Global Prevalence Estimates Research Articles

Abstract 4124675: Deep Learning Screening of Cardiac MRIs Uncovers Undiagnosed Hypertrophic Cardiomyopathy in the UK BioBank

Introduction: The prevalence of hypertrophic cardiomyopathy (HCM) in the UK Biobank based on ICD-10 codes (.07%) is lower than global estimates of disease prevalence (0.2 - 0.5%). Prior studies using this data have remarked on the limitations of findings given likely underdiagnosis. The availability of cardiac MRI scans on a fraction of the participants offers an opportunity to identify missed diagnoses. Aims: This study seeks to utilize a generalizable deep learning model to detect likely cases of undiagnosed hypertrophic cardiomyopathy from cardiac MRIs in the UK Biobank. Methods: The foundational model was trained on a multi-institutional dataset of 14,073 cardiac MRIs via a self-supervised contrastive learning approach that sought to minimize the divergence between scans and their associated radiology reports. The pre-trained model was fine-tuned to diagnose hypertrophic cardiomyopathy on a distinct cohort of 4,870 MRIs with 368 cases of HCM, achieving an AUC of 0.94. The fine-tuned model was applied to the UK Biobank cardiac MRI dataset to ascertain predicted probabilities of HCM. Cases exceeding a threshold of 95% – correlating to the top 0.5% of cases (expected specificity of 97% and sensitivity of 60%) – were screened in for manual reading. In a blinded fashion, a board-certified radiologist was tasked with diagnosing HCM on a sample of cases composed of high and low predicted probabilities. Results: Of the 43,017 patients with cardiac MRIs, only 9 (.02%) had an ICD diagnosis of HCM. 266 cardiac MRIs were manually reviewed: 216 had greater than 95% predicted probability of HCM; 50 negative controls were randomly selected amongst cases with predicted probability less than 10%. The radiologist concurred with an HCM diagnosis for 115 cases (sensitivity 53%, specificity 98%), 112 of which were previously undiagnosed. The prevalence of hypertension and aortic stenosis did not significantly differ between the cohort of true positives (69.2%) and false positives (76.6%). The corrected prevalence of HCM in the UK BioBank MRI cohort is estimated at 0.28%. Conclusions: The findings of this study illustrate the remarkable ability of a generalizable deep learning model to detect undiagnosed cases of a rare disease process from cardiac MRIs. This is an important milestone that may allow for widespread screening of hypertrophic cardiomyopathy while minimizing demand for radiologist labor, and thereby allow patients to reap the substantial benefits of earlier treatment.

A global mathematical model of climatic suitability for Plasmodium falciparum malaria

Climatic conditions are a key determinant of malaria transmission intensity, through their impacts on both the parasite and its mosquito vectors. Mathematical models relating climatic conditions to malaria transmission can be used to develop spatial maps of climatic suitability for malaria. These maps underpin efforts to quantify the distribution and burden of malaria in humans, enabling improved monitoring and control. Previous work has developed mathematical models and global maps for the suitability of temperature for malaria transmission. In this paper, existing temperature-based models are extended to include two other important bioclimatic factors: humidity and rainfall. This model is combined with fine spatial resolution climatic data to produce a more biologically-realistic global map of climatic suitability for Plasmodium falciparum malaria. The climatic suitability index developed corresponds more closely than previous temperature suitability indices with the global distribution of P. falciparum malaria. There is weak agreement between the Malaria Atlas Project estimates of P. falciparum prevalence in Africa and the estimates of suitability solely based on temperature (Spearman Correlation coefficient of ρ=0.24\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho = 0.24$$\\end{document}). The addition of humidity and then rainfall improves the comparison (ρ=0.62\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho = 0.62$$\\end{document} when humidity added; ρ=0.70\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho =0.70$$\\end{document} when both humidity and rainfall added). By incorporating the impacts of humidity and rainfall, this model identifies arid regions that are not climatically suitable for transmission of P. falciparum malaria. Incorporation of this improved index of climatic suitability into geospatial models can improve global estimates of malaria prevalence and transmission intensity.

Global and regional genetic diversity of HIV-1 in 2010–21: systematic review and analysis of prevalence

