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Research Articles


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September 12, 2018
Gender differentials and state variations in suicide deaths in India: the Global Burden of Disease Study 1990–2016
Research Article

A systematic understanding of suicide mortality trends over time at the subnational level for India’s 1.3 billion people, 18% of the global population, is not readily available. Thus, we aimed to report time trends of suicide deaths, and the heterogeneity in its distribution between the states of India from 1990 to 2016. India’s proportional contribution to global suicide deaths is high and increasing. The suicide death rate in India is higher than expected for its Socio-demographic Index level, especially for women, with substantial variations in the magnitude and men-to-women ratio between the states. India must develop a suicide prevention strategy that takes into account these variations in order to address this major public health problem.

September 6, 2018
Progress toward eliminating TB and HIV deaths in Brazil, 2001–2015: a spatial assessment
Research Article

Brazil has high burdens of tuberculosis (TB) and HIV, as previously estimated for the 26 states and the Federal District, as well as high levels of inequality in social and health indicators. We improved the geographic detail of burden estimation by modelling deaths due to TB and HIV and TB case fatality ratios for the more than 5,400 municipalities in Brazil. 

August 30, 2018
The burden of disease in Russia from 1980 to 2016: a systematic analysis for the Global Burden of Disease Study 2016
Research Article

Over the past few decades, social and economic changes have had substantial effects on health and well-being in Russia. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to evaluate trends in mortality, causes of death, years lived with disability, years of life lost, disability-adjusted life years, and associated risk factors in Russia from 1980 to 2016.

August 29, 2018
Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Research Article

The Sustainable Development Goals (SDGs) mandate systematic monitoring of the health and well-being of all children to achieve optimal early childhood development. However, global epidemiological data on children with developmental disabilities are scarce. This study estimates prevalence and YLDs for epilepsy, intellectual disability, hearing loss, vision loss, autism spectrum disorder, and attention-deficit hyperactivity disorder for children younger than 5 years.

August 28, 2018
Global mortality from firearms, 1990−2016
Research Article

Understanding global variation in firearm mortality rates could guide prevention policies and interventions. This study estimated between 195,000 and 276,000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups.

August 23, 2018
Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Research Article

Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk for all-cause mortality, and cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimizes health loss is zero.

August 13, 2018
Rotavirus vaccination and the global burden of rotavirus diarrhea among children younger than 5 years
Research Article

Rotavirus infection is the global leading cause of diarrhea-associated morbidity and mortality among children younger than 5 years. This report builds on findings from the Global Burden of Disease study 2016, a cross-sectional study that measured diarrheal diseases and their etiologic agents.

August 3, 2018
The Global Nutrient Database: availability of macronutrients and micronutrients in 195 countries from 1980 to 2013
Research Article

Few data are available on the supply and consumption of nutrients at the country level. To address this data gap, we aimed to create a database that provides information on availability (i.e., supply) of 156 nutrients across 195 countries and territories from 1980 to 2013.

August 1, 2018
Burden of diseases and injuries in Afghanistan, 1990–2016: Findings From the Global Burden of Disease 2016 Study
Research Article

This study aims to report the burden of diseases and injuries in Afghanistan between 1990 and 2016. Despite improvements in certain health indicators, our study suggests an urgent intervention to improve health status of the country. Improving health infrastructures, boosting maternal and child health (MCH), battling infectious diseases as well as chronic disease risk factor modification programs can help to decrease burden of diseases.

August 1, 2018
Antimicrobial drug resistance in Salmonella Typhi and Paratyphi isolates worldwide, 1990 to 2017: A systematic review of the literature
Research Article

Salmonella Typhi and Paratyphi are WHO priority pathogens that cause serious bloodstream infections. Antimicrobial resistance presents a significant public health burden as it negatively impacts our ability to treat and control enteric fever. The aim of this project is to map the spatial distribution of drug resistant S. Typhi and Paratyphi and to incorporate the impact of AMR into the Global Burden of Disease (GBD) study estimates.

July 25, 2018
The burden of disease in Greece, health loss, risk factors, and health financing, 2000–16: an analysis of the Global Burden of Disease Study 2016
Research Article

Following the economic crisis in Greece in 2010, the country's ongoing austerity measures include a substantial contraction of health care expenditure, with reports of subsequent negative health consequences. The findings of increases in total deaths and accelerated population aging call for specific focus from health policymakers to ensure the health care system is equipped to meet the needs of the people in Greece.

