Burden of gastrointestinal cancers among working-age population over past thirty years in China.

BACKGROUND: Although gastrointestinal (GI) cancers have been becoming a great public health concern in China, there is currently a lack of comprehensive literature on the overall burden and changing trends of GI cancers in the working-age population. AIM: To assess the burden of GI cancers and to examine the overall, age- and gender-specific trends among the working-age population in China from 1990 to 2019. METHODS: Data were extracted from the Global Burden of Disease Study 2019. The burden of GI cancers was indicated by incidence, mortality, disability-adjusted life-years (DALYs), age-standardized incidence rate (ASIR), age-standardized mortality rate, and age-standardized DALYs rate. Trends in the burden of GI cancers from 1990 to 2019 were examined using annual percent change and average annual percent change with Joinpoint regression models. RESULTS: For overall GI cancers, a declining trend was observed in the ASIR, age-standardized mortality rate, and age-standardized DALYs rate, with reductions of 0.74%, 2.23%, and 2.22%, respectively, from 1999 to 2019 in the Chinese working-age population. However, an increasing trend was observed in the ASIR for overall GI cancers from 2016-2019. The number of either incident cases, mortality cases, and DALYs was higher for colon/rectum cancer and liver cancer in younger participants but lower for esophageal, gallbladder, biliary tract, pancreatic, and stomach cancer among older subjects. Moreover, sex disparity in the GI cancers burden was also examined over 30 years. CONCLUSION: The total burden of GI cancers remained heavy among the working-age population in China, although declining trends were observed from 1999 to 2019. Disparities in the GI cancers burden existed between sexes, age groups, and cancer types. Population-based precision prevention strategies are needed to tackle GI cancers among working-age individuals, considering the age, sex, and cancer type disparities in China.

The incidence, mortality and disease burden of cardiovascular diseases in China: a comparative study with the United States and Japan based on the GBD 2019 time trend analysis.

Background: Cardiovascular diseases (CVDs) are not only the primary cause of mortality in China but also represent a significant financial burden. The World Health Organization highlight that as China undergoes rapid socioeconomic development, its disease spectrum is gradually shifting towards that of developed countries, with increasing prevalence of lifestyle-related diseases such as ischemic heart disease and stroke. We reviewed the rates and trends of CVDs incidence, mortality and disability-adjusted life years (DALYs) burden in China and compared them with those in the United States (US) and Japan for formulating CVDs control policies. Methods: Data on CVDs incidence, death and DALYs in China, the US and Japan were obtained from the GBD 2019 database. The Joinpoint regression model was used to analyze the trends in CVDs incidence and mortality in China, the US and Japan, calculate the annual percentage change and determine the best-fitting inflection points. Results: In 2019, there were approximately 12,341,074 new diagnosed cases of CVDs in China, with 4,584,273 CVDs related deaths, causing 91,933,122 DALYs. The CVDs age-standardized incidence rate (ASIR) in China (538.10/100,000) was lower than that in the US and globally, while age-standardized death rate (ASDR) (276.9/100,000) and age-standardized DALY rate (6,463.47/100,000) were higher than those in the two regions. Compared with the US and Japan, from 1990 to 2019, the CVDs incidence rate in China showed an increasing trend, with a lower annual decrease in ASDR and a younger age structure of disease burden. Furthermore, the disease spectrum in China changed minimally, with stroke, ischemic heart disease, and hypertensive heart disease being the top three leading CVDs diseases in terms of incidence and disease burden, also being the major causes of CVDs in the US and Japan. Conclusion: The prevention and control of CVDs is a global issue. The aging population and increasing unhealthy lifestyles will continue to increase the burden in China. Therefore, relevant departments in China should reference the established practices for CVDs control in developed countries while considering the diversity of CVDs in different regions when adjusting national CVDs control programs.

Temporal and spatial convergence: the major depressive disorder burden attributed to intimate partner violence against women.

Background: There is a strong causal relationship between intimate partner violence and major depressive disorder, which partly endangers women's safety across the life course and potentially affects the development of future generations. The international community has placed a high priority on addressing the intimate partner violence and the resulting burden of mental illness. Data collection needs to be captured across the temporal trend and spatial distribution for major depressive disorder attributed to intimate partner violence, to reflect the priorities and expectations of survivors.Method: This research obtained raw disability-adjusted life years (DALYs) information for major depressive disorder attributed to intimate partner violence from the Global Burden of Disease 2019. Using estimated annual percentage change and two-way fixed effects models, a secondary spatio-temporal analysis of the age-standardized DALYs rate from 1990 to 2019 was performed.Results: In 2019, DALYs lost among women experiencing major depressive disorder (3.16 million) accounted for 37.18% of the DALYs lost worldwide due to intimate partner violence. The age-standardized DALYs rate of major depressive disorder attributed to intimate partner violence was 108.57 per 100,000. The highest was concentrated in the menopausal transition (45-55), with 133.61 per 100,000, and particularly distributed in Uganda (429.31 per 100,000). The early reproductive period (15-19) showed the increasing age-standardized DALYs rate from 1990 to 2019, which was mainly driven by Malaysia (3.73% per year). Furthermore, countries with higher initial levels of the age-standardized DALYs rate were growing faster than those with lower levels.Conclusions: The burden of major depressive disorder attributed to intimate partner violence showed biological and spatial inequality, prioritized intervention should be targeted at vulnerable stage women in their early reproductive period and menopausal transition. Combined political, socio-cultural as well as medical measures to prevent violence and treat major depressive disorder should be implemented and developed.

