Global Disability-adjusted Life Years Research Articles

Gender differences in global Disability-Adjusted Life Years (DALYs): a descriptive Analysis of the global burden of disease study 2021

Gender differences in global Disability-Adjusted Life Years (DALYs): a descriptive Analysis of the global burden of disease study 2021

Global, regional, and national burden of 10 digestive diseases in 204 countries and territories from 1990 to 2019.

Digestive diseases are very common worldwide and account for considerable health care use and expenditures. However, there are no global population-based estimates of the disease burden and temporal trend of digestive diseases. Annual case numbers, age-standardized rates of prevalence, incidence, death, and disability-adjusted life-years (DALYs), and their estimated annual percentage changes (EAPCs) for digestive diseases between 1990 and 2019 were derived from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019. The association between digestive disease burden and the sociodemographic index (SDI) was investigated. We also calculated DALYs attributable to risk factors that had evidence of causation with digestive diseases. Globally, in 2019, there were 88.99 million DALYs due to digestive diseases (3.51% of global DALYs). Digestive diseases were the 13th leading cause of DALYs globally in 2019. Global digestive disease DALYs were highest in the middle SDI quintile and in South Asia and were higher in males than females in 2019. Cirrhosis and other chronic liver diseases constituted the highest proportion of categorized digestive disease DALY burdens globally. From 1990 to 2019, the global age-standardized DALY rate of digestive diseases decreased from 1570.35 in 1990 to 1096.99 in 2019 per 1,00,000 population, with the EAPC being -1.32 (95% confidence interval [CI] -1.36 to -1.27). In 2019, the largest contributor to digestive disease DALYs at the global level, for both sexes, was alcohol use. The results of this systematic analysis suggest that the global burden of digestive diseases is substantial and varies markedly according to age, sex, SDI, and geographical region. These results provide comprehensive and comparable estimates that can potentially inform efforts toward digestive disease control worldwide.

Global, regional, and national HIV/AIDS disease burden levels and trends in 1990-2019: A systematic analysis for the global burden of disease 2019 study.

Since the first HIV/AIDS case appeared in 1980s, HIV/AIDS has been the focus of international attention. As a major public health problem, there are epidemiological uncertainties about the future of HIV/AIDS. It is important to monitor the global statistics of HIV/AIDS prevalence, deaths, disability adjusted life years (DALYs), and risk factors for adequate prevention and control. The Global Burden of Disease Study 2019 database was used to analyze the burden of HIV/AIDS in 1990-2019. By extracting global, regional, and national data on HIV/AIDS prevalence, deaths, and DALYs, we described the distribution by age and sex, explored the risk factors, and analyzed the trends in HIV/AIDS. In 2019, there were 36.85 million HIV/AIDS cases (95% UI: 35.15-38.86 million), 863.84 thousand deaths (95% UI: 78.61-99.60 thousand), and 47.63 million (95% UI: 42.63-55.65 million) DALYs. The global age-standardized HIV/AIDS prevalence, death, and DALY rates were 454.32 (95% UI: 433.76-478.59), 10.72 (95% UI: 9.70-12.39), and 601.49 (95% UI: 536.16-703.92) per 100,000 cases, respectively. In 2019, the global age-standardized HIV/AIDS prevalence, death, and DALY rates increased by 307.26 (95% UI: 304.45-312.63), 4.34 (95% UI: 3.78-4.90), and 221.91 (95% UI: 204.36-239.47) per 100,000 cases, respectively, compared to 1990. Age-standardized prevalence, death, and DALY rates decreased in high sociodemographic index (SDI) areas. High age-standardized rates were observed in low sociodemographic index areas, while low age-standardized rates were observed in high sociodemographic index areas. In 2019, the high age-standardized prevalence, death, and DALY rates were predominant in Southern Sub-Saharan Africa, and global DALYs peaked in 2004 and subsequently decreased. The highest global HIV/AIDS DALYs were in the 40-44 age group. The main risk factors affecting HIV/AIDS DALY rates included behavioral risks, drug use, partner violence, and unsafe sex. HIV/AIDS disease burden and risk factors vary by region, sex, and age. As access to health care increases across countries and treatment for HIV/AIDS infection improves, the HIV/AIDS disease burden is concentrated in areas with low SDIs, particularly in South Africa. Regional differences should be fully considered to target optimal prevention strategies and treatment options based on risk factors.

