clarke
- B. Conway
- B. Coutu
- B. Crousillat
- B. Curyllo
- B. Deshpande
- B. Dolecka
- B. Doucet
- B. Dubois
- B. Dudzik-Richter
- B. Eriksson
- B. Fox
- B. Gaszner
- B. Ghezai
- B. Gosciniecka
- B. Hawkins
- B. Herrero Maeso
- B. Hoffmann
- B. Ikitimur
- B. Jacobson
- B. Jacobson
- B. Jansson
- B. Jimeno Besa
- B. Kurylo
- B. Kurylo
- B. Li
- B. Liu
- B. Lokesh
- B. Martinsson
- B. Mautner
- B. Merkely
- B. Mooso
- B. Naratreekoon
- B. Okopien
- B. Opielowska-Nowak
- B. Ostrowska-Pomian
- B. Racz
- B. Raghuraman
- B. Ramjattan
- B. Rzyczkowska
- B. Sarai
- B. Schaefer
- B. Schneeweiß
- B. Schweitzer
- B. Sievers
- B. Silaruks
- B. Singh
- B. Sinha
- B. Stephanie
- B. Strohmer
- B. Subbaraman
- B. Unterkircher
- B. Uppelschoten
- B. Vandrus
- B. Vanhauwaert
- B. Vishwanathan
- B. Vogel
- B. Voigts
- B. Ward
- B. Wollaert
- B. Wozakowska-Kaplon
- B. Zhou
- B.-T. Kellner
- B.A.J. Stockins Fernandez
- B.C. Jung
- B.E. Groenemeijer
- B.R. Park
- B.Y. Sayin
- Barry Jacobson
- Bernard J. Gersh
- C. A'Court
- C. Arabetti
- C. Astudillo
- C. Axthelm
- C. Batta
- C. Beltra
- C. Bergeron
- C. Bergeron
- C. Bester
- C. Boshoff
- C. Bothin
- C. Bouvy
- C. Bradshaw
- C. Brike
- C. Brotons Cuixart
- C. Bugueño Gutiérrez
- C. Buiks
- C. Bulla
- C. Buzzetti
- C. Cannon
- C. Cantú Brito
- C. Chami
- C. Chigbo
- C. Ciabatta
- C. Conejeros
- C. Correa
- C. Corros Vicente
- C. Costantini Ortiz
- C. D'Arienzo
- C. Dias
- C. Dooldeniya
- C. Díaz de la Vega
- C. Ellervik
- C. Femiano
- C. Fonseca
- C. Fritz
- C. Funosas
- C. Giles
- C. Gines Garcia
- C. Gomez
- C. Grässjö
- C. Guldener
- C. Gómez Pajuelo
- C. Hagn
- C. Hawkins
- C. Hernández Herrera
- C. Herrick
- C. Hines
- C. Houzvic
- C. Hutton
- C. Jacobs
- C. Jean
- C. Juergens
- C. Kongsin
- C. Lara
- C. Latella
- C. Lewis
- C. Liley
- C. Lodigiani
- C. Martinelli
- C. Mazzone
- C. McCarthy
- C. McIntosh
- C. Moncada
- C. Moro Serrano
- C. Mulholland
- C. Munhoz da Fontoura Tavares
- C. Mussap
- C. Nanzer Vital
- C. Nilsson
- C. Ogurusu
- C. Ormundo
- C. Orosco
- C. Ortiz Cortes
- C. Paul
- C. Pisani
- C. Queirantes
- C. Ramesh
- C. Ravenhorst
- C. Reichelt
- C. Reimer
- C. Rey
- C. Richard
- C. Ricotti
- C. Rivera Ramos
- C. Robertson
- C. Roca Saumell
- C. Rodrigo
- C. Santolaya
- C. Scarone
- C. Scheurwegs
- C. Schubert
- C. Schwencke
- C. Seamark
- C. Simon Valero
- C. Singh
- C. Singleton
- C. Smessaert
- C. Stoll
- C. Stöcklöcker
- C. Sugimoto
- C. Takanaka
- C. Thorsen
- C. Tondo
- C. Torres
- C. Treasure
- C. Vantomme
- C. Verdi
- C. Vicente
- C. Villan
- C. Wöhrer
- C. Yeo
- C. Zecca
- C.-J. Kim
- C.-J. Lindholm
- C.A. Almeida Fernández
- C.A. Neden
- C.C. Broilo França
- C.G. Foo
- C.H. Del Carlo
- C.H. Gimenez
- C.J. Sánchez Díaz
- C.K. Ching
- C.L. Bai
- C.L. Gonzalez Garcia
- C.M. Diaz Lopez
- C.P. Jones
- C.R. Costantini Frack
- C.R. Frack Costantini
- C.S. Lee
- Carlos Jerjes Sánchez Díaz
- Carmela Alonso
- Concepcion Alonso
- D. Adak
- D. Alpay
- D. Alvarez
- D. Amstutz
- D. Andrzejewski
- D. Aras
- D. Armaganijan
- D. Atar
- D. Belenky
- D. Bertolim Precoma
- D. Blaszczyk
- D. Buckert
- D. Cassidy
- D. Castro Fernandez
- D. Chemello
- D. Cholsaringkarl
- D. Colquhoun
- D. Conde
- D. Coulshed
- D. Cresp
- D. Crimmins
- D. Davies
- D. De Cleen
- D. Denie
- D. Diercks
- D. Eccleston
- D. Edwards
- D. Faes
- D. Farquhar
- D. Fielder
- D. Fitzmaurice
- D. Fitzpatrick
- D. Flores Martínez
- D. Fournier
- D. Galley
- D. Geatch
- D. Genc
- D. Glatzel
- D. Goodwin
- D. Gray
- D. Greyling
- D. Guanaes
- D. Guedj-Meynier
- D. Gulyas
- D. Ikeda
- D. Jackson
- D. Jain
- D. Kernick
- D. Kettles
- D. Kociolek
- D. Komar
- D. Konyushenko
- D. Kroll
- D. Kruczyk
- D. Kusiak
- D. Kustrzycka-Kratochwil
- D. Lesniewska-Krynska
- D. Leung
- D. Lopes
- D. López Villezca
- D. Martinez Vasquez
- D. Merritt
- D. Michalik
- D. Montes
- D. Moreira
- D. Naik
- D. Nicolaus
- D. Nishijima
- D. O'Donnell
- D. Obadia
- D. Otero Tomera
- D. Platonov
- D. Plevak
- D. Poli
- D. Redpath
- D. Reimer
- D. Roy
- D. Rozewska-Furmanek
- D. Russell
- D. Sanchez
- D. Santos
- D. Seamark
- D. Shah
- D. Shah
- D. Shepherd
- D. Theodoro
- D. Tragen
- D. Uzun Alkan
- D. Van Lier
- D. Vandenbroeck
- D. Wright
- D. Zanolin
- D. Zateyshchikov
- D.-G. Shin
- D.-K. Kim
- D.B. Kim
- D.C. Esteves
- D.C. Sobral Filho
- D.D. Chen
- D.F. Cumberlidge
- D.H. Kim
- D.J. Choi
- D.R. Ryu
- D.W. Wang
- D.Y. Hu
- Dan Atar
- David A. Fitzmaurice
- David Fitzmaurice
- Dayi Hu
- E. Ahbeck
- E. Alborough
- E. Aleksandrova
- E. Banfi
- E. Barraquer Feu
- E. Bearez
- E. Bekieszczuk
- E. Belisario Falchetto
- E. Berge
- E. Blumberg
- E. Broton
- E. Buckley
- E. Burke
- E. Calvo Martinez