Vulnerability to different biological stages of the burden of experiencing intimate partner violence leading to major depressive disorder in women. Women in their reproductive years and during the menopausal transition were more vulnerable.Intimate partner violence-induced depressive disorder is trending younger, with an increasing burden on girls aged 15­19 over the past 30 years.The burden of major depressive disorder attributed to intimate partner violence varies increasingly across countries.

Standardised reporting of burden of disease studies: the STROBOD statement.

BACKGROUND: The burden of disease (BOD) approach, originating with the Global Burden of Disease (GBD) study in the 1990s, has become a cornerstone for population health monitoring. Despite the widespread use of the Disability-Adjusted Life Year (DALY) metric, variations in methodological approaches and reporting inconsistencies hinder comparability across studies. To tackle this issue, we set out to develop guidelines for reporting DALY calculation studies to improve the transparency and comparability of BOD estimates. METHODS AND FINDINGS: The development of the STROBOD statement began within the European Burden of Disease Network, evolving from initial concepts discussed in workshops and training sessions focused on critical analysis of BOD studies. In 2021, a working group was formed to refine the preliminary version into the final Standardised Reporting of Burden of Disease studies (STROBOD) statement, consisting of 28 items structured across six main sections. These sections cover the title, abstract, introduction, methods, results, discussion, and open science, aiming to ensure transparency and standardization in reporting BOD studies. Notably, the methods section of the STROBOD checklist encompasses aspects such as study setting, data inputs and adjustments, DALY calculation methods, uncertainty analyses, and recommendations for reproducibility and transparency. A pilot phase was conducted to test the efficacy of the STROBOD statement, highlighting the importance of providing clear explanations and examples for each reporting item. CONCLUSIONS: The inaugural STROBOD statement offers a crucial framework for standardizing reporting in BOD research, with plans for ongoing evaluation and potential revisions based on user feedback. While the current version focuses on general BOD methodology, future iterations may include specialized checklists for distinct applications such as injury or risk factor estimation, reflecting the dynamic nature of this field.

Deriving disability weights for the Netherlands: findings from the Dutch disability weights measurement study.

BACKGROUND: The aims of this study were to establish national disability weights based on the health state preferences of a Dutch general population sample, examine the relation between results and respondent's characteristics, and compare disability weights with those estimated in the European disability weights study. METHODS: In this cross-sectional study, a web-based survey was administered to a general population 18-75 years from the Netherlands. The survey included paired comparison questions. Paired comparison data were analysed using probit regression and located results onto the 0-to-1 disability weight scale using non-parametric regression. Bootstrapping was used to estimate 95% uncertainty intervals (95%UI). Spearman's correlation was used to investigate the relation of probit regression coefficients between respondent's characteristics. RESULTS: 3994 respondents completed the questionnaire. The disability weights ranged from 0.007 (95%UI: 0.003-0.012) for mild distance vision impairment to 0.741 (95% UI: 0.498-0.924) for intensive care unit admission. Spearman's correlation of probit coefficients between sub-groups based on respondent's characteristics were all above 0.95 (p < 0.001). Comparison of disability weights of 140 health states that were included in the Dutch and European disability weights study showed a high correlation (Spearman's correlation: 0.942; p < 0.001); however, for 76 (54.3%) health states the point estimate of the Dutch disability weight fell outside of the 95%UI of the European disability weights. CONCLUSIONS: Respondent's characteristics had no influence on health state valuations with the paired comparison. However, comparison of the Dutch disability weights to the European disability weights indicates that health state preferences of the general population of the Netherlands differ from those of other European countries.

Global burden of viral infectious diseases of poverty based on Global Burden of Diseases Study 2021.

