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Research Articles


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April 25, 2019
Potential for additional government spending on HIV/AIDS in 137 low-income and middle-income countries: an economic modelling study
Research Article

Between 2012 and 2016, development assistance for HIV/AIDS decreased by 20.0%; domestic financing is therefore critical to sustaining the response to HIV/AIDS. To understand whether domestic resources could fill the financing gaps created by declines in development assistance, we aimed to track spending on HIV/AIDS and estimated the potential for governments to devote additional domestic funds to HIV/AIDS.

April 25, 2019
Tracking spending on malaria by source in 106 countries, 2000–16: an economic modelling study
Research Article

Sustaining achievements in malaria control and making progress toward malaria elimination requires coordinated funding. We estimated domestic malaria spending by source in 106 countries that were malaria endemic in 2000–2016 or became malaria-free after 2000.

April 5, 2019
Mapping diphtheria-pertussis-tetanus vaccine coverage in Africa, 2000–2016: a spatial and temporal modeling study
Research Article

Routine childhood vaccination is among the most cost-effective, successful public health interventions available. Amid substantial investments to expand vaccine delivery throughout Africa and strengthen administrative reporting systems, most countries still require robust measures of local routine vaccine coverage and changes in geographical inequalities over time.

April 3, 2019
Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
Research Article

Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity.

March 26, 2019
Utilizing general human movement models to predict the spread of emerging infectious diseases in resource-poor settings
Research Article

Human mobility is an important driver of geographic spread of infectious pathogens. Our findings show that transmission patterns derived from general human movement models can improve forecasts of spatiotemporal transmission patterns in places where local mobility data is unavailable.

March 26, 2019
Geographical distribution and prevalence of podoconiosis in Rwanda: a cross-sectional country-wide survey
Research Article

Podoconiosis is a type of tropical lymphoedema that causes massive swelling of the lower limbs. The disease is associated with both economic insecurity, due to long-term morbidity-related loss of productivity, and intense social stigma. Reliable and detailed data on the prevalence and distribution of podoconiosis are scarce. We aimed to fill this data gap by doing a nationwide community-based study to estimate the number of cases throughout Rwanda.

March 14, 2019
Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Research Article

Neurological disorders are increasingly recognized as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders.

March 13, 2019
The relationships between democratic experience, adult health, and cause-specific mortality in 170 countries between 1980 and 2016: an observational analysis
Research Article

When enforced by free and fair elections, democracies are more likely than autocracies to lead to health gains for causes of mortality (e.g., cardiovascular diseases and transport injuries) that have not been heavily targeted by foreign aid and require health care delivery infrastructure. International health agencies and donors might increasingly need to consider the implications of regime type in their efforts to maximize health gains, particularly in the context of aging populations and the growing burden of non-communicable diseases.

March 12, 2019
Progress in adolescent health and well-being: tracking 12 headline indicators for 195 countries and territories, 1990–2016
Research Article

Rapid demographic, epidemiological, and nutritional transitons have brought a pressing need to track progress in adolescent health. Here, we present country-level estimates of 12 headline indicators from the Lancet Commission on adolescent health and well-being, from 1990 to 2016.

March 12, 2019
Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Research Article

Stroke is a leading cause of mortality and disability worldwide and the economic costs of treatment and post-stroke care are substantial. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic, comparable method of quantifying health loss by disease, age, sex, year, and location to provide information to health systems and policymakers on more than 300 causes of disease and injury, including stroke. The results presented here are the estimates of burden due to overall stroke and ischemic and hemorrhagic stroke from GBD 2016.

March 6, 2019
Measuring population aging: an analysis of the Global Burden of Disease Study 2017
Research Article

Traditional metrics for population health aging tend not to differentiate between extending life expectancy and adding healthy years. A population aging metric that reflects both longevity and health status, incorporates a comprehensive range of diseases, and allows for comparisons across countries and time is required to understand the progression of aging and to inform policies. The new metric facilitates the shift from thinking not just about chronological age but the health status and disease severity of aging populations. Our findings could provide inputs into policymaking by identifying key drivers of variation in the aging burden and resources required for addressing the burden.

March 5, 2019
The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births
Research Article

In 2015, high rates of microcephaly were reported in Northeast Brazil following the first South American Zika virus (ZIKV) outbreak. Reported microcephaly rates in other Zika-affected areas were significantly lower, suggesting alternate causes or the involvement of arboviral cofactors in exacerbating microcephaly rates. This study strengthens the evidence that congenital ZIKV infection, particularly in the first 2 trimesters of pregnancy, is associated with microcephaly and less frequently with other birth defects.