- E. Cardona Muñoz
- E. Chuquiure Valenzuela
- E. Corrihons
- E. Daros
- E. Davies
- E. Deweerd
- E. Domanska
- E. Ducasse
- E. Eißfeller
- E. Ellie
- E. Eriksen
- E. Escrivá Montserrat
- E. Fernandes
- E. Fernandez Escobar
- E. Fernandez Mas
- E. Feys
- E. Fisher
- E. Fulop
- E. Gasior
- E. Gjertsen
- E. Gorbunova
- E. Hartranft
- E. Hettwer Magedanz
- E. Hevia Rodriguez
- E. Jaskulska-Niedziela
- E. Kamenska
- E. Kiralyhazine Gyorke
- E. Kis
- E. Kochanska
- E. Korczowska
- E. Kowal
- E. Krcova
- E. Kremis
- E. Kropacheva
- E. Lanna Figueiredo
- E. Lewicka
- E. Lichota
- E. Lileeva
- E. Loyd
- E. Lustosa
- E. López Rosas
- E. Malone
- E. Mazur
- E. Mesolella
- E. Miedlar
- E. Molina
- E. Mollica Poeta
- E. Márquez Contreras
- E. Nagata
- E. Noori
- E. Novikova
- E. Okuyan
- E. Otaki
- E. Ozcelik
- E. Palmegiani
- E. Panchenko
- E. Pawlik-Rak
- E. Pena Garcia
- E. Polkanova
- E. Prochazkova
- E. Raymenants
- E. Rodriguez
- E. Saga
- E. Salomone
- E. Schaflinger
- E. Serralvo
- E. Shutemova
- E. Staniszewska
- E. Strieder
- E. Stuart
- E. Szuchnik
- E. Tiraferri
- E. Vanhalst
- E. Villeda Espinosa
- E. Watson
- E. Wilford
- E. Yakupov
- E. Yeter
- E. Yildirim
- E. Zaatout
- E. Zhuravleva
- E. Zidkova
- E. Zinka
- E.A. Choi
- E.B. Karaayvaz
- E.D. Alaguibe
- E.G. Lino
- E.H. Choi
- E.H. Lee
- E.J. Gonzalez Felix
- E.J. Yoon
- E.M. Esheiba
- E.M. Jang
- E.M. Koomen
- E.M. Pogliani
- E.P. Gurfinkel
- E.R. Fernandes Manenti
- E.S. Heo
- Elizaveta Panchenko
- F. Ahmed
- F. Al-Khalili
- F. Alban
- F. Aras
- F. Ayala-Paredes
- F. Banaeian
- F. Berli
- F. Bernsten
- F. Bitakova
- F. Bosman
- F. Busch
- F. Calcagnoli
- F. Casassus
- F. Chemin
- F. Chieza
- F. Choudhary
- F. Colombo Berra
- F. Cools
- F. Cosmi
- F. da Silva Paulitsch
- F. Diez
- F. Dormal
- F. Epelde Gonzalo
- F. Fernandez Voena
- F. Ferroni
- F. Flores Silva
- F. Forcignanò
- F. Freihoff
- F. Freire
- F. Geerlings
- F. Germini
- F. Gits
- F. Guerra
- F. Hakimi
- F. Hoshino
- F. Igansi
- F. Iseki
- F. Jannuzzi
- F. Juhasz
- F. Kahl
- F. Lanas
- F. Lillo
- F. Macellari
- F. Melone
- F. Mendez Zurita
- F. Minetti
- F. Okuda
- F. Paganelli
- F. Perez
- F. Petrie
- F. Ridocci Soriano
- F. Robin
- F. Rolandi
- F. Roquette
- F. Scouller
- F. Sellem
- F. Shaik
- F. Sztanyik
- F. Toyota
- F. Tradati
- F. Van Durme
- F. van Zyl
- F. Villaça Guimarães Filho
- F. Yilmaz
- F.A. Alves da Costa
- F.E. Camazzola
- F.J. Bermudez Jimenez
- F.J. Zurbrigk
- F.R. Jaufeerally
- F.Z. Wang
- Frank Cools
- Frank Misselwitz
- Freek W.A. Verheugt
- G. Agnelli
- G. Ambrosio
- G. Angel
- G. Arriagada
- G. Avanzino
- G. Baglioni
- G. Bantwal
- G. Barón Esquivias
- G. Berko
- G. Biazus
- G. Boggian
- G. Bonkowski
- G. Brauer
- G. Burns
- G. Campagna
- G. Cancho Corchado
- G. Charme Vilches
- G. Ciliberti
- G. Cimmino
- G. Conway
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- W.M. Kutayli
- W.N. Guo
- W.S. Son
- W.T. Lim
- W.Y. Lee
- W.Y. Zheng
- Wael Al Mahmeed
- Werner Hacke
- X. Chen
- X. Giry
- X. Li
- X. Robiro Robiro
- X. Sheng
- X. Vandamme
- X. Viñolas
- X.A. He
- X.F. Huang
- X.J. Gao
- X.J. Shi
- X.L. Luo
- X.S. Cheng
- X.S. Hu
- X.W. Yan
- X.Y. Zhu
- Xavier Viñolas
- Y. Abe
- Y. Atsuchi
- Y. Balthazar
- Y. Belenkova
- Y. Campisto
- Y. Emura
- Y. Fujii
- Y. Fujisawa
- Y. Go
- Y. Gomez Perez
- Y. Gottwalles
- Y. Guo
- Y. Haraguchi
- Y. Hata
- Y. Hatori
- Y. Hayashi
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- Y. Kamogawa
- Y. Kato
- Y. Katsube
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- Y. Kelfkens
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- Y. Onuki Pearce
- Y. Orlov
- Y. Osmolovskaya
- Y. Park
- Y. Saito
- Y. Sakamoto
- Y. Samejima
- Y. Santanakorn
- Y. Sasagawa
- Y. Sekine
- Y. Seta
- Y. Shapovalova
- Y. Shiina
- Y. Shimoyama
- Y. Shozawa
- Y. Stipp
- Y. Suzuki
- Y. Svyshchenko
- Y. Takagi
- Y. Tsuchiya
- Y. Ueyama
- Y. Vandekerckhove
- Y. Vorasettakarnkij
- Y. Wakasa
- Y. Ye
- Y. Yokoyama
- Y. Zhang
- Y.-I. Kim
- Y.H. Li
- Y.H. Sun
- Y.H. Yin
- Y.J. Yang
- Y.J. Yang
- Y.K. On
- Y.M. Chen
- Y.M. Lee
- Y.M. Sohn
- Y.R. Jeon
- Y.S. Oh
- Y.S. Son
- Y.S. Zhao
- Y.Y. Liu
- Ying Wang
- Yoichi Nakamura
- Yong Wang
- Yoshihisa Fujiura
- Yoshitake Fujiura
- Yuhei Shiga
- Yuichiro Nakamura
- Yukihiro Koretsune
- Yukio Shiga
- Z. Babjakova
- Z. Boda
- Z. Djaidani
- Z. Lajkowski
- Z. Laszlo
- Z. May
- Z. Monhart
- Z. Ongen
- Z. Radics
- Z.C. Lu
- Z.H. Zhou
- Z.M. Yang
- Publication venue
- Indian Heart J
- Publication date
- 01/01/2018
- Field of study
BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362
Five insights from the Global Burden of Disease Study 2019
- Author
- Abbafati C
- Abbas KM
- Abbasi M
