Author
Stephen S Lim
Other affiliations: Monash University, Guy's and St Thomas' NHS Foundation Trust, World Health Organization ...read more
Bio: Stephen S Lim is an academic researcher from Institute for Health Metrics and Evaluation. The author has contributed to research in topics: Population & Mortality rate. The author has an hindex of 99, co-authored 219 publications receiving 117059 citations. Previous affiliations of Stephen S Lim include Monash University & Guy's and St Thomas' NHS Foundation Trust.
Papers published on a yearly basis
Papers
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TL;DR: In this article, a systematic review was performed seeking population-based studies in which bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at the femoral neck in people aged 50 years and over.
Abstract: Introduction The Global Burden of Disease Study 2010 estimated the worldwide health burden of 291 diseases and injuries and 67 risk factors by calculating disability-adjusted life years (DALYs). Osteoporosis was not considered as a disease, and bone mineral density (BMD) was analysed as a risk factor for fractures, which formed part of the health burden due to falls. Objectives To calculate (1) the global distribution of BMD, (2) its population attributable fraction (PAF) for fractures and subsequently for falls, and (3) the number of DALYs due to BMD. Methods A systematic review was performed seeking population-based studies in which BMD was measured by dual-energy X-ray absorptiometry at the femoral neck in people aged 50 years and over. Age- and sex-specific mean ± SD BMD values (g/cm2) were extracted from eligible studies. Comparative risk assessment methodology was used to calculate PAFs of BMD for fractures. The theoretical minimum risk exposure distribution was estimated as the age- and sex-specific 90th centile from the Third National Health and Nutrition Examination Survey (NHANES III). Relative risks of fractures were obtained from a previous meta-analysis. Hospital data were used to calculate the fraction of the health burden of falls that was due to fractures. Results Global deaths and DALYs attributable to low BMD increased from 103 000 and 3 125 000 in 1990 to 188 000 and 5 216 000 in 2010, respectively. The percentage of low BMD in the total global burden almost doubled from 1990 (0.12%) to 2010 (0.21%). Around one-third of falls-related deaths were attributable to low BMD. Conclusions Low BMD is responsible for a growing global health burden, only partially representative of the real burden of osteoporosis.
124 citations
TL;DR: It is estimated that between 393·7 million and 472·9 million people still require vaccination in areas at risk of yellow fever virus transmission to achieve the 80% population coverage threshold recommended by WHO.
Abstract: Summary Background Substantial outbreaks of yellow fever in Angola and Brazil in the past 2 years, combined with global shortages in vaccine stockpiles, highlight a pressing need to assess present control strategies. The aims of this study were to estimate global yellow fever vaccination coverage from 1970 through to 2016 at high spatial resolution and to calculate the number of individuals still requiring vaccination to reach population coverage thresholds for outbreak prevention. Methods For this adjusted retrospective analysis, we compiled data from a range of sources (eg, WHO reports and health-service-provider registeries) reporting on yellow fever vaccination activities between May 1, 1939, and Oct 29, 2016. To account for uncertainty in how vaccine campaigns were targeted, we calculated three population coverage values to encompass alternative scenarios. We combined these data with demographic information and tracked vaccination coverage through time to estimate the proportion of the population who had ever received a yellow fever vaccine for each second level administrative division across countries at risk of yellow fever virus transmission from 1970 to 2016. Findings Overall, substantial increases in vaccine coverage have occurred since 1970, but notable gaps still exist in contemporary coverage within yellow fever risk zones. We estimate that between 393·7 million and 472·9 million people still require vaccination in areas at risk of yellow fever virus transmission to achieve the 80% population coverage threshold recommended by WHO; this represents between 43% and 52% of the population within yellow fever risk zones, compared with between 66% and 76% of the population who would have required vaccination in 1970. Interpretation Our results highlight important gaps in yellow fever vaccination coverage, can contribute to improved quantification of outbreak risk, and help to guide planning of future vaccination efforts and emergency stockpiling. Funding The Rhodes Trust, Bill & Melinda Gates Foundation, the Wellcome Trust, the National Library of Medicine of the National Institutes of Health, the European Union's Horizon 2020 research and innovation programme.
