Showing papers by "Achala Upendra Jayatilleke published in 2020"
TL;DR: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates, and there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries.
5,802 citations
TL;DR: To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—the authors estimated additional population equivalents with UHC effective coverage from 2018 to 2023, and quantified frontiers of U HC effective coverage performance on the basis of pooled health spending per capita.
304 citations
James Cook University1, University of New South Wales2, Institute for Health Metrics and Evaluation3, University of Washington4, Adigrat University5, Debre Berhan University6, Mayo Clinic7, Carol Davila University of Medicine and Pharmacy8, Iran University of Medical Sciences9, Manipal University10, Memorial Hospital of South Bend11, Medical University of Łódź12, Bangladesh University13, University of Auckland14, Kermanshah University of Medical Sciences15, Shiraz University of Medical Sciences16, The George Institute for Global Health17, Babol University of Medical Sciences18, University of Porto19, Hanoi National University of Education20, Australian National University21, University of Gondar22, Public Health Foundation of India23, Mazandaran University of Medical Sciences24, Tehran University of Medical Sciences25, University of Sydney26, Bielefeld University27, Haramaya University28, World Health Organization29, Erasmus University Medical Center30, University of Bergen31, Curtin University32, University of Texas at Austin33, University of Ibadan34, Baptist Memorial Hospital-Memphis35, Shahid Beheshti University of Medical Sciences and Health Services36, La Trobe University37, University of Colombo38, University of Gilan39, Qazvin University of Medical Sciences40, All India Institute of Medical Sciences41, Jazan University42, Health Services Academy43, Ball State University44, Panjab University, Chandigarh45, National Research Council46, University of Melbourne47, University of Dammam48, University of Manitoba49, University of London50, Mekelle University51, University of Helsinki52, Pacific Institute53, Shahrekord University of Medical Sciences54, Shahroud University of Medical Sciences55, King's College London56, Duy Tan University57, McMaster University58, Muhammadiyah University of Surakarta59, Sharif University of Technology60, University of Minnesota61, Ain Shams University62, Bangladesh Institute of Development Studies63, University of Alabama at Birmingham64, Kathmandu University65, Deakin University66, Chinese Center for Disease Control and Prevention67, Wuhan University68, Urmia University69
TL;DR: There has been a decline in global drowning rates, and this study shows that the decline was not consistent across countries, reinforcing the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries.
Abstract: __Background:__ Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017.
__Methods:__ Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning.
__Results:__ Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes.
__Conclusions:__ There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low-and middle-income countries.
101 citations
TL;DR: Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017, and future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
Abstract: Background Past research in population health trends has shown
that injuries form a substantial burden of population health loss.
Regular updates to injury burden assessments are critical. We report
Global Burden of Disease (GBD) 2017 Study estimates on morbidity
and mortality for all injuries.
Methods We reviewed results for injuries from the GBD 2017 study.
GBD 2017 measured injury-specific mortality and years of life lost
(YLLs) using the Cause of Death Ensemble model. To measure non-fatal
injuries, GBD 2017 modelled injury-specific incidence and converted
this to prevalence and years lived with disability (YLDs). YLLs and YLDs
were summed to calculate disability-adjusted life years (DALYs).
Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138)
injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554)
deaths in 2017, while age-standardised mortality decreased from 1079
(1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were
354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802)
new cases of injury globally, which increased to 520 710 288 (493
430 247 to 547 988 635) new cases in 2017. During this time, agestandardised incidence decreased non-significantly from 6824 (6534 to
7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017,
age-standardised DALYs decreased from 4947 (4655 to 5233) per
100 000 to 3267 (3058 to 3505).
Interpretation Injuries are an important cause of health loss
globally, though mortality has declined between 1990 and 2017.
Future research in injury burden should focus on prevention in highburden populations, improving data collection and ensuring access to
medical care.
99 citations
Aniruddha Deshpande1, Molly K. Miller-Petrie1, Paulina A. Lindstedt1, Mathew M. Baumann2 +727 more•Institutions (123)
TL;DR: Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia, and these mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and to indicate additional data collection or intervention might be warranted before MDA programmes cease.
