The global burden of cardiovascular disease attributable to diet high in sugar-sweetened beverages among people aged 60 years and older: an analysis for the global burden of disease study 2019.

Objectives: This study aimed to quantify the global cardiovascular disease (CVD) burden attributable to diet high in sugar-sweetened beverages (SSB) among adults aged 60 years and older using data from the Global Burden of Disease (GBD) Study 2019. Methods: We extracted data on CVD mortality, disability-adjusted life-years (DALYs), and risk-factor exposures from the GBD 2019 study for people aged 60 and older. Age-period-cohort models were used to estimate the overall annual percentage change in mortality and DALY rate (net drift, % per year), mortality and DALY rate for each age group from 1990 to 2019 (local drift, % per year), longitudinal age-specific rate corrected for period bias (age effect), and mortality and Daly rate for each age group from 1990 to 2019 (local drift, % per year). And period/cohort relative risk (period/cohort effect). Results: Between 1990 and 2019, global age-standardized CVD mortality (ASMR) and disability-adjusted life years (DALY) rates attributable to high SSB intake decreased, with larger reductions in high-SDI regions. ASMR declined from 19.5 to 13 per 100,000 (estimated annual percentage change (EAPC): -1.46%) and ASDR declined from 345.8 to 220.6 per 100,000 (EAPC: -1.66%). Age-period-cohort analysis showed CVD deaths and DALYs increased exponentially with age, peaking at 85-89 years. Period effects indicated declining CVD mortality and DALY rates since 1999, especially in higher-SDI regions. Cohort effects demonstrated consistent risk declines across successive generations born between 1900 and 1959. Predictions suggest continuing decreases through 2045 globally, but slower declines in lower-SDI regions. Conclusion: In conclusion, this comprehensive assessment of global CVD burden among older adults attributable to high SSB intake highlights major achievements but also persistent areas needing attention. Favorable declining mortality and DALY rate trends reflect substantial progress in CVD control amid population growth and aging.

Association between obesity and liver cancer from 2012 to 2023: Bibliometric analysis and global trends.

Incidence rates of liver cancer have increased worldwide in recent decades, making it a major public health problem globally. Obesity can be caused by multiple factors and promotes the development of liver cancer in many ways. Although the research on the association between obesity and liver cancer was previously explored, we first employed bibliometrics to analyze the current research status. From 2012 to 2023, the Web of Science Core Collection database was searched for studies regarding the association between obesity and liver cancer. To evaluate worldwide trends and research hotspots in this topic, bibliometric analysis tools such as VOSviewer, CiteSpace, and R Package were employed. Altogether 233 eligible publications, consisting of 167 articles and 66 reviews, were analyzed. The yearly number of publications and average citation numbers have increased over the last 11 years, particularly the last 6 years. The great majority of published articles on this topic originated from the United States (n = 89, 38.20%), followed by China (n = 60, 25.75%), and England (n = 23, 9.87%). In this subject's research, American scholars embodied considerable production, great prominence, and high academic influence. The most cited article was Yoshimoto, S et al of Japan Science and Technology Agency published in 2013 with a citation number of 1410. We apply bibliometric analysis for the first time in this field, expecting to help scholars efficiently and effectively retrieve the association between obesity and liver cancer.

Can a Well-Being Economy Save Us?

The COVID-19 pandemic led many countries to consider reforms to their economic policies, in part to better deal with global warming, mass population migration and displacements, and worsening global inequalities. Some health progressive changes have been made, but the world still confronts the contradiction between economic growth and the need to reduce aggregate global consumption. Well-being economies based on valuing human and planetary health have been proposed as a viable option, with more appeal than concepts such as degrowth or postgrowth economics. Some governments are moving in a "well-being economy" direction, but are they moving far and fast enough? What are the policy actions governments must take, and how will they overcome powerful interests opposed to any economic changes that might challenge their privileges? The idea of well-being economies resonates strongly with most cultures; and therein lies its civil society activist potential.

Assessing Global Evidence on Cost-Effectiveness to Inform Development of Pakistan's Essential Package of Health Services.

