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  • Sbarra, AN, et al. (författare)
  • Mapping routine measles vaccination in low- and middle-income countries
  • 2021
  • Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 589:7842, s. 415-
  • Tidskriftsartikel (refereegranskat)abstract
    • The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.
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  • Kinyoki, DK, et al. (författare)
  • Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
  • 2020
  • Ingår i: Nature medicine. - : Springer Science and Business Media LLC. - 1546-170X .- 1078-8956. ; 26:5, s. 750-759
  • Tidskriftsartikel (refereegranskat)abstract
    • A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.
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  • Sepanlou, SG, et al. (författare)
  • Levels and Trends of Maternal Mortality and Morbidity by Cause in North Africa and Middle East, 1990 to 2019: An Analysis for the Global Burden of Disease Study 2019
  • 2022
  • Ingår i: Archives of Iranian medicine. - : Maad Rayan Publishing Company. - 1735-3947 .- 1029-2977. ; 25:10, s. 666-675
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Methods: This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Results: Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6–171.2) to 94.3 (73.4–121.1) per 100000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3–6.8) in Kuwait to 502.9 (375.2–655.3) per 100000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0–6.4) in Kuwait to 269.9 (195.8–368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion: MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn’t achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.
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  • Sepanlou, SG, et al. (författare)
  • Neonate, Infant, and Child Mortality by Cause in Provinces of Iran: An Analysis for the Global Burden of Disease Study 2019
  • 2022
  • Ingår i: Archives of Iranian medicine. - : Maad Rayan Publishing Company. - 1735-3947 .- 1029-2977. ; 25:8, s. 484-495
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Since 1990, neonatal, infant, and child mortality has substantially decreased in Iran. However, estimates for mortality by cause at subnational scale are not available. Methods: This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report the number and rates of neonate, infant, and child deaths by cause across provinces of Iran from 1990 to 2019. Results: Between 1990 and 2019, the neonatal mortality rate per 1000 live births decreased from 31.8 (95% UI: 28.1–35.5) to 6.8 (6.1–7.4). The child mortality rates decreased from 71.2 (63.6–79.1) to 11.1 (10.2–12.0) per 1000 live births. Mortality rates among neonates per 1000 live births ranged from 3.1 (2.6–3.7) to 10.0 (9.2–10.8) across provinces in 2019. Child mortality rate per 1000 live births ranged from 5.5 (4.6–6.5) to 17.9 (16.4–19.4) across provinces in 2019. Neonatal disorders, congenital birth defects, and lower respiratory infections were the three main causes of mortality in almost all provinces of Iran. The majority of neonatal disorders were due to neonatal preterm birth and neonatal asphyxia, trauma, and infections. The trends of mortality across provinces from 1990 to 2019 were converging and decreased along with increase in sociodemographic index (SDI). Conclusions: All provinces achieved the Sustainable Development Goal 3.2 of neonatal mortality less than 12 and child mortality less than 25 per 1000 live births. However, disparities still exist across provinces, specifically in low-SDI provinces.
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