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Real-world cost-effectiveness of elbasvir/grazoprevir (EBR/GZR) in treatment-naive (TN) patients with chronic hepatitis C (CHC) virus genotype 1 (GT1) in the United States (US) [Meeting Abstract]
Corman, S L; Bacon, B; Curry, M P; Dieterich, D T; Flamm, S L; Jiang, Y; Kowdley, K V; Milligan, S; Nwankwo, C; Tsai, N C; Younossi, Z M; Afdhal, N H
Background: An estimated 2.7 million patients are infected with CHC in the US. EBR/GZR is a fixed-dose combination direct-acting antiviral that was approved in the US in January 2016. The objective of this analysis was to evaluate real-world cost-effectiveness of 12 weeks of EBR/GZR compared to no treatment in TN GT1-infected patients, using data from the TRIO Network. Methods: A Markov model was constructed to evaluate the cost-effectiveness of EBR/GZR over a lifetime time horizon from the payer perspective. The model consists of 16 health states encompassing METAVIR fibrosis score (F0-F4), treatment success or failure, decompensated cirrhosis, hepatocellular carcinoma, liver transplant, and liver-related death. Baseline patient characteristics, discontinuation rates, and the proportion of treatment-naive GT1 patients achieving sustained virologic response were collected from a realworld study of 214 TN GT1 patients who were treated with EBR/GZR between January and October 2016, using data from the TRIO Network. Other inputs were obtained from published sources. The primary outcome was incremental cost-utility ratio (ICUR) for EBR/GZR vs. no treatment. Results are reported separately for cirrhotic and non-cirrhotic GT1a patients without resistance-associated variants (RAVs) and GT1b patients; sample size was insufficient to include GT1a patients with RAVs. Results: Treatment with EBR/GZR was associated with greater quality-adjusted life years (QALYs) and costs compared to no treatment in all subpopulations modeled (Table). ICURs ranged from $195/QALY in GT1b TN cirrhotic patients to $16,910 in GT1b TN non-cirrhotic patients. Conclusion: Using real-world patient characteristics and outcomes, EBR/GZR is cost-effective compared to no treatment in TN patients with GT1 CHC
EMBASE:618935240
ISSN: 1527-3350
CID: 2778892
Large-scale ex vivo generation of human neutrophils from cord blood CD34+ cells [Meeting Abstract]
Jie, Z; Zhang, Y; Wang, C; Shen, B; Guan, X; Ren, Z; Ding, X; Dai, W; Jiang, Y
Ex vivo expansion of hematopoietic stem cell and subsequent differentiation into mature neutrophils remains a challenge. Here, we have developed a three-stage culture system to produce efficiently functional neutrophils derived from cord blood CD34+ cells. A procedure of ex vivo expansion and differentiation in a large-scale was developed in a modified IMDM basal medium supplemented with transferrin, insulin, fetal bovine serum, and some other nutrients with selected cytokine combination that contained stem cell factor (SCF), Flt-3 ligand (FL), granulocyte-colony stimulating factor(G-CSF), granulocyte macrophage colony-stimulating factor(GM-CSF) and thrombopoietin (TPO) in stage I (days 0~6); SCF, FL, G-CSF, interleukin 3 (IL-3), and GM-CSF in stage II (days 6~9); SCF, FL, and G-CSF in stage III (days 9~18), respectively. Enriched CD34+ cells were firstly cultured and expanded in 25-T flasks. After 6 day-culture, the cells were transferred to a 2-L bottle with 500 ml of medium in the bottle-turning device system. During the differentiation process, neutrophil marker CD66b was evaluated by flow cytometry. Ex vivo generated neutrophils or medium only were incubated with E.coli overnight for its bacteria killing assay, and then the E.coli colony-forming units were counted separately. Matured neutrophils or vehicle were transplanted into NOD/SCID mice intravenously for chemotactic activity in vivo. The cells that accumulated in the pouch with chemoattractant were collected and subjected to flow cytometric analysis for human CD66b antigen. The ex vivo generated neutrophils/progenitors were then injected into sub-lethal irradiated NOD/SCID mice to monitor the viability and maturation in vivo. After the three-stage culture, proliferation fold of total cell reached 30013 x 286.5 with 60.2% x 2.4% for CD66b+ neutrophils. The calculated yield of matured neutrophils from each CD34+ cell was ranged from 1.8 x 104 to 1.87 x 104 for 18-day culture. There was no E.coli colony formed after incubation with neutrophils in bacteria killing assay, indicating that the generated neutrophils was functional. For in vivo chemotaxis assay, the neutrophils collected from 18-day culture were injected into mice and detected at 1.08% x0.16% for human CD66b+ cells and no any CD66b+ cell observed for negative control group. In addition, the CD66b+ cells were extended for 4 days from a 15-day cultured neutrophil group in mouse peripheral blood (PB), while only for 2 days from a freshly isolated human PB neutrophils post injection, indicating that the ex vivo generated neutrophils/progenitors could further matured in vivo. Taken together, we have established a pilot-scale culture system to produce functional human neutrophils ex vivo. Considering that one neutrophil transfusion unit (100ml) contains 2x1010 cells, the CD34+ cells from one CB unit (80 ml) would generate 1.6x1011 neutrophils, which are equivalent to 8 unit doses of neutrophils in the clinical application
EMBASE:618664642
ISSN: 1538-7445
CID: 2751462
Application of rare variant transmission disequilibrium tests to epileptic encephalopathy trio sequence data
Allen, A S; Berkovic, S F; Bridgers, J; Cossette, P; Dlugos, D; Epstein, M P; Glauser, T; Goldstein, D B; Heinzen, E L; Jiang, Y; Johnson, M R; Kuzniecky, R; Lowenstein, D H; Marson, A G; Mefford, H C; O'Brien, T J; Ottman, R; Petrou, S; Petrovski, S; Poduri, A; Ren, Z; Scheffer, I E; Sherr, E; Wang, Q; Balling, R; Barisic, N; Baulac, S; Caglayan, H; Craiu, D; De, Jonghe P; Depienne, C; Guerrini, R; Helbig, I; Hjalgrim, H; Hoffman-Zacharska, D; Jahn, J; Klein, K M; Koeleman, B; Komarek, V; Krause, R; Leguern, E; Lehesjoki, A -E; Lemke, J R; Lerche, H; Linnankivi, T; Marini, C; May, P; Moller, R S; Muhle, H; Pal, D; Palotie, A; Rosenow, F; Selmer, K; Serratosa, J M; Sisodiya, S; Stephani, U; Sterbova, K; Striano, P; Suls, A; Talvik, T; Von, Spiczak S; Weber, Y; Weckhuysen, S; Zara, F; Abou-Khalil, B; Alldredge, B K; Amrom, D; Andermann, E; Andermann, F; Bautista, J F; Bluvstein, J; Cascino, G D; Consalvo, D; Crumrine, P; Devinsky, O; Fiol, M E; Fountain, N B; French, J; Friedman, D; Haas, K; Haut, S R; Hayward, J; Joshi, S; Kanner, A; Kirsch, H E; Kossoff, E H; Kuperman, R; McGuire, S M; Motika, P V; Novotny, E J; Paolicchi, J M; Parent, J; Park, K; Shellhaas, R A; Sirven, J; Smith, M C; Sullivan, J; Thio, L L; Venkat, A; Vining, E P G; Von, Allmen G K; Weisenberg, J L; Widdess-Walsh, P; Winawer, M R
The classic epileptic encephalopathies, including infantile spasms (IS) and Lennox-Gastaut syndrome (LGS), are severe seizure disorders that usually arise sporadically. De novo variants in genes mainly encoding ion channel and synaptic proteins have been found to account for over 15% of patients with IS or LGS. The contribution of autosomal recessive genetic variation, however, is less well understood. We implemented a rare variant transmission disequilibrium test (TDT) to search for autosomal recessive epileptic encephalopathy genes in a cohort of 320 outbred patient-parent trios that were generally prescreened for rare metabolic disorders. In the current sample, our rare variant transmission disequilibrium test did not identify individual genes with significantly distorted transmission over expectation after correcting for the multiple tests. While the rare variant transmission disequilibrium test did not find evidence of a role for individual autosomal recessive genes, our current sample is insufficiently powered to assess the overall role of autosomal recessive genotypes in an outbred epileptic encephalopathy population
EMBASE:616406906
ISSN: 1018-4813
CID: 2618382
Mobile insulin titration intervention (MITI)-a texting program to help type 2 diabetes (T2D) patients at bellevue hospital and gouverneur health find their basal insulin dose-an interim analysis [Meeting Abstract]
Levy, A K; Orzeck-Byrnes, N; Moloney, D; Aidasani, S R; Hu, L; Langford, A; Jiang, Y; Sevick, M A; Rogers, E