BACKGROUND: Viral infectious diseases of poverty (vIDPs) remain a significant global health challenge. Despite their profound impact, the burden of these diseases is not comprehensively quantified. This study aims to analyze the global burden of six major vIDPs, including coronavirus disease 2019 (COVID-19), HIV/AIDS, acute hepatitis, dengue, rabies, and Ebola virus disease (EVD), using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021). METHODS: Following the GBD 2021 framework, we analyzed the incidence, mortality, and disability-adjusted life years (DALYs) of the six vIDPs across 204 countries and territories from 1990 to 2021. We examined the association between the Socio-Demographic Index (SDI) and the burden of vIDPs. All estimates were reported as numbers and rates per 100,000 population, calculated using the Bayesian statistical model employed by GBD 2021, with 95% uncertainty intervals (UI). RESULTS: In 2021, vIDPs caused approximately 8.7 million deaths and 259.2 million DALYs, accounting for 12.8% and 9.0% of the global all-cause totals, respectively. Globally, the burden of vIDPs varied significantly: COVID-19 caused around 7.9 million (95% UI: 7.5, 8.4) deaths and 212.0 million (95% UI 197.9, 234.7) DALYs in 2021. Acute hepatitis had the second-highest age-standardized incidence rate, with 3411.5 (95% UI: 3201.8, 3631.3) per 100,000 population, while HIV/AIDS had a high age-standardized prevalence rate, with 483.1 (95% UI: 459.0, 511.4) per 100,000 population. Dengue incidence cases rose from 26.5 million (95% UI: 3.9, 51.9) in 1990 to 59.0 million (95% UI: 15.5, 106.9) in 2021. Rabies, although reduced in prevalence, continued to pose a significant mortality risk. EVD had the lowest overall burden but significant outbreak impacts. Age-standardized DALY rates for vIDPs were significantly negatively correlated with SDI: acute hepatitis (r = -0.8, P < 0.0001), rabies (r = -0.7, P < 0.0001), HIV/AIDS (r = -0.6, P < 0.0001), COVID-19 (r = -0.5, P < 0.0001), dengue (r = -0.4, P < 0.0001), and EVD (r = -0.2, P < 0.005). CONCLUSIONS: VIDPs pose major public health challenges worldwide, with significant regional, age, and gender disparities. The results underscore the need for targeted interventions and international cooperation to mitigate the burden of these diseases. Policymakers can use these findings to implement cost-effective interventions and improve health outcomes, particularly in regions with high or increasing burdens.

Analysis of global prevalence, DALY and trends of inflammatory bowel disease and their correlations with sociodemographic index: Data from 1990 to 2019.

BACKGROUND: Inflammatory bowel disease (IBD) is a kind of chronic inflammatory disorders of the gastrointestinal tract with diverse prevalence rates and patterns globally. Accurate comprehension of the disease's epidemiological characteristics is imperative for disease control and prevention all over the world. OBJECTIVE: To provide the most updated estimates on the global burden of IBD using the 2019 Global Burden of Disease (GBD) study data, to systematically analyze the IBD epidemiological characteristics at the global, regional, and national levels including the prevalence, incidence, and disability-adjusted life years (DALY) rates, and to analyze the correlations of the socioeconomic development level with IBD epidemiological characteristics. METHODS: We conducted an overall analysis of the global, regional, and national burden of IBD from 1990 to 2019, data from the 2019 GBD study. The GBD's classification of the world into 21 regions and 204 countries and territories facilitated a thorough examination. Age-standardized estimated annual percentage changes (EAPCs) were computed to assess the temporal trends in IBD age-standardized rates (ASRs), with age standardization employed to mitigate potential confounding effects from age structure. The sociodemographic Index (SDI) was used to correlate the socioeconomic development level with the epidemiological characteristics of IBD. RESULTS: From 1990 to 2019, the global age-standardized prevalence, incidence, and DALY rates of IBD remained high. There was a slight downward trend in the global age-standardized incidence and DALY rates of IBD and men exhibited higher DALY rates than women. In 2019, high-income North America recorded the highest age-standardized prevalence, incidence, and DALY rates, while Oceania had the lowest age-standardized prevalence and incidence rates. South Asia had the lowest age-standardized DALY rates. The age-standardized mortality and DALY rates decreased as SDI values increased and remained higher than the expected levels over the past three decades. A negative correlation was observed between age-standardized DALY rates and SDI at the national level. CONCLUSIONS: This analysis of the GBD 2019 database demonstrates that the overall global burden of IBD is still high. Meanwhile, an increasing disease burden is observed in the middle and low SDI locations.

Sex disparities in global burden of gallbladder and biliary tract cancer: analysis of Global Burden of Disease study from 2010 to 2019.

BACKGROUND AND AIM: The global burden of gallbladder and biliary tract cancer (GBTC) has been on the rise, making it a major public health concern. We aim to comprehensively analyze sex disparities in the temporal trends of GBTC incidence, mortality, and disability-adjusted life years (DALYs) regionally and globally from 2010 to 2019. METHODS: Age-standardized rates of GBTC incidence, death, and DALYs were analyzed utilizing the Global Burden of Disease study 2019. RESULTS: From 2010 to 2019, the estimated annual percent change (APC) of the age-standardized incidence rates (ASIRs) and age-standardized disability-adjusted life years (ASDALYs) due to GBTC globally decreased in both sexes (males, APC: -0.80%; APC: -1.00%) and (females, APC: -0.89%; APC: -0.96%). At the same time, age-standardized death rates (ASDRs) decreased only in males (APC: -0.82%) and remained stable in females. By regions, ASIRs and ASDR increased in both sexes only in Southeast Asia (SEA) but decreased in the other regions. All regions had decreased ASDALYs except for an increase in ASDALYs for females only in the SEA region (APC: 0.41%), and males have a stable trend. CONCLUSIONS: Our study reveals substantial geographic variance in the burden of GBTC, specifically in the SEA region. Therefore, localized interventional methodologies must be undertaken to effectively address this global burden from GBTC.