The extensive global genetic diversity of HIV-1 poses a major challenge to HIV vaccine development. We aimed to determine recent estimates of and changes in the global and regional distributions of HIV-1 genetic variants. We conducted a systematic literature review by searching PubMed, Embase, Global Health, and CINAHL for studies containing country-specific HIV-1 subtyping data, published between Jan 1, 2010and Sep 16, 2022. The proportions of HIV-1 subtypes, circulating recombinant forms (CRFs), and unique recombinant forms (URFs) in each country were weighted by UNAIDS estimates of the numbers of people living with HIV (PLHIV) in each country to obtain regional and global prevalence estimates of HIV-1 subtypes, CRFs, and URFs with 95% CIs for the time periods 2010-15and 2016-21. The protocol is registered with PROSPERO, CRD42017067164. We obtained 1044datasets, containing HIV-1 subtyping data from 653 013PLHIV from 122countries in 2010-2021. In 2016-2021, subtype Caccounted for 50·4% (95% CI 50·2-50·7; n=18 570 462of 36 823 798) of global HIV infections, subtype Afor 12·4% (12·2-12·6; n=4 571 250), subtype Bfor 11·3% (11·1-11·5; n=4 157 686), subtype Gfor 2·9% (2·9-3·0; n=1 083 568), subtype Dfor 2·6% (2·5-2·7; n=945 815), subtype Ffor 0·9% (0·8-0·9; n=316 724), CRFs for 15·1% (14·9-15·3; n=5 564 566), and URFs for 2·0% (1·9-2·1; n=733 374). Subtypes H, J, and K each accounted for 0·1% or less of infections. Compared with 2010-15, we observed significant (p<0·0001) increases in global proportions of subtype A (0·9%, 95% CI 0·7to 1·1) and subtype C (3·4%, 3·0to 3·7) and decreases in subtype D (-0·5%, -0·6to -0·4), subtype G (-0·8%, -1·0to -0·7), CRFs (-1·0%, -1·3to -0·8), and URFs (-1·8%, -1·9to -1·7), with no changes for subtypes Band F. The global proportion of infections attributed torecombinants decreased from 21·6% (95% CI 21·4 to 21·7; n=7 099 252of 32 622 808) in 2010-15to 19·3% (19·1to 19·5; n=7 094 694of 36 823 798) in 2016-21 (-2·3%, 95% CI -2·6to -2·0; p<0·0001). Regional distributions of HIV-1 variants were complex and evolving, with global trends in the prevalence of HIV-1 variants supported by trends across the regions. Global and regional HIV-1 genetic diversity are complex and continue to evolve. Continued and improved surveillance of HIV-1 variants remains vital for HIV vaccine development and implementation. None.

Awareness and Knowledge of Medical Interns in the Diagnosis and Management of Anaphylaxis in Medina Region, Saudi Arabia.

Background Anaphylaxis is a severe hypersensitivity reaction caused by IgE-mediated mechanisms. This life-threatening condition affects multiple body systems. Global lifetime prevalence estimates for anaphylaxis range from 0.3% to 5.1%, with increasing incidence noted, particularly among young individuals. Symptoms range from mild skin manifestations like urticaria and pruritus to severe respiratory distress and hypotension. Objectives This study aimed to assess the knowledge level of medical interns in the Medina region, Saudi Arabia, regarding the diagnosis and management of anaphylaxis. Method A prospective cross-sectional study was conducted in hospitals in Saudi Arabia by delivering a questionnaire designed to assess the level of awareness and knowledge (including signs, symptoms, and management of anaphylaxis) among medical interns in the Medina region. The data collected were coded and analyzed using IBM SPSS Statistics for Windows, Version 22.0 (released 2013, IBM Corp., Armonk, NY). Results The study involved 291 interns from the universities in the Medina region. Most participants (275, 94.5%) correctly defined anaphylaxis and identified food allergies or insect stings as the main triggers (254, 87.3%). The participants demonstrated good knowledge of health education practices and anaphylaxis symptoms, such as the importance of carrying an adrenaline auto-injector (269, 92.4%) and recognizing syncope as a cardiovascular symptom (196, 67.4%). Regarding management, most correctly identified the initial step as removing the allergen (226, 77.7%) and epinephrine as the preferred medication (256, 88.0%). Significant gender differences were observed in the knowledge of management aspects (P = 0.001, P = 0.002, P = 0.049, P = 0.004, P = 0.001). Conclusion The study found that most participants had a good understanding of the definition of anaphylaxis and its most common triggers. The participants also demonstrated knowledge of symptoms and signs associated with anaphylaxis and the appropriate management of anaphylaxis. However, there were some differences in knowledge between females and males, suggesting that further education and awareness campaigns may be needed to ensure an accurate and consistent understanding of anaphylaxis among both genders. Overall, the study highlights the importance of education and awareness in effectively managing anaphylaxis and preventing its complications.

#305 Global health inequalities of CKD: a systematic review and meta-analysis examining prevalence and disparities in age, sex and socio-economic status

Abstract Background and Aims Chronic kidney disease (CKD) is a significant contributor to global morbidity and mortality. Age, sex and socio-economic status are considered to be influential in the development, progression and outcomes from CKD. This study investigated disparities in age, sex and socio-economic status in CKD and updated global prevalence estimates through systematic review and meta-analysis. Method Five databases (MEDLINE/PubMed, Embase, Cochrane CENTRAL Library, CINAHL, Web of Science) were searched from 2014 to 2022, with 14,871 articles screened, 119 papers included and data analysed on 29,159,948 participants. Studies were included if they described CKD prevalence in participants over the age of 18 and were carried out in the general population. CKD was defined on the basis of albuminuria/proteinuria and/or an estimated glomerular filtration rate of &amp;lt;60 ml/min/m2. Random effects meta-analyses using generalised linear mixed models were conducted to determine overall prevalence, prevalence of stages 3–5 and prevalence in males and females. Influences of age, sex and socio-economic status were assessed in subgroup analyses, and risk of bias assessment and meta-regressions were conducted to explore heterogeneity. Results Overall prevalence of CKD was 13.0% (11.3–14.8%) and 6.6% (5.6–7.8%) for stages 3–5. Prevalence was higher in studies where all participants were over the age of 60 (19.3% for stages 1–5. 15.0% for stages 3–5) and meta-regression demonstrated association of age, body mass index, diabetes and hypertension with prevalence of CKD stages 3–5. The prevalence of CKD stages 1–5 was similar in males and females (13.1% versus 13.2%) but prevalence of stages 3–5 was higher in females (6.4% versus 7.5%). Overall prevalence was 11.4%, 15.0% and 10.8% in low, middle and high-income countries respectively; for stages 3–5 prevalence was 4.0%, 6.7% and 6.8%, respectively. Risk of bias of included studies was generally moderate or high, with 8% at low risk of bias, 44% at moderate risk of bias and 48% at high risk of bias. Conclusion With nearly 30 million participants, this study is the largest systematic review on CKD prevalence to date, with prevalence demonstrated to be persistently high globally. It has highlighted that important disparities related to age, sex and socio-economic status may exist, and addressing these concerns should be a priority for policymakers. Future research should focus on targeted screening and treatment approaches, improving access to care and more effective data monitoring, particularly in low and middle income countries.