STATEMENT OF PROBLEM OR QUESTION (ONE SENTENCE): T2D patients needing insulin adjustments require multiple clinic visits for titration, but face barriers (missed work, transportation costs, clinic co-pays) all of which disproportionately affect vulnerable populations. OBJECTIVES OF PROGRAM/INTERVENTION (NO MORE THAN THREE OBJECTIVES): MITI aims to be clinically efficacious, patientcentered, and highly accessible (only requires text messaging and phone calls). DESCRIPTION OF PROGRAM/INTERVENTION, INCLUDING ORGANIZATIONAL CONTEXT (E.G. INPATIENT VS. OUTPATIENT, PRACTICE OR COMMUNITY CHARACTERISTICS): MITI is an efficacious, patient-centered, accessible program that remotely guides T2D patients to their correct basal insulin dose (glargine, detemir). Eligible patients have T2D, an A1c >8%, a phone that can text, and need titration of basal insulin. Patients referred by their providers are enrolled on a secure website which sends a weekday text message asking 'What was your fasting blood sugar this morning?' Each day the MITI nurse checks the website for alarm values (extreme high or low values). Once a week, the MITI nurse calls patients and, using the MITI titration algorithm, advises them on dose adjustments. The goal of the program is to find the optimal basal insulin dose (OID), which is the dose that achieves a fasting blood sugar between 80 and 130 (or the maximal dose of 50 units). MITI lasts a maximum of 12 weeks. When the program ends, patients return to usual care. MEASURES OF SUCCESS (DISCUSS QUALITATIVE AND/OR QUANTITATIVE METRICS WHICH WILL BE USED TO EVALUATE PROGRAM/INTERVENTION): Using a single-group, quasiexperimental approach, we examined the proportion of patients reaching OID within 12 weeks, the mean number of days required to reach OID, and reductions in fasting glucose and A1c. We described participant response rates, staff time required to deliver the intervention, and patient time saved. Qualitative interviews were also conducted. FINDINGS TO DATE (IT IS NOT SUFFICIENT TOSTATE FINDINGS WILL BE DISCUSSED): Of the 71 participants who completed the program, 86% reached OID, 5.6% did not reach OID, and 8.5% terminated the program early. Those reaching OID did so in a mean of 21 (SD 21) days. Fasting glucose levels decreased from 209 (SD 77) mg/dl to 140 (SD 45), and mean A1c (for those with follow up labs thus far) decreased from 11.6% (SD 1.9) to 10.0% (SD 2.2). Ninety-one percent of text prompts received a response from the participant. Mean staff time required to deliver MITI was 16 min (SD 5) per participant per week, and patients reported a mean time saving of 150 (SD 74) min each time an in-person visit was averted. Qualitative interviews suggest that clinical staff perceived MITI to be a preferred alternative to clinic-based insulin titration, one that resulted in good care without interfering with clinic flow. Patients reported that the enrollment process was easy and that MITI motivated them to eat healthier food, take their insulin, and check their blood sugars. Because of MITI they reported feeling more connected to their medical team. KEYLESSONS FORDISSEMINATION(WHAT CANOTHERS TAKE AWAY FOR IMPLEMENTATION TO THEIR PRACTICE OR COMMUNITY?): MITI is a clinically efficacious, patient-centered and accessible program for the titration of basal insulin for T2D patients. By eliminating the need for in-person access, MITI proves especially helpful for vulnerable populations. Patients and staff found MITI to be convenient, time-saving, and motivating for patients
EMBASE:615582064
ISSN: 0884-8734
CID: 2553772
Cyclodextrin has conflicting actions on autophagy flux in vivo in brains of normal and Alzheimer model mice
Yang, Dun-Sheng; Stavrides, Philip; Kumar, Asok; Jiang, Ying; Mohan, Panaiyur S; Ohno, Masuo; Dobrenis, Kostantin; Davidson, Cristin D; Saito, Mitsuo; Pawlik, Monika; Huo, Chunfeng; Walkley, Steven U; Nixon, Ralph A
2-hydroxypropyl-beta-cyclodextrin (CYCLO), a modifier of cholesterol efflux from cellular membrane and endo-lysosomal compartments, reduces lysosomal lipid accumulations and has therapeutic effects in animal models of Niemann-Pick disease type C and several other neurodegenerative states. Here, we investigated CYCLO effects on autophagy in wild-type mice and TgCRND8 mice - an Alzheimer's Disease (AD) model exhibiting beta-amyloidosis, neuronal autophagy deficits leading to protein and lipid accumulation within greatly enlarged autolysosomes. A 14-day intracerebroventricular administration of CYCLO to 8 month old TgCRND8 mice that exhibit moderately advanced neuropathology markedly diminished the sizes of enlarged autolysosomes and lowered their content of GM2 ganglioside and Abeta-immunoreactivity without detectably altering amyloid precursor protein processing or extracellular Abeta/beta-amyloid burden. We identified two major actions of CYCLO on autophagy underlying amelioration of lysosomal pathology. First, CYCLO stimulated lysosomal proteolytic activity by increasing cathepsin D activity, levels of cathepsins B and D and two proteins known to interact with cathepsin D, NPC1 and ABCA1. Second, CYCLO impeded autophagosome-lysosome fusion as evidenced by accumulation of LC3, SQSTM1/p62, and ubiquitinated substrates in an expanded population of autophagosomes in the absence of greater autophagy induction. By slowing substrate delivery to lysosomes, autophagosome maturational delay, as further confirmed by our in vitro studies, may relieve lysosomal stress due to accumulated substrates. These findings provide in vivo evidence for lysosomal enhancing properties of CYCLO, but caution that prolonged interference with cellular membrane fusion/autophagosome maturation could have unfavorable consequences, which might require careful optimization of dosage and dosing schedules.
PMCID:6075207
PMID: 28062666
ISSN: 1460-2083
CID: 2386972
Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
Wang, Haidong; Naghavi, Mohsen; Allen, Christine; Barber, Ryan M; Bhutta, Zulfiqar A; Carter, Austin; Casey, Daniel C; Charlson, Fiona J; Chen, Alan Zian; Coates, Matthew M; Coggeshall, Megan; Dandona, Lalit; Dicker, Daniel J; Erskine, Holly E; Ferrari, Alize J; Fitzmaurice, Christina; Foreman, Kyle; Forouzanfar, Mohammad H; Fraser, Maya S; Pullman, Nancy; Gething, Peter W; Goldberg, Ellen M; Graetz, Nicholas; Haagsma, Juanita A; Hay, Simon I; Huynh, Chantal; Johnson, Catherine; Kassebaum, Nicholas J; Kinfu, Yohannes; Kulikoff, Xie Rachel; Kutz, Michael; Kyu, Hmwe H; Larson, Heidi J; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S; Lind, Margaret; Lozano, Rafael; Marquez, Neal; Mensah, George A; Mikesell, Joe; Mokdad, Ali H; Mooney, Meghan D; Nguyen, Grant; Nsoesie, Elaine; Pigott, David M; Pinho, Christine; Roth, Gregory A; Salomon, Joshua A; Sandar, Logan; Silpakit, Naris; Sligar, Amber; Sorensen, Reed JD; Stanaway, Jeffrey; Steiner, Caitlyn; Teeple, Stephanie; Thomas, Bernadette A; Troeger, Christopher; VanderZanden, Amelia; Vollset, Stein Emil; Wanga, Valentine; Whiteford, Harvey A; Wolock, Timothy; Zoeckler, Leo; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abera, Semaw Ferede; Abreu, Daisy MX; Abu-Raddad, Laith J; Abyu, Gebre Yitayih; Achoki, Tom; Adelekan, Ademola Lukman; Ademi, Zanfina; Adou, Arsene Kouablan; Adsuar, Jose C; Afanvi, Kossivi Agbelenko; Afshin, Ashkan; Agardh, Emilie Elisabet; Agarwal, Arnav; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ajala, Oluremi N; Akanda, All Shafqat; Akinyemi, Rufus Olusola; Akinyemiju, Tomi F; Akseer, Nadia; Al Lami, Faris Hasan; Alabed, Samer; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore KM; Alasfoor, Deena; Aldhahri, Saleh Fahed; Aldridge, Robert William; Alegretti, Miguel Angel; Aleman, Alicia V; Alemu, Zewdie Aderaw; Alexander, Lily T; Alhabib, Samia; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amegah, Adeladza Kofi; Ameh, Emmanuel A; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H; Anderson, Benjamin; Anderson, Gregory M; Antonio, Carl Abelardo T; Aregay, Atsede Fantahun; Arnlov, Johan; Arsenijevic, Valentina SArsic; Al Artaman; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Arthur Avokpaho, Euripide Frinel G; Awasthi, Ashish; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Bahit, Maria C; Balakrishnan, Kalpana; Banerjee, Amitava; Barac, Aleksandra; Barker-Collo, Suzanne L; Barnighausen, Till; Barregard, Lars; Barrero, Lope H; Basu, Arindam; Basu, Sanjay; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Belay, Haileeyesus Adamu; Bell, Brent; Bell, Michelle L; Bello, Aminu K; Bennett, Derrick A; Bensenor, Isabela M; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhalla, Ashish; Biadgilign, Sibhatu; Bikbov, Boris; Bin Abdulhak, Aref A; Biroscak, Brian J; Biryukov, Stan; Bjertness, Espen; Blore, Jed D; Blosser, Christopher D; Bohensky, Megan A; Borschmann, Rohan; Bose, Dipan; Bourne, Rupert RA; Brainin, Michael; Brayne, Carol EG; Brazinova, Alexandra; Breitborde, Nicholas JK; Brenner, Hermann; Brewer, Jerry D; Brown, Alexandria; Brown, Jonathan; Brugha, Traolach S; Buckle, Geoffrey Colin; Butt, Zahid A; Calabria, Bianca; Campos-Novato, Ismael Ricardo; Campuzano, Julio Cesar; Carapetis, Jonathan R; Cardenas, Rosario; Carpenter, David; Carrero, Juan Jesus; Castaneda-Oquela, Carlos A; Rivas, Jacqueline Castillo; Catala-Lopez, Ferran; Cavalleri, Fiorella; Cercy, Kelly; Cerda, Jorge; Chen, Wanqing; Chew, Adrienne; Chiang, Peggy Pei -Chia; Chibalabala, Mirriam; Chibueze, Chioma Ezinne; Chimed-Ochir, Odgerel; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Chowdhury, Rajiv; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Cirillo, Massimo; Cohen, Aaron J; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M; Cooper, Cyrus; Cooper, Leslie Trumbull; Cortinovis, Monica; Cowie, Benjamin C; Crump, John A; Damsere-Derry, James; Danawi, Hadi; Dandona, Rakhi; Daoud, Farah; Darby, Sarah C; Dargan, Paul I; das Neves, Jose; Davey, Gail; Davis, Adrian C; Davitoiu, Dragos V; de Castro, EFilipa; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Dellavalle, Robert P; Deribe, Kebede; Deribew, Amare; Dharmaratne, Samath D; Dhillon, Preet K; Diaz-Torne, Cesar; Ding, Eric L; dos Santos, Kadine Priscila Bender; Dossou, Edem; Driscoll, Tim R; Duan, Leilei; Dubey, Manisha; Bartholow, Bruce; Ellenbogen, Richard G; Lycke, Christian; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Faghmous, Imad DA; Fahimi, Saman; Jose, Emerito; Farid, Talha A; Sa Farinha, Carla Sofia e; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Feigin, Valery L; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Fernandes, Joao C; Fischer, Florian; Fitchett, Joseph RA; Flaxman, Abraham; Foigt, Nataliya; Fowkes, FGerry R; Franca, Elisabeth Barboza; Franklin, Richard