Research Articles (School of Health Systems and Public Health (SHSPH))

Permanent URI for this collectionhttp://hdl.handle.net/2263/1723

For inquiries regarding this collection or items in the collection, please contact : Estelle Grobler
Tel.: +27 12 354 1433

Browse

Now showing 1 - 20 of 1240

Reliability, validity and dimensionality of the 12-Item General Health Questionnaire among South African healthcare workers
(AOSIS, 2024-10) Kufe, Nyuyki Clement; Bernstein, Colleen; Wilson, Kerry Sidwell
Healthcare workers (HCWs) were among the high-risk groups for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and suffer a high burden of challenges with mental health including depression, anxiety, traumatic stress, avoidance and burnout. The 12-Item General Health Questionnaire (GHQ-12) has shown the best fit in both a one-factor structure and a multidimensional structure for the screening of common mental disorders and psychiatric well-being. The aim was to test for reliability and validity and ascertain the factor structure of the GHQ-12 in a South African HCW population. Data were collected from 832 public hospital and clinic staff during the coronavirus disease 2019 (COVID-19) pandemic in Gauteng, South Africa. The factor structure of the GHQ-12 in this professional population was examined by exploratory factor analysis (EFA) to identify factors, confirmatory factor analysis (CFA) for construct validity and structural equation modelling (SEM) to establish model fit. The GHQ-12 median score was higher (n = 25) in women than in men (n = 24), p = 0.044. The assumptions for inferential statistics were tested: the determinant for the correlation matrix was 0.034, Bartlett’s test of sphericity was p < 0.001, Chi-square 2262.171 and the Kaiser-Meyer-Olkin (KMO) of sampling adequacy was 0.877. The four factors identified were labelled as social dysfunction (37.8%), anxiety depression (35.4%), capable (24.9%) and self-efficacy (22.7%). The sample had a Cronbach’s alpha and McDonald’s Omega coefficient of 0.85. CONTRIBUTION : The study highlighted the gaps in the use of GHQ-12. The findings affirm the validity and reliability of the GHQ-12 in this group of professionals and the multidimensional structure for screening for psychological distress.
Contributions of a community health worker program in improving district health system performance in South Africa, using routine health service variables in a quasi-experimental study design
(BioMed Central, 2025-08) Thomas, Leena Susan; Jordaan, Joyce; Pillay, Yogan; Buch, Eric; leena.thomas@up.ac.za
BACKGROUND : Globally low- and middle-income countries are investing in community health worker (CHW) programs. These programs are viewed as fundamental to ensuring universal health coverage for all. Where CHW programs are doing what they should be doing and doing it adequately, they should make a difference in population health outcomes, reflecting health system changes. However, there are not many studies exploring the contributions and effectiveness of large-scale, comprehensive community health worker programs on health system performance. METHODS : This study takes place in the Ekurhuleni health district, in urban South Africa. A before (pre) and after (post) intervention study (quasi-experimental) using routine health service variables (secondary data) from district clinics over nine years was conducted. Performance of intervention clinics with community health worker teams that had more than 60% population coverage were compared to similar control clinics that had no teams or teams with less than 30% coverage. RESULTS : Both groups of clinics generally improved over time for routine health service variables for maternal, child health, infectious diseases, and cervical cancer programmes. Over nine years, intervention clinics showed more improved performance, statistically significant, in six health variables while controls improved in four. But importantly, intervention clinics improved proportionately better pre to post in seven of the nine (78%) variables studied compared to controls, demonstrating reduced diarrhoeal disease and pneumonia in children, better Vitamin A coverage, fewer severely malnourished children, better testing for HIV, and better screening for Tuberculosis and cervical cancer. Illustrating the comprehensive range of services provided by CHWs, the seven routine health service variables represented maternal, child health, infectious and non-communicable diseases. We also observed less uncontrolled hypertensive and diabetics in intervention clinics compared to control clinics. CONCLUSION : Large-scale, sustained and comprehensive community health worker programs adequately covering populations contributed to improved urban district health system performance in Ekurhuleni, demonstrating their effectiveness. This was explored through improvements in health system performance over time. These findings, using routine health service variables, have policy implications for financial and other resource allocations in health districts in low- and middle-income countries.
PrEP awareness and willingness to use oral PrEP among males ≥ 18 years attending VMMC services in Gauteng, South Africa
(Springer, 2025) Shangase, Nosipho; Tobaiwa, Ocean; Cutler, Ewalde; Singh, Beverley; Brukwe, Zinhle; Pillay, Erushka; Dorrell, Philip; Moyo, Khumbulani; Zondi, Lindokuhle; Pillay, Yogan; Patrick, Sean Mark; Puren, Adrian; Kufa, Tendesayi
Integration of voluntary medical male circumcision (VMMC) with pre-exposure prophylaxis (PrEP) services may increase access to and/or uptake of combination HIV prevention strategies. We examined awareness of and willingness to use oral PrEP among adult males attending VMMC services in Gauteng province, South Africa. A cross-sectional study was conducted among HIV-negative males aged ≥ 18 years seeking healthcare at one of six high-volume public VMMC clinics from June-October 2021. Participants provided written informed consent, completed an interviewer-administered questionnaire (covering demographics, clinical history, sexual behavioural and risk perception, PrEP eligibility, PrEP awareness and PrEP willingness), and underwent a rapid dual HIV/syphilis test. Logistic regression models (adjusted for education, age and sexual debut) were used to determine factors associated with PrEP awareness and PrEP willingness. Among the participants, 40% were at substantial risk of HIV and thus eligible for PrEP, 45% were aware of PrEP and 80% were likely/highly likely to use oral PrEP. Awareness of PrEP was lower among males who reported being at substantial risk of HIV than males not at substantial risk (aOR = 0.59, 95% CI: 0.41–0.86). PrEP willingness was higher in males who reported: (1) not being married, separated or widowed compared to married males (aOR = 2.28, 95% CI: 1.14–4.54); (2) being aware of PrEP (aOR = 1.91, 95% CI: 1.19–3.08) than those who were not aware of PrEP; and (3) having high/very high self-perceived HIV risk compared to those with lower self-perceived HIV risk (aOR = 1.94, 95% CI: 1.01–3.73). Considering the significant proportion of males attending VMMC who are at risk of HIV, integrating PrEP and VMMC services can significantly impact HIV prevention efforts by increasing awareness and uptake. Programs should prioritize PrEP awareness campaigns and highlight the combined benefits of VMMC and PrEP.
Women’s experiences of alcohol-related severe intimate partner violence : findings from formative research in South Africa
(Kettil Bruun Society for Social and Epidemiological Research on Alcohol , Canada, 2025-03) Ramsoomar, Leane; Willan, Samantha; Paile, Charntel; Mtimkulu, Maureen; Ketelo, Asiphe; Zembe, Amanda; Pass, Desiree; Nothling, Jani; Machisa, Mercilene; Abrahams, Naeemah; Shai, Nwabisa; Jewkes, Rachel
INTRODUCTION : Gender-based violence (GBV) is a threat to the health and well-being of women globally, and a key barrier to the achievement of the Sustainable Development Goals 3.3 and 5.2. Harmful alcohol use is a recognised risk factor for the perpetration and experience of GBV, particularly, intimate partner violence, and for the severity of intimate partner violence. This paper seeks to explore the role of alcohol in women’s experience of severe intimate partner violence (SIPV) in South Africa. METHODS : We conducted a qualitative study, using six focus group discussions and 20 in-depth interviews with 62 demographically diverse adult women from three provinces in South Africa (Gauteng, KwaZulu-Natal, and the Western Cape) who sought help for SIPV. FINDINGS : Women reported alcohol-related SIPV, frequently describing that her partner intentionally started arguments after he had been drinking. Their abuse included controlling and coercive behavior that restricted their movement and ability to participate in daily activities, economic abuse, and instances of severe physical and sexual intimate partner violence and attempted femicide. They viewed men's alcohol use as a ‘right’ associated with masculinity, that often intersected with expressions of masculinity, including controlling behavior, dominance, and aggression, and performing a provider role, especially among friends in taverns and bars. CONCLUSIONS : Planning for effective prevention, providing services and policy efforts requires an understanding of the complexity of the interaction between men's alcohol abuse and their perpetration of SIPV particularly in a context like South Africa, where both harmful alcohol use and GBV are prevalent.