- Abbasi-Kangevari M
- Abbasifard M
- Abbastabar H
- Abd El Razek HM
- Abd El Razek MM
- Abd-Allah F
- Abdelalim A
- Abdollahi M
- Abdollahpour I
- Abdulkader RS
- Abdullah KH
- Abedi A
- Abedi P
- Abegaz KH
- Abolhassani H
- Abosetugn AE
- Aboyans V
- Abrams EM
- Abreu LG
- Abrigo MRM
- Abu Haimed AK
- Abu-Gharbieh E
- Abu-Raddad LJ
- Abualhasan A
- Abushouk AI
- Acebedo A
- Ackerman IN
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- Adebayo OM
- Adedeji IA
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- Adelson JD
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- Publication venue
- Publication date
- 01/01/2020
- Field of study
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3.5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.Peer reviewe
Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019
- Author
- Abbafati C
- Abbas KM
- Abbasi M
- Abbasi-Kangevari M
- Abbasifard M
- Abbastabar H
- Abd El Razek HM
- Abd El Razek MM
- Abd-Allah F
- Abdelalim A
- Abdollahi M
- Abdollahpour I
- Abdulkader RS
- Abdullah KH
- Abedi A
- Abedi P
- Abegaz KH
- Abolhassani H
- Abosetugn AE
- Aboyans V
- Abrams EM
- Abreu LG
- Abrigo MRM
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- Abu-Gharbieh E
- Abu-Raddad LJ
- Abualhasan A
- Abushouk AI
- Acebedo A
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- Yaya S
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- Yeheyis TY
- Yeshitila YG
- Yilgwan CS
- Yilma MT
- Yip P
- Yonemoto N
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- York HW
- Younis MZ
- Younker TP
- Yousefi B
- Yousefi Z
- Yousefifard M
- Yousefinezhadi T
- Yousuf AY
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- Yu Y
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- Yuce D
- Yusefzadeh H
- Zadey S
- Zahabi SS
- Zaidi SS
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- Zakzuk J
- Zamani M
- Zamanian M
- Zandian H
- Zangeneh A
- Zarafshan H
- Zastrozhin MS
- Zewdie KA
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- Zhang Y
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- Zhao X-JG
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- Zlavog BS
- Zodpey S
- Publication venue
- 'Elsevier BV'
- Publication date
- 17/10/2020
- Field of study
Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2
- Author
- Abellán Javier
- Acosta-isaac René
- Aguado Jose María
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- Fernández-ferrero Silvia
- Fernández-robelo Uxía
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- Fernández-sampedro Marta
- Fernández-villa Tania
- Flores Carlos
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- Friaza Vicente
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- Fuertes-núñez Marta
- Fumadó Victoria
- Gadea Ignacio
- Gagliardi Lidia
- Gago-domínguez Manuela
- Gallego Natalia
- Galoppo Cristina
- Garcia-garcía Josefina
- García Torrejón María Carmen
- García Inés
- García Leticia
- García Mercedes
- García-cerrada Carlos
- García-de-vicuña Aitor
- García-garcía Irene
- García-ibarbia Carmen
- García-montero Andrés C.
- García-soidán Ana
- García-vázquez Elisa
- Garza-frias Emiliano
- Gentile Angela
- Gil-fournier Belén
- Gonzalez-sagrado Manuel
- Gonzalo-benito Hugo
- González Bernaldo De Quirós Fernán
- González Álvarez Beatriz
- González Juan R.
- González Juan R.
- González-montelongo Rafaela
- González-neira Anna
- González-peñas Javier
- Gorgojo-galindo Oscar
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- Guillén-guío Beatriz
- Guillén-navarro Encarna
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- Gómez Sacristán Ángela
- Gómez-arrue Javier
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- Hernández Estefania
- Hernández-moro Cristina
- Hernández-ortega Luis D.
- Hernández-pérez Guillermo
- Hernández-vaquero Rebeca
- Herranz M. Teresa
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- Mar Carmen
- Marcelo Calvo Cristina
- Marcos Miguel
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- Mariscal-aguilar Pablo
- Martin-fernandez Marta
- Martin-pedraza Laura
- Martinez Amalia
- Martinez-paz Pedro
- Martín María Dolores
- Martín María M.
- Martín Vicente
- Martín-lópez Caridad
- Martín-oterino José-Ángel
- Martín-vicente María
- Martínez Juan José
- Martínez Ricardo
- Martínez Silvia
- Martínez-aquino Eleno
- Martínez-gonzález Óscar
- Martínez-lópez Iciar
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- Pujol Aurora
- Pérez Alexandra
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- Robelo Pardo Montserrat
- Rodriguez Marilyn Johanna
- Rodriguez-nicolas Antonio
- Rodriguez-palmero Agustí
- Rodriguez-urrego Paula A.