83 citations
University of Washington1, Kermanshah University of Medical Sciences2, Jimma University3, Mayo Clinic4, Iran University of Medical Sciences5, University of Gondar6, Sharif University of Technology7, Harvard University8, Heidelberg University9, Shiraz University of Medical Sciences10, The George Institute for Global Health11, Babol University of Medical Sciences12, Partners In Health13, University of Porto14, Örebro University15, Mazandaran University of Medical Sciences16, Trường ĐH Nguyễn Tất Thành17, St. Paul's Hospital18, Bielefeld University19, Kobe University20, Addis Ababa University21, Aksum University22, Mekelle University23, University of Lahore24, Erasmus University Rotterdam25, Hamdan bin Mohammed e-University26, Carol Davila University of Medicine and Pharmacy27, American Board of Legal Medicine28, Khalifa University29, Qatar Foundation30, Walter Sisulu University31, University of the Western Cape32, University of Ibadan33, Shahid Beheshti University of Medical Sciences and Health Services34, University of Colombo35, Tehran University of Medical Sciences36, Jordan University of Science and Technology37, Health Services Academy38, University of Mazandaran39, University of Melbourne40, University of Dammam41, University of Trnava42, University of Manitoba43, World Bank44, University of Helsinki45, Pomeranian Medical University46, Curtin University47, Pacific Institute48, Shahrekord University of Medical Sciences49, Shahroud University of Medical Sciences50, Duy Tan University51, University of Lagos52, McMaster University53, Manipal University54, Amirkabir University of Technology55, A.T. Still University56, Public Health England57, Imperial College London58, University College London59, University of Minnesota60, Wollega University61, Karolinska Institutet62, Ain Shams University63, Utkal University64, University of North Carolina at Charlotte65, University of Alabama at Birmingham66, National Institutes of Health67, Deakin University68, Hanoi Medical University69, Wuhan University70
TL;DR: The incidence and mortality of injuries that result from fire, heat and hot substances affect every region of the world but are most concentrated in middle and lower income areas.
Abstract: Background: Past research has shown how fires, heat and hot substances are important causes of health loss globally. Detailed estimates of the morbidity and mortality from these injuries could help drive preventative measures and improved access to care. Methods: We used the Global Burden of Disease 2017 framework to produce three main results. First, we produced results on incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years from 1990 to 2017 for 195 countries and territories. Second, we analysed these results to measure mortality-to-incidence ratios by location. Third, we reported the measures above in terms of the cause of fire, heat and hot substances and the types of bodily injuries that result. Results: Globally, there were 8 991 468 (7 481 218 to 10 740 897) new fire, heat and hot substance injuries in 2017 with 120 632 (101 630 to 129 383) deaths. At the global level, the age-standardised mortality caused by fire, heat and hot substances significantly declined from 1990 to 2017, but regionally there was variability in age-standardised incidence with some regions experiencing an increase (eg, Southern Latin America) and others experiencing a significant decrease (eg, High-income North America). Conclusions: The incidence and mortality of injuries that result from fire, heat and hot substances affect every region of the world but are most concentrated in middle and lower income areas. More resources should be invested in measuring these injuries as well as in improving infrastructure, advancing safety measures and ensuring access to care.
81 citations
Aniruddha Deshpande1, Molly K. Miller-Petrie2, Paulina A. Lindstedt2, Mathew M. Baumann2 +702 more•Institutions (292)
TL;DR: High-resolution geospatial estimates of access to drinking water and sanitation facilities in low-income and middle-income countries from 2000 to 2017 identify areas with successful approaches or in need of targeted interventions to enable precision public health to effectively progress towards universal access to safe water and sanitary facilities.
80 citations
Robert C. Reiner1, Kirsten E. Wiens2, Aniruddha Deshpande2, Mathew M. Baumann2 +629 more•Institutions (32)
TL;DR: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%.
67 citations
TL;DR: The Global Burden of Disease 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries, which should be used to help inform injury prevention policy making and resource allocation.
