| 1. |
- Danaei, Goodarz, et al.
(författare)
-
Iran in transition
- 2019
-
Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 393:10184, s. 1984-2005
-
Forskningsöversikt (refereegranskat)abstract
- Being the second-largest country in the Middle East, Iran has a long history of civilisation during which several dynasties have been overthrown and established and health-related structures have been reorganised. Iran has had the replacement of traditional practices with modern medical treatments, emergence of multiple pioneer scientists and physicians with great contributions to the advancement of science, environmental and ecological changes in addition to large-scale natural disasters, epidemics of multiple communicable diseases, and the shift towards non-communicable diseases in recent decades. Given the lessons learnt from political instabilities in the past centuries and the approaches undertaken to overcome health challenges at the time, Iran has emerged as it is today. Iran is now a country with a population exceeding 80 million, mainly inhabiting urban regions, and has an increasing burden of non-communicable diseases, including cardiovascular diseases, hypertension, diabetes, malignancies, mental disorders, substance abuse, and road injuries.
|
|
| 2. |
- Bazargan-Hejazi, Shahrzad, et al.
(författare)
-
The Burden of Road Traffic Injuries in Iran and 15 Surrounding Countries : 1990-2016
- 2018
-
Ingår i: Archives of Iranian Medicine. - 1029-2977 .- 1735-3947. ; 21:12, s. 556-565
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Global Burden of Disease (GBD) Study provides estimates of deaths, years of life lost (YLL), years of life lived with disability (YLD), and disability-adjusted life years (DALYs) due to 249 causes of death, 315 diseases and injuries, and 79 behavioral, environmental, occupational, and metabolic risk factors in 195 countries, territories, and regions by sex and 20 age categories in 195 countries and regions since 1990. In this study, we aimed to present the burden of road traffic injuries (RTIs) in Iran and 15 surrounding countries in 1990-2016.METHODS: The standard Cause of Death Ensemble modeling (CODEm) is used to estimate deaths due to all causes of injury by age, sex, country and year. A range of 27 causes is used for estimating non-fatal health outcomes based on inpatient and outpatient datasets using DisMod-MR 2.0. Disability-adjusted life years (DALYs) estimate quantify the total burden of years lost due to premature death or disability and was computed by summing the fatal burden and non-fatal burden associated with a cause (i.e., YLL+YLD).RESULTS: In 2016, age-standardized transport injuries in Iran accounted for 35.6 (UI: 29.64-43.44) deaths per 100000 compared to 60.8 (UI: 51.04-72.49) in 1990. Transport injury became the fourth leading cause of death in Iran in 2016, up from the 5th leading cause of death in 1990. The burden of RTIs was mainly caused by motor vehicles and motorcycles and mostly affected the economically productive age groups (15-49), males and children, especially those at school age. Afghanistan with 59.14 deaths (52.09-66.8) and UAE with 53.71 deaths (36.59-72.77) had the largest transport injury death rates per 100000. From 1990 to 2016, Iran had -2.06 annual percent change in transport death rates. The lowest annual percent change is reported for Turkmenistan at -3.43. While Pakistan, UAE and Qatar had the highest annual percent change in transport injury. Across all countries, the observed-to-expected ratios for transport injury death rates varied considerably in 2016.The UAE had the largest age-standardized ratios of observed-to-expected rate (2.93), followed by Oman (2.39), Saudi Arabia (2.23), Afghanistan (2.04) and Iran (1.95).CONCLUSIONS: RTIs continue to be a public health burden in Iran and its neighboring countries, even though, there is evidence for decline in RTIs across all countries except Pakistan. The most frequent sub-causes of death and injury are the motor vehicle, motorcycle, and pedestrian injuries. The most vulnerable road users are children and young adults.
|
|
| 3. |
- Bentham, James, et al.
(författare)
-
A century of trends in adult human height
- 2016
-
Ingår i: eLIFE. - 2050-084X. ; 5
-
Tidskriftsartikel (refereegranskat)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
|
|
| 4. |
- Bentham, James, et al.
(författare)
-
A century of trends in adult human height
- 2016
-
Ingår i: eLIFE. - : eLife Sciences Publications Ltd. - 2050-084X. ; 5
-
Tidskriftsartikel (refereegranskat)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3– 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8– 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
|
|
| 5. |
- Danaei, Goodarz, et al.