- Rodríguez-artalejo Fernando
- Rodríguez-ferrer Marena
- Rodríguez-gallego Carlos
- Rodríguez-garcía José A.
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- Rodríguez-novoa German Ezequiel
- Rodríguez-ruiz Emilio
- Rojas-martinez Augusto
- Rojo Federico
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- Rosa Lidia S.
- Rosales-castillo Antonio
- Rubio Cladelis
- Ruiz Montserrat
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- Salazar-garcía Lorena
- Salgueiro-origlia Giorgina Gabriela
- Sancho-sainz Cristina
- Sande Esther
- Sangil Anna
- Santos Arnoldo
- Santos Ney P. C.
- Schlüter Agatha
- Scourge Cohort Group
- Segovia Sonia
- Serra-llovich Alex
- Sevil-puras Fernando
- Sevilla-porras Marta
- Sicolo Miguel A.
- Silbiger Vivian N.
- Silva Fabiola T. C.
- Silva Gabriela V.
- Silva Nayara S.
- Silván-fuentes Cristina
- Solé-violán Jordi
- Soria José Manuel
- Sorlí Jose V.
- Sousa Renata R.
- Souto Juan Carlos
- Souza Karla S. C.
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- Sprockel John J.
- Suárez-rama José Javier
- Suárez-zamora David A.
- Sánchez López Antonio J.
- Sánchez Pedro-luis
- Sánchez-carpintero Abad María
- Sánchez-pablo Clara
- Sánchez-pernaute Olga
- Sánchez-prados María Concepción
- Sánchez-real Javier
- Sánchez-redondo Jorge
- Taboada-fraga Xiana
- Tamayo Eduardo
- Tamayo-velasco Alvaro
- Taracido-fernández Juan Carlos
- Tavares Nathali A. C.
- Tellería Carlos
- Tenorio-castaño Jair Antonio
- Teper Alejandro
- Torres-gutiérrez Ronald P.
- Torres-macho Juan
- Torres-tobar Lilian
- Troya Jesús
- Urioste Miguel
- Valencia-ramos Juan
- Valido Agustín
- Vargas-gallo Juan Pablo
- Varón Belén
- Vasconcelos Romero H. T.
- Vega Tomas
- Velasco-quirce Santiago
- Vidán-estévez Julia
- Vieitez-santiago Miriam
- Vilches Carlos
- Villalobos Lavinia
- Villar Felipe
- Villar-garcia Judit
- Villaverde Cristina
- Villoslada-blanco Pablo
- Virseda-berdices Ana
- Vélez-santamaría Valentina
- Víctor Virginia
- Yáñez Zuleima
- Zapatero-gaviria Antonio
- Zarate Ruth
- Zazo Sandra
- Álvarez Nuria
- Álvarez-benítez Yady
- Álvarez-navia Felipe
- Álvarez-sala Walther Rodolfo
- Íñigo-campos Antonio
- Íñiguez María
- Publication venue
- Springer Science and Business Media LLC
- Publication date
- 08/05/2024
- Field of study
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality
Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019
- Author
- Abbafati Cristiana
- Abbas Kaja M.
- Abbasi Mohammad
- Abbasi-Kangevari Mohsen
- Abbasifard Mitra
- Abbastabar Hedayat
- Abd-Allah Foad
- Abdelalim Ahmed
- Abdollahi Mohammad
- Abdollahpour Ibrahim
- Abedi Aidin
- Abedi Parisa
- Abegaz Kedir H.
- Abolhassani Hassan
- Abosetugn Akine E.
- Aboyans Victor
- Abrams Elissa M.
- Abreu Lucas G.
- Abrigo Michael R. M.
- Abu Haimed Abdulaziz K.
- Abu-Gharbieh Eman
- Abu-Raddad Laith J.
- Abualhasan Ahmed
- Abushouk Abdelrahman I.
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- Maddison Emilie R.
- Maddison Ralph
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- Mahasha Phetole W.
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- Mamun Abdullah A.
- Manafi Amir
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- Martin Randall
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- Martopullo Ira
- Masaka Anthony
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- Massenburg Benjamin B.
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- McKee Martin
- Medina-Solis Carlo E.
- Meharie Birhanu G.
- Mehndiratta Man M.
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- Mehri Fereshteh
- Mehrotra Ravi
- Mehta Kala M.
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- Melese Addisu
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- Memish Ziad A.
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- Menezes Ritesh G.
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- Moazen Babak
- Moghadaszadeh Masoud
- Mohajer Bahram
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- Mohamadi Efat
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- Monasta Lorenzo
- Mondello Stefania
- Mooney Meghan D.
- Moosazadeh Mahmood
- Moradi Ghobad
- Moradi Masoud
- Moradi-Joo Mohammad
- Moradi-Lakeh Maziar
- Moradzadeh Rahmatollah
- Moraga Paula
- Morales Linda
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- Moreno Velasquez Ilais
- Morgado-da-Costa Joana
- Morrison Shane D.
- Mosapour Abbas
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- Mustafa Ghulam
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- Nabavizadeh Behnam
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- Nagel Gabriele
- Naghavi Mohsen
- Naghshtabrizi Behshad
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- Naimzada Mukhammad D.
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- Nguefack-Tsague Georges
- Ngunjiri Josephine W.
- Nguyen Cuong T.
- Nguyen Diep N.
- Nguyen Huong L.
- Nguyen Jason Q.
- Nguyen Michele
- Nguyen Ming
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- Nichols Emma
- Nigatu Dabere
- Nigatu Yeshambel T.
- Nikbakhsh Rajan
- Nikpoor Amin R.
- Nixon Molly R.
- Nnaji Chukwudi A.
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- Ortiz Alberto
- Osarenotor Osayomwanbo
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- Otstavnov Nikita
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- P. A. Mahesh
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- Pakhale Smita
- Pakhare Abhijit P.
- Pakshir Keyvan
- Palladino Raffaele
- Pana Adrian
- Panda-Jonas Songhomitra
- Pandey Anamika
- Pangaribuan Helena U.
- Park Eun-Kee
- Park James
- Parmar Priya
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- Patel Jenil R.
- Patel Sangram K.
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- Pathak Ashish
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- Pesudovs Konrad
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- Pourmalek Farshad
- Pourmirza Kalhori Reza
- Pourshams Akram
- Poznanska Anna
- Prada Sergio I.
- Prakash Sanjay
- Prakash V.
- Prasad Narayan
- Preotescu Liliana
- Pribadi Dimas R.
- Pupillo Elisabetta
- Quazi Syed Zahiruddin
- Rabiee Mohammad
- Rabiee Navid
- Radfar Amir
- Rafiee Ata
- Rafiei Alireza
- Raggi Alberto
- Rahim Fakher
- Rahimi-Movaghar Afarin
- Rahman Mohammad H.