Estimates of primary ciliary dyskinesia prevalence: a scoping review.

Primary ciliary dyskinesia (PCD) is a rare multisystem genetic disease caused by dysfunctional motile cilia. Despite PCD being the second most common inherited airway disease after cystic fibrosis, PCD continues to be under-recognised globally owing to nonspecific clinical features and the lack of a gold standard diagnostic test. Commonly repeated prevalence estimates range from one in 10 000 to one in 20 000, based on regional epidemiological studies with known limitations. The purpose of this scoping review was to appraise the PCD literature, to determine the best available global PCD prevalence estimate and to inform the reader about the potential unmet health service needs in PCD. The primary objective of the present study was to systematically review the literature about PCD prevalence estimates. A scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) methodology. Included studies estimated PCD prevalence and used cohort, clinical or genomic data. Case reports, conference abstracts, review articles, animal studies or non-English articles were excluded. A literature review identified 3484 unique abstracts; 34 underwent full-text review and eight met the inclusion/exclusion criteria. Seven articles were based on epidemiological studies of specific geographical regions and provided prevalence estimates that ranged from approximately one to 44.1 in 100 000. Only one study estimated global prevalence, using two large genomic databases, and calculated it to be ∼13.2 in 100 000 (based on pathogenic variants in 29 disease-causing genes). A population-based genomic approach for estimating global prevalence has found that PCD is much more prevalent than previously cited in the literature. This highlights the potential unmet health service needs of people living with PCD.

Estimates of global and regional prevalence of Helicobacter pylori infection among individuals with obesity: a systematic review and meta-analysis.

The prevalence of obesity is an escalating concern in modern populations, predominantly attributed to the widespread adoption of sedentary lifestyles observed globally. Extensive research has established a significant association between obesity and Helicobacter pylori (H. pylori). Nonetheless, a comprehensive assessment of the global prevalence of H. pylori among individuals with obesity remains undetermined. A systematic search strategy was applied to PubMed, Scopus, and Web of Science. The resulting records were screened using the Rayyan online tool for the management of systematic reviews. Freeman-Tukey double arcsine transformation was used. Subgroup analyses (continent, regional classifications, developmental status, religion, global hemisphere, income, access to international waters, and H. pylori eradication) and multivariate meta-regression (latitude, longitude, male-to-all ratio, mean age, and body mass index) were done to estimate the effects of the moderators. Risk of bias assessment was done using JBI checklist for prevalence studies. A total of 472,511 individuals with obesity from 208 studies were included. The global estimation of H. pylori prevalence among individuals with obesity was 32.3% (95% CI 26.9%, 38.0%). South America had the highest prevalence. Based on the different classifications of countries, resource-rich, low-/middle-income, developing, and Islamic countries had the highest prevalence. Lower pooled prevalence was observed in the studies with adequate sample sizes (n ≥ 270). The findings have the potential to influence future health policies for preventing and treating H. pylori infection. However, there is variability among the included studies, indicating the need for more population-based research.

Prevalence of Gastric Precursor Lesions in Countries With Differential Gastric Cancer Burden: A Systematic Review and Meta-analysis

The prevalence of precursor lesions for gastric cancer (GC) and the differential burden between countries of varying GC risk is not well-understood. We conducted a systematic review and meta-analysis to estimate the global prevalence of precursor lesions. We estimated the prevalence of atrophic gastritis (AG), gastric intestinal metaplasia (IM), and dysplasia in regions with low, medium, and high GC incidence. Because IM is an advanced manifestation of AG, we assessed the prevalence of less advanced precursors, regardless of the presence of more advanced lesions. Prevalence was sub-stratified by Helicobacter pylori infection, symptomatology, and period (<2000, 2000-2010, and >2010). Among the 582 articles that underwent full-text review, 166 studies met inclusion criteria. The global prevalence estimates of AG, IM, and dysplasia were 25.4%, 16.2%, and 2.0%, respectively, on the basis of 126 studies that reported the prevalence of less advanced precursors, regardless of the presence of more advanced lesions. The prevalence of all precursor lesions was higher in high and medium compared with low GC incidence countries (P < .01). Prevalence of AG and IM was significantly higher among H pylori-infected individuals (P < .01) but not statistically different between symptomatic and asymptomatic individuals (P > .17). All precursors demonstrated a secular decrease in prevalence over time. Gastric precursor lesions have differences in prevalence in regions with differential GC incidence and are associated with H pylori infection. Because of the substantial prevalence of precursor lesions in both symptomatic and asymptomatic individuals, symptomatic evaluation may not be sufficient to identify individuals at risk. These estimates provide important insights for tailoring GC prevention strategies.