BACKGROUND: Countries designing a health benefit package (HBP) to support progress towards universal health coverage (UHC) require robust cost-effectiveness evidence. This paper reports on Pakistan's approach to assessing the applicability of global cost-effectiveness evidence to country context as part of a HBP design process. METHODS: A seven-step process was developed and implemented with Disease Control Priority 3 (DCP3) project partners to assess the applicability of global incremental cost-effectiveness ratios (ICERs) to Pakistan. First, the scope of the interventions to be assessed was defined and an independent, interdisciplinary team was formed. Second, the team familiarized itself with intervention descriptions. Third, the team identified studies from the Tufts Medical School Global Health Cost-Effectiveness Analysis (GH-CEA) registry. Fourth, the team applied specific knock-out criteria to match identified studies to local intervention descriptions. Matches were then cross-checked across reviewers and further selection was made where there were multiple ICER matches. Sixth, a quality scoring system was applied to ICER values. Finally, a database was created containing all the ICER results with a justification for each decision, which was made available to decision-makers during HBP deliberation. RESULTS: We found that less than 50% of the interventions in DCP3 could be supported with evidence of cost-effectiveness applicable to the country context. Out of 78 ICERs identified as applicable to Pakistan from the Tufts GH-CEA registry, only 20 ICERs were exact matches of the DCP3 Pakistan intervention descriptions and 58 were partial matches. CONCLUSION: This paper presents the first attempt globally to use the main public GH-CEA database to estimate cost-effectiveness in the context of HBPs at a country level. This approach is a useful learning for all countries trying to develop essential packages informed by the global database on ICERs, and it will support the design of future evidence and further development of methods.

Global, regional, national epidemiology and trends of neglected tropical diseases in youths and young adults aged 15-39 years from 1990 to 2019: findings from the global burden of disease study 2019.

BACKGROUND: In recent years, the escalating concern for neglected tropical diseases (NTDs) has been recognized as a pressing global health issue. This concern is acutely manifested in low- and middle-income countries, where there is an escalating prevalence among adolescents and young adults. The burgeoning of these conditions threatens to impair patients' occupational capabilities and overall life quality. Despite the considerable global impact of NTDs, comprehensive studies focusing on their impact in younger populations remain scarce. Our study aims to describe the global prevalence of neglected tropical diseases among people aged 15 to 39 years over the 30-year period from 1990 to 2019, and to project the disease burden of the disease up to 2040. METHODS: Annual data on incident cases, mortality, and disability-adjusted life years (DALYs) for NTDs were procured from the Global Burden of Disease Study 2019 (GBD 2019). These data were stratified by global and regional distribution, country, social development index (SDI), age, and sex. We computed age-standardized rates (ASRs) and the numbers of incident cases, mortalities, and DALYs from 1990 to 2019. The estimated annual percentage change (EAPC) in the ASRs was calculated to evaluate evolving trends. RESULTS: In 2019, it was estimated that there were approximately 552 million NTD cases globally (95% Uncertainty Interval [UI]: 519.9 million to 586.3 million), a 29% decrease since 1990. South Asia reported the highest NTD prevalence, with an estimated 171.7 million cases (95% UI: 150.4 million to 198.6 million). Among the five SDI categories, the prevalence of NTDs was highest in the moderate and low SDI regions in 1990 (approximately 270.5 million cases) and 2019 (approximately 176.5 million cases). Sub-Saharan Africa recorded the most significant decline in NTD cases over the past three decades. Overall, there was a significant inverse correlation between the disease burden of NTDs and SDI. CONCLUSION: NTDs imposed over half a billion incident cases and 10.8 million DALYs lost globally in 2019-exerting an immense toll rivaling major infectious and non-communicable diseases. Encouraging declines in prevalence and disability burdens over the past three decades spotlight the potential to accelerate progress through evidence-based allocation of resources. Such strategic integration could substantially enhance public awareness about risk factors and available treatment options.

Faster and farther towards the abyss: global health accelerators instead of tangible changes.

Global health accelerators have become the leading expression of global health engagement and policy. While accelerators seem to be the strategy of the moment, the term is meaningless and devoid of any statement of content. Moreover, acceleration can make social processes too fast to be subject to rational control or governance, especially in an era of (un-)social media, which makes the pace of communication and information. Under the dominance of neoliberalism, acceleration and accelerators pose a particular risk because they encounter a situation in which mankind is moving away from solving vital challenges and addressing their root causes. The fashionable emergence of accelerators cannot inspire confidence in the future trends in global health unless they actually result in tangible change and new approaches to tackling systemic challenges.

Trend and projection of the prevalence and burden of near vision loss in China and globally from 1990 to 2030: A Bayesian age-period-cohort modeling study.

Background: Few studies have investigated near vision loss (NVL) in China. To address this gap, we aimed to explore trends in the prevalence and disease burden of NVL from 1990 to 2019 and to predict trends over the next decade. Methods: Using data from the Global Burden of Disease 2019 study, we calculated the age-standardised prevalence rate (ASPR), age-specific disability-adjusted life years (DALYs), and annual percentage change (EAPC) in China and different regions. We then used the Bayesian age-period-cohort (BAPC) predictive model to predict the prevalence trends from 2020 to 2030 in both contexts. Results: At the global level, ASPRs increased from 5613.27 in 1990 to 5937.81 per 100 000 population in 2019, with an EAPC of 0.06. The ASPR in China specifically decreased from 7538.14 in 1990 to 7392.86 per 100 000 population in 2019 (EAPC = -0.02). The age-standardised DALY rate was higher in women than in men, both globally and in China. The NVL burden was relatively higher in low-income regions, low sociodemographic index regions, and the South-East Asia Region compared to other regions. The predictive model indicated that the ASR trend for NVL slowly increased at a global level after 2020, yet decreased in China. Conclusions: Despite a decline in the age-standardised prevalence of NVL in China over the next decade, the current burden remains substantial. To alleviate this burden, decision-makers should adopt inclusive approaches by involving all stakeholders.