MANAGEMENT OF MALNUTRITION IN CHILDREN WITH AYURVEDA INTERVENTIONS: A REVIEW

In India, malnutrition remains a significant and challenging public health issue despite dietary rehabilitation and the effort of the government to tackle malnutrition. Childhood malnutrition is an underlying cause of an estimated 35% of all deaths among children under five and 21% of global disability-adjusted life years lost among less than five children. In Ayurveda, malnutrition in children is described as balashosha, karshya, phakka and parigarbhika. A large number of clinical studies on the management of malnutrition with Ayurveda drugs have been conducted and published. The purpose of this study is to evaluate the effect of Ayurveda interventions in the management of malnutrition in children. This review is accomplished using a complete and organized search of the available literature in Ayurveda texts and published articles. The searches were performed using various databases, including PubMed, Scopus, MedLine, and Google Scholar. Ayurveda drugs described for managing karshya and balashosha are formulated to meet all the deficiencies and cure the same. The findings of this review suggest that Ayurveda drugs, along with nutritional rehabilitation, proves to be more effective than nutritional rehabilitation alone, which may be due to the presence of deepana, pachana, brimhana and rasayana property of the Ayurveda drug. These findings will provide a substratum for future research studies for generating good-quality evidence that can help design new health policies to combat malnutrition effectively.

Global Burden and Improvement Gap of Non-Rheumatic Calcific Aortic Valve Disease: 1990-2019 Findings from Global Burden of Disease Study 2019.

The aim of this study was to explore the most updated changing trends of non-rheumatic calcific aortic valve disease (nrCAVD) and reveal possible improvements. We analyzed the age-standardized rates (ASRs) of prevalence, incidence, disability-adjusted life-years (DALYs), and mortality trends of nrCAVD from 1990 to 2019 using data from the Global Burden of Disease (GBD) study 2019. The relations between ASRs and socio-demographic index (SDI) were analyzed with Pearson's correlation coefficients. Decomposition and frontier analysis were employed to reveal the contribution proportion of influence factors and regions where improvement can be achieved. In 2019, there were 9.40 million (95% uncertainty interval (UI): 8.07 to 10.89 million) individuals with nrCAVD globally. From 1990 to 2019, the prevalence rate of nrCAVD increased by 155.47% (95% IU: 141.66% to 171.7%), with the largest increase observed in the middle SDI region (821.11%, 95% UI: 709.87% to 944.23%). Globally, there were no significant changes in the mortality rate of nrCAVD (0.37%, 95% UI: -8.85% to 7.99%). The global DALYs decreased by 10.97% (95% UI: -17.94% to -3.46%). The population attributable fraction (PAF) of high systolic blood pressure increased in the population aged 15-49 years, while it declined slightly in population aged 50+ years. Population growth was the main contributing factor to the increased DALYs across the globe (74.73%), while aging was the driving force in the high-SDI region (80.27%). The Netherlands, Finland, Luxembourg, Germany, and Norway could reduce DALY rates of nrCAVD using their socio-demographic resources. According to these results, we revealed that the burden of nrCAVD increased markedly from 1990 to 2019 in high-SDI and high-middle-SDI regions. There was a downward trend in the mortality due to nrCAVD since 2013, which is possibly owing to profound advances in transcatheter aortic valve replacement. Some countries may reduce burdens of nrCAVD using their socio-demographic resources.

Global, regional, national burden and gender disparity of cataract: findings from the global burden of disease study 2019