116 citations
TL;DR: The percentage of people with high total serum cholesterol who are effectively treated remains small in selected high- and middle-income countries, and Untreated high blood cholesterol represents a missed opportunity in the face of a global epidemic of chronic diseases.
Abstract: OBJECTIVE: To determine the fraction of individuals with high total serum cholesterol who get diagnosed and effectively treated in eight high- and middle-income countries METHODS: Using data from nationally representative health examination surveys conducted in 1998-2007, we studied a probability sample of 79 039 adults aged 40-79 years from England, Germany, Japan, Jordan, Mexico, Scotland, Thailand and the United States of America For each country we calculated the prevalence of high total serum cholesterol (total serum cholesterol > 62 mmol/l or > 240 mg/dl) and the mean total serum cholesterol level We also determined the fractions of individuals being diagnosed, treated with cholesterol-lowering medication and effectively controlled (total serum cholesterol < 62 mmol/l or < 240 mg/dl) FINDINGS: The proportion of undiagnosed individuals was highest in Thailand (78%; 95% confidence interval, CI: 74-82) and lowest in the United States (16%; 95% CI: 13-19) The fraction diagnosed but untreated ranged from 9% in Thailand (95% CI: 8-11) to 53% in Japan (95% CI: 50-57) The proportion being treated who had attained evidence of control ranged from 4% in Germany (95% CI: 3-5) to 58% in Mexico (95% CI: 54-63) Time series estimates showed improved control of high total serum cholesterol over the past two decades in England and the United States CONCLUSION: The percentage of people with high total serum cholesterol who are effectively treated remains small in selected high- and middle-income countries Many of those affected are unaware of their condition Untreated high blood cholesterol represents a missed opportunity in the face of a global epidemic of chronic diseases
116 citations
TL;DR: A new comprehensive measure of expected human capital is provided, defined for each birth cohort as the expected years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and functional health status for 195 countries from 1990 to 2016, to facilitate monitoring the production of human capital.
115 citations
Journal Article•
TL;DR: In this paper, the authors identified surveys that measured total serum cholesterol and that asked respondents if they used cholesterol-lowering medication and found that most surveys did not differentiate between prescribed and over-the-counter medications or between statin and nonstatin medication.
Abstract: Introduction Cardiovascular disease caused over 18 million deaths in the world in 2005. (1) Of these deaths, eight million (44%) occurred in people under 60 years of age and 80% took place in low- and middle-income countries. (1,2) In response, the World Health Organization (WHO) has set a goal of reducing the global rate of death from chronic diseases by 2% a year up to 2015. (3) This goal rests on the recognition that throughout the world deaths from cardiovascular causes are attributable to a few modifiable risk factors, most importantly high blood pressure, smoking and high total serum cholesterol. (4,5) Lowering total serum cholesterol levels is an ideal strategy for reducing the burden of cardiovascular disease. Potent, safe and highly effective cholesterol-lowering medication is available in the form of statins, (6) and there are many low-cost methods for identifying those who need to lower their serum cholesterol. (7,8) Modelling studies suggest that lowering total serum cholesterol, either by treating elevated total serum cholesterol alone or by managing multiple risk factors, is cost-effective in many low- and middle-income countries. (9) While the use of cholesterol-lowering medication is considered important in reducing the burden of cardiovascular disease, differences in the way various health systems are implementing this strategy are not well understood. (10,11) Comparing individual studies is difficult because the definition of a high blood cholesterol level varies among studies and, until recently, population-wide data has been lacking for many places. The growing number of national health examination surveys that measure total serum cholesterol provides an opportunity to ascertain how well cholesterol-lowering medication is being-delivered to populations at risk of cardiovascular disease. (12) Using microdata from multiple national health examination surveys in eight countries, we have estimated the proportion of the population diagnosed with high total serum cholesterol, on treatment with cholesterol-lowering medication, and with evidence of therapeutic control. Methods Search strategy In 2008, we systematically searched the following for nationally