C; Friedman, Joseph; Frostad, Joseph; Hirst, Thomas; Futran, Neal D; Gall, Seana L; Gambashidze, Ketevan; Gamkrelidze, Amiran; Ganguly, Parthasarathi; Gankpe, Fortune Gbetoho; Gebre, Teshome; Gebrehiwot, Tsegaye Tsewelde; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Geleijnse, Johanna M; Gessner, Bradford D; Ghoshal, Aloke Gopal; Gibney, Katherine B; Gillum, Richard F; Gilmour, Stuart; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Giussani, Giorgia; Glaser, Elizabeth; Godwin, William W; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gosselin, Richard A; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Greaves, Felix; Gugnani, Harish Chander; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gutierrez, Reyna A; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Halasa, Yara A; Hamadeh, Randah Ribhi; Hamidi, Samer; Hancock, Jamie; Handal, Alexis J; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Haro, Josep Maria; Havmoeller, Rasmus; Heckbert, Susan R; Heredia-Pi, Ileana Beatriz; Heydarpour, Pouria; Hilderink, Henk BM; Hoek, Hans W; Hogg, Robert S; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hotez, Peter J; Hoy, Damian G; Hsairi, Mohamed; Htet, Aung Soe; Than Htike, Maung Maung; Hu, Guoqing; Huang, Cheng; Huang, Hsiang; Huiart, Laetitia; Husseini, Abdullatif; Huybrechts, Inge; Huynh, Grace; Iburg, Kim Moesgaard; Innos, Kaire; Inoue, Manami; Iyer, Veena J; Jacobs, Troy A; Jacobsen, Kathryn H; Jahanmehr, Nader; Jakovljevic, Mihajlo B; James, Peter; Javanbakht, Mehdi; Jayaraman, Sudha P; Jayatilleke, Achala Upendra; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jimenez-Corona, Aida; Jonas, Jost B; Joshi, Tushar Kant; Kabir, Zubair; Karnak, Ritul; Kan, Haidong; Kant, Surya; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Karletsos, Dimitris; Karthikeyan, Ganesan; Kasaeian, Amir; Katibeh, Marzieh; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Francoise; Keiyoro, Peter Njenga; Kemmer, Laura; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kereselidze, Maia; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim A; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young-Ho; Khera, Sahil; Muthafer Khoja, Tawfik Ahmed; Kieling, Christian; Kim, Daniel; Kim, Yun Jin; Kissela, Brett M; Kissoon, Niranjan; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Krog, Norun Hjertager; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A; Kuipers, Ernst J; Kulkarni, Veena S; Kumar, GAnil; Kwan, Gene F; Lal, Aparna; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lam, Hilton; Lam, Jennifer O; Langan, Sinead M; Lansingh, Van C; Larsson, Anders; Laryea, Dennis Odai; Latif, Asma Abdul; Lawrynowicz, Alicia Elena Beatriz; Leigh, James; Levi, Miriam; Li, Yongmei; Lindsay, MPatrice; Lipshultz, Steven E; Liu, Patrick Y; Liu, Shiwei; Liu, Yang; Lo, Loon-Tzian; Logroscino, Giancarlo; Lotufo, Paulo A; Lucas, Robyn M; Lunevicius, Raimundas; Lyons, Ronan A; Ma, Stefan; Pedro Machado, Vasco Manuel; Mackay, Mark T; MacLachlan, Jennifer H; Abd El Razek, Hassan Magdy; Abd El Razek, Mohammed Magdy; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Ayele Manamo, Wondimu Ayele; Mandisarisa, John; Mangalam, Srikanth; Mapoma, Chabila C; Marcenes, Wagner; Margolis, David Joel; Martin, Gerard Robert; Martinez-Raga, Jose; Marzan, Melvin Barrientos; Masiye, Felix; Mason-Jones, Amanda J; Massano, Joao; Matzopoulos, Richard; Mayosi, Bongani M; McGarvey, Stephen Theodore; McGrath, John J; Mckee, Martin; McMahon, Brian J; Meaney, Peter A; Mehari, Alem; Mehndiratta, Man Mohan; Mena-Rodriguez, Fabiola; Mekonnen, Alemayehu B; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R; Mirarefin, Mojde; Misganaw, Awoke; Mock, Charles N; Abdulmuhsin Mohammad, Karzan; Mohammadi, Alireza; Mohammed, Shafiu; Mohan, Viswanathan; Mola, Glen Liddell D; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montero, Pablo; Montico, Marcella; Montine, Thomas J; Moradi-Lakeh, Maziar; Morawska, Lidia; Morgan, Katherine; Mori, Rintaro; Mozaffarian, Dariush; Mueller, Ulrich; Satyanarayana Murthy, Gudlavalleti Venkata; Murthy, Srinivas; Musa, Kamarul Imran; Nachega, Jean B; Nagel, Gabriele; Naidoo, Kovin S; Naik, Nitish; Naldi, Luigi; Nangia, Vinay; Nash, Denis; Nejjari, Chakib; Neupane, Subas; Newton, Charles R; Newton, John N; Ng, Marie; Ngalesoni, Frida Namnyak; Ngirabega, Jean de Dieu; Quyen Le Nguyen; Nisar, Muhammad Imran; Nkamedjie Pete, Patrick Martial; Nomura, Marika; Norheim, Ole F; Norman, Paul E; Norrving, Bo; Nyakarahuka, Luke; Ogbo, Felix Akpojene; Ohkubo, Takayoshi; Ojelabi, Foluke Adetola; Olivares, Pedro R; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Ortiz, Alberto; Osman, Majdi; Ota, Erika; Ozdemir, Raziye; Pa, Mahesh; Pandian, Jeyaraj D; Pant, Puspa Raj; Papachristou, Christina; Park, Eun-Kee; Park, Jae-Hyun; Parry, Charles D; Parsaeian, Mahboubeh; Caicedo, Angel JPaternina; Patten, Scott B; Patton, George C; Paul, Vinod K; Pearce, Neil; Pedro, Joao Mario; Stokic, Ljiljana Pejin; Pereira, David M; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B; Pillay, Julian David; Plass, Dietrich; Platts-Mills, James A; Polinder, Suzanne; Pope, CArden; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prabhakaran, Dorairaj; Qorbani, Mostafa; Quame-Amaglo, Justice; Quistberg, DAlex; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajavi, Zhale; Rajsic, Sasa; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M; Ranabhat, Chhabi L; Rangaswamy, Thara; Rao, Puja; Rao, Sowmya R; Refaat, Amany H; Rehm, Jurgen; Reitsma, Marissa B; Remuzzi, Giuseppe; Resnikofff, Serge; Ribeiro, Antonio L; Ricci, Stefano; Blancas, Maria Jesus Rios; Roberts, Bayard; Roca, Anna; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Rothenbacher, Dietrich; Roy, Ambuj; Roy, Nawal K; Ruhago, George Mugambage; Sagar, Rajesh; Saha, Sukanta; Sahathevan, Ramesh; Saleh, Muhammad Muhammad; Sanabria, Juan R; Sanchez-Nino, Maria Dolores; Sanchez-Riera, Lidia; Santos, Itamar S; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schaub, Michael P; Schmidt, Maria Ines; Schneider, Ione JC; Schottker, Ben; Schutte, Aletta E; Schwebel, David C; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shackelford, Katya A; Shaddick, Gavin; Shaheen, Amira; Shahraz, Saeid; Shaikh, Masood Ali; Shakh-Nazarova, Marina; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Shen, Ziyan; Shepard, Donald S; Sheth, Kevin N; Shetty, Balakrishna P; Shi, Peilin; Shibuya, Kenji; Shin, Min-Jeong; Shiri, Rahman; Shiue, Ivy; Shrime, Mark G; Sigfusdottir, Inga Dora; Silberberg, Donald H; Silva, Diego Augusto Santos; Silveira, Dayane Gabriele Alves; Silverberg, Jonathan I; Simard, Edgar P; Singh, Abhishek; Singh, Gitanjali M; Singh, Jasvinder A; Singh, Om Prakash; Singh, Prashant Kumar; Singh, Virendra; Soneji, Samir; Soreide, Kjetil; Soriano, Joan B; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Stein, Dan J; Stein, Murray B; Stranges, Saverio; Stroumpoulis, Konstantinos; Sunguya, Bruno F; Sur, Patrick; Swaminathan, Soumya; Sykes, Bryan L; Szoeke, Cassandra EI; Tabares-Seisdedos, Rafael; Tabb, Karen M; Takahashi, Ken; Takala, Jukka S; Talongwa, Roberto Tchio; Tandon, Nikhil; Tavakkoli, Mohammad; Taye, Bineyam; Taylor, Hugh R; Ao, Braden JTe; Tedla, Bemnet Amare; Tefera, Worku Mekonnen; Ten Have, Margreet; Terkawi, Abdullah Sulieman; Tesfay, Fisaha Haile; Tessema, Gizachew Assefa; Thomson, Alan J; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tillmann, Taavi; Tirschwell, David L; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Nx, Jeffrey Allen Towb; Traebert, Jefferson; Tran, Bach Xuan; Truelsen, Thomas; Trujillo, Ulises; Tura, Abera Kenay; Tuzcu, Emin Murat; Uchendu, Uche S; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uthman, Olalekan A; Van Dingenen, Rita; Van Donkelaar, Aaron; Vasankari, Tommi; Vasconcelos, Ana Maria Nogales; Venketasubramanian, Narayanaswamy; Vidavalur, Ramesh; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S; Vlassov, Vasiliy Victorovich; Wagner, Joseph A; Wagner, Gregory R; Wallin, Mitchell T; Wang, Linhong; Watkins, David A; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Westerman, Ronny; White, Richard A; Wijeratne, Tissa; Wilkinson, James D; Williams, Hywel C; Wiysonge, Charles Shey; Woldeyohannes, Solomon Meseret; Wolfe, Charles DA; Won, Sungho; Wong, John Q; Woolf, Anthony D; Xavier, Denis; Xiao, Qingyang; Xu, Gelin; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yan, Lijing L; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yebyo, Henock Gebremedhin; Yip, Paul; Yirsaw, Biruck Desalegn; Yonemoto, Naohiro; Yonga, Gerald; Younis, Mustafa Z; Yu, Shicheng; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zannad, Faiez; Zavala, Diego E; Zeeb, Hajo; Zeleke, Berihun M; Zhang, Hao; Zodpey, Sanjay; Zonies, David; Zuhlke, Liesl Joanna; Vos, Theo; Lopez, Alan D; Murray, Christopher JL; GBD 015 Mortality and Causes Death
Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems
PMCID:5388903
PMID: 27733281
ISSN: 1474-547x
CID: 2374702
Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015