BackgroundTo evaluate the global burden of cataracts by year, age, region, gender, and socioeconomic status using disability-adjusted life years (DALYs) and prevalence from the Global Burden of Disease (GBD) study 2019.MethodsGlobal, regional, or national DALY numbers, crude DALY rates, and age-standardized DALY rates caused by cataracts, by year, age, and gender, were obtained from the Global Burden of Disease Study 2019. Socio-demographic Index (SDI) as a comprehensive indicator of the national or regional development status of GBD countries in 2019 was obtained from the GBD official website. Kruskal-Wallis test, linear regression, and Pearson correlation analysis were performed to explore the associations between the health burden with socioeconomic levels, Wilcoxon Signed-Rank Test was used to investigate the gender disparity.ResultsFrom 1990 to 2019, global DALY numbers caused by cataracts rose by 91.2%, crude rates increased by 32.2%, while age-standardized rates fell by 11.0%. Globally, age-standardized prevalence and DALYs rates of cataracts peaked in 2017 and 2000, with the prevalence rate of 1283.53 [95% uncertainty interval (UI) 1134.46–1442.93] and DALYs rate of 94.52 (95% UI 67.09–127.24) per 100,000 population, respectively. The burden was expected to decrease to 1232.33 (95% UI 942.33–1522.33) and 91.52 (95% UI 87.11–95.94) by 2050. Southeast Asia had the highest blindness rate caused by cataracts in terms of age-standardized DALY rates (99.87, 95% UI: 67.18–144.25) in 2019. Gender disparity has existed since 1990, with the female being more heavily impacted. This pattern remained with aging among different stages of vision impairments and varied through GBD super regions. Gender difference (females minus males) of age-standardized DALYs (equation: Y = -53.2*X + 50.0, P < 0.001) and prevalence rates (equation: Y = − 492.8*X + 521.6, P < 0.001) was negatively correlated with SDI in linear regression.ConclusionThe global health of cataracts is improving but the steady growth in crude DALY rates suggested that health progress does not mean fewer demands for cataracts. Globally, older age, females, and lower socioeconomic status are associated with higher cataract burden. The findings of this study highlight the importance to make gender-sensitive health policies to manage global vision loss caused by cataracts, especially in low SDI regions.

Progress in research of determinants of healthy life expectancy

Objective: To analyze the influencing factors of healthy life expectancy (HLE). Methods: Seven Chinese and English databases were used for the retrieval of related literatures published by May 7, 2022 to identify influencing factors of HLE, including diseases and injuries and their risk factors. Based on the ecological model of health determinants, this study classifies the risk factors of diseases and injuries into five levels: personal characteristics, individual behavior and lifestyle, social network, living and working conditions, and macroscopic socio-economic, cultural and environmental conditions. Contents of research area, HLE indicators, research population, influencing factors, data sources and results were extracted. The frequencies of reported documents of different HLE indicators and influencing factors of different dimensions were visualized by using evidence map, and the empirical studies of four authoritative English medical journals and Chinese core medical journals were further compared and described. Results: A total of 90 studies were selected, in which 26 were conducted in China (28.9%). Fifty-three studies are about diseases and injuries in the first dimension, and all of them have studied non-communicable diseases, accounting for the highest proportion (58.9%). There were 77 studies about the analysis on the determinants of health at five levels by an ecological model, all the studies reported multi-level results. Among them, 53 studies reported personal characteristics (58.9%), 47 studies reported individual behavior and lifestyle (52.2%), 10 studies reported social networks (11.1%), 35 studies reported living and working environment (38.9%), 8 studies reported social economy, culture status and environment condition (8.9%). The literatures about HLE published by 4 authoritative English medical journals and 21 Chinese core medical journals in recent three years were selected. Non-communicable diseases and personal characteristics were the top two most commonly studied factors of HLE, and 11 (52.3%) and 12 (57.1%) studies reported these two kinds of factors respectively. The most important factor contributing to the global disability-adjusted life years of non-communicable diseases was individual behavior and lifestyle, which was the most changeable factor. Conclusions: In recent three years, studies involving influencing factors of HLE were mainly non-communicable diseases and personal characteristics. In the future, individual behavior, lifestyle and working environment should be strengthened.

Quantifying the global burden of mental disorders and their economic value.

SummaryBackgroundEpidemiological and economic estimates suggest that the global burden of mental disorders is considerable, both in its impacts on human health and losses to societal welfare. The availability of additional data and the emergence of new approaches present an opportunity to examine these estimates, which form a critical part in making the investment case for global mental health.MethodsThis study reviews, develops, and incorporates new estimates and methods in quantifying the global burden of mental illness. Using a composite estimation approach that accounts for premature mortality due to mental disorders and additional sources of morbidity and applying a value of a statistical life approach to economic valuation, we determine global and regional estimates of the economic cost that can be associated with mental disorders, building on data from the 2019 Global Burden of Disease study.FindingsWe estimate that 418 million disability-adjusted life years (DALYs) could be attributable to mental disorders in 2019 (16% of global DALYs)—a more than three-fold increase compared to conventional estimates. The economic value associated with this burden is estimated at about USD 5 trillion. At a regional level, the losses could account for between 4% of gross domestic product in Eastern sub-Saharan Africa and 8% in High-income North America.InterpretationThe burden of mental illness in terms of both health and economic losses may be much higher than previously assessed.FundingNone.

