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H3Africa comes of age [Editorial]
Mensah, George A; Peprah, Emmanuel K; Sampson, Uchechukwu K A; Cooper, Richard S
PMCID:4547554
PMID: 25962946
ISSN: 1680-0745
CID: 2173972
NHLBI perspectives on the growth of heart, lung, blood and sleep conditions in Africa: global and domestic insights, challenges and opportunities
Gibbons, Gary H; Sampson, Uchechukwu K A; Cook, Nakela L; Mensah, George A
PMCID:4557487
PMID: 25962943
ISSN: 1680-0745
CID: 2173982
A global health strategy to capitalize on proven-effective interventions for heart, lung, and blood diseases
Engelgau, Michael M; Peprah, Emmanuel; Sampson, Uchechukwu K A; Mensah, George A
PMCID:4498675
PMID: 25754575
ISSN: 2211-8179
CID: 2173992
Implementation research: an imperative for improving global health and health inequities [Editorial]
Sampson, Uchechukwu K A; Mensah, George A; Narula, Jagat
PMID: 25754560
ISSN: 2211-8179
CID: 2174002
Carotid adventitial vasa vasorum and intima-media thickness in a primary prevention population
Sampson, Uchechukwu K A; Harrell, Frank E Jr; Fazio, Sergio; Nwosu, Sam; Mercaldo, Nate; Mensah, George A; Davidson, Michael H; Coll, Blai; Feinstein, Steve B
BACKGROUND: Vasa vasorum (VV) vessels are critical in the genesis of atherosclerosis. Therefore, we assessed measures of carotid VV, intima-media thickness (CIMT), and patient risk factors in a primary prevention population. METHODS: We used multivariable linear models to evaluate the relationship between baseline covariates and a measure of carotid VV (VV ratio) and CIMT among 324 diabetics and 141 nondiabetics. RESULTS: Median CIMT (in mm) and VV ratio among nondiabetics were 0.82 +/- 0.22 and 0.80 +/- 0.19, respectively, and 1.06 +/- 0.19 and 1.21 +/- 0.26 among diabetics (P < 0.0001). Diabetes was associated with 36% (95% CI: 24.3-48.0, P < 0.001) higher VV ratio whereas a unit change in BMI was associated with approximately 1% (95% CI: 0.5-1.4, P < 0.001) change in VV ratio. A 10-year increase in age was associated with 4% (95% CI: 1-7, P = 0.005) higher CIMT. Each 10 mmHg increase in mean systolic blood pressure was associated with 2% (95% CI: 1-4, P = 0.003) higher CIMT whereas diabetes conferred 31% (95% CI: 19.1-42.1, P < 0.001) higher CIMT. Female sex was associated with a 9% (95% CI: -12.9 to -4.1, P < 0.001) lower CIMT. Low density lipoprotein (LDL) cholesterol, blood pressure, and CIMT were not significantly associated with VV ratio. CONCLUSION: In this cohort of patients with low CIMT, VV ratio, and CIMT were distinctly unrelated, but each independently associated with diabetes. VV ratio and CIMT relationships warrant further investigation in large-scale studies and across a spectrum of atherosclerostic states.
PMID: 24930883
ISSN: 1540-8175
CID: 2174052
Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
Wang, H; Lozano, R; Davis, A; Liang, X; Zhou, M; Vollset, SE; Ozgoren, AA; Abdalla, S; Abd-Allah, F; Aziz, MIA; Abera, SF; Aboyans, V; Abraham, B; Abraham, JP; Abuabara, KE; Abubakar, I; Abu-Raddad, LJ; Abu-Rmeileh, NME; Achoki, T; Adelekan, A; Ademi, Z; Adofo, K; Adou, AK; Adsuar, JC; Arnlov, J; Agardh, EE; Akena, D; Al Khabouri, MJ; Alasfoor, D; Albittar, M; Alegretti, MA; Aleman, AV; Alemu, ZA; Alfonso-Cristancho, R; Alhabib, S; Ali, MK; Ali, R; Alla, F; Al