Vos, Theo; Allen, Christine; Arora, Megha; Barber, Ryan M; Bhutta, Zulfiqar A; Brown, Alexandria; Carter, Austin; Casey, Daniel C; Charlson, Fiona J; Chen, Alan Z; Coggeshall, Megan; Cornaby, Leslie; Dandona, Lalit; Dicker, Daniel J; Dilegge, Tina; Erskine, Holly E; Ferrari, Alize J; Fitzmaurice, Christina; Fleming, Tom; Forouzanfar, Mohammad H; Fullman, Nancy; Gething, Peter W; Goldberg, Ellen M; Graetz, Nicholas; Haagsma, Juanita A; Johnson, Catherine O; Kassebaum, Nicholas J; Kawashima, Toana; Kemmer, Laura; Khalil, Ibrahim A; Kinfu, Yohannes; Kyu, Hmwe H; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S; Lopez, Alan D; Lozano, Rafael; Marczak, Laurie; Mensah, George A; Mokdad, Ali H; Naghavi, Mohsen; Nguyen, Grant; Nsoesie, Elaine; Olsen, Helen; Pigott, David M; Pinho, Christine; Rankin, Zane; Reinig, Nikolas; Salomon, Joshua A; Sandar, Logan; Smith, Alison; Stanaway, Jeffrey; Steiner, Caitlyn; Teeple, Stephanie; Thomas, Bernadette A; Troeger, Christopher; Wagner, Joseph A; Wang, Haidong; Wanga, Valentine; Whiteford, Harvey A; Zoeckler, Leo; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J; Abu-Rmeileh, Niveen ME; Ackerman, Ilana N; Adebiyi, Akindele Olupelumi; Ademi, Zanfina; Adou, Arsene Kouablan; Afanvi, Kossivi Agbelenko; Agardh, Emilie Elisabet; Agarwal, Arnav; Kiadaliri, Aliasghar Ahmad; Ahmadieh, Hamid; Ajala, Oluremi N; Akinyemi, Rufus Olusola; Akseer, Nadia; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore KM; Aldhahri, Saleh Fahed; Alegretti, Miguel Angel; Alemu, Zewdie Aderaw; Alexander, Lily T; Alhabib, Samia; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amberbir, Alemayehu; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H; Anderson, Gregory M; Anderson, Benjamin; Antonio, Carl Abelardo T; Aregay, Atsede Fantahun; Arnlov, Johan; Al Artaman; Asayesh, Hamid; Assadi, Reza; Atique, Suleman; Avokpaho, Euripide Frinel GArthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Banerjee, Amitava; Barac, Aleksandra; Barker-Collo, Suzanne L; Barnighausen, Till; Barregard, Lars; Barrero, Lope H; Basu, Arindam; Bazargan-Hejazi, Shahrzad; Bell, Brent; Bell, Michelle L; Bennett, Derrick A; Bensenor, Isabela M; Benzian, Habib; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhatt, Samir; Biadgilign, Sibhatu; Bienhofff, Kelly; Bikbov, Boris; Biryukov, Stan; Bisanzio, Donal; Bjertness, Espen; Blore, Jed; Borschmann, Rohan; Boufous, Soufiane; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas JK; Brown, Jonathan; Buchbinder, Rachelle; Buckle, Geoffrey Colin; Butt, Zahid A; Calabria, Bianca; Ricardo Campos-Nonato, Ismael; Cesar Campuzano, Julio; Carabin, Helene; Cardenas, Rosario; Carpenter, David O; Carrero, Juan Jesus; Castaneda-Orjuela, Carlos A; Castillo Rivas, Jacqueline; Catala-Lopez, Ferran; Chang, Jung-Chen; Chiang, Peggy Pei-Chia; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Chowdhury, Rajiv; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Cirillo, Massimo; Coates, Matthew M; Colquhoun, Samantha M; Cooper, Cyrus; Cortinovis, Monica; Crump, John A; Damtew, Solomon Abrha; Dandona, Rakhi; Daoud, Farah; Dargan, Paul I; das Neves, Jose; Davey, Gail; Davis, Adrian C; De Leo, Diego; Degenhardt, Louisa; Del Gobbo, Liana C; Dellavalle, Robert P; Deribe, Kebede; Deribew, Amare; Derrett, Sarah; Des Jarlais, Don C; Dharmaratne, Samath D; Dhillon, Preet K; Diaz-Torne, Cesar; Ding, Eric L; Driscoll, Tim R; Duan, Leilei; Dubey, Manisha; Duncan, Bruce Bartholow; Ebrahimi, Hedyeh; Ellenbogen, Richard G; Elyazar, Iqbal; Endres, Matthias; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Estep, Kara; Farid, Talha A; Sofia e Sa Farinha, Carla; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Feigin, Valery L; Felson, David T; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Fernandes, Joao C; Fischer, Florian; Fitchett, Joseph RA; Foreman, Kyle; Fowkes, Gerry R; Fox, Jordan; Franklin, Richard C; Friedman, Joseph; Frostad, Joseph; Furst, Thomas; Futran, Neal D; Gabbe, Belinda; Ganguly, Parthasarathi; Gankpe, Fortune Gbetoho; Gebre, Teshome; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Geleijnse, Johanna M; Gessner, Bradford D; Gibney, Katherine B; Ginawi, Ibrahim Abdelmageem Mohamed; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Glaser, Elizabeth; Godwin, William W; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Grainger, Rebecca; Greaves, Felix; Guillemin, Francis; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gutierrez, Reyna A; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Halasa, Yara A; Hamadeh, Randah Ribhi; Hamidi, Samer; Hammami, Mouhanad; Hancock, Jamie; Handal, Alexis J; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Maria Haro, Josep; Havmoeller, Rasmus; Hay, Roderick J; Beatriz Heredia-Pi, Ileana; Heydarpour, Pouria; Hoek, Hans W; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hoy, Damian G; Htet, Aung Soe; Huang, Hsiang; Huang, John J; Huynh, Chantal; Iannarone, Marissa; Iburg, Kim Moesgaard; Innos, Kaire; Inoue, Manami; Iyer, Veena J; Jacobsen, Kathryn H; Jahanmehr, Nader; Jakovljevic, Mihajlo B; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jee, Sun Ha; Jeemon, Panniyammakal; Jensen, Paul N; Jiang, Ying; Jibat, Tariku; Jimenez-Corona, Aida; Jin, Ye; Jonas, Jost B; Kabir, Zubair; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Karimkhani, Chante; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Keren, Andre; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khaiff, Abdur Rahman; Khaiff, Ejaz Ahmad; Khang, Young-Ho; Khera, Sahil; Khoja, Tawfik Ahmed Muthafer; Khubchandani, Jagdish; Kieling, Christian; Kim, Pauline; Kim, Cho-il; Kim, Daniel; Kim, Yun Jin; Kissoon, Niranjan; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A; Kosen, Soewarta; Kotsakis, Georgios A; Koul, Parvaiz A; Koyanagi, Ai; Kravchenko, Michael; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A; Kuipers, Ernst J; Kumar, GAnil; Kutz, Michael; Kwan, Gene F; Lal, Aparna; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lam, Jennifer O; Langan, Sinead M; Larsson, Anders; Lavados, Pablo M; Leasher, Janet L; Leigh, James; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Liang, Juan; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K; Lo, Warren D; Logroscino, Giancarlo; Looker, Katharine J; Lotufo, Paulo A; Lunevicius, Raimundas; Lyons, Ronan A; Mackay, Mark T; Abd El Razek, Mohammed Magdy; Mahdavi, Mandi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Marcenes, Wagner; Margolis, David Joel; Martinez-Raga, Jose; Masiye, Felix; Massano, Joao; McGarvey, Stephen Theodore; McGrath, John J; McKee, Martin; McMahon, Brian J; Meaney, Peter A; Mehari, Alem; Meija-Rodriguez, Fabiola; Mekonnen, Alemayehu B; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J; Mhimbira, Francis Apolinary; Miller, Ted R; Mills, Edward J; Mirarefin, Mojde; Mitchell, Philip B; Mock, Charles N; Mohammadi, Alireza; Mohammed, Shafiu; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montico, Marcella; Mooney, Meghan D; Moradi-Lakeh, Maziar; Morawska, Lidia; Mueller, Ulrich O; Mullany, Erin; Mumford, John Everett; Murdoch, Michele E; Nachega, Jean B; Nagel, Gabriele; Naheed, Aliya; Naldi, Luigi; Nangia, Vinay; Newton, John N; Ng, Marie; Ngalesoni, Frida Namnyak; Quyen Le Nguyen; Nisar, Muhammad Imran; Nkamedjie Pete, Patrick Martial; Nona, Joan M; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nunes, Bruno P; Ogbo, Felix Akpojene; Oh, In-Hwan; Ohkubo, Takayoshi; Olivares, Pedro R; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Ortiz, Alberto; Osman, Majdi; Ota, Erika; Mahesh, PA; Park, Eun-Kee; Parsaeian, Mahboubeh; de Azeredo Passos, Valeria Maria; Paternina Caicedo, Angel J; Patten, Scott B; Patton, George C; Pereira, David M; Perez-Padilla, Rogelio; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B; Pillay, Julian David; Pishgar, Farhad; Plass, Dietrich; Platts-Mills, James A; Polinder, Suzanne; Pond, Constance D; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prabhakaran, Dorairaj; Prasad, Noela M; Qorbani, Mostafa; Rabiee, Rynaz HS; Radfar, Amir; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajsic, Sasa; Ram, Usha; Rao, Puja; Refaat, Amany H; Reitsma, Marissa B; Remuzzi, Giuseppe; Resnikofff, Serge; Reynolds, Alex; Ribeiro, Antonio L; Rios Blancas, Maria Jesus; Rolm, Hirbo Shore; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A; Rothenbacher, Dietrich; Roy, Ambuj; Sagar, Rajesh; Sahathevan, Ramesh; Sanabria, Juan R; Dolores Sanchez-Nino, Maria; Santos, Itamar S; Santos, Joao Vasco; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schaub, Michael P; Schmidt, Maria Ines; Schneider, Ione JC; Schottker, Ben; Schwebel, David C; Scott, James G; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shackelford, Katya A; Shaheen, Amira; Shaikh, Masood Ali; Sharma, Rajesh; Sharma, Upasana; Shen, Jiabin; Shepard, Donald S; Sheth, Kevin N; Shibuya, Kenji; Shin, Min-Jeong; Shiri, Rahman; Shiue, Ivy; Shrime, Mark G; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Alves Silveira, Dayane Gabriele; Singh, Abhishek; Singh, Jasvinder A; Singh, Om Prakash; Singh, Prashant Kumar; Sivonda, Anna; Skirbekk, Vegard; Skogen, Jens Christoffer; Sligar, Amber; Silwa, Karen; Soljak, Michael; Soreide, Kjetil; Soriano, Joan B; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Steel, Nicholas; Stein, Dan J; Steiner, Timothy J; Steinke, Sabine; Stovner, Lars; Stroumpoulis, Konstantinos; Sunguya, Bruno F; Sur, Patrick; Swaminathan, Soumya; Sykes, Bryan L; Szoeke, Cassandra EI; Tabares-Seisdedos, Rafael; Takala, Jukka S; Landon, Nikhil; Tanne, David; Tavakkoli, Mohammad; Taye, Bineyam; Taylor, Hugh R; Te Ao, Braden J; Tedla, Bemnet Amare; Terkawi, Abdullah Sulieman; Thomson, Alan J; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tobe-Gai, Ruoyan; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Tran, Bach Xuan; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tura, Abera Kenay; Tuzcu, Emin Murat; Tyrovolas, Stefanos; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uneke, Chigozie Jesse; Uthman, Olalekan A; van Gool, Coen H; Varakin, Yuri Y; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Verma, Raj Kumar; Violante, Francesco S; Vladimirov, Sergey K; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wagner, Gregory R; Waller, Stephen G; Wang, Linhong; Watkins, David A; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Westerman, Ronny; White, Richard A; Williams, Hywel C; Wiysonge, Charles Shey; Wolfe, Charles DA; Won, Sungho; Woodbrook, Rachel; Wubshet, Mamo; Xavier, Denis; Xu, Gelin; Yadav, Ajit Kumar; Yan, Lijing L; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yebyo, Henock Gebremedhin; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zeeb, Hajo; Zhou, Maigeng; Zodpey, Sanjay; Zuhlke, Liesl Joanna; Murray, Christopher JL; GBD 2015 Dis Injury Incidence