Global, regional, and national burden of disorders affecting the nervous system, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier, 2024-04) Steinmetz, Jaimie D.; Seeher, Katrin Maria; Schiess, Nicoline; Nichols, Emma; Cao, Bochen; Servili, Chiara; Cavallera, Vanessa; Cousin, Ewerton; Hagins, Hailey; Moberg, Madeline E.; Mehlman, Max L.; Abate, Yohannes Habtegiorgis; Abbas, Jaffar; Abbasi, Madineh Akram; Mohammadreza , Abbasian; Abbastabar, Hedayat; Abdelmasseh, Michael; Abdollahi, Mohammad; Abdollahi, Mozhan; Abdollahifar, Mohammad-Amin; Abd-Rabu, Rami; Abdulah, Deldar Morad; Abdullahi, Auwal; Abedi, Aidin; Abedi, Vida; Abeldaño Zuñiga, Roberto Ariel; Abidi, Hassan; Abiodun, Olumide; Aboagye, Richard Gyan; Abolhassani, Hassan; Aboyans, Victor; Abrha, Woldu Aberhe; Abualhasan, Ahmed; Abu-Gharbieh, Eman; Aburuz, Salahdein; Adamu, Lawan Hassan; Addo, Isaac Yeboah; Adebayo, Oladimeji M.; Adekanmbi, Victor; Adekiya, Tayo Alex; Adikusuma, Wirawan; Adnani, Qorinah Estiningtyas Sakilah; Adra, Saryia; Afework, Tsion; Afolabi, Aanuoluwapo Adeyimika; Afraz, Ali; Afzal, Saira; Aghamiri, Shahin; Agodi, Antonella; Agyemang-Duah, Williams; Ahinkorah, Bright Opoku; Ahmad, Aqeel; Ahmad, Danish; Ahmad , Sajjad; Ahmadzade, Amir Mahmoud; Ahmed, Ali; Ahmed, Ayman; Ahmed, Haroon; Ahmed, Jivan Qasim; Ahmed, Luai A.; Ahmed, Muktar Beshir; Ahmed, Syed Anees; Ajami, Marjan; Aji, Budi; Ajumobi, Olufemi; Akade, Seyed Esma’il; Akbari, Morteza; Akbarialiabad, Hossein; Akhlaghi, Shiva; Akinosoglou, Karolina; Akinyemi, Rufus Olusola; Akonde, Maxwell; Al Hasan, Syed Mahfuz; Alahdab, Fares; AL-Ahdal, Tareq Mohammed Ali; Al-amer, Rasmieh Mustafa; Albashtawy, Mohammed; AlBataineh, Mohammad T.; Aldawsari, Khalifah A.; Alemi, Hediyeh; Alemi, Sharifullah; Algammal, Abdelazeem M.; Al-Gheethi, Adel Ali Saeed; Alhalaiqa, Fadwa Alhalaiqa Naji; Alhassan, Robert Kaba; Ali, Abid; Ali, Endale Alemayehu; Ali, Liaqat; Ali, Mohammed Usman; Ali, Musa Mohammed; Ali, Rafat; Ali, Shahid; Ali, Syed Shujait Shujait; Ali, Zahid; Alif, Sheikh Mohammad; Alimohamadi, Yousef; Aliyi, Ahmednur Adem; Aljofan, Mohamad; Aljunid, Syed Mohamed; Alladi, Suvarna; Almazan, Joseph Uy; Almustanyir, Sami; Al-Omari, Basem; Alqahtani, Jaber S.; Alqasmi, Ibrahim; Alqutaibi, Ahmed Yaseen; Al-Shahi Salman, Rustam; Altaany, Zaid; Al-Tawfiq, Jaffar A.; Altirkawi, Khalid A; Alvis-Guzman, Nelson; Al-Worafi, Yaser Mohammed; Aly, Hany; Aly, Safwat; Alzoubi, Karem H.; Amani, Reza; Amindarolzarbi, Alireza; Amiri, Sohrab; Amirzade-Iranaq, Mohammad Hosein; Amu, Hubert; Amugsi, Dickson A.; Amusa, Ganiyu Adeniyi; Amzat, Jimoh; Ancuceanu, Robert; Anderlini, Deanna; Anderson, David B.; Andrei, Catalina Liliana; Androudi, Sofia; Angappan, Dhanalakshmi; Angesom, Teklit W.; Anil, Abhishek; Ansari-Moghaddam, Alireza; Anwer, Razique; Arafat, Mosab; Aravkin, Aleksandr Y.; Areda, Demelash; Ariffin, Hany; Arifin, Hidayat; Arkew; Ärnlöv, Johan; Arooj, Mahwish; Artamonov, Anton A.; Artanti, Kurnia Dwi; Aruleba, Raphael Taiwo; Asadi-Pooya, Ali A.; Asena, Tilahun Ferede; Asghari-Jafarabadi, Mohammad; Ashraf, Muhammad; Ashraf, Tahira; Atalell, Kendalem Asmare; Athari, Seyyed Shamsadin; Atinafu, Bantalem Tilaye Tilaye; Atorkey, Prince; Atout, Maha Moh’d Wahbi; Atreya, Alok; Aujayeb, Avinash; Avan, Abolfazl; Ayala Quintanilla, Beatriz Paulina; Ayatollahi, Haleh; Ayinde, Olatunde O.; Ayyoubzadeh, Seyed Mohammad; Azadnajafabad, Sina; Azizi, Zahra; Azizian, Khalil; Azzam, Ahmed Y.; Babaei, Mahsa; Badar, Muhammad; Badiye, Ashish D.; Baghdadi, Soroush; Bagherieh, Sara; Bai, Ruhai; Baig, Atif Amin; Balakrishnan, Senthilkumar; Balalla, Shivanthi; Baltatu, Ovidiu Constantin; Banach, Maciej; Bandyopadhyay, Soham; Banerjee, Indrajit; Baran, Mehmet Firat; Barboza, Miguel A.; Barchitta, Martina; Bardhan, Mainak; Barker-Collo, Suzanne Lyn; Bärnighausen, Till Winfried; Barrow, Amadou; Bashash, Davood; Bashiri, Hamideh; Bashiru, Hameed Akande; Basiru, Afisu; Basso, João Diogo; Basu, Sanjay; Batiha, Abdul-Monim Mohammad; Batra, Kavita; Baune, Bernhard T.; Bedi, Neeraj; Begde, Ahmet; Begum, Tahmina; Behnam, Babak; Behnoush, Amir Hossein; Beiranvand, Maryam; Béjot, Yannick; Bekele, Alehegn; Belete, Melaku Ashagrie; Belgaumi, Uzma Iqbal; Bemanalizadeh, Maryam; Bender, Rose G.; Benfor, Bright; Bennett, Derrick A.; Bensenor, Isabela M.; Berice, Betyna; Bettencourt, Paulo J.G.; Beyene, Kebede A; Bhadra, Abhishek; Bhagat, Devidas S.; Bhangdia, Kayleigh; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhargava, Ashish; Bhaskar, Sonu; Bhat, Ajay Nagesh; Bhat, Vivek; Bhatti, Gurjit Kaur; Bhatti, Jasvinder Singh; Bhatti, Rajbir; Bijani, Ali; Bikbov, Boris; Bilalaga, Mariah Malak; Biswas, Atanu; Bitaraf, Saeid; Bitra, Veera R.; Bjørge, Tone; Bodolica, Virginia; Bodunrin, Aadam Olalekan; Boloor, Archith; Braithwaite, Dejana; Brayne, Carol; Brenner, Hermann; Briko, Andrey; Bringas Vega, Maria L.; Brown, Julie; Budke, Christine M; Buonsenso, Danilo; Burkart, Katrin; Burns, Richard A.; Bustanji, Yasser; Butt, Muhammad Hammad; Butt, Nadeem Shafique; Butt, Zahid A.; Cabral, Lucas Scotta; Caetano dos Santos, Florentino Luciano; Calina, Daniela; Campos-Nonato, Ismael R.; Cao, Chao; Carabin, Hélène; Cárdenas, Rosario; Carreras, Giulia; Carvalho, Andre F; Castañeda-Orjuela, Carlos A.; Casulli, Adriano; Catalá-López, Ferrán; Catapano, Alberico L .; Caye, Arthur; Cegolon, Luca; Cenderadewi, Muthia; Cerin, Ester; Chacón-Uscamaita, Pamela R.; Chan, Jeffrey Shi Kai; Chanie, Gashaw Sisay; Charan, Jaykaran; Chattu, Vijay Kumar; Chekol Abebe, Endeshaw; Chen, Hui; Chen, Jianqi; Chi, Gerald; Chichagi, Fatemeh; Chidambaram, Saravana Babu; Chimoriya, Ritesh; Ching, Patrick R.; Chitheer, Abdulaal; Chong, Yuen Yu; Chopra, Hitesh; Choudhari, Sonali Gajanan; Chowdhury, Enayet Karim; Chowdhury, Rajiv; Hanne , Christensen; Chu, Dinh-Toi; Chukwu, Isaac Sunday; Chung, Eric; Coberly, Kaleb; Columbus, Alyssa; Comachio, Josielli; Conde, Joao; Cortesi, Paolo Angelo; Costa, Vera Marisa; Couto, Rosa A.S.; Criqui, Michael H.; Cruz-Martins, Natália; Dabbagh Ohadi, Mohammad Amin; Dadana, Sriharsha; Dadras, Omid; Dai, Xiaochen; Dai, Zhaoli; D’Amico, Emanuele; Danawi, Hadi A.; Dandona, Lalit; Dandona, Rakhi; Darwish, Amira Hamed; Das, Saswati; Das, Subasish; Dascalu, Ana Maria; Dash, Nihar Ranjan; Dashti, Mohsen; De la Hoz, Fernando Pio; De la