Abstract: BACKGROUND: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. METHODS: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. RESULTS: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. CONCLUSIONS: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
45 citations
Juanita A. Haagsma1, Spencer L. James2, Chris D Castle2, Zachary V Dingels2 +324 more•Institutions (155)
TL;DR: The overall global pattern is that of declining injury burden with increasing SDI, however, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs.
Abstract: Background: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Methods: Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. Results: For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. Conclusions: The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.
38 citations
Kirsten E. Wiens1, Paulina A. Lindstedt1, Brigette F. Blacker1, Kimberly B. Johnson1 +843 more•Institutions (363)
TL;DR: This study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, and can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities.
TL;DR: The goal of this consensus statement is to provide a focused summary of such “blind spots” identified during an expert group intense analysis of “missed opportunities” during the initial wave of the pandemic.
Abstract: As the COVID-19 pandemic continues, important discoveries and considerations emerge regarding the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pathogen; its biological and epidemiological characteristics; and the corresponding psychological, societal, and public health (PH) impacts. During the past year, the global community underwent a massive transformation, including the implementation of numerous nonpharmacological interventions; critical diversions or modifications across various spheres of our economic and public domains; and a transition from consumption-driven to conservation-based behaviors. Providing essential necessities such as food, water, health care, financial, and other services has become a formidable challenge, with significant threats to the existing supply chains and the shortage or reduction of workforce across many sectors of the global economy. Food and pharmaceutical supply chains constitute uniquely vulnerable and critically important areas that require high levels of safety and compliance. Many regional health-care systems faced at least one wave of overwhelming COVID-19 case surges, and still face the possibility of a new wave of infections on the horizon, potentially in combination with other endemic diseases such as influenza, dengue, tuberculosis, and malaria. In this context, the need for an effective and scientifically informed leadership to sustain and improve global capacity to ensure international health security is starkly apparent. Public health “blind spotting,” promulgation of pseudoscience, and academic dishonesty emerged as significant threats to population health and stability during the pandemic. The goal of this consensus statement is to provide a focused summary of such “blind spots” identified during an expert group intense analysis of “missed opportunities” during the initial wave of the pandemic.
05 Aug 2020
TL;DR: Multiple factors affect limb viability following compromised distal circulation and data show a trend towards various subsets of limbs that are more vulnerable due to inherent or acquired paucity of collateral circulation.
Abstract: Objective For more than half a century, surgeons who managed vascular injuries were guided by a 6-hour maximum ischaemic time dogma in their decision to proceed with vascular reconstruction or not. Contemporary large animal survival model experiments aimed at redefining the critical ischaemic time threshold concluded this to be less than 5 hours. Our clinical experience from recent combat vascular trauma contradicts this dogma with limb salvage following vascular reconstruction with an average ischaemic time of 6 hours. Methods During an 8-month period of the Sri Lankan Civil War, all patients with penetrating extremity vascular injuries were prospectively recorded by a single surgeon and retrospectively analysed. A total of 76 arterial injuries was analysed for demography, injury anatomy and physiology, treatment and outcomes. Subsequent statistical analysis was performed to evaluate the impact of independent variables to include; injury anatomy, concomitant venous, skeletal trauma, shock at presentation and time delay from injury to reconstruction. Results In this study, the 76 extremity arterial injuries had a median ischaemic time of 290 (IQR 225–375) min. Segmental arterial injury (p=0.02), skeletal trauma (p=0.05) and fasciotomy (p=0.03) were found to have a stronger correlation to subsequent amputation than ischaemic time. Conclusions Multiple factors affect limb viability following compromised distal circulation and our data show a trend towards various subsets of limbs that are more vulnerable due to inherent or acquired paucity of collateral circulation. Early identification and prioritisation of these limbs could achieve functional limb salvage if recognised. Further prospective research should look into the clinical, biochemical and morphological markers to facilitate selection and prioritisation of limb revascularisation.
Robert C. Reiner1, Kirsten E. Wiens1, Aniruddha Deshpande1, Mathew M. Baumann1 +728 more•Institutions (310)
TL;DR: Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017 is presented.