7 research outputs found

    Additional file 1: of Development of a food atlas for Sri Lankan adults

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    Details on types of photographs employed to depict the food items. (XLSX 21ร‚ย kb

    Additional file 1: of Body weight perception among Sri Lankan cardiac patients

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    Multiple logistic regression models for under-perception, correct perception and over perception of body weight. (DOCX 17 kb

    Additional file 1: of Physical inactivity among physiotherapy undergraduates: exploring the knowledge-practice gap

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    Interviewer Guide (contains the set of open-ended semi-structured questions used during the focus group discussions by the interviewers to guide the participants and to keep uniformity between the different focus groups). (DOC 31 kb

    Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

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    BackgroundRegularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels.MethodsWe applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level.FindingsIn 2019, there were 12ยท2 million (95% UI 11ยท0-13ยท6) incident cases of stroke, 101 million (93ยท2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6ยท55 million (6ยท00-7ยท02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11ยท6% [10ยท8-12ยท2] of total deaths) and the third-leading cause of death and disability combined (5ยท7% [5ยท1-6ยท2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70ยท0% (67ยท0-73ยท0), prevalent strokes increased by 85ยท0% (83ยท0-88ยท0), deaths from stroke increased by 43ยท0% (31ยท0-55ยท0), and DALYs due to stroke increased by 32ยท0% (22ยท0-42ยท0). During the same period, age-standardised rates of stroke incidence decreased by 17ยท0% (15ยท0-18ยท0), mortality decreased by 36ยท0% (31ยท0-42ยท0), prevalence decreased by 6ยท0% (5ยท0-7ยท0), and DALYs decreased by 36ยท0% (31ยท0-42ยท0). However, among people younger than 70 years, prevalence rates increased by 22ยท0% (21ยท0-24ยท0) and incidence rates increased by 15ยท0% (12ยท0-18ยท0). In 2019, the age-standardised stroke-related mortality rate was 3ยท6 (3ยท5-3ยท8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3ยท7 (3ยท5-3ยท9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62ยท4% of all incident strokes in 2019 (7ยท63 million [6ยท57-8ยท96]), while intracerebral haemorrhage constituted 27ยท9% (3ยท41 million [2ยท97-3ยท91]) and subarachnoid haemorrhage constituted 9ยท7% (1ยท18 million [1ยท01-1ยท39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79ยท6 million [67ยท7-90ยท8] DALYs or 55ยท5% [48ยท2-62ยท0] of total stroke DALYs), high body-mass index (34ยท9 million [22ยท3-48ยท6] DALYs or 24ยท3% [15ยท7-33ยท2]), high fasting plasma glucose (28ยท9 million [19ยท8-41ยท5] DALYs or 20ยท2% [13ยท8-29ยท1]), ambient particulate matter pollution (28ยท7 million [23ยท4-33ยท4] DALYs or 20ยท1% [16ยท6-23ยท0]), and smoking (25ยท3 million [22ยท6-28ยท2] DALYs or 17ยท6% [16ยท4-19ยท0]).InterpretationThe annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.FundingBill & Melinda Gates Foundation

    Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019

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    Background: Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990โ€“2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings: In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73ยท7% (68ยท3 to 77ยท4) were classified as due to type 1 diabetes. The age-standardised death rate was 0ยท50 (0ยท44 to 0ยท58) per 100 000 population, and 15 900 (97ยท5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0ยท13 (0ยท12 to 0ยท14) per 100 000 population in the high SDI quintile, 0ยท60 (0ยท51 to 0ยท70) per 100 000 population in the low-middle SDI quintile, and 0ยท71 (0ยท60 to 0ยท86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0ยท62). From 1990 to 2019, age-standardised death rates decreased globally by 17ยท0% (โˆ’28ยท4 to โˆ’2ยท9) for all diabetes, and by 21ยท0% (โ€“33ยท0 to โˆ’5ยท9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (โˆ’13ยท6% [โ€“28ยท4 to 3ยท4]) and for type 1 diabetes (โˆ’13ยท6% [โ€“29ยท3 to 8ยท9]). Interpretation: Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Funding: Bill & Melinda Gates Foundation
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