Lami, F; Allebeck, P; AlMazroa, MA; Al-Shahi, Salman, R; Alsharif, U; Alvarez, E; Alviz-Guzman, N; Amankwaa, AA; Amare, AT; Ameli, O; Amini, H; Ammar, W; Anderson, HR; Anderson, BO; Antonio, CAT; Anwari, P; Apfel, H; Cunningham, SA; Arsenijevic, VSA; Artaman, A; Asad, MM; Asghar, RJ; Assadi, R; Atkins, LS; Atkinson, C; Badawi, A; Bahit, MC; Bakfalouni, T; Balakrishnan, K; Balalla, S; Banerjee, A; Barber, RM; Barker-Collo, SL; Barquera, S; Barregard, L; Barrero, LH; Barrientos-Gutierrez, T; Basu, A; Basu, S; Basulaiman, MO; Beardsley, J; Bedi, N; Beghi, E; Bekele, T; Bell, ML; Benjet, C; Bennett, DA; Bensenor, IM; Benzian, H; Bertozzi-Villa, A; Beyene, TJ; Bhala, N; Bhalla, A; Bhutta, ZA; Bikbov, B; Abdulhak, AB; Biryukov, S; Blore, JD; Blyth, FM; Bohensky, MA; Borges, G; Bose, D; Boufous, S; Bourne, RR; Boyers, LN; Brainin, M; Brauer, M; Brayne, CEG; Brazinova, A; Breitborde, N; Brenner, H; Briggs, ADM; Brown, JC; Brugha, TS; Buckle, GC; Bui, LN; Bukhman, G; Burch, M; Campos Nonato, IR; Carabin, H; Cardenas, R; Carapetis, J; Carpenter, DO; Caso, V; Castanda-Orjuela, CA; Castro, RE; Catala-Lopez, F; Cavalleri, F; Chang, J-C; Charlson, FC; Che, X; Chen, H; Chen, Y; Chen, JS; Chen, Z; Chiang, PP-C; Chimed-Ochir, O; Chowdhury, R; Christensen, H; Christophi, CA; Chuang, T-W; Chugh, SS; Cirillo, M; Coates, MM; Coffeng, LE; Coggeshall, MS; Cohen, A; Colistro, V; Colquhoun, SM; Colomar, M; Cooper, LT; Cooper, C; Coppola, LM; Cortinovis, M; Courville, K; Cowie, BC; Criqui, MH; Crump, JA; Cuevas-Nasu, L; Da, Costa, Leite, I; Dabhadkar, KC; Dandona, L; Dandona, R; Dansereau, E; Dargan, PI; Dayama, A; De la Cruz-Gongora, V; De La Vega, SF; De Leo, D; Degenhardt, L; Del Pozo-Cruz, B; Dellavalle, RP; Deribe, K; Des, Jarlais, DC; Dessalegn, M; DeVeber, GA; Dharmaratne, SD; Dherani, M; Diaz-Ortega, J-L; Diaz-Torne, C; Dicker, D; Ding, EL; Dokova, K; Dorsey, ER; Driscoll, TR; Duan, L; Duber, HC; Durrani, AM; Ebel, BE; Edmond, KM; Ellenbogen, RG; Elshrek, Y; Ermakov, SP; Erskine, HE; Eshrati, B; Esteghamati, A; Estep, K; Furst, T; Fahimi, S; Fahrion, AS; Faraon, EJA; Farzadfar, F; Fay, DFJ; Feigl, AB; Feigin, VL; Felicio, MM; Fereshtehnejad, S-M; Fernandes, JG; Ferrari, AJ; Fleming, TD; Foigt, N; Foreman, K; Forouzanfar, MH; Fowkes, FGR; Paleo, UF; Franklin, RC; Futran, ND; Gaffikin, L; Gambashidze, K; Gankpe, FG; Garc-Guerra, FA; Garcia, AC; Geleijnse, JM; Gessner, BD; Gibney, KB; Gillum, RF; Gilmour, S; Ginawi, IAM; Giroud, M; Glaser, EL; Goenka, S; Dantes, HG; Gona, P; Gonzalez-Medina, D; Guinovart, C; Gupta, R; Gosselin, RA; Gotay, CC; Goto, A; Gouda, HN; Graetz, N; Greenwell, KF; Gugnani, HC; Gunnell, D; Gutiierez, RA; Haagsma, J; Hafezi-Nejad, N; Hagan, H; Hagstromer, M; Halasa, YA; Hamadeh, RR; Hamavid, H; Hammami, M; Hancock, J; Hankey, GJ; Hansen, GM; Harb, HL; Harewood, H; Haro, JM; Havmoeller, R; Hay, RJ; Hay, SI; Hedayati, MT; Pi, IBH; Heuton, KR; Heydarpour, P; Higashi, H; Hijar, M; Hoek, HW; Hoffman, HJ; Hornberger, JC; Hosgood, HD; Hossain, M; Hotez, PJ; Hoy, DG; Hsairi, M; Hu, G; Huang, JJ; Huffman, MD; Hughes, AJ; Husseini, A; Huynh, C; Iannarone, M; Iburg, KM; Idrisov, BT; Ikeda, N; Innos, K; Inoue, M; Islami, F; Ismayilova, S; Jacobsen, KH; Jassal, S; Jayaraman, SP; Jensen, PN; Jha, V; Jiang, G; Jiang, Y; Jonas, JB; Joseph, J; Juel, K; Kabagambe, EK; Kan, H; Karch, A; Karimkhani, C; Karthikeyan, G; Kassebaum, N; Kaul, A; Kawakami, N; Kazanjan, K; Kazi, DS; Kemp, AH; Kengne, AP; Keren, A; Kereselidze, M; Khader, YS; Ali Hassan Khalifa, SE; Khan, EA; Khan, G; Khang, Y-H; Kieling, C; Kinfu, Y; Kinge, JM; Kim, D; Kim, S; Kivipelto, M; Knibbs, L; Knudsen, AK; Kokubo, Y; Kosen, S; Kotagal, M; Kravchenko, MA; Krishnaswami, S; Krueger, H; Defo, BK; Kuipers, EJ; Kucuk, Bicer, B; Kulkarni, C; Kulkarni, VS; Kumar, K; Kumar, RB; Kwan, GF; Kyu, H; Lai, T; Balaji, AL; Lalloo, R; Lallukka, T; Lam, H; Lan, Q; Lansingh, VC; Larson, HJ; Larsson, A; Lavados, PM; Lawrynowicz, AEB; Leasher, JL; Lee, J-T; Leigh, J; Leinsalu, M; Leung, R; Levitz, C; Li, B; Li, Y; Liddell, C; Lim, SS; De