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Pushing the Pace: Progress and Challenges in Fighting Childhood Pneumonia
Pushing the Pace: Progress and Challenges in Fighting Childhood Pneumonia examines recent gains in reducing child deaths from pneumonia. This report advances our understanding of the burden of childhood pneumonia and its toll within the context of the leading killers of children; global trends in funding to address pneumonia; and health system factors involved in the effective prevention, diagnosis, and treatment of pneumonia.
Random-effects, fixed-effects and the within-between specification for clustered data in observational health studies: a simulation study
When unaccounted-for group-level characteristics affect an outcome variable, traditional linear regression is inefficient and can be biased. The random- and fixed-effects estimators (RE and FE, respectively) are two competing methods that address these problems. While each estimator controls for otherwise unaccounted-for effects, the two estimators require different assumptions. Health researchers tend to favor RE estimation, while researchers from some other disciplines tend to favor FE estimation. In addition to RE and FE, an alternative method called within-between (WB) was suggested by Mundlak in 1978, although is utilized infrequently.
A comprehensive database of the geographic spread of past human Ebola outbreaks
Ebola is a zoonotic filovirus that has the potential to cause outbreaks of variable magnitude in human populations. This database collates our existing knowledge of all known human outbreaks of Ebola for the first time by extracting details of their suspected zoonotic origin and subsequent human-to-human spread from a range of published and non-published sources. In total, 22 unique Ebola outbreaks were identified, composed of 117 unique geographic transmission clusters.
Obesity and associated factors — Kingdom of Saudi Arabia, 2013
Data on obesity from the Kingdom of Saudi Arabia (KSA) are nonexistent, making it impossible to determine whether the efforts of the Saudi Ministry of Health are having an effect on obesity trends. To determine obesity prevalence and associated factors in the KSA, we conducted a national survey on chronic diseases and their risk factors.
Status of the diabetes epidemic in the Kingdom of Saudi Arabia, 2013
In the Kingdom of Saudi Arabia (KSA), current data on diabetes are lacking, and a rise of the epidemic is feared, given the epidemiologic transition in the country. To inform public health authorities on the current status of the diabetes epidemic, we analyzed data from the Saudi Health Interview Survey (SHIS).
Estimation of district-level under-5 mortality in Zambia using birth history data, 1980–2010
We find that performance is highly dependent on the birth history method applied and how temporal trends are accounted for. We estimated trends in district-level under-5 mortality in Zambia from 1980 to 2010 using the best-performing model. We find that under-5 mortality is highly variable within Zambia: there was a 1.8-fold difference between the lowest and highest levels in 2010, and declines over the period 1980 to 2010 ranged from less than 5% to more than 50%.
Health Service Provision in Kenya: Assessing Facility Capacity, Costs of Care, and Patient Perspectives
This report draws from the Access, Bottlenecks, Costs, and Equity (ABCE) project in Kenya, a multi-pronged and multi-country research collaboration focused on understanding what drives and hinders health service provision
Health Service Provision in Uganda: Assessing Facility Capacity, Costs of Care, and Patient Perspectives
This report draws from the Access, Bottlenecks, Costs, and Equity (ABCE) project in Uganda, a multi-pronged and multi-country research collaboration focused on understanding what drives and hinders health service provision.
Burden of disease, injuries, and risk factors in the Kingdom of Saudi Arabia, 1990–2010
We report the burden of disease and risk factors measured by causes of death, years of life lost attributable to premature mortality (YLLs), years of life lived with disability (YLDs), and disability-adjusted life years (DALYs) for 1990, 2005, and 2010 in the Kingdom of Saudi Arabia (KSA).