representative health examination surveys performed since 1997: Google Scholar and PubMed (using relevant keywords), the WHO Global Infobase, (13) the WHO STEPwise approach to surveillance database (14) and the European Health Interview Surveys and Health Examination Surveys database. (15) We identified surveys that measured total serum cholesterol and that asked respondents if they used cholesterol-lowering medication. Individual-level data was downloaded from agency web sites when publicly available or obtained through formal application procedures and by contacting study authors. Survey characteristics The following national health examination surveys met our criteria: Germany (1998), Japan (2000), Scotland (2003), Thailand (2004), the United States of America (2005-2006), England (2006), Mexico (2006) and Jordan (Jordan Ministry of Health, unpublished data, 2007). (16-22) Our study included five high-income countries, one upper-middle-income country and two lower-middle-income countries. Table 1 shows the year in which the surveys were conducted, the questions used in these surveys for the self-reported diagnosis of high total serum cholesterol and the self-reported use of cholesterol-lowering medication. Most surveys did not differentiate between prescribed and over-the-counter medications or between statin and nonstatin medication. Enzyme-based automated methods were used in all surveys to measure total serum cholesterol levels. The guidelines of the United States Centers for Disease Control and Prevention and WHO were followed in all countries except Germany and Thailand, where national guidelines were observed. Blood tests were performed in a central laboratory in all countries except Thailand, which relied on five regional university laboratories. …
112 citations
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TL;DR: Authors/Task Force Members: Piotr Ponikowski* (Chairperson) (Poland), Adriaan A. Voors* (Co-Chair person) (The Netherlands), Stefan D. Anker (Germany), Héctor Bueno (Spain), John G. F. Cleland (UK), Andrew J. S. Coats (UK)
13,400 citations
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex, using the Cause of Death Ensemble model.
11,809 citations
Theo Vos1, Amanuel Alemu Abajobir, Kalkidan Hassen Abate2, Cristiana Abbafati3 +775 more•Institutions (305)
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016.
10,401 citations
TL;DR: In this paper, the authors estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010.
9,324 citations
University of Washington1, Sapienza University of Rome2, Mekelle University3, University of Texas at San Antonio4, King Saud bin Abdulaziz University for Health Sciences5, Debre markos University6, Emory University7, University of Oxford8, University of Cartagena9, United Nations Population Fund10, University of Birmingham11, Stanford University12, Aga Khan University13, University of Melbourne14, National Taiwan University15, University of Cambridge16, University of California, San Diego17, Public Health Foundation of India18, Public Health England19, University of Peradeniya20, Harvard University21, National Institutes of Health22, Tehran University of Medical Sciences23, Auckland University of Technology24, University of Sheffield25, University of Western Australia26, Karolinska Institutet27, Birzeit University28, Brandeis University29, American Cancer Society30, Ochsner Medical Center31, Yonsei University32, University of Bristol33, Heidelberg University34, Vanderbilt University35, South African Medical Research Council36, Jordan University of Science and Technology37, New Generation University College38, Northeastern University39, Simmons College40, Norwegian Institute of Public Health41, Boston University42, Chinese Center for Disease Control and Prevention43, University of Bari44, University of São Paulo45, University of Otago46, University of Crete47, International Centre for Diarrhoeal Disease Research, Bangladesh48, Fred Hutchinson Cancer Research Center49, Teikyo University50, Bhabha Atomic Research Centre51, University of Tokyo52, Finnish Institute of Occupational Health53, Heriot-Watt University54, University of Alabama at Birmingham55, Griffith University56, National Center for Disease Control and Public Health57, University of California, Irvine58, Johns Hopkins University59, New York University60, University of Queensland61, Universidade Federal de Minas Gerais62, National Research University – Higher School of Economics63, University of Bergen64, Columbia University65, Shandong University66, University of North Carolina at Chapel Hill67, Fujita Health University68, Korea University69, Chongqing Medical University70, Zhejiang University71
TL;DR: The global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013 is estimated using a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs).
9,180 citations