Lima, GMF; Lind, ML; Lipshultz, SE; Liu, S; Liu, Y; Lloyd, BK; Lofgren, KT; Logroscino, G; London, SJ; Lortet-Tieulent, J; Lotufo, PA; Lucas, RM; Lunevicius, R; Lyons, RA; Ma, S; Pedro, Machado, VM; MacIntyre, MF; Mackay, MT; MacLachlan, JH; Magis-Rodriguez, C; Mahdi, AA; Majdan, M; Malekzadeh, R; Mangalam, S; Mapoma, CC; Marape, M; Marcenes, W; Margono, C; Marks, GB; Marzan, MB; Masci, JR; Mashal, MT; Masiye, F; Mason-Jones, AJ; Matzopolous, R; Mayosi, BM; Mazorodze, TT; McGrath, JJ; McKay, AC; McKee, M; McLain, A; Meaney, PA; Mehndiratta, MM; Mejia-Rodriguez, F; Melaku, YA; Meltzer, M; Memish, ZA; Mendoza, W; Mensah, GA; Meretoja, A; Mhimbira, FA; Miller, TR; Mills, EJ; Misganaw, A; Mishra, SK; Mock, CN; Moffitt, TE; Ibrahim, NM; Mohammad, KA; Mokdad, AH; Mola, GL; Monasta, L; De La Cruz, Monis, J; Hernandez, JCM; Montico, M; Montine, TJ; Mooney, MD; Moore, AR; Moradi-Lakeh, M; Moran, AE; Mori, R; Moschandreas, J; Moturi, WN; Moyer, ML; Mozaffarian, D; Mueller, UO; Mukaigawara, M; Mullany, EC; Murray, J; Mustapha, A; Naghavi, P; Naheed, A; Naidoo, KS; Naldi, L; Nand, D; Nangia, V; Narayan, KMV; Nash, D; Nasher, J; Nejjari, C; Nelson, RG; Neuhouser, M; Neupane, SP; Newcomb, PA; Newman, L; Newton, CR; Ng, M; Ngalesoni, FN; Nguyen, G; Nguyen, NTT; Nisar, MI; Nolte, S; Norheim, OF; Norman, RE; Norrving, B; Nyakarahuka, L; Odell, S; O'Donnell, M; Ohkubo, T; Ohno, SL; Olusanya, BO; Omer, SB; Opio, JN; Orisakwe, OE; Ortblad, KF; Ortiz, A; Otayza, MLK; Pain, AW; Pandian, JD; Panelo, CI; Panniyammakal, J; Papachristou, C; Paternina, Caicedo, AJ; Patten, SB; Patton, GC; Paul, VK; Pavlin, B; Pearce, N; Pellegrini, CA; Pereira, DM; Peresson, SC; Perez-Padilla, R; Perez-Ruiz, FP; Perico, N; Pervaiz, A; Pesudovs, K; Peterson, CB; Petzold, M; Phillips, BK; Phillips, DE; Phillips, MR; Plass, D; Piel, FB; Poenaru, D; Polinder, S; Popova, S; Poulton, RG; Pourmalek, F; Prabhakaran, D; Qato, D; Quezada, AD; Quistberg, DA; Rabito, F; Rafay, A; Rahimi, K; Rahimi-Movaghar, V; Rahman, SUR; Raju, M; Rakovac, I; Rana, SM; Refaat, A; Remuzzi, G; Ribeiro, AL; Ricci, S; Riccio, PM; Richardson, L; Richardus, JH; Roberts, B; Roberts, DA; Robinson, M; Roca, A; Rodriguez, A; Rojas-Rueda, D; Ronfani, L; Room, R; Roth, GA; Rothenbacher, D; Rothstein, DH; Rowley, JTF; Roy, N; Ruhago, GM; Rushton, L; Sambandam, S; Soreide, K; Saeedi, MY; Saha, S; Sahathevan, R; Sahraian, MA; Sahle, BW; Salomon, JA; Salvo, D; Samonte, GMJ; Sampson, U; Sanabria, JR; Sandar, L; Santos, IS; Satpathy, M; Sawhney, M; Saylan, M; Scarborough, P; Schottker, B; Schmidt, JC; Schneider, IJC; Schumacher, AE; Schwebel, DC; Scott, JG; Sepanlou, SG; Servan-Mori, EE; Shackelford, K; Shaheen, A; Shahraz, S; Shakh-Nazarova, M; Shangguan, S; She, J; Sheikhbahaei, S; Shepard, DS; Shibuya, K; Shinohara, Y; Shishani, K; Shiue, I; Shivakoti, R; Shrime, MG; Sigfusdottir, ID; Silberberg, DH; Silva, AP; Simard, EP; Sindi, S; Singh, JA; Singh, L; Sioson, E; Skirbekk, V; Sliwa, K; So, S; Soljak, M; Soneji, S; Soshnikov, SS; Sposato, LA; Sreeramareddy, CT; Stanaway, JD; Stathopoulou, VK; Steenland, K; Stein, C; Steiner, C; Stevens, A; Stockl, H; Straif, K; Stroumpoulis, K; Sturua, L; Sunguya, BF; Swaminathan, S; Swaroop, M; Sykes, BL; Tabb, KM; Takahashi, K; Talongwa, RT; Tan, F; Tanne, D; Tanner, M; Tavakkoli, M; Ao, BT; Teixeira, CM; Templin, T; Tenkorang