Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019 a systematic analysis for the global burden of disease study 2019
- Kocarnik, Jonathan, Compton, Kelly, Dean, Fean, Fu, Weijia, Gaw, Brian, Harvey, James, Henrikson, Hannah, Lu, Dan, Pennini, Alyssa, Xu, Rixing, Ababneh, Emad, Abbasi-Kangevari, Mohsen, Abbastabar, Hedayat, Abd-Elsalam, Sherief, Abdoli, Amir, Abedi, Aidin, Abidi, Hassan, Abolhassani, Hassan, Adedeji, Isaac, Adnani, Qorinath, Advani, Shailesh, Afzal, Muhammad, Aghaali, Mohammad, Ahinkorah, Bright, Ahmad, Sajjad, Ahmad, Tauseef, Ahmadi, Ali, Ahmadi, Sepideh, Ahmed Rashid, Tarik, Rahman, Muhammad Aziz
- Authors: Kocarnik, Jonathan , Compton, Kelly , Dean, Fean , Fu, Weijia , Gaw, Brian , Harvey, James , Henrikson, Hannah , Lu, Dan , Pennini, Alyssa , Xu, Rixing , Ababneh, Emad , Abbasi-Kangevari, Mohsen , Abbastabar, Hedayat , Abd-Elsalam, Sherief , Abdoli, Amir , Abedi, Aidin , Abidi, Hassan , Abolhassani, Hassan , Adedeji, Isaac , Adnani, Qorinath , Advani, Shailesh , Afzal, Muhammad , Aghaali, Mohammad , Ahinkorah, Bright , Ahmad, Sajjad , Ahmad, Tauseef , Ahmadi, Ali , Ahmadi, Sepideh , Ahmed Rashid, Tarik , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: JAMA Oncology Vol. 8, no. 3 (2022), p. 420-444
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- Description: IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world. © 2022 American Medical Association. All rights reserved. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman" is provided in this record**
- Authors: Kocarnik, Jonathan , Compton, Kelly , Dean, Fean , Fu, Weijia , Gaw, Brian , Harvey, James , Henrikson, Hannah , Lu, Dan , Pennini, Alyssa , Xu, Rixing , Ababneh, Emad , Abbasi-Kangevari, Mohsen , Abbastabar, Hedayat , Abd-Elsalam, Sherief , Abdoli, Amir , Abedi, Aidin , Abidi, Hassan , Abolhassani, Hassan , Adedeji, Isaac , Adnani, Qorinath , Advani, Shailesh , Afzal, Muhammad , Aghaali, Mohammad , Ahinkorah, Bright , Ahmad, Sajjad , Ahmad, Tauseef , Ahmadi, Ali , Ahmadi, Sepideh , Ahmed Rashid, Tarik , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: JAMA Oncology Vol. 8, no. 3 (2022), p. 420-444
- Full Text:
- Reviewed:
- Description: IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world. © 2022 American Medical Association. All rights reserved. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman" is provided in this record**
The global burden of cancer attributable to risk factors, 2010–19 : a systematic analysis for the Global Burden of Disease Study 2019
- Tran, Khanh, Lang, Justin, Compton, Kelly, Xu, Rixing, Acheson, Alistair, Henrikson, Hannah, Kocarnik, Jonathan, Penberthy, Louise, Aali, Amirali, Abbas, Qamar, Abbasi, Behzad, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abbastabar, Hedayat, Abdelmasseh, Michael, Abd-Elsalam, Sherief, Abdelwahab, Ahmed, Abdoli, Gholamreza, Abdulkadir, Hanan, Abedi, Aidin, Abegaz, Kedir, Abidi, Aidin, Aboagye, Richard, Abolhassani, Hassan, Absalan, Abdorrahim, Abtew, Yonas, Ali, Hiwa, Abu-Gharbieh, Eman, Nguyen, Huy, Rahman, Muhammad Aziz