National, regional, and global estimates of low birthweight in 2020, with trends from 2000: a systematic analysis

Low birthweight (LBW; <2500 g) is an important predictor of health outcomes throughout the life course. We aimed to update country, regional, and global estimates of LBW prevalence for 2020, with trends from 2000, to assess progress towards global targets to reduce LBW by 30% by 2030. For this systematic analysis, we searched population-based, nationally representative data on LBW from Jan 1, 2000, to Dec 31, 2020. Using 2042 administrative and survey datapoints from 158 countries and areas, we developed a Bayesian hierarchical regression model incorporating country-specific intercepts, time-varying covariates, non-linear time trends, and bias adjustments based on data quality. We also provided novel estimates by birthweight subgroups. An estimated 19·8 million (95% credible interval 18·4-21·7 million) or 14·7% (13·7-16·1) of liveborn newborns were LBW worldwide in 2020, compared with 22·1 million (20·7-23·9 million) and 16·6% (15·5-17·9) in 2000-an absolute reduction of 1·9 percentage points between 2000 and 2020. Using 2012 as the baseline, as this is when the Global Nutrition Target began, the estimated average annual rate of reduction from 2012 to 2020 was 0·3% worldwide, 0·85% in southern Asia, and 0·59% in sub-Saharan Africa. Nearly three-quarters of LBW births in 2020 occurred in these two regions: of 19 833 900 estimated LBW births worldwide, 8 817 000 (44·5%) were in southern Asia and 5 381 300 (27·1%) were in sub-Saharan Africa. Of 945 300 estimated LBW births in northern America, Australia and New Zealand, central Asia, and Europe, approximately 35·0% (323 700) weighed less than 2000 g: 5·8% (95% CI 5·2-6·4; 54 800 [95% CI 49 400-60 800]) weighed less than 1000 g, 9·0% (8·7-9·4; 85 400 [82 000-88 900]) weighed between 1000 g and 1499 g, and 19·4% (19·0-19·8; 183 500 [180 000-187 000]) weighed between 1500 g and 1999 g. Insufficient progress has occurred over the past two decades to meet the Global Nutrition Target of a 30% reduction in LBW between 2012 and 2030. Accelerating progress requires investments throughout the lifecycle focused on primary prevention, especially for adolescent girls and women living in the most affected countries. With increasing numbers of births in facilities and advancing electronic information systems, improvements in the quality and availability of administrative LBW data are also achievable. The Children's Investment Fund Foundation; the UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction; and the Bill & Melinda Gates Foundation.

Global health inequalities of chronic kidney disease: a meta-analysis.

Chronic kidney disease (CKD) is a significant contributor to global morbidity and mortality. This study investigated disparities in age, sex and socio-economic status in CKD and updated global prevalence estimates through systematic review and meta-analysis. Five databases were searched from 2014 to 2022, with 14871 articles screened, 119 papers included and data analysed on 29159948 participants. Random effects meta-analyses were conducted to determine overall prevalence, prevalence of stages 3-5 and prevalence in males and females. Influences of age, sex and socio-economic status were assessed in subgroup analyses and risk of bias assessment and meta-regressions were conducted to explore heterogeneity. The overall prevalence of CKD was 13.0% [95% confidence interval (CI) 11.3-14.8] and 6.6% (95% CI 5.6-7.8) for stages 3-5. The prevalence was higher in studies of older populations (19.3% for stages 1-5, 15.0% for stages 3-5) and meta-regression demonstrated an association of age, body mass index, diabetes and hypertension with prevalence of stages 3-5. The prevalence of CKD stages 1-5 was similar in males and females (13.1% versus 13.2%), but the prevalence of stages 3-5 was higher in females (6.4% versus 7.5%). Overall prevalence was 11.4%, 15.0% and 10.8% in low-, middle- and high-income countries, respectively; for stages 3-5, prevalence was 4.0%, 6.7% and 6.8%, respectively. Included studies were at moderate-high risk of bias in the majority of cases (92%) and heterogeneity was high. This study provides a comprehensive assessment of CKD prevalence, highlighting important disparities related to age, sex and socio-economic status. Future research should focus on targeted screening and treatment approaches, improving access to care and more effective data monitoring, particularly in low- and middle-income countries.

545 - Prevalence of moderate and severe atopic dermatitis in Ireland: a cross-sectional, real-world study of a secondary care population.