National burden and risk factors of diabetes mellitus in China from 1990 to 2021: Results from the Global Burden of Disease study 2021.

BACKGROUND: In recent years, the prevalence and mortality rates of diabetes have been rising continuously, posing a significant threat to public health and placing a heavy burden on the population. This study was conducted to describe and analyze the burden of diabetes in China from 1990 to 2021 and its attributable risk factors. METHODS: Utilizing data from the Global Burden of Disease Study 2021, we analyzed the incidence, prevalence, and disability-adjusted life years (DALYs) of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in China from 1990 to 2021. We extracted sex- and age-specific data on diabetes, focusing on DALYs, years lived with disability, and years of life lost. Bayesian meta-regression and spatiotemporal Gaussian process regression were used to estimate disease parameters. Age-standardized rates (ASRs) and estimated annual percentage changes (EAPC) were calculated using direct standardization and log-linear regression. The population-attributable fractions were also determined for each risk factor. RESULTS: In 2021, the absolute number of incident diabetes mellitus (DM) cases was estimated at 4003543.82, including 32 000 T1DM and 3971486.24 T2DM cases. The ASRs were 244.57 for DM, 2.67 for T1DM, and 241.9 for T2DM (per 100 000 population). The absolute number of prevalent DM cases was 117288553.93, including 1442775.09 T1DM and 115845778.84 T2DM cases. The ASRs were 6142.29 for DM, 86.78 for T1DM, and 6055.51 for T2DM (per 100 000 population). In 2021, there were 178475.73 deaths caused by DM, with an ASR of mortality of 8.98 per 100 000 population. The DALYs due to DM in 2021 were 11713613.86, with an ASR of 585.43 per 100 000 population and an EAPC of 0.57. This increase can be attributed to several factors, including high body mass index, air pollution, and dietary habits. CONCLUSIONS: The burden of diabetes is considerable, with high prevalence and incidence rates, highlighting the urgent need for public health interventions. Addressing factors like high fasting plasma glucose, body mass index, air pollution, and dietary risks through effective interventions is critical.

Global burden of atrial fibrillation attributable to high body mass index from 1990 to 2021: findings from the Global Burden of Disease Study 2021.

OBJECTIVES: To assess the global burden of atrial fibrillation (AF) attributable to high body mass index (BMI) from 1990 to 2021 and analyze its spatiotemporal distribution characteristics. STUDY DESIGN: An observational study based on GBD 2021 data. METHODS: Data on AF burden due to high BMI were obtained from the Global Burden of Disease Study (GBD) 2021. Estimated annual percentage change (EAPC) was calculated to evaluate temporal trends in age-standardized rates of deaths and disability-adjusted life years (DALYs) over 30 years. RESULTS: In 2021, high BMI-related AF caused 27,000 deaths and 725,000 DALYs globally, a 376% increase since 1990. Females and the elderly (aged 70+) bore a higher burden. Upper-middle-income regions surpassed high-income regions in AF burden. Australasia had the highest age-standardized rates, while High-income Asia Pacific and South Asia had the lowest. South Asia showed rapid growth in age-standardized death rates. CONCLUSION: The global burden of high BMI-related AF varies across regions and time, threatening global health, especially for females and the elderly. Targeted strategies are needed to reduce AF and obesity.

Estimation of State and district-specific disability adjusted life years (DALYs) due to tuberculosis for Kerala, India, 2017-2020.

Background & objectives Tuberculosis (TB) control programmes routinely use indicators like incidence and mortality. A single indicator, like disability-adjusted life years (DALYs) may yield a more comprehensive burden estimate. This study attempted to estimate the state and district-specific TB burden in Kerala. Methods The sole data source for these computations was the Ni-kshay, notification register for 2017 to 2020, Kerala. Age of the patient and outcome are available in the register. Notified incident TB/1000, the median age of onset of TB, case fatality due to TB, and the median age of mortality were computed using SPSS software. DALYs was calculated using the DALYs package of the R program, using these input parameters. Disability weight was taken as 0.333. The absolute and relative DALY/100,000 population was estimated along with the 95% confidence interval (CI). Results Relative DALYs was highest in 2019 at 1482/100,000 and lowest at 1124/100,000 in the year 2020 during the period 2017 to 2020. The districts, which had the highest incidence were not the same as those with the highest DALYs. Ernakulam and Thrissur districts had the highest burden and Idukki had the least burden. Interpretation & conclusions DALYs estimates for Kerala showed an increasing trend before 2020, which could be due to the increased efforts to detect TB as part of the elimination drive. The study points towards the need for using DALYs as a measure for prioritizing districts for resource allocation.

Global, regional, and national burden of preterm birth, 1990-2021: a systematic analysis from the global burden of disease study 2021.