, EY; Terkawi, AS; Thomas, BA; Thorne-Lyman, AL; Thrift, AG; Thurston, GD; Tillmann, T; Tirschwell, DL; Tleyjeh, IM; Tonelli, M; Topouzis, F; Towbin, JA; Toyoshima, H; Traebert, J; Tran, BX; Truelsen, T; Trujillo, U; Trillini, M; Dimbuene, ZT; Tsilimbaris, M; Tuzcu, EM; Ubeda, C; Uchendu, US; Ukwaja, KN; Undurraga, EA; Vallely, AJ; Van, De, Vijver, S; Van, Gool, CH; Varakin, YY; Vasankari, TJ; Vasconcelos, AMN; Vavilala, MS; Venketasubramanian, N; Vijayakumar, L; Villalpando, S; Violante, FS; Vlassov, VV; Wagner, GR; Waller, SG; Wang, J; Wang, L; Wang, X; Wang, Y; Warouw, TS; Weichenthal, S; Weiderpass, E; Weintraub, RG; Wenzhi, W; Werdecker, A; Wessells, KRR; Westerman, R; Whiteford, HA; Wilkinson, JD; Williams, TN; Woldeyohannes, SM; Wolfe, CDA; Wolock, TM; Woolf, AD; Wong, JQ; Wright, JL; Wulf, S; Wurtz, B; Xu, G; Yang, YC; Yano, Y; Yatsuya, H; Yip, P; Yonemoto, N; Yoon, S-J; Younis, M; Yu, C; Jin, KY; El Sayed, Zaki M; Zamakhshary, MF; Zeeb, H; Zhang, Y; Zhao, Y; Zheng, Y; Zhu, J; Zhu, S; Zonies, D; Zou, XN; Zunt, JR; Vos, T; Lopez, AD; Murray, CJL; Alcala-Cerra, G; Balala, S; Chang, C-C; Gosslin, RA; Hu, H; Karam, N; Sabin, N; Temesgen, AM
BACKGROUND: Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. METHODS: We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. FINDINGS: Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100,000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. INTERPRETATION: For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade. FUNDING: Bill & Melinda Gates Foundation.
PMCID:4340604
PMID: 25530442
ISSN: 1474-547x
CID: 1514472
From Data to Action: Neuroepidemiology Informs Implementation Research for Global Stroke Prevention and Treatment
Mensah, George A; Sacco, Ralph L; Vickrey, Barbara G; Sampson, Uchechukwu K A; Waddy, Salina; Ovbiagele, Bruce; Pandian, Jeyaraj Durai; Norrving, Bo; Feigin, Valery L
As a scientific field of study, neuroepidemiology encompasses more than just the descriptive study of the frequency, distribution, determinants and outcomes of neurologic diseases in populations. It also includes experimental aspects that span the full spectrum of clinical and population science research. As such, neuroepidemiology has a strong potential to inform implementation research for global stroke prevention and treatment. This review begins with an overview of the progress that has been made in descriptive and experimental neuroepidemiology over the past quarter century with emphasis on standards for evidence generation, critical appraisal of that evidence and impact on clinical and public health practice at the national, regional and global levels. Specific advances made in high-income countries as well as in low- and middle-income countries are presented. Gaps in implementation as well as evidence gaps in stroke research, stroke burden, clinical outcomes and disparities between developed and developing countries are then described. The continuing need for high quality neuroepidemiologic data in low- and middle-income countries is highlighted. Additionally, persisting disparities in stroke burden and care by sex, race, ethnicity, income and socioeconomic status are discussed. The crucial role that national stroke registries have played in neuroepidemiologic research is also addressed. Opportunities presented by new directions in comparative effectiveness and implementation research are discussed as avenues for turning neuroepidemiological insights into action to maximize health impact and to guide further biomedical research on neurological diseases.