Background Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015. Methods We estimated incidence and prevalence by age, sex, cause, year, and geography with a wide range of updated and standardised analytical procedures. Improvements from GBD 2013 included the addition of new data sources, updates to literature reviews for 85 causes, and the identification and inclusion of additional studies published up to November, 2015, to expand the database used for estimation of non-fatal outcomes to 60 900 unique data sources. Prevalence and incidence by cause and sequelae were determined with DisMod-MR 2.1, an improved version of the DisMod-MR Bayesian meta-regression tool first developed for GBD 2010 and GBD 2013. For some causes, we used alternative modelling strategies where the complexity of the disease was not suited to DisMod-MR 2.1 or where incidence and prevalence needed to be determined from other data. For GBD 2015 we created a summary indicator that combines measures of income per capita, educational attainment, and fertility (the Socio-demographic Index [SDI]) and used it to compare observed patterns of health loss to the expected pattern for countries or locations with similar SDI scores. Findings We generated 9.3 billion estimates from the various combinations of prevalence, incidence, and YLDs for causes, sequelae, and impairments by age, sex, geography, and year. In 2015, two causes had acute incidences in excess of 1 billion: upper respiratory infections (17.2 billion, 95% uncertainty interval [UI] 15.4-19.2 billion) and diarrhoeal diseases (2.39 billion, 2.30-2.50 billion). Eight causes of chronic disease and injury each affected more than 10% of the world's population in 2015: permanent caries, tension-type headache, iron-deficiency anaemia, age-related and other hearing loss, migraine, genital herpes, refraction and accommodation disorders, and ascariasis. The impairment that affected the greatest number of people in 2015 was anaemia, with 2.36 billion (2.35-2.37 billion) individuals affected. The second and third leading impairments by number of individuals affected were hearing loss and vision loss, respectively. Between 2005 and 2015, there was little change in the leading causes of years lived with disability (YLDs) on a global basis. NCDs accounted for 18 of the leading 20 causes of age-standardised YLDs on a global scale. Where rates were decreasing, the rate of decrease for YLDs was slower than that of years of life lost (YLLs) for nearly every cause included in our analysis. For low SDI geographies, Group 1 causes typically accounted for 20-30% of total disability, largely attributable to nutritional deficiencies, malaria, neglected tropical diseases, HIV/AIDS, and tuberculosis. Lower back and neck pain was the leading global cause of disability in 2015 in most countries. The leading cause was sense organ disorders in 22 countries in Asia and Africa and one in central Latin America; diabetes in four countries in Oceania; HIV/AIDS in three southern sub-Saharan African countries; collective violence and legal intervention in two north African and Middle Eastern countries; iron-deficiency anaemia in Somalia and Venezuela; depression in Uganda; onchoceriasis in Liberia; and other neglected tropical diseases in the Democratic Republic of the Congo. Interpretation Ageing of the world's population is increasing the number of people living with sequelae of diseases and injuries. Shifts in the epidemiological profile driven by socioeconomic change also contribute to the continued increase in years lived with disability (YLDs) as well as the rate of increase in YLDs. Despite limitations imposed by gaps in data availability and the variable quality of the data available, the standardised and comprehensive approach of the GBD study provides opportunities to examine broad trends, compare those trends between countries or subnational geographies, benchmark against locations at similar stages of development, and gauge the strength or weakness of the estimates available
PMCID:5055577
PMID: 27733282
ISSN: 1474-547x
CID: 2374712
Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015
Kassebaum, Nicholas J; Arora, Megha; Barber, Ryan M; Bhutta, Zulfigar A; Carter, Austin; Casey, Daniel C; Charlson, Fiona J; Coates, Matthew M; Coggeshall, Megan; Cornaby, Leslie; Dandona, Lalit; Dicker, Daniel J; Erskine, Holly E; Ferrari, Alize J; Fitzmaurice, Christina; Foreman, Kyle; Forouzanfar, Mohammad H; Fullman, Nancy; Gething, Peter W; Goldberg, Ellen M; Graetz, Nicholas; Haagsma, Juanita A; Johnson, Catherine; Kemmer, Laura; Khalil, Ibrahim A; Kinfu, Yohannes; Kutz, Michael J; Kyu, Hmwe H; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S; Lim, Stephen S; Lozano, Rafael; Mensah, George A; Mikesell, Joe; Mokdad, Ali H; Mooney, Meghan D; Naghavi, Mohsen; Nguyen, Grant; Nsoesie, Elaine; Pigott, David M; Pinho, Christine; Rankin, Zane; Reinig, Nikolas; Salomon, Joshua A; Sandar, Logan; Smith, Alison; Sorensen, Reed JD; Stanaway, Jeffrey; Steiner, Caitlyn; Teeple, Stephanie; Thomas, Bernadette A; Troeger, Chris; VanderZanden, Amelia; Wagner, Joseph A; Wanga, Valentine; Whiteford, Harvey A; Zhou, Maigeng; Zoeckler, Leo; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J; Abu-Rmeileh, Niveen ME; Achoki, Tom; Ackerman, Ilana N; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adsuar, Jose C; Afanvi, Kossivi Agbelenko; Afshin, Ashkan; Agardh, Emilie Elisabet; Agarwal, Arnav; Kumar, Sanjay; Ahmed, Muktar Beshir; Kiadaliri, Aliasghar Ahmad; Ahmadieh, Hamid; Akseer, Nadia; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore KM; Aldhahri, Saleh Fahed; Alegretti, Miguel Angel; Aleman, Alicia V; Alemu, Zewdie Aderaw; Alexander, Lily T; Raghib, Ali; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Alsharif, Ubai; Altirkawi, Khalid A; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Anderson, Gregory M; Anderson, Benjamin O; Antonio, Carl Abelardo T; Anwari, Palwasha; Arnlov, Johan; Arsenijevic, Valentina SArsic; Artaman, Al; Asayesh, Hamid; Asghar, Rana Jawad; Avokpaho, Euripide Frinel GArthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Banerjee, Amitava; Barac, Aleksandra; Barker-Collo, Suzanne L; Barnighausen, Till; Barregard, Lars; Barrero, Lope H; Basu, Sanjay; Bayou, Tigist Assefa; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Bell, Brent; Bell, Michelle L; Benjet, Corina; Bennett, Derrick A; Bensenor, Isabela M; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhansali, Anil; Bhatt, Samir; Biadgilign, Sibhatu; Bienhofff, Kelly; Bikbov, Boris; Bin Abdulhak, Aref A; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D; Borschmann, Rohan; Boufous, Soufiane; Bourne, Rupert RA; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas JK; Brugha, Traolach S; Buchbinder, Rachelle; Buckle, Geoffrey Colin; Butt, Zahid A; Calabria, Bianca; Campos-Nonato, Ismael Ricardo; Campuzano, Julio Cesar; Carabin, Helene; Carapetis, Jonathan R; Cardenas, Rosario; Carrero, Juan Jesus; Castaneda-Orjuela, Carlos A; Rivas, Jacqueline Castillo; Catala-Lopez, Ferran; Cavalleri, Fiorella; Chang, Jung-Chen; Chiang, Peggy Pei-Chia; Chibalabala, Mirriam; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Choudhury, Lincoln; Christensen, Hanne; Ciobanu, Liliana G; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M; Cortinovis, Monica; Crump, John A; Damasceno, Albertino; Dandona, Rakhi; Dargan, Paul I; Das Neves, Jose; Davey, Gail; Davis, Adrian C; De Leo, Diego; Degenhardt, Louisa; Del Gobbo, Liana C; Derrett, Sarah; Des Jarlais, Don C; Deveber, Gabrielle A; Dharmaratne, Samath D; Dhillon, Preet K; Ding, Eric L; Doyle, Kerrie E; Driscoll, Tim R; Duan, Leilei; Dubey, Manisha; Duncan, Bruce Bartholow; Ebrahimi, Hedyeh; Ellenbogen, Richard G; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Fahimi, Saman; Farid, Talha A; Sa Farinha, Carla Sofia e; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Feigin, Valery L; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Fernandes, Joao C; Fischer, Florian; Fitchett, Joseph RA; Foigt, Nataliya; Fowkes, FGerry R; Franklin, Richard C; Friedman, Joseph; Frostad, Joseph; Furst, Thomas; Futran, Neal D; Gabbe, Belinda; Gankpe, Fortune Gbetoho; Garcia-Basteiro, Alberto L; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Geleijnse, Johanna M; Gibney, Katherine B; Gillum, Richard F; Ginawi, Ibrahim Abdelmageem Mohamed; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Godwin, William W; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gutierrez, Reyna A; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Halasa, Yara A; Ribhi, Randah; Hamadeh; Hamidi, Samer; Hammami, Mouhanad; Handal, Alexis J; Hankey, Graeme J; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Haro, Josep Maria; Hassanvand, Mohammad Sadegh; Hassen, Tahir Ahmed; Havmoeller, Rasmus; Hay, Roderick