Background: Preterm birth and its complications are leading causes of mortality among children under five years of age. Given the increasing burden of preterm birth on neonatal mortality and long-term health outcomes worldwide, a comprehensive global analysis is essential to guide effective public health interventions and policies. This study aims to assess the burden of preterm birth at the global, regional, and national levels. Methods: Using data from the Global Burden of Disease (GBD) 2021 database, this study analysed trends in age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), and disability-adjusted life-years (DALYs) as primary outcomes for preterm birth from 1990 to 2021 at global, regional, and national levels. Data were assessed using joinpoint regression analysis, decomposition analysis, and the health inequality concentration index. Findings: Globally, the incidence, mortality and DALYs due to preterm birth have shown a declining trend, but ASIR started to increase in 2016. Males were more commonly born preterm than females (12329075.82, 95% uncertainty interval [UI]: 12192632.55-12464605.4 vs. 9224694.94, 95% UI: 9113876.1-9330107.89). Changes in DALYs were primarily due to epidemiological change (111.97%) and population (-21.59%). Low Socio-demographic Index (SDI) regions increased in annual incidence cases (43.1%, 95% UI: 40.17-46.09), while high SDI regions decreased in annual incidence cases (-9.6%, 95% UI: -11.45 to -7.79). The highest annual mortality and DALYs respectively occurred in sub-Saharan Africa (295490.66, 95% UI: 241762.78-353624.41) and South Asia (32760273.93, 95% UI: 27295547.76-39070225.69). Western sub-Saharan Africa showed the largest increase in annual incidence (98.95%, 95% UI: 94.77 to 103.09), and Australasia had the lowest annual mortality (287.18, 95% UI: 244.26-339.42) and DALYs (61081.4, 95% UI: 50897.33-73069.96). Western sub-Saharan Africa also had the highest ASMR (21.57, 95% confidence interval [CI]: 17.9-25.89). The highest ASIR (543.78, 95% CI: 535.11-553.21) and age-standardized DALYs (2064.65, 95% CI: 1717.27-2473.36) both occurred in South Asia, while the lowest ASIR and age-standardized DALYs were seen in East Asia (147.31, 95% CI: 144.22-150.85) and High-income Asia Pacific (143.32, 95% CI: 117.9-167.25). India, Nigeria, and Pakistan ranked highest globally in terms of annual incidence cases, mortality, and DALYs, while the lowest annual incidence, mortality and DALYs respectively occurred in Tokelau (2.34, 95% UI: 2.12-2.56), San Marino (0.04, 95% UI: 0.02-0.07) and Tokelau (17.22, 95% UI: 11.11-24.95). Interpretation: While the global burden of preterm birth has decreased, significant disparities persist, especially in low SDI regions. There is a need for more refined policies and preventive measures to effectively address preterm birth. Funding: No funds, grants, or other support was received.

Cross-country inequalities in disease burden and care quality of chronic kidney disease due to type 2 diabetes mellitus, 1990-2021: Findings from the global burden of disease study 2021.

AIM: To explore the trend of burden and care quality of chronic kidney disease due to type 2 diabetes mellitus (CKD-T2DM) and their cross-country inequalities from 1990 to 2021. MATERIALS AND METHODS: Data were from the Global Burden of Disease 2021 study. Disease burden and care quality were quantified using the disability-adjusted life years rate and the quality-of-care index (QCI). Trend analyses of the age-standardized disability-adjusted life years rate (ASDR) and age-standardized QCI from 1990 to 2021 were conducted using the estimated annual percentage change. The associations of disease burden and care quality with the socio-demographic index (SDI) were explored. Cross-country inequalities in disease burden and care quality were assessed using the slope index of inequality (SII) and concentration index. RESULTS: From 1990 to 2021, the global ASDR for CKD-T2DM increased, while the age-standardized QCI slightly decreased, with an estimated annual percentage change of 0.81 [95% confidence interval (CI): 0.75, 0.87] and -0.08 (95% CI: -0.09, -0.07). The ASDR escalated with increasing SDI, reaching a peak at mid-level SDI, followed by a decrease. The age-standardized QCI was higher with increasing SDI. Globally, ASDR concentrated on countries/territories with a lower SDI. The SII of ASDR was -96.64 (95% CI: -136.94, -56.35) in 1990 and -118.15 (95% CI: -166.36, -69.94) in 2021,  with a concentration index of -0.1298 (95% CI: -0.1904, -0.0692) in 1990 and -0.1104 (95% CI: -0.1819, -0.0389) in 2021. In 1990 and 2021, countries/territories at higher SDI levels exhibited increased age-standardized QCI, indicated by an SII of 15.09 (95% CI: 10.74, 19.45) and 15.75 (95% CI: 10.92, 20.59), and a concentration index of 0.0393 (95% CI: 0.0283, 0.0503) and 0.0400 (95% CI: 0.0264, 0.0536). CONCLUSIONS: Our study highlights considerable disparities in the burden and care quality of CKD-T2DM. Regions experiencing an increasing burden and a declining care quality simultaneously underscore the need for further research and tailored health interventions.