Global, Regional, and National Trends of Chagas Disease from 1990 to 2019: Comprehensive Analysis of the Global Burden of Disease Study.

Background:Chagas disease (CD) is a neglected tropical disease, endemic in Latin America, but due to migration and environmental changes it has become a global public health issue.Objectives:To assess the global prevalence and disability-adjusted life years due to CD using findings from the Global Burden of Disease Study 2019.Methods:The Global Burden of Disease data was obtained from the Global Burden of Disease Collaborative Network; results were provided by the Institute for Health Metrics and Evaluation. The prevalence and disability-adjusted life-years (DALYs) were described at a global, regional, and national level, including data from 1990 to 2019.Results:Globally, CD prevalence decreased by 11.3% during the study period, from 7,292,889 cases estimated in 1990 to 6,469,283 in 2019. Moreover, the global DALY rate of CD decreased by 23.7% during the evaluated period, from 360,872 in 1990 to 275,377 in 2019. In addition, significant differences in the burden by sex, being men the most affected, age, with the elderly having the highest burden of the disease, and sociodemographic index (SDI), with countries with the lowest SDI values having the highest prevalence of the disease, were observed. Finally, the prevalence trends have followed different patterns according to the region, with a sustained decrease in Latin America, compared to an increasing trend in North America and Europe until 2010.Conclusion:The global burden of CD has changed in recent decades, with a sustained decline in the number of cases. Although the majority of cases remain concentrated in Latin America, the increase observed in countries in North America and Europe highlights the importance of screening at-risk populations and raising awareness of this neglected tropical disease.

Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019

ObjectiveTo report the global, regional, and national burden of chronic obstructive pulmonary disease (COPD) and its attributable risk factors between 1990 and 2019, by age, sex, and sociodemographic index.DesignSystematic analysis.Data...

Temporal trends of lung cancer burden in India in comparison to global burden from 1990 to 2019: An observation analysis.

e21081 Background: Lung cancer is the leading cause of cancer-related deaths worldwide and remains a significant health concern globally. There is limited understanding of the lung cancer epidemiology trends in India. This study compares lung cancer incidence, disability-adjusted life years (DALYs), and mortality in the Indian population with the global burden. Methods: The lung cancer incidence, DALYs, and mortality data were analyzed for males and females from 1990-2019 using the Global Burden of Disease (GBD) database. GBD is an open-source data repository managed by the Institute for Health Metrics and Evaluation research center, University of Washington. International Classification of Diseases (ICD) code C34 were used for data extraction. Temporal trends in lung cancer were evaluated using descriptive statistics. Results: India had a lower lung cancer-related disease burden than the global population. Incidence trends: In India, lung cancer age-standardized incidence rates (ASIRs) increased from 6.62/100,000 in 1990 to 7.7/100,00 in 2019. ASIRs increased from 10.36 to 11.16 in males and 2.68 to 4.49 in females. In contrast, overall and male ASIRs decreased globally from 28.39 to 27.66 and 46.22 to 40.44, respectively. But global lung cancer incidence in females increased from 13.77 to 16.83, mirroring the trends in the Indian female population. DALYs trends: In India, DALYs increased uniformly from 1990 to 2019. The overall DALYs (including males and females) increased from 166.66 to 190.16. In males, DALYs increase from 258.05 to 271.30, and in females DALYs increase from 68.80 to 112.90. Similarly, at the global level, DALYs in females increased from 311.7 to 327.57. However, overall and male’s global DALYs improved from 657.97 to 551.58 and 1053.25 to 802.86, respectively. Mortality trends: In the Indian population, there was only a slight overall increase in age-standardized mortality rates (ASMRs) from 7.04 to 8.06. A similar slight increase in mortality rates was observed in males (11.04 to 11.73). However, in females, there was a substantial increase from 2.85 to 4.70. In contrast, overall and male ASMRs decreased globally from 27.39 to 25.18 and 45.08 to 37.38, respectively. Similar females’ mortality trends in India, globally, females ASMRs increased from 13.04 to 14.96. Conclusions: Our study reports a lower lung cancer-associated health burden in the Indian population. However, there is an increase in the incidence, DALYs, and mortality in both males and females in the Indian population from 1990 to 2019. Similar worsening trends are observed in females at the global level. In contrast, there is a hint towards improvement in the incidence, DALYs, and mortality at the global level in general, primarily due to improvement in males’ disease burden. There is also a persistent gap in males and females epidemiology, where males have a higher lung cancer burden than females.