- Authors: Tran, Khanh , Lang, Justin , Compton, Kelly , Xu, Rixing , Acheson, Alistair , Henrikson, Hannah , Kocarnik, Jonathan , Penberthy, Louise , Aali, Amirali , Abbas, Qamar , Abbasi, Behzad , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abbastabar, Hedayat , Abdelmasseh, Michael , Abd-Elsalam, Sherief , Abdelwahab, Ahmed , Abdoli, Gholamreza , Abdulkadir, Hanan , Abedi, Aidin , Abegaz, Kedir , Abidi, Aidin , Aboagye, Richard , Abolhassani, Hassan , Absalan, Abdorrahim , Abtew, Yonas , Ali, Hiwa , Abu-Gharbieh, Eman , Nguyen, Huy , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: The Lancet Vol. 400, no. 10352 (2022), p. 563-591
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- Description: Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). Interpretation: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliates “Muhammad Aziz Rahman and Huy Nguyen” are provided in this record**
- Authors: Tran, Khanh , Lang, Justin , Compton, Kelly , Xu, Rixing , Acheson, Alistair , Henrikson, Hannah , Kocarnik, Jonathan , Penberthy, Louise , Aali, Amirali , Abbas, Qamar , Abbasi, Behzad , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abbastabar, Hedayat , Abdelmasseh, Michael , Abd-Elsalam, Sherief , Abdelwahab, Ahmed , Abdoli, Gholamreza , Abdulkadir, Hanan , Abedi, Aidin , Abegaz, Kedir , Abidi, Aidin , Aboagye, Richard , Abolhassani, Hassan , Absalan, Abdorrahim , Abtew, Yonas , Ali, Hiwa , Abu-Gharbieh, Eman , Nguyen, Huy , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: The Lancet Vol. 400, no. 10352 (2022), p. 563-591
- Full Text:
- Reviewed:
- Description: Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). Interpretation: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliates “Muhammad Aziz Rahman and Huy Nguyen” are provided in this record**
Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018
- Kinyoki, Damaris, Osgood-Zimmerman, Aaron, Bhattacharjee, Natalia, Schaeffer, Lauren, Lazzar-Atwood, Alice, Lu, Dan, Ewald, Samuel, Donkers, Katie, Letourneau, Ian, Collison, Michael, Schipp, Megan, Abajobir, Amanuel, Abbasi, Sima, Abbasi, Nooshin, Abbasifard, Mitra, Abbasi-Kangevari, Mohsen, Abbastabar, Hedayat, Abd-Allah, Foad, Abdelalim, Ahmed, Abd-Elsalam, Sherief, Abdoli, Amir, Abdollahpour, Ibrahim, Abedi, Aidin, Abolhassani, Hassan, Abraham, Biju, Abreu, Lucas, Abrigo, Michael, Abualhasan, Ahmed, Abu-Gharbieh, Eman, Rahman, Muhammad Aziz
- Authors: Kinyoki, Damaris , Osgood-Zimmerman, Aaron , Bhattacharjee, Natalia , Schaeffer, Lauren , Lazzar-Atwood, Alice , Lu, Dan , Ewald, Samuel , Donkers, Katie , Letourneau, Ian , Collison, Michael , Schipp, Megan , Abajobir, Amanuel , Abbasi, Sima , Abbasi, Nooshin , Abbasifard, Mitra , Abbasi-Kangevari, Mohsen , Abbastabar, Hedayat , Abd-Allah, Foad , Abdelalim, Ahmed , Abd-Elsalam, Sherief , Abdoli, Amir , Abdollahpour, Ibrahim , Abedi, Aidin , Abolhassani, Hassan , Abraham, Biju , Abreu, Lucas , Abrigo, Michael , Abualhasan, Ahmed , Abu-Gharbieh, Eman , Rahman, Muhammad Aziz
- Date: 2021