July 20, 2018
Burden of disease in Brazil, 1990–2016: a systematic subnational analysis for the Global Burden of Disease Study 2016
Research Article

Political, economic, and epidemiological changes in Brazil have affected health and the health system. Health improved from 1990 to 2016, but improvements and disease burden varied between states. An epidemiological transition toward non-communicable diseases and related risks occurred nationally, but later in some states, while interpersonal violence grew as a health concern. 

July 20, 2018
The burden of disease in Spain: Results from the Global Burden of Disease 2016
Research Article

This study used the estimates of the GBD to summarise the state of health in Spain in 2016 and report trends in mortality and morbidity from 1990 to 2016.

July 12, 2018
Vulnerability to snakebite envenoming: a global mapping of hotspots
Research Article

Snakebite envenoming is a frequently overlooked cause of mortality and morbidity. Identifying exact populations vulnerable to the most severe outcomes of snakebite envenoming at a subnational level is important for prioritizing new data collection and collation, reinforcing envenoming treatment, existing health care systems, and deploying currently available and future interventions.

July 5, 2018
Childhood vaccines in Uganda and Zambia: Determinants and barriers to vaccine coverage
Research Article

Improving childhood vaccine coverage is a priority for global health, but challenging in low and middle-income countries. This study provides evidence that determinants should be approached in the context of relevant outcomes, and evidence of specific determinants that could have the greatest impact if targeted.

June 28, 2018
On the road to universal health care in Indonesia, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Research Article

As Indonesia moves to provide health coverage for all citizens, understanding patterns of morbidity and mortality is important to allocate resources and address inequality.

June 18, 2018
Methods to measure quality of care and quality indicators through health facility surveys in low- and middle-income countries
Research Article

This study underscores that, with adequate resources and technical expertise, collecting data for quality indicators at scale in low- and middle-income countries is possible. 

June 13, 2018
Morbidity, mortality, and long-term consequences associated with diarrhea from Cryptosporidium infection in children younger than 5 years: a meta-analyses study
Research Article

The protozoan Cryptosporidium is a leading cause of diarrhea morbidity and mortality in children younger than 5 years. Our findings show that the substantial short-term burden of diarrhea from Cryptosporidium infection on childhood growth and well-being is an underestimate of the true burden.

June 7, 2018
Mortality due to snakebite and other venomous animals in the Indian state of Bihar: Findings from a representative mortality study
Research Article

Animal bites and stings contribute significantly to mortality in certain parts of the world. India accounts for the highest number of snakebites and related mortality globally. We report on mortality due to bite or sting of a venomous animal from a population-based study in the Indian state of Bihar which estimated the causes of death using verbal autopsy.

June 4, 2018
Measuring and mapping the global burden of antimicrobial resistance
Research Article

Despite the long-standing recognition of antimicrobial resistance (AMR) across many settings, there is surprisingly poor information about its geographical distribution over time and trends in its population prevalence and incidence. This makes reliable assessments of the health burden attributable to AMR difficult, weakening the evidence base to drive forward research and policy agendas to combat AMR. The inclusion of mortality and morbidity data related to drug-resistant infections into the annual Global Burden of Disease Study should help fill this policy void.

June 4, 2018
Measuring and mapping the global burden of antimicrobial resistance
Research Article

Despite the long-standing recognition of antimicrobial resistance (AMR) across many settings, there is surprisingly poor information about its geographical distribution over time and trends in its population prevalence and incidence. The inclusion of mortality and morbidity data related to drug-resistant infections into the annual Global Burden of Disease Study should help fill this policy void.

June 2, 2018
Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups, 1990 to 2016
Research Article

The increasing burden due to cancer and other non-communicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. This study assessed the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus.

June 2, 2018
Hospitals by day, dispensaries by night: Hourly fluctuations of maternal mortality within Mexican health institutions, 2010–2014
Research Article

Quality of obstetric care may not be constant within clinics and hospitals. Night shifts and weekends experience understaffing and other organizational hurdles in comparison with the weekday morning shifts, and this may influence the risk of maternal deaths. This study analyzed the hourly variation of maternal mortality within Mexican health institutions.

May 24, 2018
Appropriate and timely antibiotic administration for neonatal sepsis in Mesoamérica
Research Article

Neonatal sepsis is a leading cause of mortality among children under 5 in Latin America. This study examines the delivery of timely and appropriate antibiotics for neonatal sepsis among facilities participating in the Salud Mesoamérica Initiative project. 

May 23, 2018
Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016
Research Article

A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016.

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