Reported stroke symptoms and their associated risk factors in the Kingdom of Saudi Arabia, 2013
Abstract Stroke is the second-leading cause of death globally, and in the Kingdom of Saudi Arabia, with hypertension being the predominant risk factor. At-risk individuals experience stroke symptoms but remain undiagnosed. However, no data exist on stroke symptoms and their associated factors in KSA. We assessed self-reported stroke symptoms and their association with pre-diabetes, diabetes, hypercholesterolemia, hypertension, and health-seeking behaviors. Methods We conducted a nationally representative multistage survey of individuals aged 15 years or older on socio-demographic characteristics; tobacco consumption, diet, physical activity, health care utilization, different health-related behaviors, and self-reported chronic conditions. We used a backward elimination multivariate logistic regression model to measure associations between symptoms of stroke and risk factors. Results Between April and June 2013, a total of 12,000 households were contacted, and a total of 10,735 participants completed the survey (response rate of 89.4%). Overall, 579 (4.8% age-adjusted) respondents reported experiencing at least one symptom of stroke, while 55 (0.4% age-adjusted) reported being previously diagnosed with a stroke. The likelihood of reporting symptoms of stroke was associated with sex, older age, high levels of physical activity, and a history of diagnoses of any of the following conditions: pre-diabetes, diabetes, hypercholesterolemia, and hypertension. Our study showed that a high percentage of Saudis reporting stroke symptoms have undiagnosed or uncontrolled blood pressure. Moreover, 61% of those reporting stroke symptoms have never been to a doctor. Conclusions Our study showed that a high percentage of individuals with suspected stroke have not sought medical care. Moreover, a large proportion of those with reported symptoms have uncontrolled conditions. To reduce the burden on stroke in KSA, prevention and control strategies should be accelerated with a focus on use of free preventive care services.
2014 Roux Prize Winner
Dr. Rodrigo Guerrero used scientific detective work to determine the factors driving violence, the number-one cause of early death and disability in Colombia.
2014 Premio Roux Ganador
El Dr. Rodrigo Guerrero usó trabajo científico detectivesco para determinar los factores que desencadenaban la violencia, la principal causa de muerte prematura y discapacidad en Colombia.
Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression
Prevalence increased gradually with age, showing a steep increase between the third and fourth decades of life that was driven by a peak in incidence at around 38 years of age. There were considerable variations in prevalence and incidence between regions and countries. Policymakers need to be aware of a predictable increasing burden of SP due to the growing world population associated with an increasing life expectancy and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.
An innovative approach to measuring efficiency of health service provision in developing countries
Governments of developing countries lack information about the process of providing health services. When services are provided inefficiently, scarce resources that could be used to treat additional patients are wasted. Even when the political will for efficiency assessment exists, the lack of adequate data represents a barrier to conducting accurate studies on the production and costs of health care services.
Vaccine resource tracking systems
From 1999 to 2010, annual disbursements of development assistance for health for vaccinations increased from $0.5 billion to $2.0 billion (all financial values USD 2010). In its 2012 Global Vaccine Action Plan (GVAP), the World Health Assembly recommended establishing a comprehensive vaccination resource tracking system to better understand the source and recipients of these funds, and ultimately their impact on outcomes.
Effective coverage: a metric for monitoring universal health coverage
A major challenge in monitoring universal health coverage (UHC) is identifying an indicator that can adequately capture the multiple components underlying the UHC initiative. Effective coverage, which unites individual and intervention characteristics into a single metric, offers a direct and flexible means to measure health system performance at different levels.
Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis
Liver cirrhosis is a major yet largely preventable and underappreciated cause of global health loss. Variations in cirrhosis mortality at the country level reflect differences in prevalence of risk factors such as alcohol use and hepatitis B and C infection. We estimated annual age-specific mortality from liver cirrhosis in 187 countries between 1980 and 2010.
Mapping the zoonotic niche of Ebola virus disease in Africa
Ebola virus disease (EVD) is a complex zoonosis that is highly virulent in humans. We assembled location data on all recorded zoonotic transmission to humans and Ebola virus infection in bats and primates (1976–2014). Using species distribution models, these occurrence data were paired with environmental covariates to predict a zoonotic transmission niche covering 22 countries across Central and West Africa.
Does distance matter for institutional delivery in rural India?
This article estimates the causal effect of distance to health facility on in-facility birth in rural India, taking into account the endogenous placement of the health facility.We find that women living farther away from the health facilities are less likely to give birth at a health facility.
Hypercholesterolemia and its associated risk factors — Kingdom of Saudi Arabia, 2013
To assess the prevalence of hypercholesterolemia and its associated factors in the Kingdom of Saudi Arabia (KSA).
Hypertension and its associated risk factors in the Kingdom of Saudi Arabia, 2013: A national survey
Current data on hypertension in the Kingdom of Saudi Arabia are lacking. We conducted a national survey to inform decision-makers on the current magnitude of the epidemic. We measured systolic and diastolic blood pressure of 10,735 Saudis aged 15 years or older and interviewed them through a national multistage survey.