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1.
Sci Rep ; 14(1): 3806, 2024 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-38361118

RESUMEN

Genetic neuromuscular diseases are clinically and genetically heterogeneous genetic disorders that primarily affect the peripheral nerves, muscles, and neuromuscular junctions. This study aimed to identify pathogenic variants, calculate carrier frequency, and predict the genetic prevalence of autosomal recessive neuromuscular diseases (AR-NMDs). We selected 268 AR-NMD genes and analyzed their genetic variants sourced from the gnomAD database. After identifying the pathogenic variants using an algorithm, we calculated the carrier frequency and predicted the genetic prevalence of AR-NMDs. In total, 10,887 pathogenic variants were identified, including 3848 literature verified and 7039 manually verified variants. In the global population, the carrier frequency of AR-NMDs is 32.9%, with variations across subpopulations ranging from 22.4% in the Finnish population to 36.2% in the non-Finnish European population. The predicted genetic prevalence of AR-NMDs was estimated to be 24.3 cases per 100,000 individuals worldwide, with variations across subpopulations ranging from 26.5 to 41.4 cases per 100,000 individuals in the Latino/Admixed American and the Ashkenazi Jewish populations, respectively. The AR-NMD gene with the highest carrier frequency was GAA (1.3%) and the variant with the highest allele frequency was c.-32-13 T>G in GAA with 0.0033 in the global population. Our study revealed a higher-than-expected frequency of AR-NMD carriers, constituting approximately one-third of the global population, highlighting ethnic heterogeneity in genetic susceptibility.


Asunto(s)
Predisposición Genética a la Enfermedad , Enfermedades Neuromusculares , Humanos , Frecuencia de los Genes , Enfermedades Neuromusculares/epidemiología , Enfermedades Neuromusculares/genética , Prevalencia , Salud Global
3.
Antimicrob Resist Infect Control ; 13(1): 19, 2024 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-38355604

RESUMEN

The escalating challenge of antimicrobial resistance (AMR) poses a considerable concern for global health, particularly impacting low- and middle-income countries (LMICs). This article highlights the critical importance of tackling AMR in LMICs by adopting the Global Antimicrobial Stewardship Accreditation Scheme (GAMSAS). GAMSAS is portrayed as a holistic and sustainable strategy for antimicrobial stewardship, extending beyond accreditation to include educational programs, capacity enhancement, improved surveillance, and support for AMS policy research. While acknowledging the global uptake of the scheme, the article highlights its preliminary phase of adoption in LMICs, particularly in high-AMR burden regions like Sub-Saharan Africa. The piece stresses the imperative for LMICs to integrate GAMSAS, underscoring its significance in optimizing antimicrobial usage and patient health outcomes. It advocates for an all-encompassing approach that leverages international cooperation and sustained financial backing, crucial for the effective deployment and enduring success of antimicrobial stewardship efforts in these key areas.


Asunto(s)
Antiinfecciosos , Programas de Optimización del Uso de los Antimicrobianos , Humanos , Países en Desarrollo , Antiinfecciosos/uso terapéutico , Cooperación Internacional , Salud Global
4.
Global Health ; 20(1): 14, 2024 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-38374045

RESUMEN

BACKGROUND: There is an inconsistency in the way pharmaceutical research is financed. While pull mechanisms are predominantly used to incentivize later-stage pharmaceutical research for products with demand in the Global North, so-called neglected diseases are chiefly financed by push funding. This discrepancy has so far been ignored in the academic debate, and any compelling explanation for why we draw the line between push and pull at poor people is lacking. MAIN BODY: Clinical development of new pharmaceuticals is chiefly financed by free market pull mechanisms. Even in cases where markets fail to deliver adequate incentives, demand enhancement mechanisms are used to replicate pull funding artificially, for example, with subscription models for antibiotics. Push funding in clinical research is almost always used when the poverty of patients means that markets fail to create sufficient demand. The general question of whether push or pull generally is the more efficient way to conduct pharmaceutical research arises. CONCLUSIONS: If the state is efficient in directing limited budgets for pharmaceutical research, push funding should be expanded to global diseases. If private industry is the more efficient actor, there would be enormous value in experimenting more aggressively with different approaches to enhance market demand artificially for neglected diseases.


Asunto(s)
Enfermedades Desatendidas , Investigación Farmacéutica , Humanos , Enfermedades Desatendidas/tratamiento farmacológico , Salud Global , Antibacterianos
6.
BMJ ; 384: q426, 2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38378196
9.
Med Sci Monit ; 30: e943911, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38298093

RESUMEN

In December 2023, the US Centers for Disease Control and Prevention (CDC) published the updated 2024 Advisory Committee on Immunization Practices (ACIP) Adult Immunization Schedule, which is available online for access by the public and healthcare professionals. These new guidelines come at a time when the incidence of vaccine-preventable viral infections from SARS-CoV-2 (JN.1), respiratory syncytial virus (RSV), influenza, and measles are increasing in adults and children due to vaccine hesitancy, or non-compliance. This editorial aims to highlight the ongoing global health concerns for the consequences of increasing reports of vaccine-preventable infections, including SARS-CoV-2 (JN.1), influenza, RSV, and measles, to understand the causes of vaccine hesitancy, and introduce some public health measures that could improve vaccine uptake.