PMCID:4633278
PMID: 26505615
ISSN: 1423-0208
CID: 2173912
Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
Kassebaum, Nicholas J; Bertozzi-Villa, Amelia; Coggeshall, Megan S; Shackelford, Katya A; Steiner, Caitlyn; Heuton, Kyle R; Gonzalez-Medina, Diego; Barber, Ryan; Huynh, Chantal; Dicker, Daniel; Templin, Tara; Wolock, Timothy M; Ozgoren, Ayse Abbasoglu; Abd-Allah, Foad; Abera, Semaw Ferede; Abubakar, Ibrahim; Achoki, Tom; Adelekan, Ademola; Ademi, Zanfina; Adou, Arsene Kouablan; Adsuar, Jose C; Agardh, Emilie E; Akena, Dickens; Alasfoor, Deena; Alemu, Zewdie Aderaw; Alfonso-Cristancho, Rafael; Alhabib, Samia; Ali, Raghib; Al Kahbouri, Mazin J; Alla, Francois; Allen, Peter J; AlMazroa, Mohammad A; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amankwaa, Adansi A; Amare, Azmeraw T; Amini, Hassan; Ammar, Walid; Antonio, Carl A T; Anwari, Palwasha; Arnlov, Johan; Arsenijevic, Valentina S Arsic; Artaman, Ali; Asad, Majed Masoud; Asghar, Rana J; Assadi, Reza; Atkins, Lydia S; Badawi, Alaa; Balakrishnan, Kalpana; Basu, Arindam; Basu, Sanjay; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Bernabe, Eduardo; Beyene, Tariku J; Bhutta, Zulfiqar; Bin Abdulhak, Aref; Blore, Jed D; Basara, Berrak Bora; Bose, Dipan; Breitborde, Nicholas; Cardenas, Rosario; Castaneda-Orjuela, Carlos A; Castro, Ruben Estanislao; Catala-Lopez, Ferran; Cavlin, Alanur; Chang, Jung-Chen; Che, Xuan; Christophi, Costas A; Chugh, Sumeet S; Cirillo, Massimo; Colquhoun, Samantha M; Cooper, Leslie Trumbull; Cooper, Cyrus; da Costa Leite, Iuri; Dandona, Lalit; Dandona, Rakhi; Davis, Adrian; Dayama, Anand; Degenhardt, Louisa; De Leo, Diego; del Pozo-Cruz, Borja; Deribe, Kebede; Dessalegn, Muluken; deVeber, Gabrielle A; Dharmaratne, Samath D; Dilmen, Ugur; Ding, Eric L; Dorrington, Rob E; Driscoll, Tim R; Ermakov, Sergei Petrovich; Esteghamati, Alireza; Faraon, Emerito Jose A; Farzadfar, Farshad; Felicio, Manuela Mendonca; Fereshtehnejad, Seyed-Mohammad; de Lima, Graca Maria Ferreira; Forouzanfar, Mohammad H; Franca, Elisabeth B; Gaffikin, Lynne; Gambashidze, Ketevan; Gankpe, Fortune Gbetoho; Garcia, Ana C; Geleijnse, Johanna M; Gibney, Katherine B; Giroud, Maurice; Glaser, Elizabeth L; Goginashvili, Ketevan; Gona, Philimon; Gonzalez-Castell, Dinorah; Goto, Atsushi; Gouda, Hebe N; Gugnani, Harish Chander; Gupta, Rahul; Gupta, Rajeev; Hafezi-Nejad, Nima; Hamadeh, Randah Ribhi; Hammami, Mouhanad; Hankey, Graeme J; Harb, Hilda L; Havmoeller, Rasmus; Hay, Simon I; Pi, Ileana B Heredia; Hoek, Hans W; Hosgood, H Dean; Hoy, Damian G; Husseini, Abdullatif; Idrisov, Bulat T; Innos, Kaire; Inoue, Manami; Jacobsen, Kathryn H; Jahangir, Eiman; Jee, Sun Ha; Jensen, Paul N; Jha, Vivekanand; Jiang, Guohong; Jonas, Jost B; Juel, Knud; Kabagambe, Edmond Kato; Kan, Haidong; Karam, Nadim E; Karch, Andre; Karema, Corine Kakizi; Kaul, Anil; Kawakami, Norito; Kazanjan, Konstantin; Kazi, Dhruv S; Kemp, Andrew H; Kengne, Andre Pascal; Kereselidze, Maia; Khader, Yousef Saleh; Khalifa, Shams Eldin Ali Hassan; Khan, Ejaz Ahmed; Khang, Young-Ho; Knibbs, Luke; Kokubo, Yoshihiro; Kosen, Soewarta; Defo, Barthelemy Kuate; Kulkarni, Chanda; Kulkarni, Veena S; Kumar, G Anil; Kumar, Kaushalendra; Kumar, Ravi B; Kwan, Gene; Lai, Taavi; Lalloo, Ratilal; Lam, Hilton; Lansingh, Van C; Larsson, Anders; Lee, Jong-Tae; Leigh, James; Leinsalu, Mall; Leung, Ricky; Li, Xiaohong; Li, Yichong; Li, Yongmei; Liang, Juan; Liang, Xiaofeng; Lim, Stephen S; Lin, Hsien-Ho; Lipshultz, Steven E; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K; London, Stephanie J; Lotufo, Paulo A; Ma, Jixiang; Ma, Stefan; Machado, Vasco Manuel Pedro; Mainoo, Nana Kwaku; Majdan, Marek; Mapoma, Christopher Chabila; Marcenes, Wagner; Marzan, Melvin Barrientos; Mason-Jones, Amanda J; Mehndiratta, Man Mohan; Mejia-Rodriguez, Fabiola; Memish, Ziad A; Mendoza, Walter; Miller, Ted R; Mills, Edward J; Mokdad, Ali H; Mola, Glen Liddell; Monasta, Lorenzo; de la Cruz Monis, Jonathan; Hernandez, Julio Cesar Montanez; Moore, Ami R; Moradi-Lakeh, Maziar; Mori, Rintaro; Mueller, Ulrich O; Mukaigawara, Mitsuru; Naheed, Aliya; Naidoo, Kovin S; Nand, Devina; Nangia, Vinay; Nash, Denis; Nejjari, Chakib; Nelson, Robert G; Neupane, Sudan Prasad; Newton, Charles R; Ng, Marie; Nieuwenhuijsen, Mark