Abstract Introduction/Background Atopic dermatitis (AD) is a common chronic inflammatory skin disease with significant unmet needs globally.1 European prevalence rates range from up to 8% and 20% of adults and children respectively.2 In the E.U., a 12-month prevalence of AD has been reported at 4.4%.4 Self-reported moderate-to-severe AD affects between 46-66% of E.U. adult AD patients.4 However, global prevalence estimates vary widely. In Ireland, the epidemiology of AD is not fully understood. Objectives The aim of this study was to estimate the prevalence of patients aged 12 years or older presenting to secondary care dermatology clinics in Ireland with moderate-to-severe AD. The primary objective was to estimate the prevalence of patients aged 12 years and over with moderate or severe AD within secondary care clinics in Ireland. Secondary objectives included estimating the prevalence and incidence of moderate-to-severe AD patients aged 12–17 and ≥ 18 years respectively within secondary care clinics in Ireland. Methods Three secondary care sites located in the south of Ireland collated the number of AD patients ≥ 12 years old (one visit per patient only) with moderate or severe AD presenting between August 2021 and March 2022. The aggregated six-month data from each site was expected to include all patients with AD being actively treated within secondary care in the Munster region. As this epidemiological study was exploratory in nature, no limit was placed on the volume of aggregated patient data collected. Prevalence of AD was standardised to the regional population by dividing the total number of patients with a clinic visit, by the regional population covered by the sites using the 2016 census data. Incidence of AD was standardised similarly by dividing the total number of new patients attending clinic by the regional population covered by the sites using the 2016 census data. The regional prevalence and incidence estimates were stratified by age group and gender and then multiplied by the total Irish population (per the 2016 county level census data) to estimate the national number of cases of moderate and severe AD in secondary care over a six-month period. Results The outcome of the analysis estimates an overall prevalence rate for moderate-to-severe AD in secondary care in Ireland of 2.893 patients per 10,000 people in the Irish population. The total estimated number of moderate-to-severe AD cases in secondary care was 1,141. The prevalence rate (95% CI) was 1.456 (1.236, 1.704) and 1.437 (1.218, 1.683) per 10,000 for patients with moderate AD and severe AD respectively. The highest overall prevalence rate of 6.03 patients per 10,000 of the Irish population was observed for patients aged 12–17 years with moderate-to-severe AD in secondary care. Amongst adults, similar prevalence rates were reported for moderate and severe AD patients (1.204 and 1.359 patients per 10,000 respectively) with the highest prevalence rates for 18–24 year olds (2.680 and 2.776 patients per 10,000 for moderate and severe AD respectively). An overall incidence rate of 0.385 patients per 10,000 (in 6-months) was observed for patients aged 12 years and older with moderate-to-severe AD in secondary care, with an estimated 152 new AD patients entering secondary care in Ireland in 6 months. Twenty percent of all current AD patients had attended their first secondary care AD clinic visit during the study period. Conclusions Considering E.U. prevalence estimates of AD4, the findings of this study suggest that a very small proportion of patients with moderate-to-severe AD are being seen in secondary care clinics in Ireland.

Intimate partner violence during COVID-19: systematic review and meta-analysis according to methodological choices

BackgroundIntimate Partner Violence (IPV) is the most common form of interpersonal violence and a major public health problem. The COVID-19 pandemic might have contributed to an increase in IPV experiences. To evaluate changes in IPV prevalence during the pandemic, it is important to consider studies’ methodological characteristics such as the assessment tools used, samples addressed, or administration modes (e.g., face-to-face, telephone or online interviews), since they may influence disclosure and were likely affected by pandemic-imposed mobility restrictions.MethodsSystematic review and meta-analysis of empirical studies addressing IPV against women, men, or both, during the COVID-19 period. We searched six electronic databases until December 2021, including articles in English, German, Spanish, French or Portuguese languages. We extracted and synthesised characteristics of studies related to sampling (clinical, community, convenience), type assessment tool (standardised questionnaire, specifically created questions), method of administration (online, telephone, face-to-face), and estimates of different forms of IPV (physical, sexual, psychological). IPV estimates were pooled stratified by study characteristics using random-effects models.ResultsOf 3581 publications, we included 103 studies. Fifty-five studies used a standardized instrument (or some adaptations) to assess IPV, with the World Health Organisation Questionnaire and the Revised Conflicts Tactics Scales being the most frequent. For 34 studies, the authors created specific questions to assess IPV. Sixty-one studies were conducted online, 16 contacted participants face-to-face and 11 by telephone. The pooled prevalence estimate for any type of violence against women (VAW) was 21% (95% Confidence Interval, 95%CI = 18%-23%). The pooled estimate observed for studies assessing VAW using the telephone was 19% (95%CI = 10%-28%). For online studies it was 16% (95%CI = 13%-19%), and for face-to-face studies, it was 38% (95%CI = 28%-49%). According to the type of sample, a pooled estimate of 17% (95%CI = 9%-25%) was observed for studies on VAW using a clinical sample. This value was 21% (95%CI = 18%-24%) and 22% (95%CI = 16%-28%) for studies assessing VAW using a convenience sample and a general population or community sample, respectively. According to the type of instrument, studies on VAW using a standardized tool revealed a pooled estimate of 21% (95%CI = 18%-25%), and an estimate of 17% (95%CI = 13%-21%) was found for studies using specifically created questions.ConclusionsDuring the pandemic, IPV prevalence studies showed great methodological variation. Most studies were conducted online, reflecting adaptation to pandemic measures implemented worldwide. Prevalence estimates were higher in face-to-face studies and in studies using a standardized tool. However, estimates of the different forms of IPV during the pandemic do not suggest a marked change in prevalence compared to pre-pandemic global prevalence estimates, suggesting that one in five women experienced IPV during this period.