- Rahman Muhammad A.
- Rajabpour-Sanati Ali
- Rajati Fatemeh
- Rakovac Ivo
- Ram Pradhum
- Ramezanzadeh Kiana
- Rana Saleem M.
- Ranabhat Chhabi L.
- Ranta Annemarei
- Rao Puja C.
- Rao Sowmya J.
- Rasella Davide
- Rashedi Vahid
- Rastogi Prateek
- Rath Goura K.
- Rathi Priya
- Rawaf David L.
- Rawaf Salman
- Rawal Lal
- Rawassizadeh Reza
- Rawat Ramu
- Razo Christian
- Redford Sofia B.
- Regassa Lemma D.
- Reiner Robert C.
- Reinig Nickolas
- Reitsma Marissa B.
- Remuzzi Giuseppe
- Renjith Vishnu
- Renzaho Andre M. N. (R17978)
- Ärnlöv Johan
- Øverland Simon
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2020
- Field of study
Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019.
Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
- Author
- Abbafati Cristiana
- Abbas Kaja M.
- Abbasi Mohammad
- Abbasi-Kangevari Mohsen
- Abbasifard Mitra
- Abbastabar Hedayat
- Abd El Razek Hassan Magdy
- Abd El Razek Muhammed Magdy
- Abd-Allah Foad
- Abdelalim Ahmed
- Abdollahi Mohammad
- Abdollahpour Ibrahim
- Abdulkader Rizwan Suliankatchi
- Abdullah Kanaan Hamagharib
- Abedi Aidin
- Abedi Parisa
- Abegaz Kedir Hussein
- Abolhassani Hassan
- Abosetugn Akine Eshete
- Aboyans Victor
- Abrams Elissa M.
- Abreu Lucas Guimaraes
- Abrigo Michael R. M.
- Abu Haimed Abdulaziz Khalid
- Abu-Gharbieh Eman
- Abu-Raddad Laith Jamal
- Abualhasan Ahmed
- Abushouk Abdelrahman I.
- Acebedo Alyssa
- Ackerman Ilana N.
- Adabi Maryam
- Adair Tim
- Adamu Abdu A.
- Adebayo Oladimeji M.
- Adedeji Isaac Akinkunmi
- Adekanmbi Victor
- Adelson Jaimie D.
- Adeoye Abiodun Moshood
- Adetokunboh Olatunji O.
- Adham Davoud
- Advani Shailesh M.
- Afarideh Mohsen
- Afshari Mahdi
- Afshin Ashkan
- Agardh Emilie E.
- Agarwal Gina
- Agasthi Pradyumna
- Agesa Kareha M.
- Aghaali Mohammad
- Aghamir Seyed Mohammad Kazem
- Agrawal Anurag
- Ahmad Tauseef
- Ahmadi Alireza
- Ahmadi Keivan
- Ahmadi Mehdi
- Ahmadieh Hamid
- Ahmadpour Ehsan
- Ahmed Muktar Beshir
- Aji Budi
- Akalu Temesgen Yihunie
- Akinyemi Rufus Olusola
- Akinyemiju Tomi
- Akombi Blessing
- Akunna Chisom Joyqueenet
- Al-Aly Ziyad
- Al-Mekhlafi Hesham M.
- Al-Raddadi Rajaa M.
- Alahdab Fares
- Alam Khurshid
- Alam Noore
- Alam Samiah
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- Alanzi Turki M.
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- Alcalde-Rabanal Jacqueline Elizabeth
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- Alemu Biresaw Wassihun
- Alemu Yihun Mulugeta
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- Ali Muhammad
- Ali Saqib
- Alicandro Gianfranco
- Alijanzadeh Mehran
- Alinia Cyrus
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- Kneib Cameron J.
- Knibbs Luke D.
- Knight Megan
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- Moazen Babak
- Moghadam Telma Zahirian
- Moghadaszadeh Masoud
- Moghaddam Sahar Saeedi
- Mohajer Bahram
- Mohamad Osama
- Mohamadi Efat
- Mohammad Dara K.
- Mohammad Yousef
- Mohammadbeigi Abolfazl
- Mohammadian-Hafshejani Abdollah
- Mohammadifard Noushin
- Mohammadpourhodki Reza
- Mohammed Ammas Siraj
- Mohammed Hussen
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- Mohammed Shafiu
- Mohebi Farnam
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- Moradi Ghobad
- Moradi Masoud
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- Moradi-Lakeh Maziar
- Moradzadeh Rahmatollah
- Moraga Paula
- Morales Linda
- Morawska Lidia
- Morgado-da-Costa Joana
- Morrison Shane Douglas
- Mosapour Abbas
- Mosser Jonathan F.
- Motlagh Soraya Nouraei
- Mouodi Simin
- Mousavi Seyyed Meysam
- Mueller Ulrich Otto
- Mukhopadhyay Satinath
- Mullany Erin C.
- Mumford John Everett
- Munro Sandra B.
- Muriithi Moses K.
- Murray Christopher J. L.
- Musa Kamarul Imran
- Mustafa Ghulam
- Muthupandian Saravanan
- Nabavizadeh Behnam
- Nabhan Ashraf F.
- Naderi Mehdi
- Nagaraja Sharath Burugina
- Nagarajan Ahamarshan Jayaraman
- Nagel Gabriele
- Naghavi Mohsen
- Naghshtabrizi Behshad
- Naik Gurudatta
- Naimzada Mukhammad David
- Nair Sanjeev
- Najafi Farid
- Naldi Luigi
- Nandakumar Vishnu
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- Nangia Vinay
- Nansseu Jobert Richie
- Nasab Entezar Mehrabi
- Naserbakht Morteza
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- Nazari Javad
- Ndejjo Rawlance
- Ndwandwe Duduzile Edith
- Negoi Ionut
- Negoi Ruxandra Irina
- Netsere Henok Biresaw
- Neupane Subas
- Ngari Kiirithio N.
- Nguefack-Tsague Georges
- Ngunjiri Josephine W.
- Nguyen Cuong Tat
- Nguyen Diep Ngoc
- Nguyen Huong Lan Thi
- Nguyen Jason
- Nguyen Michele
- Nguyen Ming
- Nguyen Trang Huyen
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- Nigatu Dabere
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- Nikbakhsh Rajan
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- Nnaji Chukwudi A.
- Nomura Shuhei
- Norheim Ole F.