Asunto(s)
COVID-19 , Enfermedades Transmisibles , Vacunas contra la Influenza , Gripe Humana , Sarampión , Niño , Adulto , Humanos , Gripe Humana/epidemiología , SARS-CoV-2 , Virus Sincitiales Respiratorios , Salud Global , COVID-19/prevención & control , Sarampión/epidemiología , Sarampión/prevención & control
10.
Cien Saude Colet ; 29(2): e15782022, 2024 Feb.
Artículo en Español, Inglés | MEDLINE | ID: mdl-38324832

RESUMEN

This study reviews the current state of the good health and well-being indicators included in the Sustainable Development Goals (SDG), identifying the most significant challenges faced by countries in the world and in the Americas region. The HJ-Biplot multivariate technique is used to represent variances and covariances between 16 SDG 3 indicators, reported as of 2022, based on data from 176 countries, including 31 countries of the American continent. The findings show that indicators such as life expectancy at birth, universal health coverage and satisfied demand for family planning are key characteristics of developed countries. In contrast, developing countries still face significant challenges in terms of promoting maternal health, the well-being of children and the control of communicable and chronic diseases. For this reason, in the framework of the 2030 Agenda, it is necessary to continue working on public policy actions that enable making progress in the implementation of programs to improve the health and well-being of the population, especially in lower-income countries.


En este estudio se analiza el estado actual de los indicadores de salud y bienestar pertenecientes a los objetivos de desarrollo sostenible (ODS), identificando los desafíos más significativos que se presentan entre los países del mundo y en la región de las Américas. Se utiliza la técnica multivariante HJ-Biplot para representar las variaciones y covariaciones existentes entre 16 indicadores del ODS 3, reportados al año 2022, según datos de 176 países, entre ellos, 31 del continente americano. Los resultados obtenidos muestran que indicadores como la esperanza de vida al nacer, la cobertura sanitaria universal y la demanda de planificación familiar satisfecha, caracterizan a los países desarrollados. En contraste, los países en vía de desarrollo aún registran retos importantes para favorecer la salud materna, el bienestar de los niños y en el control de enfermedades trasmisibles y crónicas. Por ello, en el marco de la Agenda 2030, es necesario continuar trabajando en acciones de política pública que permitan avanzar en la implementación de programas para mejorar la salud y el bienestar de la población, en especial entre las naciones de menores ingresos.


Asunto(s)
Salud Global , Desarrollo Sostenible , Humanos , Niño , Recién Nacido , Política Pública , Cobertura Universal del Seguro de Salud , Esperanza de Vida
11.
Lancet ; 403(10426): 503, 2024 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-38341240
13.
BMC Public Health ; 24(1): 486, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38360585

RESUMEN

BACKGROUND: Nutritional deficiencies remain serious medical and public health issues worldwide, especially in children. This study aims to analyze cross-country inequality in four common nutritional deficiencies (protein-energy malnutrition, dietary iron deficiency, vitamin A deficiency and iodine deficiency) among children from 1990 to 2019 based on Global Burden of Disease (GBD) 2019 data. METHODS: Prevalence and disability-adjusted life years (DALYs) data as measures of four nutritional deficiency burdens in people aged 0 to 14 years were extracted from the GBD Results Tool. We analyzed temporal trends in prevalence by calculating the average annual percent change (AAPC) and quantified cross-country inequalities in disease burden using the slope index. RESULTS: Globally, the age-standardized prevalence rates of dietary iron deficiency, vitamin A deficiency and iodine deficiency decreased, with AAPCs of -0.14 (-0.15 to -0.12), -2.77 (-2.96 to -2.58), and -2.17 (-2.3 to -2.03) from 1999 to 2019, respectively. Significant reductions in socio-demographic index (SDI)-related inequality occurred in protein-energy malnutrition and vitamin A deficiency, while the health inequality for dietary iron deficiency and iodine deficiency remained basically unchanged. The age-standardized prevalence and DALY rates of the four nutritional deficiencies decreased as the SDI and healthcare access and quality index increased. CONCLUSIONS: The global burden of nutritional deficiency has decreased since 1990, but cross-country health inequalities still exist. More efficient public health measures are needed to reduce disease burdens, particularly in low-SDI countries/territories.