Near vision data and near correction requirements from community eye health programmes in nine countries.

Recent estimates of global prevalence of uncorrected presbyopia range from 510 to 826 million. There is a shortage of primary data regarding Near Visual Impairment (NVI) magnitude. Near visual acuity (NVA) and NVI data was collected from over 388,000 people aged 35 or over across 9 countries, within Community Eye Health programmes between January 2022 and June 2023. In Kenya (n = 34,328), dioptric power of required near correction was also recorded, and any association with age, gender or level of NVA was assessed via linear regression model. 146,801 of 388,939 people failed initial near vision screening (37.74%, 95% CI 37.59-37.89%), with significantly higher prevalence of NVI in Sub-Saharan Africa than South Asia. Of those with distance acuity 6/12 or better, 27.97% failed (95% CI 27.81-28.13%) with evidence of difference between genders (p < 0.001): 30.77% of women vs. 24.47% of men. The most commonly required dioptric powers of correction were +2.00D, +2.50D and +3.00D, and required power correlated with age and NVA. NVI remains common among Community Eye Health programme participants aged 35 and over. Data from large scale programmes such as these provide an opportunity to contribute to more accurate epidemiological estimates, and to guide future research, resource planning and intervention, ideally with improved standardisation of testing in the future.

Where do those data go? Reuse of screening results from clinical trials to estimate population prevalence of HBV infection in adults in Kilifi, Kenya

Chronic hepatitis B infection (CHB) is a significant problem worldwide with around 300 million people infected. Ambitious goals have been set towards its elimination as a public health threat by 2030. However, accurate seroprevalence estimates in many countries are lacking or fail to provide representative population estimates, particularly in the WHO African Region (AFRO). This means the full extent of HBV infection is not well described, leading to a lack of investment in diagnostics, treatment and disease prevention. Clinical trials in the WHO AFRO region have been increasing over time and many test for infectious diseases including hepatitis B virus (HBV) to determine baseline eligibility for participants, however these screening data are not reported. Here we review data from six clinical trials completed at the KEMRI-Wellcome Trust Research Programme between 2016 and 2023 that screened for HBV using hepatitis B surface antigen (HBsAg) as part of the trial exclusion criteria. 1727 people had HBsAg results available, of which 60 tested positive. We generated a crude period HBV prevalence estimate of 3.5% (95% CI 2.6–4.5%), and after standardisation for sex and age to account for the population structure of the Kilifi Health Demographics Surveillance System (KHDSS), the prevalence estimate increased to 5.0% (95% CI 3.4–6.6%). The underrepresentation of women in these trials was striking with 1263/1641 (77%) of participants being male. Alanine aminotransferase (ALT) was significantly higher in the HBsAg positive group but was not outside the normal range. We argue that routine collation and publishing of data from clinical trials could increase precision and geographical representation of global HBV prevalence estimates, enabling evidence-based provision of clinical care pathways and public health interventions to support progress towards global elimination targets. We do acknowledge when using clinical trials data for seroprevalence estimates, that local population structure data is necessary to allow standardisation of results, and the point of care tests used here are limited in sensitivity and specificity.

Global, regional, and national burdens of hypertensive heart disease from 1990 to 2019 ：A multilevel analysis based on the global burden of Disease Study 2019

AimThis study aimed to describe the prevalence, deaths, and disability-adjusted life-years (DALYs) of hypertensive heart disease (HHD) at the global, regional, and national levels and analyze epidemiological trends. MethodWe extracted global estimates of prevalence, deaths, and DALYs related to HHD in 204 countries and regions from the 2019 Global Burden of Diseases Study. Average annual percent change (AAPC) was calculated to represent temporal trends. Joinpoint regression models were used to analyze time trends from 1990 to 2019. Finally, the decomposition analysis showed the driving factors of burden changes. ResultsFrom 1990 to 2019, the global prevalence of HHD cases increased by 138 %, reaching 18,598,025 cases (95 % uncertainty interval [UI]: 13,544,365–24,898,411). DALYs also rose by 154 %, reaching 21,508,002 (95 % UI, 16,400,051–23,899,879). The death rate increased to 14.95 (95 % UI, 11.11–16.52) per 100,000 people. Of the five sociodemographic index (SDI) regions, the prevalence rate related to HHD was the highest in the high-middle SDI region. In contrast, the death and DALY rate related to HHD were the highest in the middle SDI region. In other regions, the prevalence rate was the highest in East Asia (548.87 per 100,000 people; 95 % UI, 395.40–747.83), and the death rate was the highest in Central Europe (42.64 per 100,000 people; 95 % UI, 30.58–49.38). At the national level, the Cook Islands had the highest prevalence rate for HHD (703.08 per 100,000 people; 95 % UI, 532.87–920.72), Bulgaria had the highest death rate (75.08 per 100,000 people; 95 % UI, 46.38–92.81), and Afghanistan had the highest DALY rate (1374.12 per 100,000 people; 95 % UI, 467.17–2020.70). High body mass index, a diet high in sodium, alcohol use, lead exposure, high temperature, and low temperature were identified as risk factors for death and DALYs related to HHD in 2019. Aging and population growth were the major drivers of prevalence, death, and DALYs. Finally, over the past 30 years, the global age-standardized prevalence rate (ASPR) of HHD has significantly risen (AAPC = 0.21 %, 95 % confidence interval [CI]: 0.17–0.24; P < 0.001), while the age-standardized deaths rate (ASDR) has shown significant declining trends (AAPC = −0.86 %, 95 % CI: 1.00 to −0.71; P < 0.001), and age-standardized DALY rates (AAPC = −1.08 %, 95 % CI: 1.23 to −0.93; P < 0.001). ConclusionDespite a significant decline in the global ASDR and age-standardized DALY rate of HHD over the past 30 years, the ASPR continues to rise. The burden of HHD is more heavily skewed towards non-high-income economies. Active prevention, control of risk factors, and improvement of medical protection levels to address the disease burden caused by population growth and aging are needed.

