Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

doi:10.1016/S0140-6736(17)32154-2

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Journal Article•DOI•

Tracking spending on malaria by source in 106 countries, 2000-16: an economic modelling study.

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Annie Haakenstad¹, Anton C Harle², Golsum Tsakalos², Angela E Micah², Tianchan Tao², Mina Anjomshoa³, Mina Anjomshoa⁴, Jessica Cohen¹, Nancy Fullman², Simon I. Hay², Tomislav Mestrovic, Shafiu Mohammed⁵, Shafiu Mohammed⁶, Seyyed Meysam Mousavi³, Molly R Nixon², David M. Pigott², Khanh Bao Tran⁷, Christopher J L Murray², Joseph L Dieleman² - Show less +15 more•Institutions (7)

Harvard University¹, Institute for Health Metrics and Evaluation², Tehran University of Medical Sciences³, Rafsanjan University of Medical Sciences⁴, Heidelberg University⁵, Ahmadu Bello University⁶, University of Auckland⁷

01 Jul 2019-Lancet Infectious Diseases

TL;DR: Tracking global malaria spending provides insight into how far the world is from reaching the malaria funding target of $6·6 billion annually by 2020, and how to mobilise additional government resources for malaria.

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Abstract: Summary Background Sustaining achievements in malaria control and making progress toward malaria elimination requires coordinated funding. We estimated domestic malaria spending by source in 106 countries that were malaria-endemic in 2000–16 or became malaria-free after 2000. Methods We collected 36 038 datapoints reporting government, out-of-pocket (OOP), and prepaid private malaria spending, as well as malaria treatment-seeking, costs of patient care, and drug prices. We estimated government spending on patient care for malaria, which was added to government spending by national malaria control programmes. For OOP malaria spending, we used data reported in National Health Accounts and estimated OOP spending on treatment. Spatiotemporal Gaussian process regression was used to ensure estimates were complete and comparable across time and to generate uncertainty. Findings In 2016, US$4·3 billion (95% uncertainty interval [UI] 4·2–4·4) was spent on malaria worldwide, an 8·5% (95% UI 8·1–8·9) per year increase over spending in 2000. Since 2000, OOP spending increased 3·8% (3·3–4·2) per year, amounting to $556 million (487–634) or 13·0% (11·6–14·5) of all malaria spending in 2016. Governments spent $1·2 billion (1·1–1·3) or 28·2% (27·1–29·3) of all malaria spending in 2016, increasing 4·0% annually since 2000. The source of malaria spending varied depending on whether countries were in the malaria control or elimination stage. Interpretation Tracking global malaria spending provides insight into how far the world is from reaching the malaria funding target of $6·6 billion annually by 2020. Because most countries with a high burden of malaria are low income or lower-middle income, mobilising additional government resources for malaria might be challenging. Funding The Bill & Melinda Gates Foundation.

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46 citations

Journal Article•DOI•

Global and regional needs, unmet needs and access to hearing aids.

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Aislyn U. Orji¹, Kaloyan Kamenov², Mae Dirac¹, Adrian Davis³, Shelly Chadha², Theo Vos¹ - Show less +2 more•Institutions (3)

University of Washington¹, World Health Organization², University College London³

03 Feb 2020-International Journal of Audiology

TL;DR: Development of innovative low-cost technologies with effective service delivery models, policy and regulatory changes to improve access, and combatting the stigma and lack of awareness are some of the potential solutions to improveAccess to hearing aids.

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Abstract: Objectives: This article aims to estimate the global and regional needs, unmet needs and access to hearing aids, as well as the morbidity that can be averted by their use.Design: The study was based on Global Burden of Disease data. Study sample: Hearing impaired individuals "in need" of a hearing aid were defined as those in the moderate, moderately severe, and severe categories.Results: Globally, 401.4 million people are 'in need' of hearing aids. The large majority (83%) of them do not use hearing aids, with higher levels being in some regions such as the African region (90%). Accounting for hearing aid coverage reduced morbidity by 14.6% (95% UI 13.1- 16) - from 25 million YLDs to 21.3 million YLDs. It was estimated that if every single prevalent case in need would use a hearing aid, the burden of disease in this population would be reduced from the untreated 25 million YLDs to 10.3 million YLDs - a reduction of 59%.Conclusions: Development of innovative low-cost technologies with effective service delivery models, policy and regulatory changes to improve access, and combatting the stigma and lack of awareness are some of the potential solutions to improve access to hearing aids.

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46 citations

Journal Article•DOI•

Novel Three-Day, Community-Based, Nonpharmacological Group Intervention for Chronic Musculoskeletal Pain (COPERS): A Randomised Clinical Trial

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Stephanie Taylor¹, Dawn Carnes¹, Kate Homer¹, Brennan C Kahan¹, Natalia Hounsome¹, Sandra Eldridge¹, Anne Spencer², Tamar Pincus³, Anisur Rahman⁴, Martin Underwood⁵ - Show less +6 more•Institutions (5)

Queen Mary University of London¹, University of Exeter², Royal Holloway, University of London³, University College London⁴, University of Warwick⁵

14 Jun 2016-PLOS Medicine

TL;DR: The effectiveness of a novel, theoretically based group pain management support intervention for chronic musculoskeletal pain is described, designed to promote self-efficacy to manage chronic pain.