J; Nisar, Muhammad Imran; Nolte, Sandra; Norheim, Ole F; Nyakarahuka, Luke; Oh, In-Hwan; Ohkubo, Takayoshi; Olusanya, Bolajoko O; Omer, Saad B; Opio, John Nelson; Orisakwe, Orish Ebere; Pandian, Jeyaraj D; Papachristou, Christina; Park, Jae-Hyun; Caicedo, Angel J Paternina; Patten, Scott B; Paul, Vinod K; Pavlin, Boris Igor; Pearce, Neil; Pereira, David M; Pesudovs, Konrad; Petzold, Max; Poenaru, Dan; Polanczyk, Guilherme V; Polinder, Suzanne; Pope, Dan; Pourmalek, Farshad; Qato, Dima; Quistberg, D Alex; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; ur Rahman, Sajjad; Raju, Murugesan; Rana, Saleem M; Refaat, Amany; Ronfani, Luca; Roy, Nobhojit; Pimienta, Tania Georgina Sanchez; Sahraian, Mohammad Ali; Salomon, Joshua A; Sampson, Uchechukwu; Santos, Itamar S; Sawhney, Monika; Sayinzoga, Felix; Schneider, Ione J C; Schumacher, Austin; Schwebel, David C; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shakh-Nazarova, Marina; Sheikhbahaei, Sara; Shibuya, Kenji; Shin, Hwashin Hyun; Shiue, Ivy; Sigfusdottir, Inga Dora; Silberberg, Donald H; Silva, Andrea P; Singh, Jasvinder A; Skirbekk, Vegard; Sliwa, Karen; Soshnikov, Sergey S; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stroumpoulis, Konstantinos; Sturua, Lela; Sykes, Bryan L; Tabb, Karen M; Talongwa, Roberto Tchio; Tan, Feng; Teixeira, Carolina Maria; Tenkorang, Eric Yeboah; Terkawi, Abdullah Sulieman; Thorne-Lyman, Andrew L; Tirschwell, David L; Towbin, Jeffrey A; Tran, Bach X; Tsilimbaris, Miltiadis; Uchendu, Uche S; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uzun, Selen Begum; Vallely, Andrew J; van Gool, Coen H; Vasankari, Tommi J; Vavilala, Monica S; Venketasubramanian, N; Villalpando, Salvador; Violante, Francesco S; Vlassov, Vasiliy Victorovich; Vos, Theo; Waller, Stephen; Wang, Haidong; Wang, Linhong; Wang, XiaoRong; Wang, Yanping; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Westerman, Ronny; Wilkinson, James D; Woldeyohannes, Solomon Meseret; Wong, John Q; Wordofa, Muluemebet Abera; Xu, Gelin; Yang, Yang C; Yano, Yuichiro; Yentur, Gokalp Kadri; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Jin, Kim Yun; El Sayed Zaki, Maysaa; Zhao, Yong; Zheng, Yingfeng; Zhou, Maigeng; Zhu, Jun; Zou, Xiao Nong; Lopez, Alan D; Naghavi, Mohsen; Murray, Christopher J L; Lozano, Rafael
BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0.3% (-1.1 to 0.6) from 1990 to 2003, and -2.7% (-3.9 to -1.5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0.4% (0.2-0.6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956.8 (685.1-1262.8) in South Sudan to 2.4 (1.6-3.6) in Iceland. INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. FUNDING: Bill & Melinda Gates Foundation.
PMCID:4255481
PMID: 24797575
ISSN: 1474-547x
CID: 2174062
Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
Wang, Haidong; Liddell, Chelsea A; Coates, Matthew M; Mooney, Meghan D; Levitz, Carly E; Schumacher, Austin E; Apfel, Henry; Iannarone, Marissa; Phillips, Bryan; Lofgren, Katherine T; Sandar, Logan; Dorrington, Rob E; Rakovac, Ivo; Jacobs, Troy A; Liang, Xiaofeng; Zhou, Maigeng; Zhu, Jun; Yang, Gonghuan; Wang, Yanping; Liu, Shiwei; Li, Yichong; Ozgoren, Ayse Abbasoglu; Abera, Semaw Ferede; Abubakar, Ibrahim; Achoki, Tom; Adelekan, Ademola; Ademi, Zanfina; Alemu, Zewdie Aderaw; Allen, Peter J; AlMazroa, Mohammad AbdulAziz; Alvarez, Elena; Amankwaa, Adansi A; Amare, Azmeraw T; Ammar, Walid; Anwari, Palwasha; Cunningham, Solveig Argeseanu; Asad, Majed Masoud; Assadi, Reza; Banerjee, Amitava; Basu, Sanjay; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Bhutta, Zulfiqar; Blore, Jed D; Basara, Berrak Bora; Boufous, Soufiane; Breitborde, Nicholas; Bruce, Nigel G; Bui, Linh Ngoc; Carapetis, Jonathan R; Cardenas, Rosario; Carpenter, David O; Caso, Valeria; Castro, Ruben Estanislao; Catala-Lopez, Ferran; Cavlin, Alanur; Che, Xuan; Chiang, Peggy Pei-Chia; Chowdhury, Rajiv; Christophi, Costas A; Chuang, Ting-Wu; Cirillo, Massimo; da Costa Leite, Iuri; Courville, Karen J; Dandona, Lalit; Dandona, Rakhi; Davis, Adrian; Dayama, Anand; Deribe, Kebede; Dharmaratne, Samath D; Dherani, Mukesh K; Dilmen, Ugur; Ding, Eric L; Edmond, Karen M; Ermakov, Sergei Petrovich; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fijabi, Daniel