The global burden of heart failure: a systematic analysis for the Global Burden of Disease Study 2021

Abstract Background Heart failure is a common reason for hospitalization and is associated with high health care costs and high symptom burden. Updated estimates of global and regional prevalence and underlying causes of HF may be helpful in guiding health policy and investment priorities. Purpose To provide comparable and consistent estimates of heart failure burden as part of the Global Burden of Disease (GBD) 2021. Methods We identified all available data on prevalence, incidence, and mortality for heart failure in the general population. Sources included published scientific literature, administrative records from national health systems, and vital registration data. We generated estimates of heart failure prevalence using DisMod-MR 2.1, a geospatial modelling software program. We then estimated the proportion of prevalent heart failure due to each of 27 underlying aetiologies to produce age-, sex-, location-, year-, and aetiology-specific estimates of heart failure burden. Results In 2021, there were 56.5 million (95% Uncertainty Interval (UI): 49.7 million to 63.7 million) prevalent cases of heart failure globally. There were 27.3 million (24.0 to 30.8) prevalent cases in females and 29.2 million (25.6 to 33.0) cases among males. Age-standardized prevalence increased from 647.9 (556.3 to 739.9) per 100,000 in 1990 to 682.7 (602.8 to 766.8) per 100,000 in 2021. The North Africa and Middle East super region had the highest age-standardized prevalence in 2021 (780.5 per 100,000 (658.7 to 907.6)) and South Asia had the lowest age-standardized prevalence (600.1 per 100,000 (526.5 to 671.4)). In 2021, Ischaemic heart disease, hypertensive heart disease, and other cardiomyopathy were responsible for the majority of prevalent heart failure cases worldwide, at 33.8% (28.4% to 38.3%), 22.6% (19.0% to 27.1%), and 8.2% (7.0% to 9.6%), respectively. Country specific estimates for both sexes combined in 2021 are shown in the map. Conclusion Heart failure is a highly prevalent condition, particularly in older age groups. As populations age and risk profiles change around the world, knowledge of the global epidemiology of heart failure will be critical in preventing or treating its underlying aetiologies in order to decrease its overall burden.Heart failure prevalence, 2021

The Global Molecular Prevalence of Bartonella spp. in Cats and Dogs: A Systematic Review and Meta-Analysis

Bartonella species are vector-borne infectious pathogens with a severe impact on animal and human health. This comprehensive systematic review aimed to perform a meta-analysis to evaluate the global impact of this pathogen on pet health. A literature search was performed on electronic databases (Web of Science, PubMed, and Scopus) to find relevant peer-reviewed published papers (n = 131). A random-effects model was employed to calculate pooled prevalence estimates, and Q-statistic and I2 index were used to assess the heterogeneity. Based on 20.133 cats and 9.824 dogs, the global prevalence estimates were 15.3% and 3.6%. The heterogeneity was significantly high in both species, with I2 = 95.8%, p-value &lt;0.0001, and I2 = 87.7%, p-value &lt;0.0001 in cats and dogs, respectively. The meta-analysis conducted using location coordinates showed a consistently high prevalence in regions located between latitudes −40 to −30 or latitudes 30–40 in both populations, in agreement with the pure spatial analysis results, which computed significantly high relative risk areas within these region coordinates. When analyzing cat data for other subgroup moderators, Bartonella spp. prevalence was higher in animals of young age (&lt;1 year, p-value = 0.001), with a free roaming lifestyle (p-value &lt;0.0001) and/or having ectoparasite infestation (p-value = 0.004). Globally, among the Bartonella species detected in cats, Bartonella henselae was the most frequent (13.05%), followed by Bartonella clarridgeiae (1.7%) and Bartonella koehlerae (0.11%). When considering Bartonella henselae genotype distribution, high heterogeneity ( p &lt; 0.0001 ) was observed based on geographical subgroups. Dogs displayed infection by Bartonella vinsonii subsp. berkhoffii (1.1%), B. henselae (1%), Candidatus B. merieuxii (0.9%) and B. rochalimae (0.38%). The present study provides a global picture of the epidemiological distribution of Bartonella spp. in cat and dog populations that may be pivotal for implementing proper preventive and control measures.

