Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021

Background Anaemia is a major health problem worldwide. Global estimates of anaemia burden are crucial for developing appropriate interventions to meet current international targets for disease mitigation. We describe the prevalence, years lived with disability, and trends of anaemia and its underlying causes in 204 countries and territories. Methods We estimated population-level distributions of haemoglobin concentration by age and sex for each location from 1990 to 2021. We then calculated anaemia burden by severity and associated years lived with disability (YLDs). With data on prevalence of the causes of anaemia and associated cause-specific shifts in haemoglobin concentrations, we modelled the proportion of anaemia attributed to 37 underlying causes for all locations, years, and demographics in the Global Burden of Disease Study 2021. Findings In 2021, the global prevalence of anaemia across all ages was 24·3% (95% uncertainty interval [UI] 23·9–24·7), corresponding to 1·92 billion (1·89–1·95) prevalent cases, compared with a prevalence of 28·2% (27·8–28·5) and 1·50 billion (1·48–1·52) prevalent cases in 1990. Large variations were observed in anaemia burden by age, sex, and geography, with children younger than 5 years, women, and countries in sub-Saharan Africa and south Asia being particularly affected. Anaemia caused 52·0 million (35·1–75·1) YLDs in 2021, and the YLD rate due to anaemia declined with increasing Socio-demographic Index. The most common causes of anaemia YLDs in 2021 were dietary iron deficiency (cause-specific anaemia YLD rate per 100 000 population: 422·4 [95% UI 286·1–612·9]), haemoglobinopathies and haemolytic anaemias (89·0 [58·2–123·7]), and other neglected tropical diseases (36·3 [24·4–52·8]), collectively accounting for 84·7% (84·1–85·2) of anaemia YLDs. Interpretation Anaemia remains a substantial global health challenge, with persistent disparities according to age, sex, and geography. Estimates of cause-specific anaemia burden can be used to design locally relevant health interventions aimed at improving anaemia management and prevention. Funding Bill & Melinda Gates Foundation

Reducing antimicrobial use in food animals

The large and expanding use of antimicrobials in livestock, a consequence of growing global demand for animal protein, is of considerable concern in light of the threat of antimicrobial resistance (AMR). Use of antimicrobials in animals has been linked to drug-resistant infections in animals (1) and humans (2). In September 2016, the United Nations (UN) General Assembly recognized the inappropriate use of antimicrobials in animals as a leading cause of rising AMR. In September 2018, the interagency group established by the UN Secretary General will report on progress in the global response to AMR, including antimicrobial consumption in animals. We provide a baseline to monitor efforts to reduce antimicrobial use and assess how three global policies might curb antimicrobial consumption in food animal production: (i) enforcing global regulations to cap antimicrobial use, (ii) adherence to nutritional guidelines leading to reduced meat consumption, and (iii) imposing a global user fee on veterinary antimicrobial use.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Surgical hip dislocation versus hip arthroscopy for femoroacetabular impingement: clinical and morphological short-term results

INTRODUCTION: Surgical hip dislocation (SHD) is an accepted standard to treat femoroacetabular impingement (FAI). However, arthroscopic techniques have gained widespread popularity and comparable results are reported. The purpose of this prospective comparative study was to test the hypothesis that, when compared to SHD, hip arthroscopy (HA) results in faster recovery, better short-term outcome, and equivalent morphological corrections. MATERIALS AND METHODS: 38 patients presenting with clinically and morphologically verified isolated FAI were allocated to either HA or SHD. Morphological evaluation consisted of pre- and postoperative X-rays, and arthro-MRI. Demographic data, sport activities, hospital stay, complications, and the time off work were recorded. The subjective hip value, WOMAC, HHS, and hip abductor strength were measured up to 1 year. RESULTS: Shorter hospital stay and time off work, less pain at 3 months and 1 year, higher subjective hip values at 6 weeks and 3 months, and better WOMAC at 3 months were seen after HA. The HHS and the hip abductor strengths were higher in the HA group. However, morphological corrections at the head-neck-junction achieved by HA showed some overcorrection when compared to SHD. Labral refixation was performed less frequent in the HA group. CONCLUSION: When compared to SHD, HA results in faster recovery and better short-term outcome. However, some overcorrection of the cam deformity and limited frequency of labrum refixation with HA in this study may have a negative impact on long-term outcome