Obadare; Foigt, Nataliya; Forouzanfar, Mohammad H; Garcia, Ana C; Geleijnse, Johanna M; Gessner, Bradford D; Goginashvili, Ketevan; Gona, Philimon; Goto, Atsushi; Gouda, Hebe N; Green, Mark A; Greenwell, Karen Fern; Gugnani, Harish Chander; Gupta, Rahul; Hamadeh, Randah Ribhi; Hammami, Mouhanad; Harb, Hilda L; Hay, Simon; Hedayati, Mohammad T; Hosgood, H Dean; Hoy, Damian G; Idrisov, Bulat T; Islami, Farhad; Ismayilova, Samaya; Jha, Vivekanand; Jiang, Guohong; Jonas, Jost B; Juel, Knud; Kabagambe, Edmond Kato; Kazi, Dhruv S; Kengne, Andre Pascal; Kereselidze, Maia; Khader, Yousef Saleh; Khalifa, Shams Eldin Ali Hassan; Khang, Young-Ho; Kim, Daniel; Kinfu, Yohannes; Kinge, Jonas M; Kokubo, Yoshihiro; Kosen, Soewarta; Defo, Barthelemy Kuate; Kumar, G Anil; Kumar, Kaushalendra; Kumar, Ravi B; Lai, Taavi; Lan, Qing; Larsson, Anders; Lee, Jong-Tae; Leinsalu, Mall; Lim, Stephen S; Lipshultz, Steven E; Logroscino, Giancarlo; Lotufo, Paulo A; Lunevicius, Raimundas; Lyons, Ronan Anthony; Ma, Stefan; Mahdi, Abbas Ali; Marzan, Melvin Barrientos; Mashal, Mohammad Taufiq; Mazorodze, Tasara T; McGrath, John J; Memish, Ziad A; Mendoza, Walter; Mensah, George A; Meretoja, Atte; Miller, Ted R; Mills, Edward J; Mohammad, Karzan Abdulmuhsin; Mokdad, Ali H; Monasta, Lorenzo; Montico, Marcella; Moore, Ami R; Moschandreas, Joanna; Msemburi, William T; Mueller, Ulrich O; Muszynska, Magdalena M; Naghavi, Mohsen; Naidoo, Kovin S; Narayan, K M Venkat; Nejjari, Chakib; Ng, Marie; de Dieu Ngirabega, Jean; Nieuwenhuijsen, Mark J; Nyakarahuka, Luke; Ohkubo, Takayoshi; Omer, Saad B; Caicedo, Angel J Paternina; Pillay-van Wyk, Victoria; Pope, Dan; Pourmalek, Farshad; Prabhakaran, Dorairaj; Rahman, Sajjad U R; Rana, Saleem M; Reilly, Robert Quentin; Rojas-Rueda, David; Ronfani, Luca; Rushton, Lesley; Saeedi, Mohammad Yahya; Salomon, Joshua A; Sampson, Uchechukwu; Santos, Itamar S; Sawhney, Monika; Schmidt, Jurgen C; Shakh-Nazarova, Marina; She, Jun; Sheikhbahaei, Sara; Shibuya, Kenji; Shin, Hwashin Hyun; Shishani, Kawkab; Shiue, Ivy; Sigfusdottir, Inga Dora; Singh, Jasvinder A; Skirbekk, Vegard; Sliwa, Karen; Soshnikov, Sergey S; Sposato, Luciano A; Stathopoulou, Vasiliki Kalliopi; Stroumpoulis, Konstantinos; Tabb, Karen M; Talongwa, Roberto Tchio; Teixeira, Carolina Maria; Terkawi, Abdullah Sulieman; Thomson, Alan J; Thorne-Lyman, Andrew L; Toyoshima, Hideaki; Dimbuene, Zacharie Tsala; Uwaliraye, Parfait; Uzun, Selen Begum; Vasankari, Tommi J; Vasconcelos, Ana Maria Nogales; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Waller, Stephen; Wan, Xia; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Westerman, Ronny; Wilkinson, James D; Williams, Hywel C; Yang, Yang C; Yentur, Gokalp Kadri; Yip, Paul; Yonemoto, Naohiro; Younis, Mustafa; Yu, Chuanhua; Jin, Kim Yun; El Sayed Zaki, Maysaa; Zhu, Shankuan; Vos, Theo; Lopez, Alan D; Murray, Christopher J L
BACKGROUND: Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. METHODS: We generated updated estimates of child mortality in early neonatal (age 0-6 days), late neonatal (7-28 days), postneonatal (29-364 days), childhood (1-4 years), and under-5 (0-4 years) age groups for 188 countries from 1970 to 2013, with more than 29,000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. FINDINGS: We estimated that 6.3 million (95% UI 6.0-6.6) children under-5 died in 2013, a 64% reduction from 17.6 million (17.1-18.1) in 1970. In 2013, child mortality rates ranged from 152.5 per 1000 livebirths (130.6-177.4) in Guinea-Bissau to 2.3 (1.8-2.9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from -6.8% to 0.1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000-13 than during 1990-2000. In 2013, neonatal deaths accounted for 41.6% of under-5 deaths compared with 37.4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1.4 million more child deaths, and rising income per person and maternal education led to 0.9 million and 2.2 million fewer deaths, respectively. Changes in secular trends led to 4.2 million fewer deaths. Unexplained factors accounted for only -1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. INTERPRETATION: Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030. FUNDING: Bill & Melinda Gates Foundation, US Agency for International Development.