- Norrving Bo
- Noubiap Jean Jacques
- Nowak Christoph
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- Nunez-Samudio Virginia
- Oancea Bogdan
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- Ogbo Felix Akpojene
- Oghenetega Onome Bright
- Oh In-Hwan
- Oiu Adrian O.
- Okunga Emmanuel Wandera
- Oladnabi Morteza
- Olagunju Andrew T.
- Olusanya Bolajoko Olubukunola
- Olusanya Jacob Olusegun
- Oluwasanu Mojisola Morenike
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- Oren Eyal
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- Ortiz Alberto
- Osarenotor Osayomwanbo
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- Otstavnov Nikita
- Otstavnov Stanislav S.
- Overland Simon
- Owolabi Mayowa O.
- Padubidri Jagadish Rao
- Pakhale Smita
- Pakhare Abhijit P.
- Pakshir Keyvan
- Palladino Raffaele
- Pana Adrian
- Panda-Jonas Songhomitra
- Pandey Anamika
- Pangaribuan Helena Ullyartha
- Park Eun-Kee
- Park James
- Parmar Priya G. Kumari
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- Pasovic Maja
- Pasupula Deepak Kumar
- Patel Jenil R.
- Patel Sangram Kishor
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- Pathak Ashish
- Pathak Mona
- Patten Scott B.
- Patton George C.
- Paudel Deepak
- Paudel Sagun
- Paulson Katherine R.
- Pease Spencer A.
- Peden Amy E.
- Pennini Alyssa
- Pepito Veincent Christian Filipino
- Peprah Emmanuel K.
- Pereira Alexandre
- Pereira David M.
- Pereira Jeevan
- Perico Norberto
- Pescarini Julia Moreira
- Pesudovs Konrad
- Pham Hai Quang
- Phillips Michael R.
- Piccinelli Cristiano
- Pierce Maxwell
- Pigott David M.
- Pilgrim Thomas
- Pilz Tessa M.
- Pinheiro Marina
- Piradov Michael A.
- Pirsaheb Meghdad
- Pishgar Farhad
- Plana-Ripoll Oleguer
- Plass Dietrich
- Pletcher Martin
- Pokhrel Khem Narayan
- Polibin Roman V.
- Polinder Suzanne
- Polkinghorne Kevan R.
- Pond Constance Dimity
- Postma Maarten J.
- Pottoo Faheem Hyder
- Pourjafar Hadi
- Pourmalek Farshad
- Pourshams Akram
- Poznanska Anna
- Prada Sergio I.
- Prakash Sanjay
- Prakash V.
- Prasad Narayan
- Preotescu Liliana
- Pribadi Dimas Ria Angga
- Pupillo Elisabetta
- Quazi Syed Zahiruddin
- Quintanilla Beatriz Paulina Ayala
- Rabiee Mohammad
- Rabiee Navid
- Radfar Amir
- Rafiee Ata
- Rafiei Alireza
- Raggi Alberto
- Rahim Fakher
- Rahimi-Movaghar Afarin
- Rahman Mohammad Hifz Ur
- Rahman Muhammad Aziz
- Rajabpour-Sanati Ali
- Rajati Fatemeh
- Rakovac Ivo
- Ram Pradhum
- Ramezanzadeh Kiana
- Rana Saleem Muhammad
- Ranabhat Chhabi Lal
- Ranta Annemarei
- Rao Puja C.
- Rao Sowmya J.
- Rasella Davide
- Rashedi Vahid
- Rastogi Prateek
- Rath Goura Kishor
- Rathi Priya
- Rawaf David Laith
- Rawaf Salman
- Rawal Lal
- Rawassizadeh Reza
- Rawat Ramu
- Razo Christian
- Regassa Lemma Demissie
- Reiner Robert C., Jr.
- Reinig Nickolas
- Reitsma Marissa Bettay
- Remuzzi Giuseppe
- Renjith Vishnu
- Renzaho Andre M. N.
- Resnikoff Serge
- Rezaei Negar
- Rezaei Nima
- Rezai Mohammad Sadegh
- Rezapour Aziz
- Rhinehart Phoebe-Anne
- Riahi Seyed Mohammad
- Ribeiro Antonio Luiz P.
- Ribeiro Daniel Cury
- Ribeiro Daniela
- Rickard Jennifer
- Rincon Julio Cesar Campuzano
- Rivera Juan A.
- Robalik Toshana
- Roberts Nicholas L. S.
- Roberts Shaun
- Robinson Stephen R.
- Rodriguez-Ramirez Sonia
- Roever Leonardo
- Rolfe Sam
- Romoli Michele
- Ronfani Luca
- Room Robin
- Roshandel Gholamreza
- Rostamian Morteza
- Roth Gregory A.
- Rothenbacher Dietrich
- Rubagotti Enrico
- Rumisha Susan Fred
- Rwegerera Godfrey M.
- Saadatagah Seyedmohammad
- Sabour Siamak
- Sachdev Perminder S.
- Saddik Basema
- Sadeghi Ehsan
- Sadeghi Masoumeh
- Saeedi Reza
- Saeidi Shahram
- Safari Yahya
- Safi Sare
- Safiri Saeid
- Sagar Rajesh
- Sahebkar Amirhossein
- Sahraian Mohammad Ali
- Sajadi S. Mohammad
- Salahshoor Mohammad Reza
- Salam Nasir
- Salama Joseph S.
- Salamati Payman
- Salem Hosni
- Salem Marwa R.
- Salimi Yahya
- Salimzadeh Hamideh
- Salman Omar Mukhtar
- Salomon Joshua A.
- Salz Inbal
- Samad Zainab
- Sambala Evanson Zondani
- Samy Abdallah M.
- Sanabria Juan
- Sanchez-Pimienta Tania G.
- Santomauro Damian Francesco
- Santos Itamar S.
- Santos Joao Vasco
- Santric-Milicevic Milena M.
- Saraswathy Sivan Yegnanarayana Iyer
- Sarmiento-Suarez Rodrigo
- Sarrafzadegan Nizal
- Sartorius Benn
- Sarveazad Arash
- Sathian Brijesh
- Sathish Thirunavukkarasu
- Sattin Davide
- Savic Miloje
- Sawyer Susan M.
- Saxena Deepak
- Saxena Sonia
- Saylan Mete
- Sbarra Alyssa N.
- Schaeffer Lauren E.
- Schiavolin Silvia
- Schlaich Markus P.
- Schmidt Maria Ines
- Schutte Aletta Elisabeth
- Schwebel David C.
- Schwendicke Falk
- Section Mahesh P. A.
- Seedat Soraya
- Sekerija Mario
- Senbeta Anbissa Muleta
- Senthilkumaran Subramanian
- Sepanlou Sadaf G.
