Mapping child growth failure across low- and middle-income countries

Child growth failure (CGF), manifested as stunting, wasting, and underweight, is associated with high 5 mortality and increased risks of cognitive, physical, and metabolic impairments. Children in low- and middle-income countries (LMICs) face the highest levels of CGF globally. Here we illustrate national and subnational variation of under-5 CGF indicators across LMICs, providing 2000–2017 annual estimates mapped at a high spatial resolution and aggregated to policy-relevant administrative units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the World Health 10 Organization’s ambitious Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and rates of progress exist across regions, countries, and within countries; our maps identify areas where high prevalence persists even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where subnational disparities exist and the highest-need populations reside, these geospatial estimates can support policy-makers in planning locally 15 tailored interventions and efficient directing of resources to accelerate progress in reducing CGF and its health implications

Mapping disparities in education across low- and middle-income countries

Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations. Educational attainment is an important social determinant of maternal, newborn, and child health(1-3). As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting(4-6). The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness(7,8); however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health(9-11). Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but-to our knowledge-no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries(12-14). By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations.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

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

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

Optimizing Genomic Selection for a Sorghum Breeding Program in Haiti: A Simulation Study

Young breeding programs in developing countries, like the Chibas sorghum breeding program in Haiti, face the challenge of increasing genetic gain with limited resources. Implementing genomic selection (GS) could increase genetic gain, but optimization of GS is needed to account for these programs’ unique challenges and advantages. Here, we used simulations to identify conditions under which genomic-assisted recurrent selection (GARS) would be more effective than phenotypic recurrent selection (PRS) in small new breeding programs. We compared genetic gain, cost per unit gain, genetic variance, and prediction accuracy of GARS (two or three cycles per year) vs. PRS (one cycle per year) assuming various breeding population sizes and trait genetic architectures. For oligogenic architecture, the maximum relative genetic gain advantage of GARS over PRS was 12–88%, which was observed only during the first few cycles. For the polygenic architecture, GARS provided maximum relative genetic gain advantage of 26–165%, and was always superior to PRS. Average prediction accuracy declines substantially after several cycles of selection, suggesting the prediction models should be updated regularly. Updating prediction models every year increased the genetic gain by up to 33–39% compared to no-update scenarios. For small populations and oligogenic traits, cost per unit gain was lower in PRS than GARS. However, with larger populations and polygenic traits cost per unit gain was up to 67% lower in GARS than PRS. Collectively, the simulations suggest that GARS could increase the genetic gain in small young breeding programs by accelerating the breeding cycles and enabling evaluation of larger populations

Unlocking Diversity in Germplasm Collections via Genomic Selection: A Case Study Based on Quantitative Adult Plant Resistance to Stripe Rust in Spring Wheat

Harnessing diversity from germplasm collections is more feasible today because of the development of lower-cost and higher-throughput genotyping methods. However, the cost of phenotyping is still generally high, so efficient methods of sampling and exploiting useful diversity are needed. Genomic selection (GS) has the potential to enhance the use of desirable genetic variation in germplasm collections through predicting the genomic estimated breeding values (GEBVs) for all traits that have been measured. Here, we evaluated the effects of various scenarios of population genetic properties and marker density on the accuracy of GEBVs in the context of applying GS for wheat ( L.) germplasm use. Empirical data for adult plant resistance to stripe rust ( f. sp. ) collected on 1163 spring wheat accessions and genotypic data based on the wheat 9K single nucleotide polymorphism (SNP) iSelect assay were used for various genomic prediction tests. Unsurprisingly, the results of the cross-validation tests demonstrated that prediction accuracy increased with an increase in training population size and marker density. It was evident that using all the available markers (5619) was unnecessary for capturing the trait variation in the germplasm collection, with no further gain in prediction accuracy beyond 1 SNP per 3.2 cM (∼1850 markers), which is close to the linkage disequilibrium decay rate in this population. Collectively, our results suggest that larger germplasm collections may be efficiently sampled via lower-density genotyping methods, whereas genetic relationships between the training and validation populations remain critical when exploiting GS to select from germplasm collections

Virulence Characterization of Wheat Stripe Rust Fungus Puccinia striiformis f. sp. tritici in Ethiopia and Evaluation of Ethiopian Wheat Germplasm for Resistance to Races of the Pathogen from Ethiopia and the United States

Stripe rust, caused by Puccinia striiformis f. sp. tritici, is one of the most important diseases of wheat in Ethiopia. In total, 97 isolates were recovered from stripe rust samples collected in Ethiopia in 2013 and 2014. These isolates were tested on a set of 18 Yr single-gene differentials for characterization of races and 7 supplementary differentials for additional information of virulence. Of 18 P. striiformis f. sp. tritici races identified, the 5 most predominant races were PSTv-105 (21.7%), PSTv-106 (17.5%), PSTv-107 (11.3%), PSTv-76 (10.3%), and PSTv-41 (6.2%). High frequencies (>40%) were detected for virulence to resistance genes Yr1, Yr2, Yr6, Yr7, Yr8, Yr9, Yr17, Yr25, Yr27, Yr28, Yr31, Yr43, Yr44, YrExp2, and YrA. Low frequencies (<40%) were detected for virulence to Yr10, Yr24, Yr32, YrTr1, Hybrid 46, and Vilmorin 23. None of the isolates were virulent to Yr5, Yr15, YrSP, and YrTye. Among the six collection regions, Arsi Robe and Tiyo had the highest virulence diversities, followed by Bekoji, while Bale and Holeta had the lowest. Evaluation of 178 Ethiopian wheat cultivars and landraces with two of the Ethiopian races and three races from the United States indicated that the Ethiopian races were more virulent on the germplasm than the predominant races of the United States. Thirteen wheat cultivars or landraces that were resistant or moderately resistant to all five tested races should be useful for breeding wheat cultivars with resistance to stripe rust in both countries

Population structure and its relationship to stripe rust resistance.

<p>A) Dendrogram based on Ward clustering of the spring wheat core collection, B) pairwise kinship matrix depicting clustering of the accessions based on identity-by-decent (IBD), C) population structure based on principal component analysis (PCA). Both genetic relatedness and principal component analyses grouped the accessions into two subpopulations, Subpopulation 1 (SP1) and Subpopulation 2 (SP2). Clustering pattern based on PCA also explained geographic origin and improvement status of the spring wheat core collection. D) Effect of population structure on stripe rust infection type (IT) and severity (SEV). Box plots show trait distribution and compare the levels of stripe rust between the two subpopulations. MTV_12 = Mount Vernon 2012, MTV_13 = Mount Vernon 2013, MTV_14 = Mount Vernon 2014, PLM_12 = Pullman 2012, PLM_13 = Pullman 2013, PLM_14 = Pullman 2014.</p

Patterns of genome wide linkage disequilibrium (LD) in the germplasm panel.

<p>A) Scatter plot of average LD (<i>r</i>^<i>2</i>) as a function of genetic distance between markers, B) chromosome-wise distribution of the number of marker pairs that showed LD due to physical linkage (B).</p