The global birth prevalence of clubfoot: a systematic review and meta-analysis

Estimates of the birth prevalence of clubfoot in low and middle income settings range from 0.5 to 2 per 1000 births. However, there is currently no estimate of global birth prevalence of clubfoot. We conducted a systematic review of studies reporting the birth prevalence of clubfoot across all countries and regions worldwide in the last 10 years. Africa Wide Information, EMBASE, CINAHL, Global Health, LILACS and Medline databases were searched for relevant studies from January 1st 2012 to February 9th 2023. Pooled prevalence estimates were calculated using the inverse variance method, and a random effects model was applied to account for heterogeneity between studies. Quality appraisal was performed using a modified Newcastle-Ottawa Quality Assessment Scale for Cohort studies. This review was registered with PROSPERO, CRD42023398410. The search generated 757 studies. Thirty-five studies from 36 countries and five WHO regions were included. The pooled prevalence of clubfoot was 1.18 per 1000 births (95% CI: 1.00-1.36) based on data from 44,818,965 births. The highest prevalence rates were observed in low- and middle-income countries, particularly in the South-East Asia Region (1.80, 95% CI: 1.32-2.28) and the Africa Region (1.31, 95% CI: 0.86-1.77). We estimate that 176,476 (95% CI: 126,126-227,010) children will be born with clubfoot globally each year. This study provides a comprehensive estimate of the global prevalence of clubfoot and highlights the significant burden of this condition, particularly in low- and middle-income countries. The findings underscore the need for improving access to effective treatment and prevention strategies in resource-limited settings. SR received funds from the Global Clubfoot Initiative and the Rhodes Trust.

Global and regional estimates of genital human papillomavirus prevalence among men: a systematic review and meta-analysis

The epidemiology of human papillomavirus (HPV) in women has been well documented. Less is known about the epidemiology of HPV in men. We aim to provide updated global and regional pooled overall, type-specific, and age-specific prevalence estimates of genital HPV infection in men. We conducted a systematic review and meta-analysis to assess the prevalence of genital HPV infection in the general male population. We searched Embase, Ovid MEDLINE, and the Global Index Medicus for studies published between Jan 1, 1995, and June 1, 2022. Inclusion criteria were population-based surveys in men aged 15 years or older or HPV prevalence studies with a sample size of at least 50 men with no HPV-related pathology or known risk factors for HPV infection that collected samples from anogenital sites and used PCR or hybrid capture 2 techniques for HPV DNA detection. Exclusion criteria were studies conducted among populations at increased risk of HPV infection, exclusively conducted among circumcised men, and based on urine or semen samples. We screened identified reports and extracted summary-level data from those that were eligible. Data were extracted by two researchers independently and reviewed by a third, and discrepancies were resolved by consensus. We extracted only data on mucosal α-genus HPVs. Global and regional age-specific prevalences for any HPV, high-risk (HR)-HPV, and individual HPV types were estimated using random-effects models for meta-analysis and grouped by UN Sustainable Development Goals geographical classification. We identified 5685 publications from database searches, of which 65 studies (comprising 44 769 men) were included from 35 countries. The global pooled prevalence was 31% (95% CI 27-35) for any HPV and 21% (18-24) for HR-HPV. HPV-16 was the most prevalent HPV genotype (5%, 95% CI 4-7) followed by HPV-6 (4%, 3-5). HPV prevalence was high in young adults, reaching a maximum between the ages of 25 years and 29 years, and stabilised or slightly decreased thereafter. Pooled prevalence estimates were similar for the UN Sustainable Development Goal geographical regions of Europe and Northern America, Sub-Saharan Africa, Latin America and the Caribbean, and Australia and New Zealand (Oceania). The estimates for Eastern and South-Eastern Asia were half that of the other regions. Almost one in three men worldwide are infected with at least one genital HPV type and around one in five men are infected with one or more HR-HPV types. Our findings show that HPV prevalence is high in men over the age of 15 years and support that sexually active men, regardless of age, are an important reservoir of HPV genital infection. These estimates emphasise the importance of incorporating men in comprehensive HPV prevention strategies to reduce HPV-related morbidity and mortality in men and ultimately achieve elimination of cervical cancer and other HPV-related diseases. Instituto de Salud Carlos III, European Regional Development Fund, Secretariat for Universities and Research of the Department of Business and Knowledge of the Government of Catalonia, and Horizon 2020. For the Spanish and French translations of the abstract see Supplementary Materials section.

The global burden of metabolic disease: Data from 2000 to 2019

Global estimates of prevalence, deaths, and disability-adjusted life years (DALYs) from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were examined for metabolic diseases (type 2 diabetes mellitus [T2DM], hypertension, and non-alcoholic fatty liver disease [NAFLD]). For metabolic risk factors (hyperlipidemia and obesity), estimates were limited to mortality and DALYs. From 2000 to 2019, prevalence rates increased for all metabolic diseases, with the greatest increase in high socio-demographic index (SDI) countries. Mortality rates decreased over time in hyperlipidemia, hypertension, and NAFLD, but not in T2DM and obesity. The highest mortality was found in the World Health Organization Eastern Mediterranean region, and low to low-middle SDI countries. The global prevalence of metabolic diseases has risen over the past two decades regardless of SDI. Urgent attention is needed to address the unchanging mortality rates attributed to metabolic disease and the entrenched sex-regional-socioeconomic disparities in mortality.