Little is known about survival outcomes of HIV patients on first-line antiretroviral therapy (ART) on a large-scale in India, or facility level factors that influence patient survival to guide further improvements in the ART program in India. We examined factors at the facility level in addition to patient factors that influence survival of adult HIV patients on ART in the publicly-funded ART program in a high- and a low-HIV prevalence state.
Young people’s health has emerged as a neglected yet pressing issue in global development. Changing patterns of young people’s health have the potential to undermine future population health as well as global economic development unless timely and effective strategies are put into place. We report the past, present, and anticipated burden of disease in young people aged 10–24 years from 1990 to 2013 using data on mortality, disability, injuries, and health risk factors.
Indigenous women in Mesoamerica experience disproportionately high maternal mortality rates and are less likely to have institutional deliveries. Identifying correlates of institutional delivery, and satisfaction with institutional deliveries, may help improve facility utilization and health outcomes in this population. We used baseline surveys from the Salud Mesoamérica Initiative to analyze data from 10,895 indigenous and non-indigenous women in Guatemala and Mexico (Chiapas State) and indigenous women in Panama.
Zika virus was discovered in Uganda in 1947 and is transmitted by Aedes mosquitoes, which also act as vectors for dengue and chikungunya viruses throughout much of the tropical world. Possible associations with microcephaly and Guillain-Barré syndrome observed in this outbreak have raised concerns about continued global spread of Zika virus, prompting its declaration as a Public Health Emergency of International Concern by the World Health Organization. We conducted species distribution modelling to map environmental suitability for Zika. We show a large portion of tropical and sub-tropical regions globally have suitable environmental conditions with over 2.17 billion people inhabiting these areas.
Dengue is a serious global burden. Objective, systematic, comparable measures of dengue burden are needed to track health progress, assess the application and financing of emerging preventive and control strategies, and inform health policy. We estimated the global economic burden of dengue by country and super-region.
Disbursements of development assistance for health (DAH) have risen substantially during the past several decades. More recently, the international community’s attention has turned to other international challenges, introducing uncertainty about the future of disbursements for DAH.
In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected.
Increased demand for antiretroviral therapy (ART) services combined with plateaued levels of development assistance for HIV/AIDS requires that national ART programs monitor program effectiveness. In this pilot study, we compared commonly utilized performance metrics of 12- and 24-month retention with rates of viral load (VL) suppression at 15 health facilities in Uganda.
To better understand the global response to HIV/AIDS, this study tracked development assistance for HIV/AIDS at a granular, program level.
The health status of the young people is an important indicator for future health and health care needs of the next generation. In order to understand the health risk factors of Saudi youth, we analyzed data from a large national survey in the Kingdom of Saudi Arabia.
The burden of cancer in Mexico shows complex regional patterns by age, sex, types of cancer, and deprivation status. The study analyzed mortality and incidence for 28 cancers by deprivation status, age and sex from 1990 to 2013.
Under-5 mortality in Zambia has declined since 1990, with reductions accelerating after 2000. Zambia’s scale-up of malaria control is viewed as the driver of these gains, but past studies have not fully accounted for other potential factors. This study sought to systematically evaluate the impact of malaria vector control on under-5 mortality.
High-quality epidemiological studies evaluating the burden of cutaneous leishmaniasis worldwide are lacking. We compared the burden of cutaneous leishmaniasis in each country to the overall global burden and assessed the equality of cutaneous leishmaniasis burden across different countries and regions.
Dengue is the most common arbovirus infection globally, but its burden is poorly quantified. We estimated dengue mortality, incidence, and burden for the Global Burden of Disease study 2013.
In the 2012 Global Vaccine Action Plan, development assistance partners committed to providing sustainable financing for vaccines and expanding vaccination coverage to all children in low- and middle-income countries by 2020. To assess progress toward these goals, the Institute for Health Metrics and Evaluation produced estimates of development assistance for vaccinations.
With the lack of appropriate data, we conducted a large household survey in 2013 to determine current rates of physical activity in the Kingdom of Saudi Arabia (KSA).
Low-resource countries can greatly benefit from even small increases in efficiency of health service provision, supporting a strong case to measure and pursue efficiency improvement in low- and middle-income countries (LMICs). However, the knowledge base concerning efficiency measurement remains scarce for these contexts.
The literature focuses on mortality among children younger than 5 years. Comparable information on nonfatal health outcomes among these children and the fatal and nonfatal burden of diseases and injuries among older children and adolescents is scarce.
Care practices and risk factors for diarrhea among impoverished communities across Mesoamerica are unknown. Using Salud Mesoamérica Initiative baseline data, collected 2011–2013, we assessed the prevalence of diarrhea, adherence to evidence-based treatment guidelines, and potential diarrhea correlates in poor and indigenous communities across Mesoamerica. This study surveyed 14,500 children under 5 years of age in poor areas of El Salvador, Guatemala, Mexico (Chiapas State), Nicaragua, and Panama.
There is increasing recognition of stroke as an important contributor to childhood morbidity and mortality. Current estimates of global childhood stroke burden and its temporal trends are sparse. Accurate and up-to-date estimates of childhood stroke burden are important for planning research and the resulting evidence-based strategies for stroke prevention and management.
In May, 2015, locally acquired cases of Zika virus—an arbovirus found in Africa and Asia-Pacific and transmitted via Aedes mosquitoes—were confirmed in Brazil. The presence of Aedes mosquitoes across Latin America, coupled with suitable climatic conditions, have triggered a Zika virus epidemic in Brazil, currently estimated at 440 000–1 300 000 cases.
Pathogen distribution models that predict spatial variation in disease occurrence require data from a large number of geographic locations to generate disease risk maps. We have developed a supervised learning process to validate geolocated disease outbreak data in a timely manner.
We conducted a large household survey in 2013 to determine the current status of oral health practices and use of oral health services in the Kingdom of Saudi Arabia (KSA).
In this study, we report findings from exit surveys of patients receiving HIV and non-HIV services at a diverse sample of facilities across Zambia.