Global lessons on delivery of primary healthcare services for people with non-communicable diseases: convergent mixed methods.

OBJECTIVE: To extract key lessons on primary healthcare (PHC) service delivery strategies for non-communicable diseases (NCD) from the work of researchers funded by the Global Alliance for Chronic Diseases (GACD). DESIGN: A convergent mixed methods study that extracted data using a standardised template from research projects funded by the GACD that focused on PHC. The strategies implemented in these studies were mapped onto the PHC Performance Initiative framework. Semistructured qualitative interviews were conducted with researchers from purposefully selected projects to understand the strategies and contextual factors in more depth. SETTING: PHC contexts from low or middle-income countries (LMIC) as well as vulnerable groups within high-income countries. Projects came from all regions of the world, particularly East Asia and Pacific, sub-Saharan Africa, South Asia, Latin America and Caribbean. PARTICIPANTS: The study extracted data on 84 research projects and interviewed researchers from 16 research projects. RESULTS: Research projects came from all regions of the world, and mainly focused on diabetes (35.3%), hypertension (28.3%) and mental health (27.6%). Mapped onto the PHC Performance Initiative framework: 49.4% focused on high-quality PHC (particularly the comprehensiveness of NCD care, 41.2%); 41.2% on the availability of PHC services (particularly the competence of healthcare workers, 36.5%); 35.3% on population health management (particularly community-based services, 35.3%); 34.1% on facility organisation and management (particularly team-based care, 20.0%) and 31.8% on access (particularly digital technology, 23.5%). Most common strategies were task shifting and training to improve the comprehensiveness of NCD care through community-based services. Contextual factors related to inputs: infrastructure, equipment and medication, workforce (particularly community health workers), finances, health information systems and digital technology. CONCLUSION: Key strategies and contextual factors to improve PHC service delivery for NCDs in LMICs were identified. These strategies should combine with other strategies to strengthen the PHC system as a whole, while improving care for NCDs.

Global Case Fatality of Bacterial Meningitis During an 80-Year Period: A Systematic Review and Meta-Analysis.

Importance: The impact of vaccination, antibiotics, and anti-inflammatory treatment on pathogen distribution and outcome of bacterial meningitis over the past century is uncertain. Objective: To describe worldwide pathogen distribution and case fatality ratios of community-acquired bacterial meningitis. Data Sources: Google Scholar and MEDLINE were searched in January 2022 using the search terms bacterial meningitis and mortality. Study Selection: Included studies reported at least 10 patients with bacterial meningitis and survival status. Studies that selected participants by a specific risk factor, had a mean observation period before 1940, or had more than 10% of patients with health care-associated meningitis, tuberculous meningitis, or missing outcome were excluded. Data Extraction and Synthesis: Data were extracted by 1 author and verified by a second author. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Random-effects models stratified by age (ie, neonates, children, adults), Human Development Index (ie, low-income or high-income countries), and decade and meta-regression using the study period's year as an estimator variable were used. Main Outcome and Measure: Case fatality ratios of bacterial meningitis. Results: This review included 371 studies performed in 108 countries from January 1, 1935, to December 31, 2019, describing 157 656 episodes. Of the 33 295 episodes for which the patients' sex was reported, 13 452 (40%) occurred in females. Causative pathogens were reported in 104 598 episodes with Neisseria meningitidis in 26 344 (25%) episodes, Streptococcus pneumoniae in 26 035 (25%) episodes, Haemophilus influenzae in 22 722 (22%), other bacteria in 19 161 (18%) episodes, and unidentified pathogen in 10 336 (10%) episodes. The overall case fatality ratio was 18% (95% CI, 16%-19%), decreasing from 32% (95% CI, 24%-40%) before 1961 to 15% (95% CI, 12%-19%) after 2010. It was highest in meningitis caused by Listeria monocytogenes at 27% (95% CI, 24%-31%) and pneumococci at 24% (95% CI, 22%-26%), compared with meningitis caused by meningococci at 9% (95% CI, 8%-10%) or H influenzae at 11% (95% CI, 10%-13%). Meta-regression showed decreasing case fatality ratios overall and stratified by S pneumoniae, Escherichia coli, or Streptococcus agalactiae (P < .001). Conclusions and Relevance: In this meta-analysis with meta-regression, declining case fatality ratios of community-acquired bacterial meningitis throughout the last century were observed, but a high burden of disease remained.

