Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Background: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods: GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings: The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation: Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts

Health in times of uncertainty in the eastern Mediterranean region, 1990�2013: a systematic analysis for the Global Burden of Disease Study 2013

Background The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100�000 people), which increased by 17·2 since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100�000 people) in 2013, which decreased by 26·9 since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3 since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60�80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7 to 7·5 between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY licens

Spatial correlation between the predictor variables and the weighting values calculated during the mapping of the environmental factors of mass movements in the Beni Idder region (northern Rif)

The Tleta of Beni Ider region located in the SW of Tetouan (Rif Septentrional) knows many mass instabilities. The diagnostic via the inventory, the mapping and the characterization of mass movements was made by using satellite imagery, aerial photography and field data coupled with existing documents (geological, geomorphological,…). The understanding of both their spatial distribution and the mechanism generating them, is very complex because of the existence of an important number of natural factors (geological, geomorphological, hydrological) in a relative mountainous landscape with deep valleys, steep slopes and significant elevation changes. Thus, a multidisciplinary approach was adopted to elaborate the landslide susceptibility map of the region taking into account interactions and causal relationships between the various natural parameters that tend to accentuate and aggravate the setting of landslides. The multidisciplinary database allowed us to evaluate the susceptibility thanks to a bivariate probabiliste model (Weight of Evidence). The obtained landslide susceptibility map is a major contribution to the development of urban development plans in the region

Spatial correlation between the predictor variables and the weighting values calculated during the mapping of the environmental factors of mass movements in the Beni Idder region (northern Rif)

The Tleta of Beni Ider region located in the SW of Tetouan (Rif Septentrional) knows many mass instabilities. The diagnostic via the inventory, the mapping and the characterization of mass movements was made by using satellite imagery, aerial photography and field data coupled with existing documents (geological, geomorphological,…). The understanding of both their spatial distribution and the mechanism generating them, is very complex because of the existence of an important number of natural factors (geological, geomorphological, hydrological) in a relative mountainous landscape with deep valleys, steep slopes and significant elevation changes. Thus, a multidisciplinary approach was adopted to elaborate the landslide susceptibility map of the region taking into account interactions and causal relationships between the various natural parameters that tend to accentuate and aggravate the setting of landslides. The multidisciplinary database allowed us to evaluate the susceptibility thanks to a bivariate probabiliste model (Weight of Evidence). The obtained landslide susceptibility map is a major contribution to the development of urban development plans in the region

Landslide susceptibility mapping using AHP method and GIS in the peninsula of Tangier (Rif-northern morocco)

The peninsula of Tangier (Northern Morocco) is submitted to a significant number of landslides each year due to its lithological, structural and morphological complexity; which cause a lot of damage to the road network and other related infrastructure. The main objective of this study is to create a landslide indexed susceptibility map of Tangier peninsula, by using AHP (Analytical Hierarchical Processes) model to calculate each factor’s weight. The work is made via GIS by using an ArcGIS AHP extension. In the current research, First of all, the four main types of landslides were identified and mapped from existing documents, works and new data which came from either remote sensing or fieldwork. Lithology, land use, slope, hypsometry, exposure, fault density and drainage network density were used as main parameters controlling the occurrence of the selected landslides. Then, afterward, each parameter is classified into a number of significant classes based on their relative influence on gravitational movement genesis. The validity of the susceptibility zoning map which is obtained through linear summation of indexed maps was tested and cross-checked by inventoried and studied landslides. The obtained landslide susceptibility map constitutes a powerful decision-making tool in land-use planning, i.e. New highways, secondary highways, railways, etc. within the national development program in the Northern provinces. It is a necessary step for the landslides hazard assessment in the Tangier peninsula in northern Morocco

Landslide susceptibility mapping using AHP method and GIS in the peninsula of Tangier (Rif-northern morocco)

The peninsula of Tangier (Northern Morocco) is submitted to a significant number of landslides each year due to its lithological, structural and morphological complexity; which cause a lot of damage to the road network and other related infrastructure. The main objective of this study is to create a landslide indexed susceptibility map of Tangier peninsula, by using AHP (Analytical Hierarchical Processes) model to calculate each factor’s weight. The work is made via GIS by using an ArcGIS AHP extension. In the current research, First of all, the four main types of landslides were identified and mapped from existing documents, works and new data which came from either remote sensing or fieldwork. Lithology, land use, slope, hypsometry, exposure, fault density and drainage network density were used as main parameters controlling the occurrence of the selected landslides. Then, afterward, each parameter is classified into a number of significant classes based on their relative influence on gravitational movement genesis. The validity of the susceptibility zoning map which is obtained through linear summation of indexed maps was tested and cross-checked by inventoried and studied landslides. The obtained landslide susceptibility map constitutes a powerful decision-making tool in land-use planning, i.e. New highways, secondary highways, railways, etc. within the national development program in the Northern provinces. It is a necessary step for the landslides hazard assessment in the Tangier peninsula in northern Morocco