J; Hedayati, Mohammad T; Heredia-Pi, Ileana Beatriz; Heydarpour, Pouria; Hoek, Hans W; Hoffman, Daniel J; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hoy, Damian G; Hsairi, Mohamed; Huang, Hsiang; Huang, John J; Iburg, Kim Moesgaard; Idrisov, Bulat T; Innos, Kaire; Inoue, Manami; Jacobsen, Kathryn H; Jauregui, Alejandra; Jayatilleke, Achala Upendra; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jimenez-Corona, Aida; Jin, Ye; Jonas, Jost B; Kabir, Zubair; Kajungu, Dan K; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Kandel, Amit; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Kasaeian, Amir; Katibeh, Marzieh; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young-Ho; Khoja, Tawfik Ahmed Muthafer; Khubchandani, Jagdish; Kieling, Christian; Kim, Cho-il; Kim, Daniel; Kim, Yun Jin; Kissoon, Niranjan; Kivipelto, Miia; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A; Koul, Parvaiz A; Koyanagi, Ai; Defo, Barthelemy Kuate; Kuchenbecker, Ricardo S; Bicer, Burcu Kucuk; Kuipers, Ernst J; Kumar, GAnil; Kwan, Gene F; Lalloo, Ratilal; Lallukka, Tea; Larsson, Anders; Latif, Asma Abdul; Lavados, Pablo M; Lawrynowicz, Alicia Elena Beatriz; Leasher, Janet L; Leigh, James; Leung, Ricky; Li, Yichong; Li, Yongmei; Lipshultz, Steven E; Liu, Patrick Y; Liu, Yang; Lloyd, Belinda K; Logroscino, Giancarlo; Looker, Katharine J; Lotufo, Paulo A; Lucas, Robyn M; Lunevicius, Raimundas; Lyons, Ronan A; El Razek, Hassan Magdy Abd; Mandavi, Mandi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Marcenes, Wagner; Martinez-Raga, Jose; Masiye, Felix; Mason-Jones, Amanda J; Matzopoulos, Richard; Mayosi, Bongani M; McGrath, John J; Mckee, Martin; Meaney, Peter A; Mehari, Alem; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J; Mesfin, Yonatan Moges; Mhimbira, Francis Apolinary; Miller, Ted R; Mills, Edward J; Mirarefin, Mojde; Mirrakhimov, Erkin M; Mitchell, Philip B; Mock, Charles N; Mohammad, Karzan Abdulmuhsin; Mohammadi, Alireza; Mohammed, Shafiu; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montico, Marcella; Moradi-Lakeh, Maziar; Mori, Rintaro; Mueller, Ulrich O; Mumford, John Everett; Murdoch, Michele E; Murthy, Gudlavalleti Venkata Satyanarayana; Nachega, Jean B; Naheed, Aliya; Naldi, Luigi; Nangia, Vinay; Newton, John N; Ng, Marie; Ngalesoni, Frida Namnyak; Le Nguyen, Quyen; Nisar, Muhammad Imran; Pete, Patrick Martial Nkamedjie; Nolla, Joan M; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Obermeyer, Carla Makhlouf; Ogbo, Felix Akpojene; Oh, In-Hwan; Oladimeji, Olanrewaju; Olivares, Pedro R; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Oren, Eyal; Ortiz, Alberto; Ota, Erika; Oyekale, Abayomi Samuel; Pa, Mahesh; Park, Eun-Kee; Parsaeian, Mahboubeh; Patten, Scott B; Patton, George C; Pedro, Joao Mario; Pereira, David M; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B; Pillay, Julian David; Pishgar, Farhad; Plass, Dietrich; Polinder, Suzanne; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prasad, Noela M; Qorbani, Mostafa; Rabiee, Rynaz HS; Radfar, Amir; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Dheeraj; Rai, Rajesh Kumar; Rajsic, Sasa; Raju, Murugesan; Ram, Usha; Ranganathan, Kavitha; Refaat, Amany H; Reitsma, Marissa B; Remuzzi, Giuseppe; Resnikoff, Serge; Reynolds, Alex; Ribeiro, Antonio L; Ricci, Stefano; Roba, Hirbo Shore; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A; Roy, Ambuj; Sackey, Ben Benasco; Sagar, Rajesh; Sanabria, Juan R; Dolores Sanchez-Nino, Maria; Santos, Itamar S; Santos, Joao Vasco; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schmidt, Maria Ines; Schneider, Ione JC; Schutte, Aletta E; Schwebel, David C; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shahraz, Saeid; Shaikh, Masood Ali; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Sheth, Kevin N; Shibuya, Kenji; Shigematsu, Mika; Shin, Min-Jeong; Shin, Rahman; Sigfusdottir, Inga Dora; Santos Silva, Diego Augusto; Silverberg, Jonathan I; Simard, Edgar P; Singh, Abhishek; Singh, Jasvinder A; Singh, Prashant Kumar; Skirbekk, Vegard; Skogen, Jens Christoffer; Soljak, Michael; Soreide, Kjetil; Sorensen, Reed JD; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Steel, Nicholas; Stein, Dan J; Stein, Murray B; Steiner, Timothy J; Stovner, Lars Jacob; Stranges, Saverio; Stroumpoulis, Konstantinos; Sunguya, Bruno F; Sur, Patrick J; Swaminathan, Soumya; Sykes, Bryan L; Szoeke, Cassandra EI; Tabares-Seisdedos, Rafael; Landon, Nikhil; Tanne, David; Tavakkoli, Mohammad; Taye, Bineyam; Taylor, Hugh R; Ao, Braden JTe; Tegegne, Teketo Kassaw; Tekle, Dejen Yemane; Terkawi, Abdullah Sulieman; Tessema, Gizachew Assefa; Thakur, JS; Thomson, Alan J; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tobe-Gai, Ruoyan; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Tran, Bach Xuan; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tura, Abera Kenay; Tuzcu, Emin Murat; Tyrovolas, Stefanos; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uneke, Chigozie Jesse; Uthman, Olalekan A; van Gool, Coen H; van Os, Jim; Vasankari, Tommi; Vasconcelos, Ana Maria Nogales; Venketasubramanian, Narayanaswamy; Violante, Francesco S; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wagner, Gregory R; Wallin, Mitchell T; Wang, Linhong; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; WestermaM, Ronny; Wijeratne, Tissa; Wilkinson, James D; Williams, Hywel C; Wiysonge, Charles Shey; Woldeyohannes, Solomon Meseret; Wolfe, Charles DA; Won, Sungho; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yan, Lijing L; Yan, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zeeb, Hajo; Zodpey, Sanjay; Zonies, David; Zuhlke, Liesl Joanna; Zeeb, Hajo; Zodpey, Sanjay; Zonies, David; Zuhlke, Liesl Joanna; Vos, Theo; Lopez, Alan D; Murray, Christopher JL; GBD 2015 DALY & HALE
Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs off set by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2.9 years (95% uncertainty interval 2.9-3.0) for men and 3.5 years (3.4-3.7) for women, while HALE at age 65 years improved by 0.85 years (0.78-0.92) and 1.2 years (1.1-1.3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum
PMCID:5388857
PMID: 27733283
ISSN: 1474-547x
CID: 2374722
Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015
Forouzanfar, Mohammad H; Afshin, Ashkan; Alexander, Lily T; Anderson, HRoss; Bhutta, Zulficiar A; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Cercy, Kelly; Charlson, Fiona J; Cohen, Aaron J; Dandona, Lalit; Estep, Kara; Ferrari, Alize J; Frostad, Joseph J; Fullman, Nancy; Gething, Peter W; Godwin, William W; Griswold, Max; Kinfu, Yohannes; Kyu, Hmwe H; Larson, Heidi J; Liang, Xiaofeng; Lim, Stephen S; Liu, Patrick Y; Lopez, Alan D; Lozano, Rafael; Marczak, Laurie; Mensah, George A; Mokdad, Ali H; Moradi-Lakeh, Maziar; Naghavi, Mohsen; Neal, Bruce; Reitsma, Marissa B; Roth, Gregory A; Salomon, Joshua A; Sur, Patrick J; Vos, Theo; Wagner, Joseph A; Wang, Haidong; Zhao, Yi; Zhou, Maigeng; Aasvang, Gunn Marit; Amanuel; Abajobir, Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abdulle, Abdishakur M; Abera, Semaw Ferede; Abraham, Biju; Abu-Raddad, Laith J; Abyu, Gebre Yitayih; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Ademi, Zanfina; Adou, Arsene Kouablan; Adsuar, Jose C; Agardh, Emilie Elisabet; Agarwal, Arnav; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ajala, Oluremi N; Akinyemiju, Tomi F; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore KM; Aldhahri, Saleh Fahed; Aldridge, Robert William; Alemu, Zewdie Aderaw; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Alsharif, Ubai; Altirkawi, Khalid A; Alvarez Martin, Elena; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H; Anderson, Benjamin O; Antonio, Carl Abelardo T; Anwar, Palwasha; Arnlov, Johan; Al Artaman; Asayesh, Hamid; Asghar, Rana Jawad; Assadi, Reza; Atique, Suleman; Avokpaho, Euripide Frinel GArthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Bahit, Maria C; Balakrishnan, Kalpana; Barac, Aleksandra; Barber, Ryan M; Barker-Collo, Suzanne L; Baernighausen, Till; Barquera, Simon; Barregard, Lars; Barrero, Lope H; Basu, Sanjay; Bans, Carolina; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Bell, Michelle L; Bello, Aminu K; Bennett, Derrick A; Bensenor, Isabela M; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhansali, Anil; Bhatt, Samir; Biadgilign, Sibhatu; Bikbov, Boris; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D; Borschmann, Rohan; Boufous, Soufiane; Bourne, Rupert RA; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas JK; Brenner, Hermann; Broday, David M; Brugha, Traolach S; Brunekreef, Bert; Butt, Zahid A; Cahill, Leah E; Calabria, Bianca; Ricardo Campos-Nonato, Ismael; Cardenas, Rosario; Carpenter, David; Casey, Daniel C; Castaneda-Oquela, Carlos A; Castillo Rivas, Jacqueline; Estanislao Castro, Ruben; Catala-Lopez, Ferran; Chang, Jung-Chen; Chiang, Peggy Pei-Chia; Chibalabala, Mirriam; Chimed-Ochir, Odgerel; Chisumpa, Vesper Hichilombwe; Chitheer, Abdulaal A; Choi, Jee-Young Jasmine; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Coates, Matthew M; Colquhoun, Samantha M; Cooper, Leslie Trumbull; Cooperrider, Kimberly; Cornaby, Leslie; Cortinovis, Monica; Crump, John A; Cuevas-Nasu, Lucia; Damasceno, Albertino; Dandona, Rakhi; Darby, Sarah C; Dargan, Paul I; das Neves, Jose; Davis, Adrian C; Davletov, Kairat; Filipa de Castro, E; De la Cruz-Gongora, Vanessa; De Leo, Diego; Degenhardt, Louisa; Del Gobbo, Liana C; del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribew, Amare; Des Jarlais, Don C; Dharmaratne, Samath