| 1. |
- Lozano, Rafael, et al.
(författare)
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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Tidskriftsartikel (refereegranskat)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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| 2. |
- Murray, Christopher J. L., et al.
(författare)
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Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1995-2051
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Tidskriftsartikel (refereegranskat)abstract
- Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation.
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| 4. |
- Tilahun, Girma, et al.
(författare)
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Seasonal variations in phytoplankton biomass and primary production in the Ethiopian Rift Valley lakes Ziway, Awassa and Chamo - The basis for fish production
- 2010
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Ingår i: Limnologica. - : Elsevier BV. - 0075-9511 .- 1873-5851. ; 40:4, s. 330-342
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Tidskriftsartikel (refereegranskat)abstract
- Seasonal variations in the biomass (Chl a) and primary production (C-14-method) of phytoplankton were studied during 12 months of 2005 in the three Ethiopian Rift Valley Lakes (ERVL) Ziway, Awassa and Chamo. Chl a showed an average value of 40, 20, and 30 mg m(-3) for the three lakes, respectively. Integrated areal primary production for the total phytoplankton (g C m(2) d(-1)) varied 2-fold in the three lakes but on different levels, from 0.67-1.8 in L Ziway, 1.8-4.6 in L. Awassa, and 1.0-2.6 in L Chamo. The overall photosynthetic efficiency of utilizing photosynthetically active radiation by the phytoplankton on molar basis (mmol C mol of photons(-1)) resulted in an average value of 1.4 for L. Ziway, 3.5 for L. Awassa and 1.6 for L. Chamo. Among the different factors regulating phytoplankton primary productivity, light penetration and nutrients were the most important in the three lakes. The seasonal variations of incident radiation (most values between 5 and 7 E m(2) h(-1)) and water temperature (most values between 22 and 24 degrees C) were small and unlikely to result in the marked differences in phytoplankton primary production. Although relative increase in nutrient concentrations occurred following the rainy periods, the major algal nutrients were either consistently low (nitrate and/or silicate) or high (phosphate and/or ammonium) and remained within a narrow range for most of the study period in all the three lakes. Consequently, phytoplankton biomass and primary production seem to be maintained more by nutrient regeneration or turnover (facilitated by high temperature) than by allochthonous nutrient input. This would be coupled with wind-induced mixing that would play an important role in determining hydrographic characteristics (water column structure) and the associated redistribution of nutrients and phytoplankton, the availability of light and subsequently the spatial (vertical) and temporal patterns of phytoplankton production in these three ERVL. Phytoplankton production (PP) is regarded as a good predictor of fish yield in lakes and seasonal measurements of PP is a prerequisite for good such estimates.
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| 5. |
- Willen, Eva, et al.
(författare)
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Cyanotoxin production in seven Ethiopian Rift Valley lakes
- 2011
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Ingår i: Inland Waters. - 2044-2041 .- 2044-205X. ; 1:2, s. 81-91
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Tidskriftsartikel (refereegranskat)abstract
- We hypothesized that unusual deaths and illnesses in wild and domestic animals in lake areas of the Rift Valley south of Addis Ababa were caused by toxic cyanobacteria. In the first cyanotoxic analyses conducted in samples from Ethiopia, we found lakes Chamo, Abaya, Awassa, Chitu, Langano, Ziway, and Koka all had concentrations of microcystins (MC) ranging from trace to hazardous, whereas only traces less than limits of detection (LOD) of cylindrospermopsin (CYN) were found. In the December 2006 dry season we sampled the lakes for analyses of MC, CYN, species structures, and calculations of cyanobacteria biomass. We used the Utermol technique to analyse cyanobacterial biomass and monitored MC toxins using HPLC-DAD, LC-ESI-MS-MRM, and ELISA-test and CYN with HPLC-DAD and ELISA. The various toxicity tests coincided well. In 4 of the lakes (Chamo, Langano, Ziway, and Koka), the inter-lake range of total MC concentration was 1.3-48 mu g L-1; in 3 (Abaya, Awassa, and Chitu), we found only traces of MC. Microcystis aeruginosa was the dominant species, with Microcystis panniformis, Anabaena spiroides, and Cylindrospermopsis spp. as subdominants. The MC concentration, especially in Lake Koka, exceeded levels for serious health hazards for humans, cattle, and wildlife.
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| 6. |
- WM-Bekele, Daniel, et al.
(författare)
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Pharmaceutical pollution in an Ethiopian rift valley lake Hawassa : occurrences and possible ecological risks
- 2024
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Ingår i: Environmental Challenges. - : Elsevier. - 2667-0100. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Most information on the occurrences of active pharmaceutical ingredients (APIs) in natural water bodies comes from developed nations, leaving developing countries like Ethiopia understudied. This study examines the presence and potential ecological risks of APIs in Lake Hawassa, a tropical freshwater lake in the Ethiopian Rift Valley. The study analyzed 36 APIs from 11 therapeutic classes of human medications in water and sediment samples. The risk quotient (RQ) method was used to assess ecological risks to aquatic organisms. Forty-five composite samples of water and sediment were collected from five sites during three sampling events. The samples were analyzed in the Chemistry laboratory at the University of Umeå, Sweden using the ultrahigh-performance liquid chromatography mass spectrometer (UHPLC-MS/MS) method. The results indicated that 16 APIs were detected in the water samples and three in the sediment. Ciprofloxacin, artesunate, mefloquine, fluconazole, and tramadol were the most frequent APIs detected in the analyzed water samples. The concentration of ciprofloxacin was the highest of all the APIs, detected with RQ > 1, indicating high risk to the aquatic biota in the Lake Hawassa ecosystem. Similarly, diclofenac, and sulfonamide in water, lorazepam, mefloquine, and lumefantrine in sediments, occurred at concentrations that could cause a medium risk (RQ > 0.1) to the aquatic biota. The occurrence of the APIs in the Lake Hawassa ecosystem affirms early warning, and the Antibiotics may create Antibiotic-resistant genes posing a public health threat. Therefore, it is crucial to implement systems for gathering unused medications and monitoring waste disposal and sewage treatment in the study area. Despite the limited research on APIs in the region where this study was conducted, our findings are highly valuable for understanding APIs in freshwater ecosystems worldwide. Our results align with global concerns about APIs, making them a valuable tool for creating universally applicable guidelines.
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