Global magnitude and temporal trends of idiopathic developmental intellectual disability attributable to lead exposure from 1990 to 2019: Results from Global Burden of Disease Study

As an important environmental pollutant, lead exposure can result in idiopathic developmental intellectual disability (IDII). However, the latest spatiotemporal patterns across the world are unclear. Therefore, in this study, the global burden of lead exposure-related IDII was assessed using the Global Burden of Disease (GBD) study (2019). The data were downloaded from the Institute for Health Metrics and Evaluation (IHME), and the estimated annual percentage change (EAPC) was calculated to assess the changing trend of the age-standardized disability-adjusted life-years (DALYs) rates (ASDR) of global IDII attributed to lead exposure. In 2019, the number of global DALYs of IDII attributed to lead exposure was 2.72 million, the corresponding ASDR was 35.70 per 100,000. The ASDR was highest in children and adolescents, and low- and middle-income countries. From 1990 to 2019, the global number of DALYs of IDII attributable to lead exposure increased by 7.89%, while the ASDR of IDII decreased by 19.19% [EAPC = −0.78, 95% confidence interval (CI): (−0.90, −0.66)]. The downward trends were seen in most GBD regions and countries, especially in high-income countries, but 11 countries presented an upward trend. Therefore, it is important to continue to improve primary mental healthcare globally, especially in low- and middle-income countries. Meanwhile, the implementation of effective strategies to reduce lead exposure should be continually strengthened.

Sex differences in global disability-adjusted life years due to ischemic stroke: findings from global burden of diseases study 2019

To investigate the sex differences in disability-adjusted life years (DALYs) due to ischemic stroke (IS) by year, location and age. We extracted sex-specific data on DALYs number, age-standardized DALYs rate (ASDR) and all-age DALYs rate of IS by year, location and age from the Global Burden of Diseases study 2019. The estimated annual percentage changes (EAPC) were calculated to evaluate the temporal trend of ASDR. For both sexes, although the ASDR of IS slightly decreased from 1990 to 2019, there has been an 60.3% increase in DALYs number worldwide. Sex difference in DALYs number (men minus women) decreased from − 2.83 million in 1990 to 0.14 million in 2019, while the men to women’s ASDR ratio slightly increased from 1.10 in 1990 to 1.21 in 2019. The sex differences in IS DALYs showed remarkable regional variation. The largest sex differences in DALYs number and ASDR were in China and Vietnam. Middle-aged men had a higher IS DALYs than their age-matched counterparts. High systolic blood pressure accounted for the highest DALYs number in 2019, but the top three attributable risk factors that had the greatest sex differences were tobacco, dietary risk, and alcohol use. Sex differences in IS DALYs varied by year, location and age, mostly attributed to the disproportion of cardiovascular risk factors between sexes. Considering the population growth and aging, it is necessary to monitor the sex difference in IS DALYs in different populations and thus provide evidence for local administration to improve current preventive and management strategies of IS.

Global trends and regional differences in the burden of anxiety disorders and major depressive disorder attributed to bullying victimisation in 204 countries and territories, 1999-2019: an analysis of the Global Burden of Disease Study.

This study aimed to analyse the temporal and spatial trends in the burden of anxiety disorders and major depressive disorder related to bullying victimisation on global, regional and country scales. Data were from the 2019 Global Burden of Disease (GBD) Study. We assessed the global disability-adjusted life years (DALYs, per 100 000 population) of anxiety disorders and major depressive disorder attributable to bullying victimisation by age, sex and geographical location. The percentage changes in age-standardised rates of DALYs were used to quantify temporal trends, and the annual rate changes across 204 countries and territories were used to present spatial trends. Furthermore, we examined the relationship between the sociodemographic index (SDI) and the burden of anxiety disorders as well as major depressive disorder attributable to bullying victimisation and its spatial and temporal characteristics globally. From 1990 to 2019, the global DALY rates of anxiety disorders and major depressive disorder attributable to bullying victimisation increased by 23.31 and 26.60%, respectively, with 27.27 and 29.07% for females and 18.88 and 23.84% for males. Across the 21 GBD regions, the highest age-standardised rates of bullying victimisation-related DALYs for anxiety disorders were in North Africa and the Middle East and for major depressive disorder in High-income North America. From 1990 to 2019, the region with the largest percentage increase in the rates of DALYs was High-income North America (54.66% for anxiety disorders and 105.88% for major depressive disorder), whereas the region with the slowest growth rate or largest percentage decline was East Asia (1.71% for anxiety disorders and -25.37% for major depressive disorder). In terms of SDI, this study found overall upward trends of bullying-related mental disorders in areas regardless of the SDI levels, although there were temporary downward trends in some stages of certain areas. The number and rates of DALYs of anxiety disorders and major depressive disorder attributable to bullying victimisation increased from 1990 to 2019. Effective strategies to eliminate bullying victimisation in children and adolescents are needed to reduce the burden of anxiety disorders and major depressive disorder. Considering the large variations in the burden by SDI and geographic location, future protective actions should be developed based on the specific cultural contexts, development status and regional characteristics of each country.

