Understanding the determinants of timely antiretroviral therapy (ART) initiation is useful for HIV programs intent on developing models of care that reduce delays in treatment initiation while maintaining a high quality of care. We analyzed patient- and facility-level determinants of time to ART initiation among patients who initiated ART in Kenya.
Following the methods of the Global Burden of Disease Study 2013 (GBD 2013), we have systematically analyzed all available demographic and epidemiological data sources for China at the provincial level. We assessed levels of and trends in all-cause mortality, causes of death, and years of life lost (YLL) in all 33 province-level administrative units in mainland China, all of which we refer to as provinces, for the years between 1990 and 2013.
In the past two decades, the under-5 mortality rate in China has fallen substantially, but progress with regard to the Millennium Development Goal (MDG) 4 at the subnational level has not been quantified. We aimed to estimate under-5 mortality rates in mainland China for the years 1970 to 2012.
Chronic diseases and their risk factors are believed to be common in the Kingdom of Saudi Arabia (KSA). Most of them require long-term management through medications. We examined patterns of medication use for chronic health conditions (CHC) in KSA based on a national survey.
The Global Burden of Disease (GBD) study assesses health losses from diseases, injuries, and risk factors using disability-adjusted life-years, which need a set of disability weights to quantify health levels associated with nonfatal outcomes. The objective of this study was to estimate disability weights for the GBD 2013 study.
The Global Burden of Disease (GBD) study is a longstanding effort to report consistent and comprehensive measures of disease burden for the world. In this paper, we describe the methods used to estimate the global burden of stroke for the GBD 2013 study. Pathologic subtypes of stroke are modeled separately for two mutually exclusive and exhaustive categories: (1) ischemic stroke and (2) hemorrhagic and other non-ischemic strokes. Acute and chronic strokes are estimated separately. The GBD 2013 study has incorporated large amounts of new data on stroke death rates, incidence, and case fatality. Disease modeling methods have been updated to better integrate mortality and incidence data. Future efforts will focus on incorporating data on the regional variation in severity of disability. Stroke remains a new area for disease modeling. A better understanding of stroke incidence, mortality, and severity, and how it varies among countries, can help guide priority setting and improve health policy related to this important condition.
Mortality for children with congenital heart disease (CHD) has declined with improved surgical techniques and neonatal screening; however, as these patients live longer, accurate estimates of the prevalence of adults with CHD are lacking.
Verbal autopsy is gaining increasing acceptance as a method for determining the underlying cause of death when the cause of death given on death certificates is unavailable or unreliable, and there are now a number of alternative approaches for mapping from verbal autopsy interviews to the underlying cause of death. For public health applications, the population-level aggregates of the underlying causes are of primary interest, expressed as the cause-specific mortality fractions (CSMFs) for a mutually exclusive, collectively exhaustive cause list. Although it allows for relative comparisons of alternative methods, CSMF Accuracy provides misleading numbers in absolute terms, because even random allocation of underlying causes yields relatively high CSMF accuracy. Therefore, the objective of this study was to develop and test a measure of CSMF that corrects this problem.
Modifiable risks account for a large fraction of disease and death, but clinicians and patients lack tools to identify high-risk populations or compare the possible benefit of different interventions.
United Nations member states have agreed to reduce premature cardiovascular disease (CVD) mortality 25% by 2025. Global CVD risk factor targets have been recommended. We produced estimates to show how selected risk factor reduction would affect CVD mortality for different regions and countries.
We use the Global Burden of Disease Study 2013 data on mortality and causes of death, and disease and injury incidence and prevalence to analyze the burden of disease and injury in England as a whole, in English regions, and within each English region by deprivation quintile. We also assess disease and injury burden in England attributable to potentially preventable risk factors. England and the English regions are compared with the remaining constituent countries of the UK and with comparable countries in the European Union (EU) and beyond.
The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.
Nigeria has made notable gains in improving childhood survival but the country still accounts for a large portion of the world’s overall disease burden, particularly among women and children. To date, no systematic analyses have comprehensively assessed trends for health outcomes and interventions across states in Nigeria.
Since the year 2000, a concerted campaign against malaria has led to unprecedented levels of intervention coverage across sub-Saharan Africa. Understanding the effect of this control effort is vital to inform future control planning.
The amount of international aid given to address non-communicable diseases is minimal. Most of it is directed to wealthier countries and focuses on the prevention of unhealthy lifestyles. Explanations for the current direction of non-communicable disease aid include that these are diseases of affluence that benefit from substantial research and development into their treatment in high-income countries and are better addressed through domestic tax and policy measures to reduce risk factor prevalence than through aid programs. This study assessed these justifications.
The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardized estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age–sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to socio-demographic development.
Patients receiving antiretroviral therapy (ART) require routine monitoring to track response to treatment and assess for treatment failure. This study aims to identify gaps in monitoring practices in Kenya and Uganda.
There are not enough data on the epidemiology of asthma in the Kingdom of Saudi Arabia (KSA). We analyzed data from a national household survey conducted in KSA in 2013 to estimate prevalence, associated risk factors, and control measurements of asthma.
Rapidly rising global rates of chronic diseases portend a consequent rise in ESRD. Despite this, kidney disease is not included in the list of noncommunicable diseases (NCDs) targeted by the United Nations for 25% reduction by year 2025. In an effort to accurately report the trajectory and pattern of global growth of maintenance dialysis, we present the change in prevalence and incidence from 1990 to 2010.
It is unknown whether Saudis receive health examinations periodically. To inform health authorities on the health-seeking behavior of the Saudi population, we investigated patterns of periodic health examination (PHE) use by Saudis.
Individual income and poverty are associated with poor health outcomes. The poor face unique challenges related to access, education, financial capacity, environmental effects, and other factors that threaten their health outcomes.
Ischemic heart disease (IHD) was responsible for 8.1 million deaths in 2013, the most recent year estimated, which was 14.8% of deaths worldwide. IHD was the leading cause of death globally among men and women in both 1990 and 2013.
As the first report in the series on faith-based health care, we review a broad body of published work and introduce some empirical evidence on the role of faith-based health care providers, with a focus on Christian faith-based health providers in sub-Saharan Africa (on which the most detailed documentation has been gathered).
Tobacco consumption is a major risk factor for morbidity and mortality. The Saudi Ministry of Health started a national tobacco control program in 2002 with increased and intensified efforts after joining the World Health Organization Framework Convention for Tobacco Control in 2005.
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne infection caused by a virus (CCHFV) from the Bunyaviridae family. We used an exhaustive database of human CCHF occurrence records and a niche modeling framework to map the global distribution of risk for human CCHF occurrence.