March 4, 2019
Past and future spread of the arbovirus vectors Aedes aegypti and Aedes albopictus
Research Article

The global population at risk from mosquito-borne diseases – including dengue, yellow fever, chikungunya, and Zika – is expanding in concert with changes in the distribution of two key vectors: Aedes aegypti and Aedes albopictus. Our maps and predictions offer an opportunity to strategically target surveillance and control programs and thereby augment efforts to reduce arbovirus burden in human populations globally.

February 21, 2019
Global, regional, national, and subnational big data to inform health equity research: perspectives from the Global Burden of Disease Study 2017
Research Article

Everyone deserves a long and healthy life, but in reality, health outcomes differ across populations. We use results from the Global Burden of Disease Study 2017 (GBD 2017) to report patterns in the burden of diseases, injuries, and risks at the global, regional, national, and subnational level, and by sociodemographic index (SDI), from 1990 to 2017.

February 20, 2019
Global, regional, and national burden of brain and other CNS cancer, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Research Article

Brain and CNS cancers (collectively referred to as CNS cancers) are a source of mortality and morbidity for which diagnosis and treatment require extensive resource allocation and sophisticated diagnostic and therapeutic technology. In this analysis, we aimed to provide a comparable and comprehensive estimation of the global burden of brain cancer between 1990 and 2016.

February 18, 2019
The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017
Research Article

Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them.

February 14, 2019
Global, regional, and national burden of epilepsy, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Research Article

Seizures and their consequences contribute to the burden of epilepsy because they can cause health loss (premature mortality and residual disability). Data on the burden of epilepsy are needed for health care planning and resource allocation. The aim of this study was to quantify health loss due to epilepsy by age, sex, year, and location using data from the Global Burden of Diseases, Injuries, and Risk Factors Study.

February 12, 2019
Antenatal care as a means to increase participation in the continuum of maternal and child healthcare: an analysis of the poorest regions of four Mesoamérican countries
Research Article

Antenatal care (ANC) is a means to identify high-risk pregnancies and educate women so that they might experience a healthier delivery and outcome. The present analysis examines whether ANC uptake is associated with other maternal and child health behaviors in poor mothers in Guatemala, Honduras, Nicaragua, and Mexico (Chiapas).

February 6, 2019
Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016
Research Article

Age-standardized mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted toward vulnerable populations if they are informed by variations in mortality rates.

January 21, 2019
Global, regional, and national burden of multiple sclerosis, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Research Article

Multiple sclerosis is the most common inflammatory neurological disease in young adults. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic method of quantifying various effects of a given condition by demographic variables and geography. In this systematic analysis, we quantified the global burden of multiple sclerosis and its relationship with country development level.

January 18, 2019
Association of adverse effects of medical treatment with mortality in the United States: a secondary analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study
Research Article

This study’s findings suggest a modest reduction in the mortality rate associated with adverse effects of medical treatment (AEMT) in the United States from 1990 to 2016 while also observing increased mortality associated with advancing age and noted geographic variability. The annual GBD releases may allow for tracking of the burden of AEMT in the United States.

January 13, 2019
Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015
Research Article

Government health spending is a primary source of funding in the health sector across the world. However, in sub-Saharan Africa, only about a third of all health spending is sourced from the government. The objectives of this study are to describe the growth in government health spending, examine its determinants and explain the variation in government health spending across sub-Saharan African countries.

December 19, 2018
Global, regional, and country-specific lifetime risks of stroke, 1990 and 2016
Research Article

The lifetime risk of stroke has been calculated in a limited number of selected populations. We sought to estimate the lifetime risk of stroke at the regional, country, and global level using data from a comprehensive study of the prevalence of major diseases.

December 13, 2018
Maternal mortality ratios in 2,852 Chinese counties, 1996–2015, and achievement of Millennium Development Goal 5 in China: a subnational analysis of the Global Burden of Disease Study 2016
Research Article

As one of only a handful of countries that have achieved both Millennium Development Goals (MDGs) 4 and 5, China has substantially lowered maternal mortality in the past two decades. Little is known, however, about the levels and trends of maternal mortality at the county level in China.

December 12, 2018
Mortality, morbidity, and hospitalizations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017
Research Article

Although the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respiratory conditions (like chronic obstructive pulmonary disease) are attributable to seasonal influenza. The Global Burden of Disease Study (GBD) 2017 is a systematic scientific effort to quantify the health loss associated with a comprehensive set of diseases and disabilities. In this article, we focus on LRTIs that can be attributed to influenza.

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