Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH

L'éruption du volcan Hunga Tonga -Hunga Ha'apai le 15 janvier 2022 : un ébranlement du système Terre à l'échelle planétaire

L'éruption explosive du volcan Hunga Tonga - Hunga Ha’apai (HTHH), le 15 janvier 2022, a produit la plus puissante explosion enregistrée depuis les explosions du Krakatau et du Tambora dans les années 1800, libérant une énergie équivalente à 110 mégatonnes de TNT. Les ondes générées sesont propagées dans le sol, et dans l’atmosphère jusqu’à l’ionosphère. L'onde atmosphérique la plus énergétique observée sur les baromètres correspond au mode de Lamb. De période supérieure à 2000 s, son amplitude est comparable à celle observée lors de l’éruption du Krakatau en 1883. L’empreinte des perturbations atmosphériques a été caractérisée à l’échelle planétaire par des réseaux de mesures au sol, à bord de satellites ou de plateformes aéroportées. L’analyse combinée de ces observations a permis d’évaluer les conséquences à court terme de l'éruption du HTHH. Les méthodes d'investigation géophysiques présentées dans cette note montrent l’apport d’analyses interdisciplinaires pour caractériser la réponse impulsionnelle des enveloppes fluides planétaires (atmosphère, océans et mers) à une éruption d’une intensité exceptionnelle

L'éruption du volcan Hunga Tonga -Hunga Ha'apai le 15 janvier 2022 : un ébranlement du système Terre à l'échelle planétaire

L'éruption explosive du volcan Hunga Tonga - Hunga Ha’apai (HTHH), le 15 janvier 2022, a produit la plus puissante explosion enregistrée depuis les explosions du Krakatau et du Tambora dans les années 1800, libérant une énergie équivalente à 110 mégatonnes de TNT. Les ondes générées sesont propagées dans le sol, et dans l’atmosphère jusqu’à l’ionosphère. L'onde atmosphérique la plus énergétique observée sur les baromètres correspond au mode de Lamb. De période supérieure à 2000 s, son amplitude est comparable à celle observée lors de l’éruption du Krakatau en 1883. L’empreinte des perturbations atmosphériques a été caractérisée à l’échelle planétaire par des réseaux de mesures au sol, à bord de satellites ou de plateformes aéroportées. L’analyse combinée de ces observations a permis d’évaluer les conséquences à court terme de l'éruption du HTHH. Les méthodes d'investigation géophysiques présentées dans cette note montrent l’apport d’analyses interdisciplinaires pour caractériser la réponse impulsionnelle des enveloppes fluides planétaires (atmosphère, océans et mers) à une éruption d’une intensité exceptionnelle

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

10.1016/S2352-3018(21)00152-1LANCET HIV810E633-E65

Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. W measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. Interpretation Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young