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Abstract: Chronic musculoskeletal pain is the leading cause of disability worldwide. The effectiveness of pharmacological treatments for chronic pain is often limited, and there is growing concern about the adverse effects of these treatments, including opioid dependence. Nonpharmacological approaches to chronic pain may be an attractive alternative or adjunctive treatment. We describe the effectiveness of a novel, theoretically based group pain management support intervention for chronic musculoskeletal pain.

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46 citations

Journal Article•DOI•

Sleep disorder-related headaches.

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Luigi Ferini-Strambi, Andrea Galbiati¹, Romina Combi²•Institutions (2)

Vita-Salute San Raffaele University¹, University of Milano-Bicocca²

01 May 2019-Neurological Sciences

TL;DR: Tension-type headache is the most common headache with sleep dysregulation frequently reported as a triggering factor for acute attacks: management of sleep disturbances seems crucial in this form of headache.

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Abstract: Migraine with and without aura, cluster headache, hypnic headache, and paroxysmal hemicranias are each reported as intrinsically related to sleep. Chronic migraine, chronic tension-type headache, and medication overuse headache may cause sleep disturbance. Otherwise, both headache and sleep disorder may be manifestations of a same systemic dysfunction. There is a vicious cycle linking sleep disorders and migraine. The poor quality or poor duration of sleep could be a trigger of migraine attack and migraineurs with poor sleep reported a higher headache frequency. Moreover, coping behaviors of migraineurs (e.g., going to sleep early to relieve migraine attacks) can be factors precipitating and perpetuating sleep disturbances themselves. During cluster headache, patients report a poor quality of sleep correlated with the amount of daylight. In particular, it was demonstrated that melatonin levels have influences on cluster headache attacks. Concerning the pathophysiology of hypnic headache, it has been hypothesized a possible role of obstructive sleep apnea in triggering nocturnal attacks: an increased number of apnea episodes has been reported in hypnic headache patients, but a lack of a temporal correlation of headache attacks with the drop of oxygen saturation has been observed. Tension-type headache is the most common headache with sleep dysregulation (lack of sleep or oversleeping) frequently reported as a triggering factor for acute attacks: management of sleep disturbances seems crucial in this form of headache.

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46 citations

Journal Article•DOI•

Liver Disease Burden of Hepatitis C Virus Infection in Iran and the Potential Impact of Various Treatment Strategies on the Disease Burden.

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Behzad Hajarizadeh¹, Devin Razavi-Shearer, Shahin Merat², Seyed Moayed Alavian, Reza Malekzadeh², Homie Razavi - Show less +2 more•Institutions (2)

Kirby Institute¹, Tehran University of Medical Sciences²

14 Jun 2016-Hepatitis Monthly

TL;DR: An increasing burden of HCV-related liver disease is expected in Iran under the current diagnosis and treatment levels and increased diagnosis andreatment uptake is required in combination with enhanced treatment efficacy to reduce the HCV burden.

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Abstract: Background Chronic hepatitis C virus (HCV) infection is emerging as the leading cause of viral hepatitis-related liver disease in Iran. Objectives This study estimated the current and future disease burden of HCV infection in Iran and assessed the impact of various strategies in access to HCV treatment on reducing the disease burden. Materials and methods A modelling approach was used to estimate the size of HCV infected population, and disease progression from 2014 to 2030. Literature review and expert consensus informed the model parameters. Base case scenario assumed the currently utilized Interferon (IFN)-based treatment. Five other scenarios assumed utilizing IFN-free direct acting anti-viral regimens with 1, the base case diagnosis and treatment uptake; 2, restricting treatment to severe liver fibrosis; 3, treatment uptake being doubled; 4, stepwise increase in treatment uptake (doubled by 2017, quadrupled thereafter); 5, targeting at least 90% reduction in HCV infections by 2030. Results In 2014, an estimated 186,500 individuals are living with HCV infection in Iran (median age: 30 years). By 2030, this number will increase to 213,700, while three to four fold increase is expected in the case numbers of decompensated cirrhosis (DC, n = 620), hepatocellular carcinoma (HCC, n = 510), and liver disease death (n = 400), assuming the current diagnosis/treatment settings. As compared with the base case scenario, scenarios 1 and 2 will have a limited impact on HCV disease burden, while scenarios 3 and 4 will result in 45% - 49% decrease in the number of individuals living with HCV infection and 60% - 69% decrease in DC, HCC and liver disease deaths by 2030. For at least 90% reduction in HCV infections by 2030 (scenario 5), diagnosis and treatment rates should be increased to 12,000 and 9,000 individuals per year in 2016, respectively and to 24,000 and 18,000 individuals per year, respectively in 2018 onward. Conclusions An increasing burden of HCV-related liver disease is expected in Iran under the current diagnosis and treatment levels. Increased diagnosis and treatment uptake is required in combination with enhanced treatment efficacy to reduce the HCV burden. The relatively young age of the HCV infected population, provides an opportunity for timely interventions to avert the projected rising HCV disease burden in Iran.

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46 citations