Global burden of periodontal disease and its relation with socioeconomic development during 1990-2019.

To analyze the global burden of periodontal disease and its relation with socioeconomic development. Data of global disability-adjusted life year (DALY) due to periodontal disease and human development index (HDI) from 1990 to 2019 were obtained from Global Health Data Exchange (GHDx) and human development reports. The trend of the global burden of periodontal disease from 1990 to 2019 was described. The correlation between age-standardized DALY rates and HDI were examined in 2019, and between-country periodontal disease burden inequality from 1990 to 2019 was measured using health-related Gini coefficients and concentration indexes. From 1990 to 2019, the global DALY rate due to periodontal disease increased from 78.63 to 85.48, and the epidemiological burden did not increase significantly. Statistical differences were found across different HDI categories for age-standardized DALY rates of periodontal disease ( 44.315, <0.01) in 2019. Linear regression analysis also revealed a negative correlation between age-standardized DALY rate of periodontal disease and HDI ( = -0.417, <0.01) . Gini coefficients decreased from 0.361 to 0.281 and concentration indexes fell from 0.0339 to -0.0538 between 1990 and 2019. The global burden of periodontal disease did not increase between 1990 and 2019, though the socioeconomic-associated inequality still existed. The burden of periodontal disease was more concentrated in less developed countries, and the socioeconomic-associated inequality has increased since 2000.

Time trends and heterogeneity in the disease burden of trachoma, 1990–2019: a global analysis

PurposeTo evaluate the epidemiological trends and associated risk factors of disease burden due to trachoma.MethodsData for the country-specific disability-adjusted life year (DALY) number, rate and age-standardised rate of trachoma together...

Escherichia Coli Encoding Extended-Spectrum Beta-Lactamases Isolated from Diarrheic Patients in Minna, Nigeria

Escherichia coli remains one of the most isolated etiological agents of diarrhea, accounting for more than 1 million deaths and about 4% of the total global disability-adjusted life-years (DALYS) per year across all age groups according to the global disease burden. This study evaluated multidrug-resistant Escherichia coli encoding extended spectrum beta-lactamases isolated from diarrheic patients in Minna, Nigeria using standard microbiological methods. A prevalence of 37.7% of Diarrheagenic E. coli (DEC) was obtained from the stool samples evaluated. Within the environment sampled, age group 21 – 30 years had the highest E. coli isolation rate (27.8%) while age group ≥71years had the least E. coli isolation rate (2.6%). Females (64.9%) were the most affected compared to males (35.1%). The isolates were significantly resistant to most of the beta-lactams tested especially to 3rd generation cephalosporins [Cefotaxime (98.2%), cefuroxime (93%), ceftazidime (84.2%), Augmentin (70.2%), Amoxicillin (59.6%)]. Resistance to other classes of antibiotics was also observed in varying percentages. A high percentage (98.2% and 87.7%) of the diarrheagenic E. coli had a multiple resistant index (MARI) ≥ of 0.3. The isolates had varying patterns of resistance with 47.6% resistant to more than 5 classes of antibiotics tested and produced ESBL characteristics phenotypically. Molecular evaluation showed that 40%, 50%, and 90% of the isolates harbored the OXA, CTX-M and TEM genes respectively while 50% harbored VEB and PER genes. This study isolated E. coli from diarrheic patients with multidrug resistance profiles and encodes more than one type of ESBL gene within Minna, Nigeria.