- Serdar Berrin
- Serre Marc L.
- Servan-Mori Edson
- Sha Feng
- Shabani Mahsima
- Shackelford Katya Anne
- Shadid Jamileh
- Shafaat Omid
- Shahabi Saeed
- Shahbaz Mohammad
- Shaheen Amira A.
- Shaikh Masood Ali
- Shaji K. S.
- Shalash Ali S.
- Shams-Beyranvand Mehran
- Shamsi MohammadBagher
- Shamsizadeh Morteza
- Shannawaz Mohammed
- Sharafi Kiomars
- Sharafi Zeinab
- Sharan Subodh
- Sharara Fablina
- Sharifi Hamid
- Sharma Rajesh
- Shaw David H.
- Sheena Brittney S.
- Sheikh Aziz
- Sheikhtaheri Abbas
- Shetty B. Suresh Kumar
- Shetty Ranjitha S.
- Shibuya Kenji
- Shield Kevin David
- Shiferaw Wondimeneh Shibabaw
- Shigematsu Mika
- Shin Min-Jeong
- Shiri Rahman
- Shirkoohi Reza
- Shivakumar K. M.
- Shrime Mark G.
- Shuval Kerem
- Siabani Soraya
- Sierpinski Radoslaw
- Sigfusdottir Inga Dora
- Sigurvinsdottir Rannveig
- Silva Diego Augusto Santos
- Silva Joao Pedro
- Simonetti Biagio
- Simpson Kyle E.
- Singh Ambrish
- Singh Jasvinder A.
- Singh Pushpendra
- Sinha Dhirendra Narain
- Skiadaresi Eirini
- Skou Soren T.
- Skryabin Valentin Yurievich
- Sliwa Karen
- Smith Amanda
- Smith Emma U. R.
- Sobngwi Eugene
- Soheili Amin
- Sokhan Anton
- Soltani Shahin
- Somefun Oluwaseyi Dolapo
- Soofi Moslem
- Sorensen Reed J. D.
- Soriano Joan B.
- Sorrie Muluken Bekele
- Soshnikov Sergey
- Soyiri Ireneous N.
- Spencer Cory N.
- Spotin Adel
- Spurlock Emma Elizabeth
- Sreeramareddy Chandrashekhar T.
- Srinivasan Vinay
- Sripada Kam
- Stanaway Jeffrey D.
- Stark Benjamin A.
- Steel Nicholas
- Stefan Simona Catalina
- Stein Caroline
- Stein Dan J.
- Steiner Caitlyn
- Steiner Timothy J.
- Steuben Krista M.
- Stockfelt Leo
- Stokes Mark A.
- Stovner Lars Jacob
- Straif Kurt
- Stranges Saverio
- Stubbs Jacob L.
- Suchdev Parminder S.
- Sudaryanto Agus
- Sufiyan Mu'awiyyah Babale
- Suleria Hafiz Ansar Rasul
- Sulo Gerhard
- Sultan Iyad
- Swope Carolyn B.
- Sykes Bryan L.
- Sylte Dillon O.
- Szocska Miklos
- Szumowski Lukasz
- Tabares-Seisdedos Rafael
- Tabb Karen M.
- Tabuchi Takahiro
- Tadakamadla Santosh Kumar
- Taddele Biruk Wogayehu
- Tadesse Degena Bahrey
- Taherkhani Amir
- Tahir Zarfishan
- Tajdini Masih
- Takahashi Ken
- Takala Jukka S.
- Tamiru Animut Tagele
- Tang Muming
- Tanser Frank C.
- Tareque Md Ismail
- Tarigan Ingan Ukur
- Taveira Nuno
- Taylor Heather Jean
- Teagle Whitney L.
- Teame Hirut
- Tediosi Fabrizio
- Tefera Yonas Getaye
- Tehrani-Banihashemi Arash
- Teklehaimanot Berhane Fseha
- Tela Freweini Gebrearegay
- Temsah Mohamad-Hani
- Terrason Sonyah
- Tesema Getayeneh Antehunegn
- Tessema Zemenu Tadesse
- Thakur Bhaskar
- Thankappan Kavumpurathu Raman
- Thapar Rekha
- Thomas Nihal
- Thomson Azalea M.
- Thrift Amanda G.
- Thurston George D.
- Titova Mariya Vladimirovna
- Tlou Boikhutso
- Tohidinik Hamid Reza
- Tonelli Marcello
- Topor-Madry Roman
- Topouzis Fotis
- Toroudi Hamidreza Pazoki
- Torre Anna E.
- Touvier Mathilde
- Tovani-Palone Marcos Roberto
- Traini Eugenio
- Tran Bach Xuan
- Travillian Ravensara
- Trias-Llimos Sergi
- Troeger Christopher E.
- Truelsen Thomas Clement
- Tsai Alexander C.
- Tsatsakis Aristidis
- Tyrovolas Stefanos
- Uddin Riaz
- Ullah Irfan
- Ullah Saif
- Umeokonkwo Chukwuma David
- Undurraga Eduardo A.
- Unnikrishnan Bhaskaran
- Upadhyay Era
- Uthman Olalekan A.
- Vacante Marco
- Vaicekonyte Regina
- Vakilian Alireza
- Valdez Pascual R.
- Valli Alessandro
- Van Donkelaar Aaron
- Vardavas Constantine
- Varughese Santosh
- Vasankari Tommi Juhani
- Vasconcelos Ana Maria Nogales
- Vasseghian Yasser
- Veisani Yousef
- Velasquez Ilais Moreno
- Venketasubramanian Narayanaswamy
- Vidale Simone
- Violante Francesco S.
- Vlassov Vasily
- Vollset Stein Emil
- Vongpradith Avina
- Vos Theo
- Vu Giang Thu
- Vujcic Isidora S.
- Vukovic Ana
- Vukovic Rade
- Waheed Yasir
- Wallin Mitchell Taylor
- Walters Magdalene K.
- Wamai Richard G.
- Wang Fang
- Wang Haidong
- Wang Hongbo
- Wang Jiayu
- Wang Yafeng
- Wang Yanzhong
- Wang Yuan-Pang
- Ward Joseph L.
- Watson Alexandrea
- Watson Stefanie
- Wei Jingkai
- Wei Melissa Y. Wei
- Weintraub Robert G.
- Weiss Daniel J.
- Weiss Jordan
- Welay Fissaha Tekulu
- Weldesamuel Girmay Teklay
- Werdecker Andrea
- West J. Jason
- Westerman Ronny
- Whisnant Joanna L.
- Whiteford Harvey A.
- Wiangkham Taweewat
- Wickramasinghe Nuwan Darshana
- Wiens Kirsten E.