PMCID:4165626
PMID: 24797572
ISSN: 1474-547x
CID: 2174072
Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013
Ng, Marie; Fleming, Tom; Robinson, Margaret; Thomson, Blake; Graetz, Nicholas; Margono, Christopher; Mullany, Erin C; Biryukov, Stan; Abbafati, Cristiana; Abera, Semaw Ferede; Abraham, Jerry P; Abu-Rmeileh, Niveen M E; Achoki, Tom; AlBuhairan, Fadia S; Alemu, Zewdie A; Alfonso, Rafael; Ali, Mohammed K; Ali, Raghib; Guzman, Nelson Alvis; Ammar, Walid; Anwari, Palwasha; Banerjee, Amitava; Barquera, Simon; Basu, Sanjay; Bennett, Derrick A; Bhutta, Zulfiqar; Blore, Jed; Cabral, Norberto; Nonato, Ismael Campos; Chang, Jung-Chen; Chowdhury, Rajiv; Courville, Karen J; Criqui, Michael H; Cundiff, David K; Dabhadkar, Kaustubh C; Dandona, Lalit; Davis, Adrian; Dayama, Anand; Dharmaratne, Samath D; Ding, Eric L; Durrani, Adnan M; Esteghamati, Alireza; Farzadfar, Farshad; Fay, Derek F J; Feigin, Valery L; Flaxman, Abraham; Forouzanfar, Mohammad H; Goto, Atsushi; Green, Mark A; Gupta, Rajeev; Hafezi-Nejad, Nima; Hankey, Graeme J; Harewood, Heather C; Havmoeller, Rasmus; Hay, Simon; Hernandez, Lucia; Husseini, Abdullatif; Idrisov, Bulat T; Ikeda, Nayu; Islami, Farhad; Jahangir, Eiman; Jassal, Simerjot K; Jee, Sun Ha; Jeffreys, Mona; Jonas, Jost B; Kabagambe, Edmond K; Khalifa, Shams Eldin Ali Hassan; Kengne, Andre Pascal; Khader, Yousef Saleh; Khang, Young-Ho; Kim, Daniel; Kimokoti, Ruth W; Kinge, Jonas M; Kokubo, Yoshihiro; Kosen, Soewarta; Kwan, Gene; Lai, Taavi; Leinsalu, Mall; Li, Yichong; Liang, Xiaofeng; Liu, Shiwei; Logroscino, Giancarlo; Lotufo, Paulo A; Lu, Yuan; Ma, Jixiang; Mainoo, Nana Kwaku; Mensah, George A; Merriman, Tony R; Mokdad, Ali H; Moschandreas, Joanna; Naghavi, Mohsen; Naheed, Aliya; Nand, Devina; Narayan, K M Venkat; Nelson, Erica Leigh; Neuhouser, Marian L; Nisar, Muhammad Imran; Ohkubo, Takayoshi; Oti, Samuel O; Pedroza, Andrea; Prabhakaran, Dorairaj; Roy, Nobhojit; Sampson, Uchechukwu; Seo, Hyeyoung; Sepanlou, Sadaf G; Shibuya, Kenji; Shiri, Rahman; Shiue, Ivy; Singh, Gitanjali M; Singh, Jasvinder A; Skirbekk, Vegard; Stapelberg, Nicolas J C; Sturua, Lela; Sykes, Bryan L; Tobias, Martin; Tran, Bach X; Trasande, Leonardo; Toyoshima, Hideaki; van de Vijver, Steven; Vasankari, Tommi J; Veerman, J Lennert; Velasquez-Melendez, Gustavo; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Vos, Theo; Wang, Claire; Wang, XiaoRong; Weiderpass, Elisabete; Werdecker, Andrea; Wright, Jonathan L; Yang, Y Claire; Yatsuya, Hiroshi; Yoon, Jihyun; Yoon, Seok-Jun; Zhao, Yong; Zhou, Maigeng; Zhu, Shankuan; Lopez, Alan D; Murray, Christopher J L; Gakidou, Emmanuela
BACKGROUND: In 2010, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life lost, and 3.8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. METHODS: We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). FINDINGS: Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28.8% (95% UI 28.4-29.3) to 36.9% (36.3-37.4) in men, and from 29.8% (29.3-30.2) to 38.0% (37.5-38.5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23.8% (22.9-24.7) of boys and 22.6% (21.7-23.6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8.1% (7.7-8.6) to 12.9% (12.3-13.5) in 2013 for boys and from 8.4% (8.1-8.8) to 13.4% (13.0-13.9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. INTERPRETATION: Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. FUNDING: Bill & Melinda Gates Foundation.
PMCID:4624264
PMID: 24880830
ISSN: 0140-6736
CID: 1173452