Torre-Luque, Alejandro; De Leo, Diego; Dean, Frances E.; Dehghan, Amin; Dehghan, Azizallah; Dejene, Hiwot; Demant, Daniel; Demetriades, Andreas K.; Demissie, Solomon; Deng, Xinlei; Desai, Hardik Dineshbhai; Devanbu, Vinoth Gnana Chellaiyan; Dhama, Kuldeep; Dharmaratne, Samath Dhamminda; Dhimal, Meghnath; Da Silva, Diana Dias; Diaz, Daniel; Dibas, Mahmoud; Ding, Delaney D.; Dinu, Monica; Dirac, M. Ashworth; Diress, Mengistie; Do, Thanh Chi; Do, Thao Huynh Phuong; Doan, Khanh Duy Khanh; Dodangeh, Milad; Doheim, Mohamed Fahmy; Dokova, Klara Georgieva; Dongarwar, Deepa; Dsouza, Haneil Larson; Dube, John; Duraisamy, Senbagam; Durojaiye, Oyewole Christopher; Dutta, Sulagna; Dziedzic, Arkadiusz Marian; Edinur, Hisham Atan; Eissazade, Negin; Ekholuenetale, Michael; Ekundayo, Temitope Cyrus; El Nahas, Nevine; El Sayed, Iman; Elahi Najafi, Mohammad Amin; Elbarazi, Iffat; Elemam, Noha Mousaad; Elgar, Frank J.; Elgendy, Islam Y.; Elhabashy, Hala Rashad; Elhadi, Muhammed; Elilo, Legesse Tesfaye; Ellenbogen, Richard G.; Elmeligy, Omar Abdelsadek Abdou; Elmonem; Elshaer, Mohammed; Elsohaby, Ibrahim; Emamverdi, Mehdi; Emeto, Theophilus I.; Endres, Matthias; Esezobor, Christopher Imokhuede; Eskandarieh, Sharareh; Fadaei, Abdolmajid; Fagbamigbe, Adeniyi Francis; Fahim, Ayesha; Faramarzi, Ali; Fares, Jawad; Farjoud Kouhanjani, Mohsen; Faro, Andre; Farzadfar, Farshad; Fatehizadeh, Ali; Fathi, Mobina; Fathi, Saeid; Fatima Fatima, Syeda Anum; Feizkhah, Alireza; Fereshtehnejad, Seyed-Mohammad; Ferrari, Alize J.; Ferreira, Nuno; Fetensa, Getahun; Firouraghi, Neda; Fischer, Florian; Fonseca, Ana Catarina; Force, Lisa M.; Fornari, Arianna; Foroutan, Behzad; Fukumoto, Takeshi; Gadanya, Muktar A.; Gaidhane, Abhay Motiramji; Galali, Yaseen; Galehdar, Nasrin; Gan, Quan; Gandhi, Aravind P.; Ganesan, Balasankar; Gardner, William M.; Garg, Naval; Gau, Shuo-Yan; Gautam, Rupesh K.; Gebre, Teshome; Gebrehiwot, Mesfin; Gebremeskel, Gebreamlak Gebremedhn; Gebreslassie, Haftay Gebremedhin; Getacher, Lemma; Ghaderi Yazdi, Bardiya; Ghadirian, Fataneh; Ghaffarpasand, Fariborz; Ghanbari, Reza; Ghasemi, MohammadReza; Ghazy, Ramy Mohamed; Ghimire, Sailaja; Gholami, Ali; Gholamrezanezhad, Ali; Ghotbi, Elena; Ghozy, Sherief; Gialluisi, Alessandro; Gill, Paramjit Singh; Glasstetter, Logan M.; Gnedovskaya, Elena V; Golchin, Ali; Golechha, Mahaveer; Goleij, Pouya; Golinelli, Davide; Gomes-Neto, Mansueto; Goulart, Alessandra C.; Goyal, Anmol; Gray, Richard J.; Grivna, Michal; Guadie, Habtamu Alganeh; Guan, Bin; Guarducci, Giovanni; Guicciardi, Stefano; Gunawardane, Damitha Asanga; Guo; Gupta, Bhawna; Gupta, Rajeev; Gupta, Sapna; Gupta, Veer Bala; Gupta, Vivek Kumar; Gutiérrez, Reyna Alma; Habibzadeh, Farrokh; Hachinski, Vladimir; Haddadi, Rasool; Hadei, Mostafa; Hadi, Najah R.; Haep, Nils; Haile, Teklehaimanot Gereziher; Haj-Mirzaian, Arvin; Hall, Brian J.; Halwani, Rabih; Hameed, Sajid; Hamiduzzaman, Mohammad; Hammoud, Ahmad; Han, Hannah; Hanifi, Nasrin; Hankey, Graeme J.; Hannan, Md Abdul; Hao, Junwei; Harapan, Harapan; Hareru, Habtamu Endashaw; Hargono, Arief; Harlianto, Netanja I.; Haro, Josep Maria; Hartman, Nicholas Nathaniel; Hasaballah, Ahmed I.; Hasan, Faizul; Hasani, Hamidreza; Hasanian, Mohammad; Hassan, Amr; Hassan, Shoaib; Hassanipour, Soheil; Hassankhani, Hadi; Hassen, Mohammed Bheser; Haubold, Johannes; Hay, Simon I.; Hayat, Khezar; Hegazy, Mohamed I.; Heidari, Golnaz; Heidari, Mohammad; Heidari-Soureshjani, Reza; Hesami, Hamed; Hezam, Kamal; Hiraike, Yuta; Hoffman, Howard J.; Holla, Ramesh; Hopf, Kathleen Pillsbury; Horita, Nobuyuki; Hossain, Md Mahbub; Hossain, Md Belal; Hossain, Sahadat; Hosseinzadeh, Hassan; Hosseinzadeh, Mehdi; Hostiuc, Sorin; Hu, Chengxi; Huang, Junjie; Huda, Md Nazmul; Hussain, Javid; Hussein, Nawfal R.; Huynh, Hong-Han; Hwang, Bing-Fang; Ibitoye, Segun Emmanuel; Ilaghi, Mehran; Ilesanmi, Olayinka Stephen; Ilic, Irena M.; Ilic, Milena D.; Immurana, Mustapha; Iravanpour, Farideh; Islam, Sheikh Mohammed Shariful; Ismail, Faisal; Iso, Hiroyasu; Isola, Gaetano; Iwagami, Masao; Iwu, Chidozie Declan; Iyer, Mahalaxmi; Jaan, Ali; Jacob, Louis; Jadidi-Niaragh, Farhad; Jafari, Mahboobeh; Jafarinia, Morteza; Jafarzadeh, Abdollah; Jahankhani, Kasra; Jahanmehr, Nader; Jahrami, Haitham; Jaiswal, Abhishek; Jakovljevic, Mihajlo; Jamora, Roland Dominic G.; Jana, Somnath; Javadi, Nilofer; Javed, Saad; Javeed, Saad; Jayapal, Sathish Kumar; Jayaram, Shubha; Jiang, Heng; Johnson, Catherine Owens; Johnson, Walter D.; Jokar, Mohammad; Jonas, Jost B.; Joseph, Abel; Joseph, Nitin; Joshua, Charity Ehimwenma; Jürisson, Mikk; Kabir, Ali; Kabir, Zubair; Kabito, Gebisa Guyasa; Kadashetti, Vidya; Kafi, Fatemeh; Kalani, Rizwan; Kalantar, Farnaz; Kaliyadan, Feroze; Kamath, Ashwin; Kamath, Sagarika; Kanchan, Tanuj; Kandel, Amit; Kandel, Himal; Kanmodi, Kehinde Kazeem; Karajizadeh, Mehrdad; Karami, Jafar; Karanth, Shama D.; Karaye, Ibraheem M.; Karch, André; Karimi, Aliasghar; Karimi, Hanie; Arman Karimi; Kasraei, Hengameh; Kassebaum, Nicholas J.; Kauppila, Joonas H.; Kaur, Harkiran; Kaur, Navjot; Kayode, Gbenga A.; Kazemi, Foad; Keikavoosi-Arani , Leila; Keller, Cathleen; Keykhaei, Mohammad; Khadembashiri, Mohammad Amin; Khader, Yousef Saleh; Khafaie, Morteza Abdullatif; Khajuria, Himanshu; Khalaji, Amirmohammad; Khamesipour, Faham; Khammarnia, Mohammad; Khan, Maseer; Khan, Moien AB; Khan; Khan Suheb, Mahammed Ziauddin; Khanmohammadi, Shaghayegh; Khanna, Tripti; Khatab, Khaled; Khatatbeh, Haitham; Khatatbeh, Moawiah Mohammad; Khateri, Sorour; Khatib, Mahalaqua Nazli; Kashani, Hamid Reza Khayat; Khonji, Mohammad Saeid; khorashadizadeh, Fatemeh; Khormali, Moein; Khubchandani, Jagdish; Kian, Saeid; Kim, Grace; Kim, Jihee; Kim, Min Seo; Kim, Yun Jin; Kimokoti, Ruth W.; Kisa, Adnan; Kisa, Sezer; Kivimäki, Mika; Kochhar, Sonali; Kolahi, Ali-Asghar; Koly, Kamrun Nahar; Kompani, Farzad; Koroshetz, Walter J.; Kosen, Soewarta; Kourosh Arami, Masoumeh; Koyanagi, Ai; Kravchenko, Michael A.; Krishan, Kewal; Krishnamoorthy, Vijay; Kuate Defo, Barthelemy; Kuddus, Md Abdul; Kumar, Ashish; Kumar, G. Anil; Kumar, Manasi; Kumar, Nithin; Kumsa, Netsanet Bogale; Kundu; Kurniasari, Maria Dyah; Kusuma, Dian; Kuttikkattu, Ambily; Kyu, Hmwe Hmwe; La Vecchia, Carlo; Ladan, Muhammad Awwal; Lahariya, Chandrakant; Tri , Laksono; Dharmesh Kumar , Lal; Lallukka, Tea; Lám, Judit; Lami, Faris Hasan; Landires, Iván; Langguth, Berthold; Lasrado, Savita; Latief, Kamaluddin; Latifinaibin, Kaveh; Lau, Kathryn Mei-Ming; Laurens, Matthew B.; Lawal, Basira Kankia; Le, Long Khanh Dao; Le, Thao Thi Thu; Ledda, Caterina; Lee, Munjae; Lee, Sang-woong; Lee, Seung Won; Lee, Wei-Chen; Lee, Yo Han; Leonardi, Matilde; Lerango, Temesgen L.; Li, Ming-Chieh; Li, Wei; Ligade, Virendra S.; Lim, Stephen S.; Linehan, Christine; Liu, Chaojie; Liu, Jue; Liu, Wei; Lo, Chun-Han; Lo, Warren David; Lobo, Stany W.; Logroscino, Giancarlo; Lopes, Graciliana; Lopukhov, Platon D.; Lorenzovici, László; Lorkowski, Stefan; Loureiro; Jailos, Lubinda; Giancarlo , Lucchetti; Lutzky Saute, Ricardo; Ma, Zheng Feei; Mabrok, Mahmoud; Machoy, Monika; Madadizadeh, Farzan; Magdy Abd El Razek, Mohammed; Maghazachi; Maghbouli, Nastaran; Mahjoub, Soleiman; Mahmoudi, Morteza; Majeed, Azeem; Malagón-Rojas, Jeadran N.; Malakan Rad, Elaheh; Malhotra, Kashish; Malik, Ahmad Azam; Malik, Iram; Mallhi, Tauqeer Hussain; Malta, Deborah Carvalho; Manilal, Aseer; Mansouri, Vahid; Mansournia, Mohammad Ali; Marasini, Bishnu P.; Marateb, Hamid Reza; Maroufi, Seyed Farzad; Martinez-Raga, Jose; Martini, Santi; Martins-Melo, Francisco Rogerlândio; Martorell, Miquel; März, Winfried; Marzo, Roy Rillera; Massano, João; Mathangasinghe, Yasith; Mathews, Elezebeth; Maude, Richard James; Maugeri, Andrea; Maulik, Pallab K.; Mayeli, Mahsa; Mazaheri, Maryam; McAlinden, Colm; McGrath, John J.; Meena, Jitendra Kumar; Mehndiratta, Man Mohan; Mendez-Lopez, Max Alberto Mendez; Mendoza, Walter; Mendoza-Cano, Oliver; Menezes, Ritesh G.; Merati, Mohsen; Meretoja, Atte; Merkin, Alexander; Mersha, Abera M.; Mestrovic, Tomislav; Mi, Tianyue; Miazgowski, Tomasz; Michalek, Irmina Maria; Mihretie, Ephrem Tesfaye; Minh, Le Huu Nhat; Mirfakhraie, Reza; Mirica, Andreea; Mirrakhimov, Erkin M; Mirzaei, Mehdi; Misganaw, Awoke; Misra, Sanjeev; Mithra, Prasanna; Mizana, Biru Abdissa; Mohamadkhani, Ashraf; Mohamed, Nouh Saad; Mohammadi, Esmaeil; Mohammadi, Hiwa; Mohammadi, Shadieh; Mohammadi, Soheil; Mohammadshahi, Marita; Mohammed, Mustapha; Mohammed, Salahuddin; Mohammed, Shafiu; Mohan, Syam; Mojiri-forushani, Hoda; Moka, Nagabhishek; Mokdad, Ali H; Molinaro, Sabrina; Möller, Holger; Monasta, Lorenzo; Moniruzzaman, Md; Montazeri, Fateme; Moradi, Maryam; Moradi, Yousef; Moradi-Lakeh, Maziar; Moraga, Paula; Morovatdar, Negar; Morrison, Shane Douglas; Mosapour, Abbas; Mosser, Jonathan F.; Mossialos, Elias; Motaghinejad, Majid; Mousavi, Parsa; Mousavi, Seyed Ehsan; Mubarik, Sumaira; Muccioli, Lorenzo; Mughal, Faraz; Mukoro, George Duke; Mulita, Admir; Mulita, Francesk; Musaigwa, Fungai; Mustafa, Ahmad; Mustafa, Ghulam; Muthu, Sathish; Nagarajan, Ahamarshan Jayaraman; Naghavi, Pirouz; Naik, Ganesh R.; Nainu, Firzan; Nair, Tapas Sadasivan; Najmuldeen, Hastyar Hama Rashid; Nakhostin Ansari, Noureddin; Nambi, Gopal; Namdar Areshtanab, Hossein; Nargus, Shumaila; Nascimento, Bruno Ramos; Naser, Abdallah Y.; Nashwan, Abdulqadir J.J.; Nasoori, Hadis; Nasreldein, Ahmed; Natto, Zuhair S.; Nauman, Javaid; Nayak, Biswa Prakash; Nazri-Panjaki, Athare; Negaresh, Mohammad; Negash, Hadush; Negoi, Ionut; Negoi, Ruxandra Irina; Negru, Serban Mircea; Nejadghaderi, Seyed Aria; Nematollahi, Mohammad Hadi; Nesbit, Olivia D.; Newton, Charles Richard James; Nguyen, Dang H.; Nguyen, Hau Thi Hien; Nguyen, Hien Quang; Nguyen, Ngoc-Trinh Thi; Nguyen, Phat Tuan; Nguyen, Van Thanh; Niazi, Robina Khan; Nikolouzakis; Niranjan, Vikram; Nnyanzi, Lawrence Achilles; Noman, Efaq Ali; Noroozi, Nafise; Norrving, Bo; Noubiap, Jean Jacques; Nri-Ezedi, Chisom Adaobi; Ntaios, George; Nuñez-Samudio, Virginia; Nurrika, Dieta; Oancea, Bogdan; Odetokun, Ismail A.; O’Donnell, Martin James; Ogunsakin, Ropo Ebenezer; Oguta, James Odhiambo; Oh, In-Hwan; Okati-Aliabad, Hassan; Okeke, Sylvester Reuben; Okekunle, Akinkunmi Paul; Okonji, Osaretin Christabel; Okwute, Patrick Godwin; Olagunju, Andrew T.; Olaiya, Muideen Tunbosun; Olana, Matifan Dereje; Olatubi, Matthew Idowu; Oliveira, Gláucia Maria Moraes; Olufadewa, Isaac Iyinoluwa; Olusanya, Bolajoko Olubukunola; Omar Bali, Ahmed; Ong, Sokking; Onwujekwe, Obinna E.; Ordak, Michal; Orji, Aislyn U.; Ortega-Altamirano, Doris V.; Osuagwu, Uchechukwu Levi; Otstavnov, Nikita; Otstavnov, Stanislav S.; Ouyahia, Amel; Owolabi, Mayowa O.; P A, Mahesh Padukudru; Pacheco-Barrios, Kevin; Padubidri, Jagadish Rao; Pal, Pramod Kumar; Palange, Padmavali Nanaji; Palladino, Claudia; Palladino, Raffaele; Palma-Alvarez, Raul Felipe; Pan, Feng; Panagiotakos, Demosthenes; Panda-Jonas, Songhomitra; Pandey, Anamika; Pandey, Ashok; Pandian, Jeyaraj Durai; Pangaribuan, Helena Ullyartha; Pantazopoulos, Ioannis; Pardhan, Shahina; Parija, Pragyan Paramita; Parikh, Romil R.; Park, Seoyeon; Parthasarathi, Ashwaghosha; Pashaei, Ava; Patel, Jay; Patil, Shankargouda; Patoulias, Dimitrios; Shrikant , Pawar; Pedersini, Paolo; Pensato, Umberto; Pereira, David M.; Pereira, Jeevan; Pereira, Maria Odete; Peres, Mario F.P.; Perico, Norberto; Perna, Simone; Petcu, Ionela-Roxana; Petermann-Rocha, Fanny Emily; Pham, Hoang Tran; Phillips, Michael R.; Pinilla-Monsalve, Gabriel D.; Piradov, Michael A.; Plotnikov, Evgenii; Poddighe, Dimitri; Polat, Burcu; Poluru, Ramesh; Pond, Constance Dimity; Poudel, Govinda Raj; Pouramini, Alireza; Pourbagher-Shahri, Ali Mohammad; Pourfridoni, Mohammad; Pourtaheri, Naeimeh; Prakash, Peralam Yegneswaran; Prakash, Sanjay; Prakash, V.; Prates, Elton Junio Sady; Pritchett, Natalie; Purnobasuki, Hery; Qasim, Nameer Hashim; Qattea, Ibrahim; Qian, Gangzhen; Radhakrishnan, Venkatraman; Raee, Pourya; Raeisi Shahraki, Hadi; Rafique, Ibrar; Raggi, Alberto; Raghav, Pankaja Raghav; Rahati, Meghdad M.; Rahim, Fakher; Rahimi, Zahra; Rahimifard, Mahban; Rahman, Md Obaidur; Rahman, Mohammad Hifz Ur; Rahman, Mosiur; Rahman, Muhammad Aziz; Rahmani, Amir Masoud; Rahmani, Shayan; Rahmani Youshanlouei, Hamed; Rahmati, Masoud; Raj Moolambally, Sheetal; Rajabpour-Sanati, Ali; Ramadan, Hazem; Ramasamy, Shakthi Kumaran; Ramasubramani, Premkumar; Ramazanu, Sheena; Rancic, Nemanja; Rao, Indu Ramachandra; Rao, Sowmya J.; Rapaka, Deepthi; Rashedi, Vahid; Rashid, Ahmed Mustafa; Rashidi; Rashidi Alavijeh, Mehran; Rasouli-Saravani, Ashkan; Rawaf, Salman; Razo, Christian; Redwan, Elrashdy