(författare)
-
Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331288 participants
- 2015
-
Ingår i: The Lancet Diabetes & Endocrinology. - 2213-8595 .- 2213-8587. ; 3:8, s. 624-637
-
Tidskriftsartikel (refereegranskat)abstract
- Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA(1c). We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defining diabetes. Diabetes was defined using HbA(1c) (HbA(1c) >= 6 . 5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT definitions (FPG >= 7 . 0 mmol/L or 2hOGTT >= 11 . 1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using different definitions graphically and by regression analyses. We calculated sensitivity and specificity of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specificity in each survey, and then pooled results using a random-effects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG- or-2hOGTT was correlated with prevalence based on FPG alone (r= 0 . 98), but was higher by 2-6 percentage points at different prevalence levels. Prevalence based on HbA(1c) was lower than prevalence based on FPG in 42 . 8% of age-sex-survey groups and higher in another 41 . 6%; in the other 15 . 6%, the two definitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA(1c)-based prevalences was partly related to participants' age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specific communities. Diabetes defined as HbA(1c) 6 . 5% or more had a pooled sensitivity of 52 . 8% (95% CI 51 . 3-54 . 3%) and a pooled specificity of 99 . 74% (99 . 71-99 . 78%) compared with FPG 7 . 0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defined based on FPG-or-2hOGTT was 30 . 5% (28 . 7-32 . 3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA(1c) versus FPG. Interpretation Different biomarkers and definitions for diabetes can provide different estimates of population prevalence of diabetes, and differentially identify people without previous diagnosis as having diabetes. Using an HbA(1c)-based definition alone in health surveys will not identify a substantial proportion of previously undiagnosed people who would be considered as having diabetes using a glucose-based test.
|
|
| 6. |
|
|
| 7. |
- Djalalinia, Shirin, et al.
(författare)
-
Prevalence and Years Lived with Disability of 310 Diseases and Injuries in Iran and its Neighboring Countries, 1990-2015 : Findings from Global Burden of Disease Study 2015
- 2017
-
Ingår i: Archives of Iranian Medicine. - 1029-2977 .- 1735-3947. ; 20:7, s. 392-402
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Due to significant achievements in reducing mortality and increasing life expectancy, the issue of disability from diseases and injuries, and their related interventions, has become one of the most important concerns of health-related research.METHODS: Using data obtained from the GBD 2015 study, the present report provides prevalence and years lived with disability (YLDs) of 310 diseases and injuries by sex and age in Iran and neighboring countries over the period 1990-2015. Age-standardized rates of all causes of YLDs are presented for both males and females in 16 countries for 1990 and 2015. We present the percentage of total YLDs for 21 categories of diseases and injuries, the percentage of YLDs for age groups, as well as the ranking of the most prevalent causes and YLDs from the top 50 diseases and injuries in Iran.RESULTS: In 2015, the burden of 310 diseases and injuries among the Iranian population was responsible for 8,357,878 loss of all-age total years, which is equal to 10.58% of total years lived per year. This differs from the neighboring countries, as it ranges from 9.05% in Turkmenistan to 13.36% in Russia. During the past 25 years, a remarkable decrease was observed in all-cause YLD rates in all 16 countries. Meanwhile, in all countries, the age-standardized rate of all causes of YLDs was higher in females than males.CONCLUSION: Based on our findings, one of the remarkable changes in NCDs observed among the studied age groups was increased rate of YLDs from mental disorders, which was replaced by musculoskeletal disorders in older age groups in 2015.
|
|
| 8. |
- Feigin, Valery L., et al.
(författare)
-
Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2019
-
Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 18:5, s. 459-480
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders.Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach.Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable).Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies.Funding: Bill & Melinda Gates Foundation.
|
|
| 9. |
|
|
| 10. |
- Karimkhani, Chante, et al.
(författare)
-
Burden of Skin and Subcutaneous Diseases in Iran and Neighboring Countries : Results from the Global Burden of Disease Study 2015
- 2017
-
Ingår i: Archives of Iranian Medicine. - 1029-2977 .- 1735-3947. ; 20:7, s. 429-440
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Iran and its neighboring countries represent four world regions with unique cultures and geography. Skin diseases span a wide diversity of etiologies including infectious, inflammatory, autoimmune, vascular, neurogenic, and oncologic. The Global Burden of Disease Study (GBD) 2015 measures the burden from skin diseases in 195 countries.METHODS: Epidemiologic data were collected from literature review, survey data, and hospital inpatient/outpatient claims data. These raw data entered modeling using a Bayesian meta-regression tool, DisMod MR-2.1, which yielded prevalence estimates by age/sex/location/year. Prevalence estimates were combined with disability weights to yield years lived with disability (YLDs). YLDs are combined with years of life lost (YLLs), from mortality estimates, to yield disability-adjusted life years (DALYs). DALYs were obtained for 16 skin conditions and both sexes in Iran and 15 surrounding countries. The sociodemographic index (SDI) for each country was also correlated with skin disease DALY rate using the Pearson coefficient (r) with two-tailed P-value.RESULTS: There was no significant correlation between individual skin diseases and SDI. Acne and dermatitis caused the greatest burden and BCC the lowest burden of skin diseases in Iran and the other 15 countries. SCC and BCC were responsible for the largest discrepancy by sex, with higher burden in males compared to females.CONCLUSION: Skin diseases, particularly dermatitis and acne, cause considerable burden in Iran and surrounding regions. Objective and transparent epidemiologic data such as GBD has the potential to inform and impact many facets of healthcare, research prioritization, public policy, and international partnerships.
|
|