- Wijeratne Tissa
- Wilner Lauren B.
- Wilson Shadrach
- Wiysonge Charles Shey
- Wojtyniak Bogdan
- Woldu Gebremariam
- Wolfe Charles D. A.
- Wondmeneh Temesgen Gebeyehu
- Wondmieneh Adam Belay
- Wool Eve E.
- Wozniak Sarah S.
- Wu Ai-Min
- Wu Chenkai
- Wu Junjie
- Wunrow Han Yong
- Xie Yang
- Xu Gelin
- Xu Rixing
- Yadgir Simon
- Yamada Tomohide
- Yamagishi Kazumasa
- Yaminfirooz Mousa
- Yano Yuichiro
- Yaya Sanni
- Yazdi-Feyzabadi Vahid
- Yearwood Jamal A.
- Yeheyis Tomas Y.
- Yeshitila Yordanos Gizachew
- Yilgwan Christopher Sabo
- Yilma Mekdes Tigistu
- Yip Paul
- Yonemoto Naohiro
- Yoon Seok-Jun
- York Hunter W.
- Younis Mustafa Z.
- Younker Theodore Patrick
- Yousefi Bahman
- Yousefi Zabihollah
- Yousefifard Mahmoud
- Yousefinezhadi Taraneh
- Yousuf Abdilahi Yousuf
- Yu Chuanhua
- Yu Yong
- Yuan Chun-Wei
- Yuce Deniz
- Yusefzadeh Hasan
- Zadey Siddhesh
- Zahabi Saleh Salehi
- Zaidi Syed Saoud
- Zaki Leila
- Zaki Maysaa El Sayed
- Zakzuk Josefina
- Zamani Mohammad
- Zamanian Maryam
- Zandian Hamed
- Zangeneh Alireza
- Zarafshan Hadi
- Zastrozhin Mikhail Sergeevich
- Zewdie Kaleab Alemayehu
- Zhang Jianrong
- Zhang Yunquan
- Zhang Zhi-Jiang
- Zhao Jeff T.
- Zhao Xiu-Ju George
- Zhao Yingxi
- Zheleva Bistra
- Zheng Peng
- Zhou Maigeng
- Zhu Cong
- Ziapour Arash
- Zimsen Stephanie R. M.
- Zlavog Bianca S.
- Zodpey Sanjay
- Publication venue
- Publication date
- 01/01/2020
- Field of study
Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016
- Author
- Abay Solomon M.
- Abbafati Cristiana
- Abd-Allah Foad
- Abdela Jemal
- Abdelalim Ahmed
- Abebe Zegeye
- Abebo Teshome Abuka
- Aboyans Victor
- Abraha Haftom Niguse
- Abreu Daisy M. X.
- Abu-Raddad Laith J.
- Adane Akilew Awoke
- Adedoyin Rufus Adesoji
- Adetokunboh Olatunji
- Adhikari Tara Ballav
- Afarideh Mohsen
- Afshin Ashkan
- Agarwal Gina
- Agius Dominic
- Agrawal Anurag
- Agrawal Sutapa
- Aichour Miloud Taki Eddine
- Akibu Mohammed
- Akinyemi Rufus Olusola
- Akinyemiju Tomi F.
- Akseer Nadia
- Al Lami Faris Hasan
- Al-Aly Ziyad
- Al-Eyadhy Ayman
- Al-Raddadi Rajaa
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- Alam Tahiya
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- Albittar Mohammed I.
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- Troeger Christopher
- Truelsen Thomas
- Tsoi Derrick
- Tudor Car Lorainne
- Tuem Kald Beshir
- Tyrovolas Stefanos
- Uchendu Uche S.
- Ukwaja Kingsley Nnanna
- Ullah Irfan
- Updike Rachel
- Uthman Olalekan A.
- Uzochukwu Benjamin S. Chudi
- Valdez Pascual Rubén
- van Boven Job F. M.
- Varughese Santosh
- Vasankari Tommi
- Venketasubramanian Narayanaswamy
- Violante Francesco S.
- Vladimirov Sergey K.
- Vlassov Vasiliy Victorovich
- Vollset Stein Emil
- Vos Theo
- Wagnew Fasil
- Waheed Yasir
- Wallin Mitchell T.
- Walson Judd L.
- Wang Yafeng
- Wang Yuan-Pang
- Wassie Molla Mesele
- Weaver Marcia R.
- Weiderpass Elisabete
- Weintraub Robert G.
- Weiss Jordan
- Weldegwergs Kidu Gidey
- Werdecker Andrea
- West T. Eoin
- Westerman Ronny
- White Richard G.
- Whiteford Harvey A.
- Widecka Justyna
- Winkler Andrea Sylvia
- Wiysonge Charles Shey
- Wolfe Charles D. A.
- Wondimkun Yohanes Ayele
- Workicho Abdulhalik
- Wyper Grant M. A.
- Xavier Denis
- Xu Gelin
- Yan Lijing L.
- Yano Yuichiro
- Yaseri Mehdi
- Yearwood Jamal
- Yimer Nigus Bililign
- Yin Peng
- Yip Paul
- Yirsaw Biruck Desalegn
- Yonemoto Naohiro
- Yonga Gerald
- Yoon Seok-Jun
- Yotebieng Marcel
- Younis Mustafa Z.
- Yu Chuanhua
- Zadnik Vesna
- Zaidi Zoubida
- Zaki Maysaa El Sayed
- Zaman Sojib Bin
- Zamani Mohammad
- Zenebe Zerihun Menlkalew
- Zhou Maigeng
- Zhu Jun
- Zimsen Stephanie R. M.
- Zipkin Ben
- Zodpey Sanjay
- Zuhlke Liesl Joanna
- Ärnlöv Johan
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2018
- Field of study
Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97\ub71 (95% UI 95\ub78-98\ub71) in Iceland, followed by 96\ub76 (94\ub79-97\ub79) in Norway and 96\ub71 (94\ub75-97\ub73) in the Netherlands, to values as low as 18\ub76 (13\ub71-24\ub74) in the Central African Republic, 19\ub70 (14\ub73-23\ub77) in Somalia, and 23\ub74 (20\ub72-26\ub78) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91\ub75 (89\ub71-93\ub76) in Beijing to 48\ub70 (43\ub74-53\ub72) in Tibet (a 43\ub75-point difference), while India saw a 30\ub78-point disparity, from 64\ub78 (59\ub76-68\ub78) in Goa to 34\ub70 (30\ub73-38\ub71) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4\ub78-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20\ub79-point to 17\ub70-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17\ub72-point to 20\ub74-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view-and subsequent provision-of quality health care for all populations
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