Moustafa Mohamed; Rekabi Bana, Atefe; Remuzzi, Giuseppe; Rezaei, Nazila; Rezaei, Negar; Rezaei, Nima; Rezaeian, Mohsen; Rhee, Taeho Gregory; Riad, Abanoub; Robinson, Stephen R.; Rodrigues, Mónica; Rodriguez, Jefferson Antonio Buendia; Roever, Leonardo; Rogowski, Emma L.B.; Romoli, Michele; Ronfani, Luca; Roy, Priyanka; Roy Pramanik, Koushik; Rubagotti, Enrico; Ruiz, Milagros A.; Russ, Tom C.; Sunnerhagen, Katharina S.; Saad, Aly M.A.; Saadatian, Zahra; Saber, Korosh; SaberiKamarposhti, Morteza; Sacco, Simona; Saddik, Basema; Sadeghi, Erfan; Sadeghian, Saeid; Saeed, Umar; Saeed, Usman; Safdarian, Mahdi; Safi, Sher Zaman; Sagar, Rajesh; Sagoe, Dominic; Sharif-Askari, Fatemeh Saheb; Sharif-Askari, Narjes Saheb; Sahebkar, Amirhossein; Sahoo, Soumya Swaroop; Sahraian, Mohammad Ali; Sajedi, Seyed Aidin; Sakshaug, Joseph W.; Saleh, Mohamed A.; Salehi Omran, Hossein; Salem, Marwa Rashad; Salimi, Sohrab; Samadi Kafil, Hossein; Samadzadeh, Sara; Samargandy, Saad; Samodra, Yoseph Leonardo; Samuel, Vijaya Paul; Samy, Abdallah M.; Sanadgol, Nima; Sanjeev, Rama Krishna; Sanmarchi, Francesco; Santomauro, Damian Francesco; Santri, Ichtiarini Nurullita; Santric-Milicevic, Milena M; Saravanan, Aswini; Sarveazad, Arash; Satpathy, Maheswar; Saylan, Mete; Sayyah, Mehdi; Scarmeas, Nikolaos; Schlaich, Markus P.; Schuermans, Art; Schwarzinger, Michaël; Schwebel, David C.; Selvaraj, Siddharthan; Sendekie, Ashenafi Kibret; Sengupta, Pallav; Senthilkumaran, Subramanian; Serban, Dragos; Sergindo, Mihretu Tagesse; Sethi, Yashendra; SeyedAlinaghi, SeyedAhmad; Seylani, Allen; Shabani, Mohammad; Shabany, Maryam; Shafie, Mahan; Shahabi, Saeed; Shahbandi, Ataollah; Shahid, Samiah; Shahraki-Sanavi, Fariba; Shahsavari, Hamid R.; Shahwan, Moyad Jamal; Shaikh, Masood Ali; Shaji, K.S.; Sham, Sunder; Shama, Adisu Tafari T.; Shamim, Muhammad Aaqib; Shams-Beyranvand, Mehran; Shamsi, Mohammad Anas; Shanawaz, Mohd; Sharath, Medha; Sharfaei, Sadaf; Sharifan, Amin; Sharma, Manoj; Sharma, Rajesh; Shashamo, Bereket Beyene; Shayan, Maryam; Sheikhi, Rahim Ali; Shekhar, Shashank; Shen, Jiabin; Shenoy, Suchitra M.; Shetty, Pavanchand H.; Shiferaw, Desalegn Shiferaw; Shigematsu, Mika; Shiri, Rahman; Shittu, Aminu; Shivakumar, K.M.; Shokri, Fereshteh; Shool, Sina; Shorofi, Seyed Afshin; Shrestha, Sunil; Siankam Tankwanchi, Akhenaten Benjamin; Siddig, Emmanuel Edwar; Sigfusdottir, Inga Dora; Silva, João Pedro; Silva, Luís Manuel Lopes Rodrigues; Sinaei, Ehsan; Singh, Balbir Bagicha; Singh, Garima; Singh, Paramdeep; Singh, Surjit; Sirota, Sarah Brooke; Sivakumar, Shravan; Sohag, Abdullah Al Mamun; Solanki, Ranjan; Soleimani, Hamidreza; Solikhah, Solikhah; Solomon, Yerukneh; Solomon, Yonatan; Song,, Suhang; Song,, Yimeng; Sotoudeh, Houman; Spartalis, Michael; Stark, Benjamin A; Starnes, Joseph R.; Starodubova, Antonina V.; Stein, Dan J.; Steiner, Timothy J.; Stovner, Lars Jacob; Suleman, Muhammad; Suliankatchi Abdulkader, Rizwan; Sultana, Abida; Sun, Jing; Sunkersing, David; Sunny, Angel; Susianti, Hani; Swain, Chandan Kumar; Szeto, Mindy D.; Tabarés-Seisdedos, Rafael; Tabatabaei, Seyyed Mohammad; Tabatabai, Shima; Tabish, Mohammad; Taheri, Majid; Tahvildari, Azin; Tajbakhsh, Ardeshir; Tampa, Mircea; Tamuzi, Jacques J.L. Lukenze; Tan, Ker-Kan; Tang, Haosu; Tareke, Minale; Tarigan, Ingan Ukur; Tat, Nathan Y.; Tat, Vivian Y.; Razieh Tavakoli; Tavangar, Seyed Mohammad; Tavasol, Arian; Tefera, Yibekal Manaye; Tehrani-Banihashemi, Arash; Temesgen, Worku Animaw; Temsah, Mohamad-Hani; Teramoto, Masayuki; Tesfaye, Amensisa Hailu; Tesfaye, Edosa Geta; Tesler, Riki; Thakali, Ocean; Thangaraju, Pugazhenthan; Thapa, Rajshree; Thapar, Rekha; Thomas, Nikhil Kenny; Thrift, Amanda G.; Ticoalu, Jansje Henny Vera; Tillawi, Tala; Toghroli, Razie; Tonelli, Marcello; Tovani-Palone, Marcos Roberto; Traini, Eugenio; Tran, Nghia Minh; Tran, Ngoc-Ha; Tran, Phu Van; Tromans, Samuel Joseph; Truelsen, Thomas Clement; Truyen, Thien Tan Tri Tai; Umair, Muhammad; Umakanthan, Srikanth; Umapathi, Krishna Kishore; Unim, Brigid; Unnikrishnan, Bhaskaran; Vaithinathan, Asokan Govindaraj; Vakilian, Alireza; Valadan Tahbaz, Sahel; Valizadeh, Rohollah; Van den Eynde, Jef; Vart, Priya; Varthya, Shoban Babu; Vasankari, Tommi Juhani; Vaziri, Siavash; Vellingiri, Balachandar; Venketasubramanian, Narayanaswamy; Verras, Georgios-Ioannis; Vervoort, Dominique; Villafañe, Jorge Hugo; Villani, Leonardo; Vinueza Veloz, Andres Fernando; Viskadourou, Maria; Vladimirov, Sergey Konstantinovitch; Vlassov, Vasily; Volovat, Simona Ruxandra; Vu, Loc Tri; Vujcic, Isidora S.; Wagaye, Birhanu; Waheed, Yasir; Wahood, Waseem; Walde, Mandaras Tariku; Wang, Fang; Wang, Shu; Wang, Yanzhong; Wang, Yuan-Pang; Waqas, Muhammad; Waris, Abdul; Weerakoon, Kosala Gayan; Weintraub, Robert G.; Weldemariam, Abrha Hailay; Westerman, Ronny; Whisnant, Joanna L.; Wickramasinghe, Dakshitha Praneeth; Wickramasinghe, Nuwan Darshana; Willekens, Barbara; Wilner, Lauren B.; Winkler, Andrea Sylvia; Wolfe, Charles D.A.; Wu, Ai-Min; Wulf Hanson, Sarah; Xu, Suowen; Xu, Xiaoyue; Yadollahpour, Ali; Yaghoubi, Sajad; Yahya, Galal; Yamagishi, Kazumasa; Yang, Lin; Yano, Yuichiro; Yao , Yao; Yehualashet, Sisay Shewasinad; Yeshaneh, Alex; Yesiltepe, Metin; Yi, Siyan; Yiğit, Arzu; Yiğit, Vahit; Yon, Dong Keon; Yonemoto, Naohiro; You, Yuyi; Younis, Mustafa Z.; Yu, Chuanhua; Yusuf, Hadiza; Zadey, Siddhesh; Zahedi, Mohammad; Zakham, Fathiah; Zaki, Nazar; Zali, Alireza; Zamagni, Giulia; Zand, Ramin; Zandieh, Ghazal G.Z.; Zangiabadian, Moein; Zarghami, Amin; Zastrozhin, Mikhail Sergeevich; Zeariya, Mohammed G.M.; Zegeye, Zelalem Banjaw; Zeukeng, Zelalem Banjaw; Zhai, Chunxia; Zhang, Chen; Zhang, Haijun; Zhang, Yunquan; Zhang, Zhi-Jiang; Zhao, Hanqing; Zhao, , , , , , , , , Yang; Zheng, Peng; Zhou, Hengxing; Zhu, Bin; Zhumagaliuly, Abzal; Zielińska, Magdalena; Zikarg, Yossef Teshome; Zoladl, Mohammad; Murray, Christopher J.L.; Ong, Kanyin Liane; Feigin, Valery L.; Vos, Theo; Dua, Tarun; Amanda G.; Amanda G.; Oliaee, Razieh Tavakoli
BACKGROUND : Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS : We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS : Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer’s disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION : As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed.