Differences in global, regional, and national time trends in disability-adjusted life years for atrial fibrillation and flutter, 1990-2019: an age-period-cohort analysis from the 2019 global burden of disease study.

Background: Atrial fibrillation and flutter, collectively referred to as AF/AFL, pose substantial public health challenges across nations of different economic statuses. Abjective: This research is intended to assess the discrepancies in global, regional, and national trends in DALYs for atrial fibrillation and flutter throughout 1990 and 2019. Methods: The GBD 2019 report included statistics on AF/AFL. An age-period-cohort (APC) model was used to calculate the changes in DALYs from ages 30 to 34 years up to 95 + years. The model calculated both net drifts and local drifts in DALYs. In addition, we analysed the relative risks for certain time periods and birth cohorts from 1990 to 2019 in order to assess their impact. In order to measure the changes over time in the age-standardized rate (ASR) of DALYs caused by AF/AFL, we calculated the average annual percentage changes (AAPCs) based on age, gender, socio-demographic index (SDI), and location. This approach enables us to analyse the impact of age, period, and cohort on trends in DALYs, which may uncover disparities in the management of AF/AFL. Results: The global number of DALYs cases was 8,393,635 [95% uncertainty interval (UI): 6,693,987 to 10,541,461], indicating a 121.6% rise (95% UI: 111.5 to 132.0) compared to 1990. From 1990 to 2019, the worldwide ASR of DALYs decreased by 2.61% (95% UI -6.9 to 1.3). However, the other SDI quintiles, except for high SDI and high-middle SDI, had an increase. During the last three decades, high-income nations in the Asia Pacific region had the most significant reduction in ASR of DALYs, whereas Central Asia experienced the highest rise (with a net drift of -0.9% [95% Confidence Interval (CI): -1.0 to -0.9] and 0.6% [95% CI: 0.5 to 0.7], respectively). Approximately 50% of the burden of AF/AFL has been transferred from areas with high and high-middle SDI to those with lower SDI. There was an inverse relationship between the AAPC and the SDI. In addition, men and older individuals were shown to have a greater burden of AF/AFL DALYs. Conclusion: The findings of this research demonstrate that the worldwide impact of AF/AFL remains significant and increasing, with the burden differing depending on SDI. The exhaustive and comparable estimates provided by these results may contribute to international efforts to attain equitable AF/AFL control.

Global burden of benign prostatic hyperplasia, urinary tract infections, urolithiasis, bladder cancer, kidney cancer, and prostate cancer from 1990 to 2021.

BACKGROUND: The burden of common urologic diseases, including benign prostatic hyperplasia (BPH), urinary tract infections (UTI), urolithiasis, bladder cancer, kidney cancer, and prostate cancer, varies both geographically and within specific regions. It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases. METHODS: We obtained data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) for the aforementioned urologic diseases by age, sex, location, and year from the Global Burden of Disease (GBD) 2021. We analyzed the burden associated with urologic diseases based on socio-demographic index (SDI) and attributable risk factors. The trends in burden over time were assessed using estimated annual percentage changes (EAPC) along with a 95% confidence interval (CI). RESULTS: In 2021, BPH and UTI were the leading causes of age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR), with rates of 5531.88 and 2782.59 per 100,000 persons, respectively. Prostate cancer was the leading cause of both age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), with rates of 12.63 and 217.83 per 100,000 persons, respectively. From 1990 to 2021, there was an upward trend in ASIR, ASPR, ASMR, and ASDR for UTI, while urolithiasis showed a downward trend. The middle and low-middle SDI quintile levels exhibited higher incidence, prevalence, mortality, and DALYs related to UTI, urolithiasis, and BPH, while the high and high-middle SDI quintile levels showed higher rates for the three cancers. The burden of these six urologic diseases displayed diverse age and sex distribution patterns. In 2021, a high body mass index (BMI) contributed to 20.07% of kidney cancer deaths worldwide, while smoking accounted for 26.48% of bladder cancer deaths and 3.00% of prostate cancer deaths. CONCLUSIONS: The global burden of 6 urologic diseases presents a significant public health challenge. Urgent international collaboration is essential to advance the improvement of urologic disease management, encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.

Global, regional, and national burden of tracheal, bronchus, and lung cancer and its risk factors from 1990 to 2021: findings from the global burden of disease study 2021.