Comprehensive evaluation of global health cities development levels.

Introduction: How to scientifically assess the health status of cities and effectively assist in formulating policies and planning for health city development remains a profound challenge in building a global "health community." Methods: This study employs the Building Research Establishment's International Healthy Cities Index (BRE HCI), encompassing ten environmental categories and fifty-eight indicators, to guide and support the scientific development of healthy cities. The entropy weight-TOPSIS method and the rank sum ratio (RSR) method were applied to comprehensively rank and categorize the health development levels of fifteen global cities. Furthermore, through cluster analysis, this research identifies universal and unique indicators that influence the development of healthy cities. Results: The results indicate that: (1) Within the scope of 58 evaluation indicators, the precedence in weight allocation is accorded to the kilometres of bicycle paths and lanes per 100,000 population (0.068), succeeded by m2 of public indoor recreation space per capita (0.047), and kilometres of bicycle paths and lanes per 100,000 population (0.042). (2) Among the ten environmental categories, the top three in terms of weight ranking are transport (0.239), leisure and recreation (0.172), and resilience (0.125). Significant disparities exist between different cities and environmental categories, with the issue of uneven health development within cities being particularly prominent. (3) The study categorizes the development levels of healthy cities into three tiers based on composite scores: it classifies Singapore, Shanghai, and Amsterdam at an excellent level; places Dubai and Johannesburg at a comparatively poor level; and situates the remaining ten cities at a moderate level. (4) The analysis identifies 53 international common indicators and 5 characteristic indicators from the 58 indicators based on the significance of the clustering analysis (p < 0.05). Discussion: The study proposes four strategic recommendations based on these findings: establishing a comprehensive policy assurance system, refining urban spatial planning, expanding avenues for multi-party participation, and augmenting distinctive health indicators. These measures aim to narrow the developmental disparities between cities and contribute to healthy global cities' balanced and sustainable growth. However, due to existing limitations in sample selection, research methodology application, and the control of potential confounding variables, further in-depth studies are required in the future.

[Hepatitis C: From diagnosis to global virus elimination]. / Hepatitis C: von der Diagnose zur weltweiten Virus-Elimination.

Chronic infection with hepatitis C virus (HCV) is a common cause of complications such as liver cirrhosis and hepatocellular carcinoma (HCC). It is one of the most significant infectious diseases worldwide, posing a substantial health burden. Since the introduction of direct-acting antiviral agents (DAAs), the treatment landscape has undergone a revolution. HCV infection is curable, and the treatment is safe and well tolerated. Due to the availability of this effective therapeutic option, the World Health Organization (WHO) set an ambitious goal in 2015 to eliminate Hepatitis C by 2030, a goal that the German government also embraced in 2016. The key tasks involve identifying previously undiagnosed cases and ensuring they receive antiviral treatment. Addressing at-risk populations through specific measures, including micro-elimination projects and population-wide campaigns, is essential to achieving the WHO's target both in Germany and globally.

Global Management of Serious Bacterial Infections in Young Infants Aged 0 to 59 Days: An Overview of Systematic Reviews.

BACKGROUND: To inform World Health Organization guidelines for the management of serious bacterial infection (SBI) (suspected or confirmed sepsis, pneumonia, or meningitis) in infants aged 0-59 days. OBJECTIVE: To conduct an "overview of systematic reviews" to: (1) understand which systematic reviews have examined diagnosis and management of SBI in infants aged 0-59 days in the last 5 years; and (2) assess if the reviews examined PICOs (population, intervention, comparator, outcomes) and regimens currently being recommended in low and middle income countries (LMICs) by the World Health Organization. DATA SOURCES: MEDLINE; Embase; Cochrane Library; Epistemonikos; PROSPERO. STUDY SELECTION: Systematic reviews of randomized controlled trials or observational studies of infants aged 0-59 days examining diagnostic accuracy and antibiotic regimens for SBI from January 1, 2018 to November 3, 2023. DATA EXTRACTION: Dual independent extraction of study characteristics, PICOs, and methodological quality. RESULTS: Nine systematic reviews met our criteria. Two reviews examined diagnostic accuracy for sepsis, and no reviews examined pneumonia or meningitis. Five reviews examined antibiotic effectiveness (sepsis [n = 4]; pneumonia [n = 1]), and no reviews examined meningitis. One review examined antibiotic duration for sepsis and one for meningitis, and no reviews for pneumonia. Only 4 of the 9 systematic reviews met criteria for high-quality. LIMITATIONS: Our review was limited to the last 5 years to inform current guideline updates. CONCLUSIONS: Few studies have examined antibiotic regimens currently being used in LMICs and quality is of concern in many studies. More high-quality data are needed to inform management of SBI in newborns, especially in LMICs.