- Type: Text , Journal article
- Relation: Nature Medicine Vol. 27, no. 10 (2021), p. 1761-1782
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- Description: Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
- Authors: Kinyoki, Damaris , Osgood-Zimmerman, Aaron , Bhattacharjee, Natalia , Schaeffer, Lauren , Lazzar-Atwood, Alice , Lu, Dan , Ewald, Samuel , Donkers, Katie , Letourneau, Ian , Collison, Michael , Schipp, Megan , Abajobir, Amanuel , Abbasi, Sima , Abbasi, Nooshin , Abbasifard, Mitra , Abbasi-Kangevari, Mohsen , Abbastabar, Hedayat , Abd-Allah, Foad , Abdelalim, Ahmed , Abd-Elsalam, Sherief , Abdoli, Amir , Abdollahpour, Ibrahim , Abedi, Aidin , Abolhassani, Hassan , Abraham, Biju , Abreu, Lucas , Abrigo, Michael , Abualhasan, Ahmed , Abu-Gharbieh, Eman , Rahman, Muhammad Aziz
- Date: 2021
- Type: Text , Journal article
- Relation: Nature Medicine Vol. 27, no. 10 (2021), p. 1761-1782
- Full Text:
- Reviewed:
- Description: Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17
- Wiens, Kirsten, Lindstedt, Paulina, Blacker, Brigette, Johnson, Kimberly, Baumann, Mathew, Schaeffer, Lauren, Abbastabar, Hedayat, Abd-Allah, Foad, Abdelalim, Ahmed, Abdollahpour, Ibrahim, Abegaz, Kedir, Abejie, Ayenew, Abreu, Lucas, Abrigo, Michael, Abualhasan, Ahmed, Accrombessi, Manfred, Acharya, Dilaram, Adabi, Maryam, Adamu, Abdu, Adebayo, Oladimeji, Adedoyin, Rufus, Adekanmbi, Victor, Adetokunboh, Olatunji, Adhena, Beyene, Afarideh, Mohsen, Ahmad, Sohail, Ahmadi, Keivan, Ahmed, Anwar, Ahmed, Muktar, Rahman, Muhammad Aziz
- Authors: Wiens, Kirsten , Lindstedt, Paulina , Blacker, Brigette , Johnson, Kimberly , Baumann, Mathew , Schaeffer, Lauren , Abbastabar, Hedayat , Abd-Allah, Foad , Abdelalim, Ahmed , Abdollahpour, Ibrahim , Abegaz, Kedir , Abejie, Ayenew , Abreu, Lucas , Abrigo, Michael , Abualhasan, Ahmed , Accrombessi, Manfred , Acharya, Dilaram , Adabi, Maryam , Adamu, Abdu , Adebayo, Oladimeji , Adedoyin, Rufus , Adekanmbi, Victor , Adetokunboh, Olatunji , Adhena, Beyene , Afarideh, Mohsen , Ahmad, Sohail , Ahmadi, Keivan , Ahmed, Anwar , Ahmed, Muktar , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 8, no. 8 (2020), p. e1038-e1060
- Full Text:
- Reviewed:
- Description: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
- Authors: Wiens, Kirsten , Lindstedt, Paulina , Blacker, Brigette , Johnson, Kimberly , Baumann, Mathew , Schaeffer, Lauren , Abbastabar, Hedayat , Abd-Allah, Foad , Abdelalim, Ahmed , Abdollahpour, Ibrahim , Abegaz, Kedir , Abejie, Ayenew , Abreu, Lucas , Abrigo, Michael , Abualhasan, Ahmed , Accrombessi, Manfred , Acharya, Dilaram , Adabi, Maryam , Adamu, Abdu , Adebayo, Oladimeji , Adedoyin, Rufus , Adekanmbi, Victor , Adetokunboh, Olatunji , Adhena, Beyene , Afarideh, Mohsen , Ahmad, Sohail , Ahmadi, Keivan , Ahmed, Anwar , Ahmed, Muktar , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 8, no. 8 (2020), p. e1038-e1060
- Full Text:
- Reviewed:
- Description: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
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