Global, regional, and national burden of neck pain, 1990–2020, and projections to 2050 : a systematic analysis of the Global Burden of Disease Study 2021
(Elsevier, 2024-03) Wu, Ai-Min; Cross, Marita; Elliott, James M.; Culbreth, Garland T.; Cousin, Ewerton; Haile, Lydia M.; Steinmetz, Jaimie D.; Hagins, Hailey; Kopec, Jacek A; Brooks, Peter M.; Woolf, Anthony D.; Kopansky-Giles, Deborah R.; Walton, David M.; Treleaven, Julia M.; Dreinhoefer, Karsten E.; Betteridge, Neil; Abbasifard, Mitra; Abbasi-Kangevari, Zeinab; Addo, Isaac Yeboah; Adesina, Miracle Ayomikun; Adnani, Qorinah Estiningtyas Sakilah; Aithala, Janardhana P.; Alhalaiqa, Fadwa Alhalaiqa Naji; Alimohamadi, Yousef; Amiri, Sohrab; Amu, Hubert; Antony, Benny; Arabloo, Jalal; Aravkin, Aleksandr Y.; Asghari-Jafarabadi, Mohammad; Atomsa, Gamechu Hunde; Azadnajafabad, Sina; Azzam, Ahmed Y.; Baghdadi, Soroush; Balogun, Saliu A.; Balta, Asaminew Birhanu; Banach, Maciej; Banakar, Morteza; Barrow, Amadou; Bashiri, Azadeh; Bekele, Alehegn; Bensenor, Isabela M.; Bhardwaj, Pankaj; Bhat, Ajay Nagesh; Bilchut, Awraris Hailu; Briggs, Andrew M.; Buchbinder, Rachelle; Cao, Chao; Chaurasia, Akhilanand; Chirinos-Caceres, Jesus Lorenzo; Christensen, Steffan Wittrup McPhee; Coberly, Kaleb; Dadras, Omid; Dai, Xiaochen; De Luca, Katie; Dehghan, Azizallah; Dong, Huan-Ji; Ekholuenetale, Michael; Elhadi, Muhammed; Eshetu, Habitu Birhan; Eskandarieh, Sharareh; Etaee, Farshid; Fagbamigbe, Adeniyi Francis; Fares, Jawad; Fatehizadeh, Ali; Feizkhah, Alireza; Ferreira, Manuela L.; Ferreira, Nuno; Fischer, Florian; Franklin, Richard Charles; Ganesan, Balasankar; Gebremichael, Mathewos Alemu; Gerema, Urge; Gholami, Ali; Ghozy, Sherief; Gill, Tiffany K.; Golechha, Mahaveer; Goleij, Pouya; Golinelli, Davide; Graham, Simon Matthew; Haj-Mirzaian, Arvin; Harlianto, Netanja I.; Hartvigsen, Jan; Hasanian, Mohammad; Hassen, Mohammed Bheser; Hay, Simon I.; Hebert, Jeffrey J.; Heidari, Golnaz; Hoveidaei, Amir Human; Hsiao, Alexander Kevin; Ibitoye, Segun Emmanuel; Iwu, Chidozie Declan; Jacob, Louis; Janodia, Manthan Dilipkumar; Jin, Yingzhao; Jonas, Jost B.; Joshua, Charity Ehimwenma; Kandel, Himal; Khader, Yousef Saleh; Khajuria, Himanshu; Khan, Ejaz Ahmad; Khan, Moien A.B.; Khatatheh, Moawiah Mohammad; Khateri, Sorour; Khayat Kashani, Hamid Reza; Khonji, Mohammad Saeid; Khubchandani, Jagdish; Kim, Yun Jin; Kisa, Adnan; Kolahi, Ali-Asghar; Koohestani, Hamid Reza; Krishan, Kewal; Kuddus, Mohammed; Kuttikkattu, Ambily; Lasrado, Savita; Lee, Yo Han; Legesse, Samson Mideksa; Lim, Stephen S.; Liu, Xuefeng; Lo, Justin; Malih, Narges; Manandhar, Shisir Prasad; Mathews, Elezebeth; Mesregah, Mohamed Kamal; Mestrovic, Tomislav; Miller, Ted R.; Mirghaderi, Seyed Peyman; Misganaw, Awoke; Mohammadi, Esmaeil; Mohammed, Shafiu; Mokdad, Ali H.; Momtazmanesh, Sara; Moni, Mohammad Ali; Mostafavi, Ebrahim; Murray, Christopher J.L.; Nair, Tapas Sadasivan; Nejadghaderi, Seyed Aria; Nzoputam, Ogochukwu Janet; Oh, In-Hwan; Okonji, Osaretin Christabel; Owolabi, Mayowa O.; Pacheco-Barrios, Kevin; Pahlevan Fallahy, Mohammad Taha; Park, Seoyeon; Patel, Jay; Pawar, Shrikant; Pedersini, Paolo; Peres, Mario F.P.; Petcu, Ionela-Roxana; Pourahmadi, Mohammadreza; Qattea, Ibrahim; Ram, Pradhum; Rashidi, Mohammad-Mahdi; Rawaf, Salman; Rezaei, Nazila; Rezaei, Negar; Saeed, Umar; Sharif-Askari, Fatemeh Saheb; Salahi, Saina; Sawhney, Monika; Schumacher, Austin E.; Shafie, Mahan; Shahabi, Saeed; Shahbandi, Ataollah; Shamekh, Ali; Sharma, Saurab; Shiri, Rahman; Shobeiri, Parnian; Sinaei, Ehsan; Singh, Ambrish; Singh, Jasvinder A.; Singh, Paramdeep; Skryabina, Anna Aleksandrovna; Smith, Amanda E.; Tabish, Mohammad; Tan, Ker-Kan; Tegegne, Masresha Derese; Tharwat, Samar; Vahabi, Seyed Mohammad; Tahbaz, Sahel Valadan; Vasankari, Tommi Juhani; Venketasubramanian, Narayanaswamy; Vollset, Stein Emil; Wang, Yuan-Pang; Wiangkham, Taweewat; Yonemoto, Naohiro; Zangiabadian, Moein; Zare, Iman; Zemedikun, Dawit T.; Zheng, Peng; Ong, Kanyin Liane; Vos, Theo; March, Lyn M.
BACKGROUND : Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. We present the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) by age, sex, and location, with forecasted prevalence to 2050. METHODS : Systematic reviews identified population-representative surveys used to estimate the prevalence of and YLDs from neck pain in 204 countries and territories, spanning from 1990 to 2020, with additional data from opportunistic review. Medical claims data from Taiwan (province of China) were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta-regression tool. Prevalence was forecast to 2050 using a mixed-effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates. We present 95% UIs for every metric based on the 2·5th and 97·5th percentiles of 100 draws of the posterior distribution. FINDINGS : Globally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163-253) people. The global age-standardised prevalence rate of neck pain was estimated to be 2450 (1960-3040) per 100 000 population and global age-standardised YLD rate was estimated to be 244 (165-346) per 100 000. The age-standardised prevalence rate remained stable between 1990 and 2020 (percentage change 0·2% [-1·3 to 1·7]). Globally, females had a higher age-standardised prevalence rate (2890 [2330-3620] per 100 000) than males (2000 [1600-2480] per 100 000), with the prevalence peaking between 45 years and 74 years in male and female sexes. By 2050, the estimated global number of neck pain cases is projected to be 269 million (219-322), with an increase of 32·5% (23·9-42·3) from 2020 to 2050. Decomposition analysis of the projections showed population growth was the primary contributing factor, followed by population ageing. INTERPRETATION : Although age-standardised rates of neck pain have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (higher in females than males), a larger effect expected in low-income and middle-income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain.
A framework for implementing integrated HIV and non-communicable disease care at primary health care facilities in southern Africa
(Ubiquity Press, 2025-07) Moyo-Chilufya, Maureen; Mgutshini, Tennyson; Hongoro, Charles; Musekiwa, Alfred; u21572152@tuks.co.za
INTRODUCTION : Comorbidities of HIV/AIDS and non-communicable diseases (NCDs) are increasingly prevalent, affecting up to 30% of individuals living with HIV/AIDS, particularly in Sub-Saharan Africa. Conventional approaches that treat NCDs separately from HIV/AIDS care have been deemed inefficient, highlighting the need for integrated models. This study aims to develop a framework for integrating NCD care into HIV programs at primary healthcare facilities in Southern Africa. METHODS : As part of a broader study examining the burden, extent and cost of HIV/NCD integration we employed a modified ‘Best fit’ framework synthesis method. Thematic analysis was the primary method of analysis used to inform the framework. RESULTS : The study expanded on existing framework themes related to effective team-working, organizational leadership, patient-centered care, community/patient/provider partnerships. It introduced seven additional themes: country specific NCD prioritization, multi stakeholder partnerships, healthcare worker mental wellbeing, unified health information systems, with enhanced privacy, establishing costing databases for HIV/NCD integrated care, robust monitoring and evaluation mechanisms, and opportunities for regional coordination. CONCLUSION : Improving existing frameworks for integrating HIV/NCD care is feasible by leveraging established HIV care platforms. These enhancements can support more efficient holistic healthcare delivery across primary healthcare facilities in Southern Africa.