Background: Studies from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021 can guide screening and prevention strategies for tracheal, bronchus, and lung (TBL) cancer. We aim to provide global, regional, and national estimates of the TBL cancer burden and its attributable risk from 1990 to 2021, including during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Incidence, age-standardised incidence rate (ASIR), deaths, age-standardised mortality rate (ASMR), disability-adjusted life years (DALYs), age-standardised rate of DALYs (ASDR), and the burden due to risk factors associated with TBL cancer were analysed from 1990 to 2021. Trends in ASIR, ASMR, and ASDR of TBL cancer during the COVID-19 pandemic (2019-2021) were also determined. All statistical analyses were performed using Join-point software (version 4.9.1.0). Findings: Between 1990 and 2021, the global incidence, deaths, and DALYs of TBL cancer to varying degrees. However, the ASIR (Average Annual Percent Change [AAPC], -0.3 [-0.4 to -0.2]), ASMR (AAPC, -0.5 [-0.7 to -0.4]), and ASDR (AAPC, -0.9 [-1.0 to -0.7]) all showed a decreasing trend. However, the ASIR, ASMR, and ASDR of TBL cancer in males all showed a decreasing trend from 1990 to 2021. In contrast, the ASIR and ASMR of TBL cancer in females showed an increasing trend, while the ASDR showed a relatively stable trend. During the COVID-19 pandemic, the trends for ASIR, ASMR, and ASDR remained stable across both sexes combined, females, males, five socio-demographic index (SDI) quintiles, and the 21 GBD regions. In 2021, smoking was a major risk factor for TBL cancer DALYs, but the attributable ASDR for smoking decreased from 1990 to 2021 in both sexes combined, as well as individually for males and females. Conversely, the attributable ASDR for secondhand smoke, high fasting plasma glucose and occupational exposure factors increased primarily among females. Furthermore, the attributable ASDR for ambient particulate matter pollution, household air pollution from solid fuels, and low-fruit diets increased primarily in regions with lower SDI quintiles from 1990 to 2021. Interpretation: The burden attributable to TBL cancer has increased in some populations from 1990 to 2021, highlighting the importance of implementing targeted measures to mitigate this trend. No significant change in the burden of TBL cancer was observed during the COVID-19 pandemic; however, post-COVID-19 rates still require further observation. Funding: This study was supported by National Key Research and Development Program of China (2023YFC3503300, 2023YFC3503305), and High Level Chinese Medical Hospital Promotion Project (HLCMHPP2023085, HLCMHPP2023001, HLCMHPP2023097).

Modeling health outcomes of air pollution in the Middle East by using support vector machines and neural networks.

This study investigates the impact of air pollution on health outcomes in Middle Eastern countries, a region facing severe environmental challenges. As such, these are important in an effort to add up to policy-level as well as interventional changes that can be put in practice in the area of public health. Numeration analysis and association with health parameters was carried out by using Analytical tools such as, AIR Data, ARIMA,ANN, SVM and Exponential smoothing. Amongst the models, Support Vector Machine came again on top, with high accuracy yielding Mean Absolute Percentage Error of approximately 1%. Mortality of Air pollution in Qat from the case of Mortality of Air Pollution in Qatar is 959 while Auto regressive Integrated Moving average is 11.096, Exponential Smoothing 9.892 and Artificial Neural Networks are the source of inspiration for the development of this paper 4.61. The above perceptions indicate that there is need to adapt modeling strategies depending on the context and establish that it is possible to implement ML models in public health planning basket. This paper publishes the methodological frameworks for the purpose of modeling and analysis of the EHDs and serves as policy prescription for the policy makers to intending to reduce the effects of air borne pollution on health.

Temporal trends in cross-country inequalities of stroke and subtypes burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021.

Background: Stroke remains a significant global health challenge, with persistent disparities in burden across different countries and regions. This study aimed to assess the temporal trends in cross-country inequalities of stroke and its subtypes burden from 1990 to 2021. Methods: We conducted a secondary analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The age-standardised disability-adjusted life years (DALYs) rate (ASDR) was used to assess the burden of stroke and its subtypes (ischemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage) across 21 GBD regions and 204 countries. The slope index of inequality (SII) and the concentration index were calculated to quantify the absolute and relative cross-country inequalities in the burden of stroke and its subtypes, with negative values indicating a higher burden in lower socio-demographic index (SDI) countries, and positive values indicating a higher burden in higher SDI countries. Estimated annual percentage change (EAPC) was used to illustrate temporal trends at global and regional levels from 1990 to 2021. The inequality changing patterns from 1990 to 2021 were classified as worsening, improving, and shifting to higher burdens among higher or lower SDI countries. Findings: From 1990 to 2021, the ASDR of total stroke decreased from 3078.95 (95% uncertainty interval [UI]: 2893.58, 3237.34) to 1886.20 (95% UI: 1738.99, 2017.90) per 100,000 population globally. While both absolute and relative inequalities increased, with a disproportionately higher burden shouldered by countries with lower SDI. The SII of total stroke exhibited a worsening inequality among lower SDI countries, increasing by 286.97 units from -2329.47 (95% confidence interval [CI]: -2857.50, -1801.43) in 1990 to -2616.44 (95% CI: -2987.33, -2245.56) in 2021. Similarly, the concentration index of total stroke increased by 0.03 from -0.0819 (95% CI: -0.1143, -0.0495) in 1990 to -0.1119 (95% CI: -0.1478, -0.0759) in 2021. The changing patterns from 1990 to 2021 were diverse across regions, yet most regions exhibited a worsening inequality among lower SDI countries in both SII and concentration index. Southern Sub-Saharan Africa showed the largest worsening inequality in SII (EAPC: -2.15, 95% CI: -2.71, -1.57) while Central Europe showed the largest worsening inequality in concentration index (EAPC: -0.51, 95% CI: -0.58, -0.44). In 2021, the highest negative SII was observed in Oceania and the highest negative concentration index was in the Caribbean. In terms of subtypes, ischemic stroke reported a worsening inequality among lower SDI countries in SII (EAPC: -2.13, 95% CI: -2.20, -2.05) while intracerebral haemorrhage showed an improving inequality in SII (EAPC: 0.44, 95% CI: 0.40, 0.47). SII in subarachnoid haemorrhage (EAPC: -0.18, 95% CI: -0.19, -0.17) and concentration index in ischemic stroke (EAPC: -0.25, 95% CI: -0.27, -0.23) presented a shift to higher burden among lower SDI countries from 1990 to 2021. Interpretation: Although the burden of stroke and its subtypes decreased from 1990 to 2021, inequalities have persisted and even widened in some regions. Timely and effective prevention and management strategies for stroke and its subtypes are needed in specific areas to reduce the stroke burden and achieve equity in health outcomes. Funding: None.

