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

Reducing the Clinical and Public Health Burden of Familial Hypercholesterolemia A Global Call to Action

Q1Q1Artículo completoE1-E13IMPORTANCE Familial hypercholesterolemia (FH) is an underdiagnosed and undertreated genetic disorder that leads to premature morbidity and mortality due to atherosclerotic cardiovascular disease. Familial hypercholesterolemia affects 1 in 200 to 250 people around the world of every race and ethnicity. The lack of general awareness of FH among the public and medical community has resulted in only 10% of the FH population being diagnosed and adequately treated. The World Health Organization recognized FH as a public health priority in 1998 during a consultation meeting in Geneva, Switzerland. The World Health Organization report highlighted 11 recommendations to address FH worldwide, from diagnosis and treatment to family screening and education. Research since the 1998 report has increased understanding and awareness of FH, particularly in specialty areas, such as cardiology and lipidology. However, in the past 20 years, there has been little progress in implementing the 11 recommendations to prevent premature atherosclerotic cardiovascular disease in an entire generation of families with FH. OBSERVATIONS In 2018, the Familial Hypercholesterolemia Foundation and the World Heart Federation convened the international FH community to update the 11 recommendations. Two meetings were held: one at the 2018 FH Foundation Global Summit and the other during the 2018 World Congress of Cardiology and Cardiovascular Health. Each meeting served as a platform for the FH community to examine the original recommendations, assess the gaps, and provide commentary on the revised recommendations. The Global Call to Action on Familial Hypercholesterolemia thus represents individuals with FH, advocacy leaders, scientific experts, policy makers, and the original authors of the 1998 World Health Organization report. Attendees from 40 countries brought perspectives on FH from low-, middle-, and high-income regions. Tables listing country-specific government support for FH care, existing country-specific and international FH scientific statements and guidelines, country-specific and international FH registries, and known FH advocacy organizations around the world were created. CONCLUSIONS AND RELEVANCE By adopting the 9 updated public policy recommendations created for this document, covering awareness; advocacy; screening, testing, and diagnosis; treatment; family-based care; registries; research; and cost and value, individual countries have the opportunity to prevent atherosclerotic heart disease in their citizens carrying a gene associated with FH and, likely, all those with severe hypercholesterolemia as well

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

Tania-Maxwell/MarSOC-Dataset: Added N checks, corrected N to %

&lt;ul&gt; &lt;li&gt;Updated Xia et al. 2022 data clean script to change g per kg to percent N&lt;/li&gt; &lt;li&gt;added outlier check for N values (no outliers removed)&lt;/li&gt; &lt;li&gt;added Caution note in the Notes column for samples N_perc was greater than OC_perc (n = 6)&lt;/li&gt; &lt;li&gt;reran scripts from reports/04_data_process/scripts/ to get updated intermediate data, and update the final dataset&lt;/li&gt; &lt;li&gt;note: this new version ran on R version 4.3.1 and it also automatically included more decimal places in most rows (which matches the original data)&lt;/li&gt; &lt;/ul&gt

The distribution of global tidal marshes from Earth observation data

AbstractAimTidal marsh ecosystems are heavily impacted by human activities, highlighting a pressing need to address gaps in our knowledge of their distribution. To better understand the global distribution and changes in tidal marsh extent, and identify opportunities for their conservation and restoration, it is critical to develop a spatial knowledge base of their global occurrence. Here, we develop a globally consistent tidal marsh distribution map for the year 2020 at 10‐m resolution.LocationGlobal.Time period2020.Major taxa studiedTidal marshes.MethodsTo map the location of the world's tidal marshes at 10‐m resolution, we applied a random forest classification model to Earth observation data from the year 2020. We trained the classification model with a reference dataset developed to support distribution mapping of coastal ecosystems, and predicted the spatial distribution of tidal marshes between 60° N and 60° S. We validated the tidal marsh map using standard accuracy assessment methods, with our final map having an overall accuracy score of 0.85.ResultsWe estimate the global extent of tidal marshes in 2020 to be 52,880 km2 (95% CI: 32,030 to 59,780 km2) distributed across 120 countries and territories. Tidal marsh distribution is centred in temperate and Arctic regions, with nearly half of the global extent of tidal marshes occurring in the temperate Northern Atlantic (45%) region. At the national scale, over a third of the global extent (18,510 km2; CI: 11,200–20,900) occurs within the USA.Main conclusionsOur analysis provides the most detailed spatial data on global tidal marsh distribution to date and shows that tidal marshes occur in more countries and across a greater proportion of the world's coastline than previous mapping studies. Our map fills a major knowledge gap regarding the distribution of the world's coastal ecosystems and provides the baseline needed for measuring changes in tidal marsh extent and estimating their value in terms of ecosystem services.</jats:sec

Global mangrove soil organic carbon stocks dataset at 30 m resolution for the year 2020 based on spatiotemporal predictive machine learning.

This dataset presents global soil organic carbon stocks in mangrove forests at 30 m resolution, predicted for 2020. We used spatiotemporal ensemble machine learning to produce predictions of soil organic carbon content and bulk density (BD) to 1 m soil depth, which were then aggregated to calculate soil organic carbon stocks. This was done by using training data points of both SOC (%) and BD in mangroves from a global dataset and from recently published studies, and globally consistent predictive covariate layers. A total of 10,331 soil samples were validated to have SOC (%) measurements and were used for predictive soil mapping. We used time-series remote sensing data specific to time periods when the training data were sampled, as well as long-term (static) layers to train an ensemble of machine learning model. Ensemble models were used to improve performance, robustness and unbiasedness as opposed to just using one learner. In addition, we performed spatial cross-validation by using spatial blocking of training data points to assess model performance. We predicted SOC stocks for the 2020 time period and applied them to a 2020 mangrove extent map, presenting both mean predictions and prediction intervals to represent the uncertainty around our predictions. Predictions are available for download under CC-BY license from 10.5281/zenodo.7729491 and also as Cloud-Optimized GeoTIFFs (global mosaics)

Global dataset of soil organic carbon in tidal marshes

Tidal marshes store large amounts of organic carbon in their soils. Field data quantifying soil organic carbon (SOC) stocks provide an important resource for researchers, natural resource managers, and policy-makers working towards the protection, restoration, and valuation of these ecosystems. We collated a global dataset of tidal marsh soil organic carbon (MarSOC) from 99 studies that includes location, soil depth, site name, dry bulk density, SOC, and/or soil organic matter (SOM). The MarSOC dataset includes 17,454 data points from 2,329 unique locations, and 29 countries. We generated a general transfer function for the conversion of SOM to SOC. Using this data we estimated a median (± median absolute deviation) value of 79.2 ± 38.1 Mg SOC ha−¹ in the top 30 cm and 231 ± 134 Mg SOC ha−¹ in the top 1 m of tidal marsh soils globally. This data can serve as a basis for future work, and may contribute to incorporation of tidal marsh ecosystems into climate change mitigation and adaptation strategies and policies.ISSN:2052-446