Prevalence and factors associated with HIV testing among women of reproductive age in Liberia : a cross-sectional study from the 2019/20 Demographic and Health Survey
(MDPI, 2025-08) Kolane, Mapei Mary Anna; Tshotetsi, Lumbani; lumbani.tshotetsi@up.ac.za
OBJECTIVE : This study explored HIV testing prevalence and its associated factors among reproductive-aged women in Liberia. STUDY DESIGN : A secondary and descriptive cross-sectional study was performed among Liberian women aged 15–49 years using the 2019 Liberia Demographic and Health Survey (LDHS) data set. METHODS : Descriptive statistics were used to describe the characteristics of these women. Bivariate and multivariable logistic regression models were applied to determine factors associated with HIV testing. All analyses were adjusted for unequal probabilities of selection and non-response by use of survey weights. RESULTS : Among the 8065 participants in this survey, 490 women had never had sex and were excluded, leading to the final sample size being 7575 women. The prevalence of HIV testing among Liberian women aged 15 to 49 years in 2020 was 57.17% (95% CI: 56.2 to 60.4). HIV testing among these women is associated with pregnancy history (aOR 6.40, 95% CI:4.99 to 8.22, p < 0.001), STI history (aOR 1.21, 95% CI:1.02 to 3.19, p < 0.001), knowledge of vertical transmission (aOR 1.65, 95% CI:1.23 to 2.21, p = 0.001), and highest educational level (primary (aOR 1.39, 95% CI:1.16 to 1.68, p < 0.001), secondary (aOR 2.10, 95% CI:1.73 to 2.53, p < 0.001), and higher education (aOR 6.80, 95% CI:3.75 to 12.32, p < 0.001)). CONCLUSIONS AND CONTRIBUTION : HIV testing prevalence of 57.17% demonstrates an unmet need for HIV testing among Liberian women aged 15 to 49 years and, thus, it is recommended that HIV testing and counseling services should mostly target these women in rural areas, with limited health services and less educated women.
Prevalence and factors associated with HIV testing among men aged 15–54 years in Kenya—evidence from the 2022 Demographic and Health Survey
(MDPI, 2025-08) Melato, Ipeleng Caroline Victoria; Musekiwa, Alfred; Nxele, Siphesihle Robin; u19306688@tuks.co.za
Sub-Saharan Africa bears the heaviest burden of HIV/AIDS. Kenya alone has an estimated 1.4 million people living with HIV. Therefore, this study determined HIV testing prevalence and associated factors among men aged 15–54 years in Kenya. The study is a secondary data analysis of the 2022 Kenya Demographic and Health Survey, a nationally representative population-based cross-sectional survey. A multivariable logistic regression model was used to determine factors associated with HIV testing. Survey weights were used to adjust analyses for unequal sampling probabilities. Out of 14,453 men included in the study, the prevalence of self-reported HIV testing was 73.5%, which was higher among men aged 30–34 years old compared to the 15–19 years (90.2% vs. 33.3%), married or living with a partner (89.1% vs. 55.5%), residing in urban areas (82.5% vs. 67.8%), with higher education (90.6% vs. 58.4%), employed (80.5% vs. 43.1%), richest (83.8% vs. 60.4%), and those with three or more sexual partners (81.7% vs. 68.0%) groups. Targeted interventions to encourage more men to participate in regular HIV testing are needed. This can be achieved by bringing HIV testing sites closer to males through HIV self-testing and community testing, particularly home-based testing.
Global, regional, and national stillbirths at 20 weeks’ gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021
(Elsevier, 2024-11) Comfort, Haley; McHugh, Theresa A.; Schumacher, Austin E.; Harris, Ashley; May, Erin A.; Paulson, Katherine R.; Gardner, William M.; Fuller, John E; Frisch, Meghan E; Taylor, Heather Jean; Leever, Andrew T.; Teply, Corey; Verghese, Nicholas Alexander; Alam, Tahiya; Abate, Yohannes Habtegiorgis; Abbastabar, Hedayat; Abd ElHafeez, Samar; Abdelmasseh, Michael; Abd-Elsalam, Sherief; Abdissa, Daba; Abdoun, Meriem; Abdulkader, Rizwan Suliankatchi; Abebe, Mesfin; Abedi, Aidin; Abidi, Hassan; Abiodun, Olumide; Aboagye, Richard Gyan; Abolhassani, Hassan; Abrigo, Michael R.M.; Abu-Gharbieh, Eman; Abu-Rmeileh, Niveen M.E.; Adane, Mesafint Molla; Addo, Isaac Yeboah; Adema, Bulcha Guye; Adesina, Miracle Ayomikun; Adetunji, Charles Oluwaseun; Adeyinka, Daniel Adedayo; Adnani, Qorinah Estiningtyas Sakilah; Afzal, Saira; Agampodi, Suneth Buddhika; Agodi, Antonella; Agyemang-Duah, Williams; Ahinkorah, Bright Opoku; Ahmad, Aqeel; Ahmad, Danish; Ahmadi, Ali; Ahmed, Ayman; Ahmed, Haroon; Ahmed, Luai A.; Ajami, Marjan; Akinosoglou, Karolina; Al Hasan, Syed Mahfuz; Al-Aly, Ziyad; Alam, Khurshid; Alanezi, Fahad Mashhour; Alanzi, Turki M.; Albashtawy, Mohammed; Alemi, Sharifullah; Algammal, Abdelazeem M; Ali Saeed Al-Gheethi, Adel; Ali, Abid; Ali, Liaqat; Ali, Mohammed Usman; Alif, Sheikh Mohammad; Aljunid, Syed Mohamed; Almazan, Joseph Uy; Al-Mekhlafi, Hesham M.; Almidani, Louay; Almustanyir, Sami; Altirkawi, Khalid A.; Aly, Hany; Aly, Safwat; Amani, Reza; Ameyaw, Edward Kwabena; Amhare, Abebe Feyissa; Amin, Tarek Tawfik; Amiri, Sohrab; Andrei, Catalina Liliana; Andrei, Tudorel; Anoushiravani, Amir; Ansar, Adnan; Anvari, Davood; Anwer, Razique; Appiah, Francis; Arab-Zozani, Morteza; Aravkin, Aleksandr Y.; Areda, Demelash; Aregawi, Brhane Berhe; Artamonov, Anton A.; Aryal, Umesh Raj; Asemi, Zatollah; Asemu, Mulu Tiruneh; Asgedom, Akeza Awealom; Ashraf, Tahira; Asresie, Melash Belachew; Atlaw, Daniel; Atout, Maha Moh’d Wahbi; Atreya, Alok; Atteraya, Madhu Sudhan; Aujayeb, Avinash; Ayala Quintanilla, Beatriz Paulina; Ayatollahi, Haleh; Ayyoubzadeh, Seyed Mohammad; Azadnajafabad, Sina; Azevedo, Rui M.S.; Azzam, Ahmed Y.; B B, Darshan; Babaei, Mahsa; Badar, Muhammad; Badiye, Ashish D.; Baghcheghi, Nayereh; Baghdadi, Soroush; Bagheri, Nasser; Bagherieh, Sara; Bahrami, Farshad; Asl; Bai, Ruhai; Bakshi, Ravleen Kaur; Bam, Kiran; Banach, Maciej; Banke-Thomas, Aduragbemi; Bansal, Hansi; Bantie Bantie, Berihun; Barchitta, Martina; Bardhan, Mainak; Bashiri, Azadeh; Basiru, Afisu; Baskaran, Pritish; Batra, Kavita; Bayani, Mojtaba; Bayleyegn, Nebiyou Simegnew; Bedi, Neeraj; Begum, Tahmina; Behnoush, Amir Hossein; Belgaumi, Uzma Iqbal; Bermudez, Amiel Nazer C.; Beyene, Kebede A.; Bhandari, Bharti; Bhandari, Dinesh; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhaskar, Sonu; Bhattarai, Suraj; Bodolica, Virginia; Braithwaite, Dejana; Brenner, Hermann; Bustanji, Yasser; Butt, Nadeem Shafique; Butt, Zahid A; Cadri, Abdul; Campos-Nonato, Ismael; Cattaruzza, Maria Sofia; Cembranel, Francieli; Cerin, Ester; Chacón-Uscamaita, Pamela Roxana; Charan, Jaykaran; Chattu, Vijay Kumar; Chauhan, Dhun; Chavula, Malizgani Paul; Chen, Simiao; Chi, Gerald; Chitheer, Abdulaal; Cho, William C.S.; Choudhari, Sonali Gajanan; Chu, Dinh-Toi; Cruz-Martins, Natalia; Dadras, Omid; Dagnew, Gizachew Worku; Dalaba, Maxwell Ayindenaba; Dandona, Lalit; Darwesh, Aso Mohammad; Das, Jai K; Das, Saswati; Dash, Nihar