The global burden of maternal disorders attributable to iron deficiency related sub-disorders in 204 countries and territories: an analysis for the Global Burden of Disease study.

Background: Pregnancy-related anemia presents a significant health concern for approximately 500 million women of reproductive age worldwide. To better prevent maternal disorders, it is essential to understand the impact of iron deficiency across different maternal disorders, regions, age groups, and subcategories. Methods: Based on the comprehensive maternal disorders data sourced from the 2019 Global Burden of Disease study, an investigation was carried out focusing on Disability-Adjusted Life Years (DALYs) associated with iron deficiency spanning the period from 1990 to 2019. In addition, Estimated Annual Percentage Changes (EAPCs) were computed for the duration of the study. Results: Our study indicates decreasing mortality rates and years of life lost due to maternal conditions related to iron deficiency, such as maternal hemorrhage, miscarriage, abortion, hypertensive disorders, and infections. However, mortality rates and years of life lost due to indirect and late maternal deaths, as well as deaths aggravated by HIV/AIDS, have increased in high socio-demographic index (SDI) regions, especially in North America. Moreover, the proportion of maternal deaths aggravated by HIV/AIDS due to iron deficiency is rising globally, especially in Southern Sub-Saharan Africa, Oceania, and Georgia. In addition, in the Maldives, the age-standardized DALYs for maternal disorders attributable to iron deficiency exhibited a notable decreasing trend, encompassing a range of conditions. Furthermore, there was a significant decrease in Disability-Adjusted Life Years rate for miscarriages and preterm births among women aged 15-49, with hypertensive disorders posing the highest burden among women aged 15-39. Conclusion: The burden of maternal disorders caused by iron deficiency is decreasing in most regions and subtypes, except for deaths aggravated by HIV/AIDS. By thoroughly understanding the details of how iron deficiency impacts the health of pregnant women, health policymakers, healthcare professionals, and researchers can more effectively pinpoint and address the root causes of inequalities in maternal health.

Nowcasting and forecasting global aging and cancer burden: analysis of data from the GLOBOCAN and Global Burden of Disease Study.

Objective: To analyze the impact of global population aging on cancer epidemiology, with a focus on the incidence and mortality rates among individuals aged 60 years and above. Methods: We utilized open-source data, retrieving population age estimates from the United Nations Population Division website. The GLOBOCAN 2020 database provided estimates for cancer cases and deaths in 2020 and 2040, while the Global Burden of Disease 2019 database supplied estimates of new cancer cases worldwide from 2000 to 2019. Inclusion criteria considered individuals aged 60 years and over, focusing on the top five deadliest cancers. The cohort-component method was employed for population prediction, with age-specific incidence and mortality rates estimated for 2020 used to forecast the cancer burden. Results: In 2021, the global population aged over 60 years accounted for 13.7%, with Europe/North America and Australia/New Zealand having the highest proportions. The older population is predicted to reach 19.2% by 2040. In 2020, of the 19.3 million new cancer cases worldwide, 64% occurred in individuals aged 60 and above, contributing to 71.3% of cancer-related deaths. The five most common cancer sites were the lung, colorectum, prostate, breast, and stomach. Cancer incidence and deaths are projected to rise significantly among older individuals, reaching 20.7 million new cases and 12.7 million deaths by 2040. Older age, tobacco use, dietary factors, alcohol consumption, and high body mass index (BMI) were identified as major risk factors for various cancers in this demographic. Conclusions: This study reveals a significant rise in cancer incidence and mortality among the elderly due to global population aging. The urgency for targeted interventions in cancer prevention, screening, and treatment for older individuals is emphasized. Despite acknowledged limitations, these findings contribute valuable insights to inform strategies for managing cancer in the elderly amidst evolving demographic trends.