Asunto(s)
Yodo , Deficiencias de Hierro , Desnutrición , Desnutrición Proteico-Calórica , Deficiencia de Vitamina A , Niño , Humanos , Carga Global de Enfermedades , Años de Vida Ajustados por Calidad de Vida , Disparidades en el Estado de Salud , Hierro de la Dieta , Inequidades en Salud , Salud Global
17.
CJEM ; 26(2): 130-133, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38329677
18.
Glob Public Health ; 19(1): 2312435, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38334114

RESUMEN

The use of targets and indicators in global health has become ubiquitous within global health and disease elimination programmes. The drive to 'end AIDS' has become a global flagship endeavour, including nation-states, donor organisations, NGOs, pharmaceutical companies, medical researchers, and activists. Almost synonymous with the campaign of ending AIDS is UNAIDS' 90-90-90 targets. Beyond indicators' role in neoliberal global health, an essential aspect of indicators and quantitative metrics is their ability to provide a basis for measurements and comparability across time and between different actors and entities. These processes are based on what has been called, commensuration, visual simplification, and serialisation. This article seeks to provide an account of how we can think about indicators in the drive to end AIDS as doing work that is contingent upon commensuration, simplification, and serialisation. The argument is that by attending to issues of commensuration, visual simplification, and serialisation we are better able to see how we risk erasing and foreclosing other forms of conceptualising what the end of AIDS could be. Logics of quantification risks erasing and foreclosing other qualitative aspects of the HIV epidemic as well as obscuring various epistemological tensions inherent in counting towards the end of AIDS.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Epidemias , Infecciones por VIH , Humanos , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Salud Global , Erradicación de la Enfermedad , Benchmarking , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control
19.
J Glob Health ; 14: 04033, 2024 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-38299781

RESUMEN

Background: Multiple myeloma (MM) is the second most common haematologic malignancy, presenting a great disease burden on the general population; however, the quality of care of MM is overlooked. We therefore assessed gains and disparity in quality of care worldwide from 1990 to 2019 based on a novel summary indicator - the quality of care index (QCI) - and examined its potential for improvement. Methods: Using the Global Burden of Disease 2019 data set, we calculated the QCI of MM for 195 countries and territories. We used the principal component analysis to extract the first principal component of ratios with the combinations of mortality to incidence, prevalence to incidence, disability-adjusted life years to prevalence, and years of life lost to years lived with disability as QCI. We also conducted a series of descriptive and comparative analyses of QCI disparities with age, gender, period, geographies, and sociodemographic development, and compared the QCI among countries with similar socio-demographic index (SDI) through frontier analysis. Results: The age-standardised rates of MM were 1.92 (95% uncertainty interval (UI) = 1.68, 2.12) in incidence and 1.42 (95% UI = 1.24, 1.52) in deaths per 100 000 population in 2019, and were predicted to increase in the future. The global age-standardised QCI increased from 51.31 in 1990 to 64.28 in 2019. In 2019, New Zealand had the highest QCI at 99.29 and the Central African Republic had the lowest QCI at 10.74. The gender disparity of QCI was reduced over the years, with the largest being observed in the sub-Saharan region. Regarding age, QCI maintained a decreasing trend in patients aged >60 in SDI quintiles. Generally, QCI improved with the SDI increase. Results of frontier analysis suggested that there is a potential to improve the quality of care across all levels of development spectrum. Conclusions: Quality of care of MM improved during the past three decades, yet disparities in MM care remain across different countries, age groups, and genders. It is crucial to establish local objectives aimed at enhancing MM care and closing the gap in health care inequality.


Asunto(s)
Carga Global de Enfermedades , Mieloma Múltiple , Humanos , Masculino , Femenino , Mieloma Múltiple/epidemiología , Mieloma Múltiple/terapia , Costo de Enfermedad , Prevalencia , Incidencia , Calidad de la Atención de Salud , Salud Global
20.
BMC Public Health ; 24(1): 456, 2024 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-38350909

RESUMEN

OBJECTIVE: Metabolic risks play a key role in the progression of pancreatic cancer. This study aimed to present global, regional and national data on mortality and disability-adjusted life-year (DALY) for pancreatic cancer attributable to metabolic risk and to forecast mortality to 2030 using data from the Global Burden of Disease (GBD). METHODS: Data on mortality and DALYs due to pancreatic cancer attributable to metabolic risks were obtained from GBD 2019. Metabolic risks include high fasting plasma glucose (FPG) and high body mass index (BMI). Total numbers and age-standardized rates per 100,000 people for mortality and DALYs were reported by age, sex, region and country/territory from 1990 to 2019. The "Bayes age-period-cohort" method was used for projections of mortality to 2030. RESULTS: Globally, there was a 3.5-fold increase in the number of pancreatic cancer deaths attributable to metabolic risk, from 22,091 in 1990 to 77,215 in 2019. High-income North America and Central Europe had the highest age-standardized mortality rates (ASMRs) of pancreatic cancer attributable to high FPG and high BMI in 2019, respectively. From 1990 to 2019, the global ASMR of pancreatic cancer attributable to high FPG and high BMI increased. Countries with high healthcare access quality had much higher age-standardized DALY rates. In the next 10 years, the ASMR of pancreatic cancer attributable to high FPG and high BMI will continue to increase. CONCLUSION: Pancreatic cancer mortality and DALYs attributable to metabolic factors remain high, particularly in high-income regions or countries. Studies on the metabolic mechanism of pancreatic cancer and effective treatment strategies are needed.


Asunto(s)
Carga Global de Enfermedades , Neoplasias Pancreáticas , Humanos , Factores de Riesgo , Teorema de Bayes , Índice de Masa Corporal , Años de Vida Ajustados por Calidad de Vida , Salud Global
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