Global, regional, and national burden of blindness and vision loss due to common eye diseases along with its attributable risk factors from 1990 to 2019: a systematic analysis from the global burden of disease study 2019

To map the magnitudes and temporal trends of blindness and vision loss (BVL) due to common eye diseases along with its attributable risk factors at the national, regional, and global levels. The annual burden of BVL in 204 countries and territories was extracted from the Global Burden of Disease Study 2019. The estimated annual percentage change (EAPC) and causes composition change were calculated to quantify the temporal trends of BVL-related disease burden by sex, region, and eye disease. The global disability-adjusted life years (DALYs) of BVL increased from 12.44 million in 1990 to 22.56 million in 2019, with a slightly decreased rate from 3.03 to 2.78 per 1000 population (EAPC = -0.30). About 29.6% of BVL-related DALYs worldwide were caused by cataract, followed by refraction disorders (29.1%), near vision loss (21.7%), other vision loss (13.7%), glaucoma (3.3%), and age-related macular degeneration (2.5%) in 2019. The age-standardized DALYs rates due to each eye disease type in most regions were decreased, especially in countries with high burden and high-middle socio-demographic index. Moreover, the contribution of smoking and air pollution from solid fuels to BVL burden decreased, however, the age-standardized burden of BVL attributed to high body-mass index and high fasting plasma glucose elevated gradually across almost all regions. The temporal trend of BVL burden due to specific eye diseases varies remarkably by region, sex and age. Understanding the real-time patterns of BVL burden is crucial for formulating more effective and targeted prevention and healthcare strategies to decrease the BVL burden.

Disability-adjusted life years due to chronic and hidden hunger under food system evolution with climate change and adaptation to 2050

ABSTRACTBackgroundClimate change presents an increasing challenge for food-nutrition security. Nutrition metrics calculated from quantitative food system projections can help focus policy actions.ObjectivesTo estimate future chronic and hidden hunger disability-adjusted life years (DALYs)—due to protein-energy undernutrition and micronutrient deficiencies, respectively—using food systems projections to evaluate the potential impact of climate change and agricultural sector investment for adaptation.MethodsWe use a novel combination of a chronic and hidden hunger DALY estimation procedure and food system projections from quantitative foresight modeling to assess DALYs under alternative agricultural sector scenarios to midcentury.ResultsTotal chronic and hidden hunger DALYs are projected to increase globally out to 2050—by over 30 million compared with 2010—even without climate change. Climate change increases total DALY change between 2010 and 2050 by nearly 10% compared with no climate change. Agricultural sector investments show promise for offsetting these impacts. With investments, DALY incidence due to chronic and hidden hunger is projected to decrease globally in 2050 by 0.24 and 0.56 per 1000 capita, respectively. Total global DALYs will still rise because projected population growth will outpace the rate reduction, especially in Africa south of the Sahara. However, projections also show important regional reductions in total DALYs due to chronic (13.9 million in South Asia, 4.3 million in East Asia and the Pacific) and hidden hunger (7.5 million in East Asia and the Pacific) with investments.ConclusionsFood system projections to 2050 show a decreasing DALY incidence from both chronic and hidden hunger. Population growth is projected to outpace these improvements and lead to increasing total chronic and hidden hunger DALYs globally, concentrated in Africa south of the Sahara. Climate change increases per-capita chronic and hidden hunger DALY incidence compared with no climate change. Agricultural sector investments show the potential to offset the climate impact on DALYs.

Stroke and dementia, leading causes of neurological disability and death, potential for prevention.

Stroke and dementia share a number of modifiable risk factors and are the leading cause of neurological disability and death worldwide. We report the 2019 estimations for global disability-adjusted life years (DALYs) and death numbers and rates related to stroke and dementia, as well as their risk attributed DALYs and deaths and their changes between 2010 and 2019. Stroke accounted for 69.8%, dementia for 17.3%, and combined contributed to 87.2% (8.2 million) of neurological deaths and 61.7% (168.5 million) of neurological DALYs in 2019. For stroke, 86.4% of DALYs and for dementias 32.8% of DALYs are attributable to risk factors. Globally, hypertension (54.8%) and unhealthy diet (30.0%) pose the greatest risk for stroke DALYs, and smoking (15.1%) and obesity (12.5%) for dementia DALYs. Worldwide, stroke and dementia cases are increasing in number, but their age-standardized rates are falling. Finding out why offers the possibility of their joint delay, mitigation, or prevention.