D; Dhillon, Preet K; Diaz-Tome, Cesar; Dicker, Daniel; Ding, Eric L; Dorsey, ERay; Doyle, Kerrie E; Driscoll, Tim R; Duan, Leilei; Dubey, Manisha; Duncan, Bruce Bartholow; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Erskine, Holly E; Eshrati, Babak; Esteghamati, Alireza; Fahimi, Saman; Aquino Faraon, Emerito Jose; Farid, Talha A; Sofia E Sa Farinha, Carla; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Feigin, Valery L; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Fischer, Florian; Fitchett, Joseph RA; Fleming, Tom; Foigt, Nataliya; Foreman, Kyle; Fowkes, FGerry R; Franklin, Richard C; Fuerst, Thomas; Futran, Neal D; Gakidou, Emmanuela; Garcia-Basteiro, Alberto L; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Geleijnse, Johanna M; Gessner, Bradford D; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Goenka, Shifalika; Carmen Gomez-Cabrera, Mari; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Gugnani, Harish Chander; Guillemin, Francis; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gutierrez, Reyna A; Haagsma, Juanita A; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Gessessew Bugssa; Halasa, Yara A; Hamadeh, Randah Ribhi; Hamidi, Samer; Handal, Alexis J; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Maria Haro, Josep; Hassanvand, Mohammad Sadegh; Hassen, Tahir Ahmed; Havmoeller, Rasmus; Beatriz Heredia-Pi, Ileana; Francisco Hernandez-Llanes, Norberto; Heydarpour, Pouria; Hoek, Hans W; Hoffman, Howard J; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hoy, Damian G; Hsairi, Mohamed; Htet, Aung Soe; Hu, Guoqing; Huang, John J; Husseini, Abdullatif; Hutchings, Sally J; Huybrechts, Inge; Iburg, Kim Moesgaard; Idrisov, Bulat T; Ileanu, Bogdan Vasile; Inoue, Manami; Jacobs, Troy A; Jacobsen, Kathryn H; Jahanmehr, Nader; Jakovljevic, Mihajlo B; Jansen, Henrica AFM; Jassal, Simerjot K; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jee, Sun Ha; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Ying; Jibat, Tariku; Jin, Ye; Johnson, Catherine O; Jonas, Jost B; Kabir, Zubair; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khang, Young-Ho; Khatibzadeh, Shahab; Khera, Sahil; Khoja, Tawfik Ahmed Muthafer; Khubchandani, Jagdish; Kieling, Christian; Kim, Cho-il; Kim, Daniel; Kimokoti, Ruth W; Kissoon, Niranjan; Kivipelto, Miia; Knibbs, Luke D; Kokubo, Yoshihiro; Kopec, Jacek A; Koul, Parvaiz A; Koyanagi, Ai; Kravchenko, Michael; Kromhout, Hans; Krueger, Hans; Ku, Tiffany; Defo, Barthelemy Kuate; Kuchenbecker, Ricardo S; Bicer, Burcu Kucuk; Kuipers, Ernst J; Kumar, GAnil; Kwan, Gene F; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lallukka, Tea; Lan, Qing; Larsson, Anders; Latif, Asma Abdul; Beatriz Lawrynowicz, Alicia Elena; Leasher, Janet L; Leigh, James; Leung, Janni; Levi, Miriam; Li, Xiaohong; Li, Yichong; Liang, Juan; Liu, Shiwei; Lloyd, Belinda K; Logroscino, Giancarlo; Lotufo, Paulo A; Lunevicius, Raimundas; Maclntyre, Michael; Mahdavi, Mandi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Manamo, Wondimu Ayele Ayele; Mapoma, Chabila C; Marcenes, Wagner; Martin, Randall V; Martinez-Raga, Jose; Masiye, Felix; Matsushita, Kunihiro; Matzopoulos, Richard; Mayosi, Bongani M; McGrath, John J; McKee, Martin; Meaney, Peter A; Medina, Catalina; Mehari, Alem; Mena-Rodriguez, Fabiola; Mekonnen, Alemayehu B; Melaku, Yohannes Adama; Memish, Ziad A; Mendoza, Walter; Mensink, Gert BM; Meretoja, Atte; Meretoja, Tuomo J; Mesfin, Yonatan Moges; Mhimbira, Francis Apolinary; Miller, Ted R; Mills, Edward J; Mirarefin, Mojde; Misganaw, Awoke; Mock, Charles N; Mohammadi, Alireza; Mohammed, Shafiu; Mola, Glen Liddell D; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montico, Marcella; Morawska, Lidia; Mori, Rintaro; Mozaffarian, Dariush; Mueller, Ulrich O; Mullany, Erin; Mumford, John Everett; Murthy, Gudlavalleti Venkata Satyanarayana; Nachega, Jean B; Naheed, Aliya; Nangia, Vinay; Nassiri, Nariman; Newton, John N; Ng, Marie; Quyen Le Nguyen; Nisar, Muhammad Imran; Pete, Patrick Martial Nkamedjie; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nyakarahuka, Luke; Obermeyer, Carla Makhlouf; Ogbo, Felix Akpojene; Oh, In-Hwan; Oladimeji, Olanrewaju; Olivares, Pedro R; Olsen, Helen; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Orozco, Ricardo; Ortiz, Alberto; Ota, Erika; Mahesh, PA; Pana, Adrian; Park, Eun-Kee; Parry, Charles D; Parsaeian, Mahboubeh; Patel, Tejas; Caicedo, Angel JPaternina; Patil, Snehal T; Patten, Scott B; Patton, George C; Pearce, Neil; Pereira, David M; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B; Pillay, Julian David; Plass, Dietrich; Polinder, Suzanne; Pond, Constance D; Pope, CArden; Pope, Daniel; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prasad, Noela M; Qorbani, Mostafa; Rabiee, Rynaz HS; Radfar, Amir; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajsic, Sasa; Raju, Murugesan; Ram, Usha; Rana, Saleem M; Ranganathan, Kavitha; Rao, Puja; Razo Garcia, Christian Aspacia; Refaat, Amany H; Rehm, Colin D; Rehm, Jurgen; Reinig, Nikolas; Remuzzi, Giuseppe; Resnikoff, Serge; Ribeiro, Antonio L; Rivera, Juan A; Rolm, Hirbo Shore; Rodriguez, Anna; Rodriguez-Ramirez, Sonia; Rojas-Rueda, David; Roman, Yesenia; Ronfani, Luca; Roshandel, Gholamreza; Rothenbacher, Dietrich; Roy, Ambuj; Saleh, Muhammad Muhammad; Sanabria, Juan R; Dolores Sanchez-Nino, Maria; Sanchez-Pimienta, Tania G; Sandar, Logan; Santomauro, Damian F; Santos, Itamar S; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schmidhuber, Josef; Schmidt, Maria Ines; Schneider, Ione JC; Schoettker, Ben; Schutte, Aletta E; Schwebel, David C; Scott, James G; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shaheen, Amira; Shahraz, Saeid; Shaikh, Masood Ali; Levy, Teresa Shamah; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Sheth, Kevin N; Shi, Peilin; Shibuya, Kenji; Shigematsu, Mika; Shin, Min-Jeong; Shiri, Rahman; Shishani, Kawkab; Shiue, Ivy; Shrime, Mark G; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Alves Silveira, Dayane Gabriele; Silverberg, Jonathan I; Simard, Edgar P; Sindi, Shireen; Singh, Abhishek; Singh, Jasvinder A; Singh, Prashant Kumar; Slepak, Erica Leigh; Soljak, Michael; Soneji, Samir; Sorensen, Reed JD; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Steckling, Nadine; Steel, Nicholas; Stein, Dan J; Stein, Murray B; Stockl, Heidi; Stranges, Saverio; Stroumpoulis, Konstantinos; Sunguya, Bruno F; Swaminathan, Soumya; Sykes, Bryan L; Szoeke, Cassandra EI; Tabares-Seisdedos, Rafael; Takahashi, Ken; Talongwa, Roberto Tchio; Landon, Nikhil; Tanne, David; Tavakkoli, Mohammad; Taye, Belaynew Wasie; Taylor, Hugh R; Tedla, Bemnet Amare; Tefera, Worku Mekonnen; Tegegne, Teketo Kassaw; Tekle, Dejen Yemane; Terkawi, Abdullah Sulieman; Thakur, JS; Thomas, Bernadette A; Thomas, Matthew Lloyd; Thomson, Alan J; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tillmann, Taavi; Tobe-Gai, Ruoyan; Tobollik, Myriam; Topor-Madry, Roman; Topouzis, Fotis; Towbin, Jeffrey Allen; Bach Xuan Tran; Dimbuene, Zacharie Tsala; Tsilimparis, Nikolaos; Tura, Abera Kenay; Tuzcu, Emin Murat; Tyrovolas, Stefanos; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uneke, Chigozie Jesse; Uthman, Olalekan A; van Donkelaar, Aaron; van Os, Jim; Varakin, Yuri Y; Vasankari, Tommi; Veerman, JLennert; Venketasubramanian, Narayanaswamy; Violante, Francesco S; Vollset, Stein Emil; Wagner, Gregory R; Waller, Stephen G; Wang, JianLi; Wang, Linhong; Wang, Yanping; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Westerman, Ronny; Whiteford, Harvey A; Wijeratne, Tissa; Wiysonge, Charles Shey; Wolfe, Charles DA; Won, Sungho; Woolf, Anthony D; Wubshet, Mamo; Xavier, Denis; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zhu, Jun; Zipkin, Ben; Zodpey, Sanjay; Zuhlke, Liesl Joanna; Murray, Christopher JL; GBD 2015 Risk Factors
Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57.8% (95% CI 56.6-58.8) of global deaths and 41.2% (39.8-42.8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211.8 million [192.7 million to 231.1 million] global DALYs), smoking (148.6 million [134.2 million to 163.1 million]), high fasting plasma glucose (143.1 million [125.1 million to 163.5 million]), high BMI (120.1 million [83.8 million to 158.4 million]), childhood undernutrition (113.3 million [103.9 million to 123.4 million]), ambient particulate matter (103.1 million [90.8 million to 115.1 million]), high total cholesterol (88.7 million [74.6 million to 105.7 million]), household air pollution (85.6 million [66.7 million to 106.1 million]), alcohol use (85.0 million [77.2 million to 93.0 million]), and diets high in sodium (83.0 million [49.3 million to 127.5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden
PMCID:5388856
PMID: 27733284
ISSN: 1474-547x
CID: 2374732
Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
Wang, Haidong; Bhutta, Zulfiriar A; Coates, Matthew M; Coggeshall, Megan; Dandona, Lalit; Diallo, Khassoum; Franca, Elisabeth Barboza; Fraser, Maya; Fullman, Nancy; Gething, Peter W; Hay, Simon I; Kinfu, Yohannes; Kita, Maaya; Kulikoff, Xie Rachel; Larson, Heidi J; Liang, Juan; Liang, Xiaofeng; Lind, Margaret; Lopez, Alan D; Lozano, Rafael; Mensah, George A; Mikesell, Joseph B; Mokdad, Ali H; Mooney, Meghan D; Nguyen, Grant; Rakovac, Ivo; Salomon, Joshua A; Silpakit, Naris; Sligar, Amber; Sorensen, Reed JD; Vos, Theo; Zhu, Jun; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbas, Kaja M; Abd-Allah, Foad; Abdulle, Abdishakur M; Abera, Semaw Ferede; Aboyans, Victor; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J; Abu-Rmeileh, Niveen ME; Abyu, Gebre Yitayih; Achoki, Tom; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adelekan, Ademola Lukman; Adou, Arsene Kouablan; Agarwal, Arnav; Ajala, Oluremi N; Akinyemiju, Tomi F; Akseer, Nadia; Alam, Khurshid; Alam, Noore KM; Alasfoor, Deena; Aldridge, Robert William; Alegretti, Miguel Angel; Alemu, Zewdie Aderaw; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Ameh, Emmanuel A; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H; Anderson, Gregory M; Antonio, Carl Abelardo T; Arnlov, Johan; Al Artaman; Asayesh, Hamid; Asghar, Rana Jawad; Assadi, Reza; Atique, Suleman; Avokpaho, Euripide Frinel GArthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Banerjee, Amitava; Banigbe, Bolanle F; Barac, Aleksandra; Barber, Ryan M; Barker-Collo, Suzanne L; Barnighausen, Till; Barrero, Lope H; Bayou, Tigist Assefa; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Bello, Aminu K; Bennett, Derrick A; Bensenor, Isabela M; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Bhatt, Samir; Biadgilign, Sibhatu; Bikbov, Boris; Birlik, Sait Mentes; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D; Bourne, Rupert RA; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas JK; Brown, Alexandria; Buckle, Geoffrey Colin; Burch, Michael; Butt, Zahid A; Campos-Nonato, Ismael Ricardo; Campuzano, Julio Cesar; Cardenas, Rosario; Carpenter, David; Carrero, Juan Jesus; Carter, Austin; Casey, Daniel C; Castaneda-Oquela, Carlos A; Rivas, Jacqueline Castillo; Castro, Ruben Estanislao; Catala-Lopez, Ferran; Cercy, Kelly; Chang, Hsing-Yi; Chang, Jung-Chen; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Chowdhury, Rajiv; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Colquhoun, Samantha M; Cooper, Cyrus; Cornaby, Leslie; Damtew, Solomon Abrha; Danawi, Hadi; Dandona, Rakhi; das Neves, Jose; Davis, Adrian C; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Deribe, Kebede; Deribew, Amare; Jarlais, Don CDes; deVeber, Gabrielle A; Dharmaratne, Samath D; Dhillon, Preet K; Ding, Eric L; Doshi, Pratik Pinal; Doyle, Kerrie E; Duan, Leilei; Dubey, Manisha; Ebrahimi, Hedyeh; Ellingsen, Christian Lycke; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Faraon, Emerito Jose Aquino; Farid, Talha A; Farinha, Carla Sofia e Sa; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fernandes, Joao C; Fischer, Florian; Fitchett, Joseph RA; Foigt, Nataliya; Franklin, Richard C; Friedman, Joseph; Furst, Thomas; Gambashidze, Ketevan; Gamkrelidze, Amiran; Ganguly, Parthasarathi; Gebre, Teshome; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Gelefinse, Johanna M; Gessner, Bradford D; Ginawi, Ibrahim Abdelmageem Mohamed; Giref, Ababi Zergaw; Gishu, Melkamu Dedefo; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Goto, Atsushi; Gouda, Hebe N; Gugnani, Harish Chander; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gyawali, Bishal; Haagsma, Juanita A; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hancock, Jamie; Handal, Alexis J; Hankey, Graeme J; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Harun, Kimani M; Havmoeller, Rasmus; Hay, Roderick J; Heredia-Pi, Ileana Beatriz; Hoek, Hans W; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hotez, Peter J; Hoy, Damian G; Hsairi, Mohamed; Hu, Guoqing; Huang, Cheng; Huang, John J; Huang, Hsiang; Huiart, Laetitia; Iburg, Kim Moesgaard; Idrisov, Bulat T; Innos, Kaire; Jacobsen, Kathryn H; Jahanmehr, Nader; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jee, Sun Ha; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jin, Ye; Jonas, Jost B; Kabir, Zubair; Kalkonde, Yogeshwar; Karnak, Ritul; Kan, Haidong; Kang, Gagandeep; Karch, Andre; Karema, Corine Kakizi; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Francoise; Kazanjan, Konstantin; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kereselidze, Maia; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim A; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young -Ho; Khonelidze, Irma; Khubchandani, Jagdish; Kim, Cho-il; Kim, Daniel; Kim, Yun Jin; Kissoon, Niranjan; Kivipelto, Miia; Knibbs, Luke D; Kokubo, Yoshihiro; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A; Kumar, GAnil; Kyu, Hmwe H; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lam, Hilton; Lam, Jennifer O; Lansingh, Van C; Larsson, Anders; Leigh, James; Leung, Ricky; Li, Yichong; Li, Yongmei; Lindsay, MPatrice; Liu, Patrick Y; Liu, Shiwei; Lloyd, Belinda K; Lo, Warren D; Logroscino, Giancarlo; Low, Nicola; Lunevicius, Raimundas; Lyons, Ronan A; Ma, Stefan; Abd El Razek, Hassan Magdy; Abd El Razek, Mohammed Magdy; Mandavi, Mandi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Mapoma, Chabila C; Marcenes, Wagner; -Raga, Jose Martinez; Marzan, Melvin Barrientos; Masiye, Felix; McGrath, John J; Meaney, Peter A; Mehari, Alem; Mehndiratta, Man Mohan; Mekonnen, Alemayehu B; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J; Mhimbira, Francis Apolinary; Miller, Ted R; Mills, Edward J; Mirarefin, Mojde; Misganaw, Awoke; Mock, Charles N; Mohammad, Karzan Abdulmuhsin; Mohammadi, Alireza; Mohammed, Shafiu; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montico, Marcella; Moore, Ami R; Moradi-Lakeh, Maziar; Morawska, Lidia; Mori, Rintaro; Mueller, Ulrich O; Murphy, Georgina AV; Murthy, Srinivas; Nachega, Jean B; Naheed, Aliya; Naidoo, Kovin S; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Neupane, Subas; Newton, Charles R; Newton, John N; Ng, Marie; Ngalesoni, Frida Namnyak; Nguhiu, Peter; Quyen Le Nguyen; Nisar, Muhammad Imran; Pete, Patrick Martial Nkamedjie; Norheim, Ole F; Norman, Rosana E; Ogbo, Felix Akpojene; Oh, In-Hwan; Ojelabi, Foluke Adetola; Olivares, Pedro R; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Oren, Eyal; Ota, Erika; Mahesh, PA; Park, Eun-Kee; Park, Hye-Youn; Parsaeian, Mahboubeh; Caicedo, Angel JPaternina; Patten, Scott B; Pedro, Joao Mario; Pereira, David M; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Pillay, Julian David; Pishgar, Farhad; Polinder, Suzanne; Pope, Daniel; Popova, Svetlana; Pourmalek, Farshad; Qorbani, Mostafa; Rabiee, Rynaz HS; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Ur Rahman, Mohammad Hifz; Ur Rahman, Sajjad; Rai, Rajesh Kumar; Raju, Murugesan; Ram, Usha; Rana, Saleem M; Ranabhat, Chhabi Lal; Rao, Puja; Refaat, Amany H; Remuzzi, Giuseppe; Resnikoff, Serge; Reynolds, Alex; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A; Roy, Ambuj; Ruhago, George Mugambage; Sagar, Rajesh; Saleh, Muhammad Muhammad; Sanabria, Juan R; Sanchez-Nino, Maria Dolores; Santos, Itamar S; Santos, Joao Vasco; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schneider, Ione JC; Schottker, Ben; Schwebel, David C; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Setegn, Tesfaye; Shahraz, Saeid; Shaikh, Masood Ali; Shakh-Nazarova, Marina; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Sheth, Kevin N; Shibuya, Kenji; Shin, Hwashin Hyun; Shin, Min-Jeong; Shiri, Rahman; Shuie, Ivy; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Silverberg, Jonathan; Simard, Edgar P; Sindi, Shireen; Singh, Abhishek; Singh, Jasvinder A; Singh, Om Prakash; Singh, Prashant Kumar; Singh, Virendra; Soriano, Joan B; Soshnikov, Sergey; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Steel, Nicholas; Stroumpoulis, Konstantinos; Sturua, Lela; Sunguya, Bruno F; Swaminathan, Soumya; Sykes, Bryan L; Szoeke, Cassandra EI; Tabares-Seisdedos, Rafael; Tavakkoli, Mohammad; Taye, Bineyam; Tedla, Bemnet Amare; Tefera, Worku Mekonnen; Tekle, Tesfaye; Shifa, Girma Temam; Terkawi, Abdullah Sulieman; Tesfay, Fisaha Haile; Tessema, Gizachew Assefa; Thapa, Kiran; Thomson, Alan J; -Lyman, Andrew LThorne; Tobe-Gai, Ruoyan; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Tran, Bach Xuan; Troeger, Christopher; Truelsen, Thomas; Dimbuene, Zacharie Tsala; Tura, Abera Kenay; Tyrovolas, Stefanos; Ukwaja, Kingsley N; Uneke, Chigozie Jesse; Uthman, Olalekan A; Vaezghasemi, Masoud; Vasankari, Tommi; Vasconcelos, Ana Maria Nogales; Venketasubramanian, Narayanaswamy; Verma, Raj Kumar; Violante, Francesco S; Vladimirov, Sergey K; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wang, Linhong; Wang, Yanping; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Weiss, Daniel J; Werdecker, Andrea; Westerman, Ronny; Widdowson, Marc -Alain; Wijeratne, Tissa; Williams, Thomas Neil; Wiysonge, Charles Shey; Wolfe, Charles DA; Wolfe, Ingrid; Won, Sungho; Wubshet, Mamo; Xiao, Qingyang; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yebyo, Henock Gebremedhin; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zeeb, Hajo; Zhang, Hao; Zhao, Yong; Zheng, Yingfeng; Zhou, Maigeng; Zodpey, Sanjay; Murray, Christopher JL; GBD 2015 Child Mortality
Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1-4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980-2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age-sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, 5.8 million (95% uncertainty interval [UI] 5.7-6.0) children younger than 5 years died in 2015, representing a 52.0% (95% UI 50.7-53.3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42.4% (41.3-43.6) to 2.6 million (2.6-2.7) neonatal deaths and 47.0% (35.1-57.0) to 2.1 million (1.8-2.5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3.0% (2.6-3.3), falling short of the 4.4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4.4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10.3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Interpretation Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030.
PMCID:5224696
PMID: 27733285
ISSN: 1474-547x
CID: 2374742