Ranjan; Dávila-Cervantes, Claudio Alberto; Davletov, Kairat; Debela, Berhanu Gidisa; Debele, Aklilu Tamire; Derese, Msganaw; Deribe, Kebede; Dervišević, Emina; Dessie, Anteneh Mengist; Dhali, Arkadeep; Dhulipala, Vishal R.; Dirac, M. Ashworth; Dong, Wanyue; Dora, Bezabih Terefe; Dsouza, Haneil Larson; Duraes, Andre Rodrigues; Dutta, Sulagna; Dziedzic, Arkadiusz Marian; Ed-Dra, Abdelaziz; Edvardsson, Kristina; Eini, Ebrahim; Ekholuenetale, Michael; El Sayed Zaki, Maysaa; Elgendy, Islam Y; Elhadi, Muhammed; Elshaer, Mohammed; Elsohaby, Ibrahim; Emeto, Theophilus I.; Bain, Luchuo Engelbert; Esayas, Hawi Leul; Eshrati, Babak; Esposito, Francesco; Fagbamigbe, Adeniyi Francis; Fakhradiyev, Ildar Ravisovich; Faramarzi, Ali; Faro, Andre; Fatehizadeh, Ali; Fekadu, Ginenus; Fischer, Florian; Fomenkov, Artem Alekseevich; Fukumoto, Takeshi; Gaal, Peter Andras; Gaidhane, Abhay Motiramji; Gajdács, Márió; Galali, Yaseen; Gallus, Silvano; Ganesan, Balasankar; Gazzelloni, Federica; Gebrehiwot, Mesfin; Gebremedhin, Amanuel Tesfay; Gebremeskel, Teferi Gebru; Geda, Yohannes Fikadu; Gezae, Kebede Embaye; Ghasemi, Mohammed-Reza; Ghazy, Ramy Mohamed; Gheno,, Gloria; Gialluisi, Alessandro; Gissler, Mika; Glasbey, James C.; Glasstetter, Logan M.; Golechha, Mahaveer; Goleij, Pouya; Golinelli, Davide; Grivna, Michal; Guha, Avirup; Guicciardi, Stefano; Guo, , , , Hanbing; Gupta, Sapna; Gupta, Veer Bala; Gupta, Vivek Kumar; Haller, Sebastian; Halwani, Rabih; Hamidi, Samer; Handal, Alexis J.; Haro, Josep Maria; Hartman, Nicholas Nathaniel; Hasan, Taufiq; Hasanpour- Dehkordi, Ali; Hasnain, Md Saquib; Hassanipour, Soheil; He, Wen-Qiang; Heidari, Mohammad; Herrera-Serna, Brenda Yuliana; Herteliu, Claudiu; Hessami, Kamran; Hezam, Kamal; Hiraike, Yuta; Holla, Ramesh; Hossain, Md Mahbub; Hosseinzadeh, Hassan; Hosseinzadeh, Mehdi; Hostiuc, Mihaela; Hostiuc, Sorin; Hu, Chengxi; Huang, Junjie; Huda, M. Mamun; Huda, Md Nazmul; Hong-Han , Huynh; Hwang, Bing-Fang; Iftikhar, Pulwasha Maria; Ilesanmi, Olayinka Stephen; IIlic, rena M; Ilic, Milena D; Immurana, Mustapha; Iranmehr, Arad; Iravanpour, Farideh; Iwagami, Masao; Iwu, Chidozie Declan; Iyasu, , , , , , , Assefa N.; Jaafari, Jalil; Jafarzadeh, Abdollah; Jahrami, Haitham; Janodia, Manthan Dilipkumar; Javadi, Nilofer; Javaheri, Tahereh; Jayapal, Sathish Kumar; Jema, Alelign Tasew; Jokar, Mohammad; Joseph, Nitin; Joshua, Charity Ehimwenma; Jürisson, Mikk; Kabir, Ali; Kabir, Zubair; Karaye, Ibraheem M.; Karimi, Hanie; Kasraei, Hengameh; Kauppila, Joonas H.; Kendal, Evie Shoshannah; Keykhaei, Mohammad; Khalid, Nauman; Khamesipour, Faham; Khan, M Nuruzzaman; Khan, Maseer; Khan, Yusra H.; Khaled , Khatab; Khatatbeh, Haitham; Khatatbeh, Moawiah Mohammad; Khateri, Sorour; Khayat Kashani, Hamid Reza; Khormali, Moein; Kim, Min Seo; Kim, Thanh V.; Kim, Yun Jin; Kimokoti, Ruth W; Kisa, Adnan; Kisa, Sezer; Kochhar, Sonali; Kolahi, Ali-Asghar; Kompani, Farzad; Koohestani, Hamid Reza; Kosen, Soewarta; Koyanagi, Ai; Krishan, Kewal; Krishnamoorthy, Vijay; Defo, Barthelemy Kuate; Kuchay, Raja Amir Hassan; Kuddus, Mohammed; Kumar, G. Anil; Kurmi, Om P.; La Vecchia, Carlo; Lacey, Ben; Lahariya, Chandrakant; Laksono, Tri; Lal, Dharmesh Kumar; Lasrado, Savita; Latief, Kamaluddin; Latifinaibin, Kaveh; Le, Thao Thi Thu; Lee, Munjae; Lee, Sang-woong; Lee, Wei-Chen; Lee, Yo Han; Lenzi, Jacopo; Li, Ming-Chieh; Li, Shanshan; Ligade, Virendra S.; Lim, Stephen S.; Liu, Gang; Liu, Jue; Liu, Xuefeng; Lorenzovici, László; Lotfizadeh, Masoud; Afifi, Ahmed M.; Madureira-Carvalho, Áurea M.; Magee, Laura A.; Majeed, Azeem; Malakan Rad, Elaheh; Malhotra, Kashish; Malik, Ahmad Azam; Malik, Iram; Mallhi, Tauqeer Hussain; Maravilla, Joemer C.; Martini, Santi; Martins-Melo, Francisco Rogerlândio Rogerlândio; Martorell, Miquel; Marzan, Melvin Barrientos; Mathangasinghe, Yasith; Mattiello, Rita; Maugeri, Andrea; Mayeli, Mahsa; Mazaheri, Maryam; Mediratta, Rishi P.; Kamran, Mehrabani-Zeinabad; Meles, Gebrekiros Gebremichael; Meles, Hadush Negash; Mendez-Lopez, Max Alberto; Mendoza, Walter; Menezes, Ritesh G.; Meretoja, Atte; Meretoja, Tuomo J.; Michalek, Irmina Maria; Minh, Le Huu Nhat; Mirfakhraie, Reza; Mirghafourvand, Mojgan; Mirica, Andreea; Mirrakhimov, Erkin M.; Mirza, Moonis; Bawa, Eric Mishio; Misra, Sanjeev; Mizana, Biru Abdissa; Mohamed, Nouh Saad; Mohammad-Alizadeh-Charandabi, Sakineh; Mohammed, Ghada; Mohammed, Salahuddin; Mohammed, Shafiu; Mokdad, Ali H.; Molinaro, Sabrina; Momtazmanesh, Sara; Monasta, Lorenzo; Moni, Mohammad Ali; Moodi Ghalibaf, AmirAli; Moraga, Paula; Morovatdar, Negar; Mosapour, Abbas; Mouodi, Simin; Mousavi, Parsa; Mueller, Ulrich Otto; Mughal, Faraz; Mulita, Admir; Mulita, Francesk; Muriithi, Moses K.; Nair, Tapas Sadasivan; Najmuldeen, Hastyar Hama Rashid; Nambi, Gopal; Nangia, Vinay; Nascimento, Gustavo G.; Nauman, Javaid; Nejadghaderi, Seyed Aria; Nematollahi, Mohammad Hadi; Nguefack-Tsague, Georges; Ngunjiri, Josephine W.; Nguyen, Dang H.; Nguyen, Hau Thi Hien; Nguyen, Hien Quang; Nguyen, Phat Tuan; Niazi, Robina Khan; Nikoobar, Ali; Nnyanzi, Lawrence Achilles; Noman, Efaq Ali; Nomura, Shuhei; Noreen, Mamoona; Nurrika, Dieta; Nzoputam, Chimezie Igwegbe; Nzoputam, Ogochukwu Janet; Oancea, Bogdan; Obamiro, Kehinde O.; Ogunsakin, Ropo Ebenezer; Okeke, Sylvester Reuben; Okekunle, Akinkunmi Paul; Okonji, Osaretin Christabel; Okwute, Patrick Godwin; Olagunju, Andrew T.; Olakunde, Babayemi Oluwaseun; Olatubi, Matthew Idowu; Olufadewa, Isaac Iyinoluwa; Olusanya, Bolajoko Olubukunola; Ordak, Michal; Ortega-Altamirano, Doris V.; Osman, Wael M.S.; Osuagwu, Uchechukwu Levi; Otoiu, Adrian; Otstavnov, Nikita; Ouyahia, Amel; Owolabi, Mayowa O.; Padron-Monedero, Alicia; Padubidri, Jagadish Rao; Pana, Adrian; Parija, Pragyan Paramita; Parikh, Romil R.; Pashaei, Ava; Patel, Sangram Kishor; Patil, Shankargouda; Pawar, Shrikant; Pedersini, Paolo; Pepito, Veincent Christian Filipino; Peprah, Prince; Pereira, Gavin; Pereira, Jeevan; Pereira, Marcos; Pereira, Maria Odete; Perianayagam, Arokiasamy; Perico, Norberto; Pesudovs, Konrad; Petcu, Ionela-Roxana; Petermann-Rocha, Fanny Emily; Pezeshki, Parmida Sadat; Pham, Tom; Phan, My Kieu; Philip, Anil K.; Pigeolet, Manon; Piracha, Zahra Zahid; Podder, Vivek; Poddighe, Dimitri; Pradhan, Pranil Man Singh; Raeisi Shahraki, Hadi; Raghav, Pankaja; Rahman, Mosiur; Rahmanian, Vahid; Raimondo, Ivano; Ramasamy, Shakthi Kumaran; Ranabhat, Chhabi Lal; Rancic, Nemanja; Rao, Chythra R.; Rao, Sowmya J.; Rasella, Davide; Rashid, Ahmed Mustafa; Rawassizadeh, Reza; Redwan, Elrashdy Moustafa Mohamed; Remuzzi, Giuseppe; Rengasamy, Kannan R.R.; Renzaho, Andre M.N.; Rezaei, Nazila; Rezaei, Negar; Rezaeian, Mohsen; Robinson-Oden, Hannah Elizabeth; Roever, Leonardo; Rohloff, Peter; Ronfani, Luca; Rwegerera, Godfrey M.; Saad, Aly M.A.; Saadatian, Zahra; Sabour, Siamak; Saddik, Basema Ahmad; Sadeghi, Malihe; Saeb, Mohammad Reza; Saeed, Umar; Saghazadeh, Amene; Sagoe, Dominic; Saheb Sharif-Askari, Fatemeh; Saheb Sharif-Askari, Narjes; Sahebkar, Amirhossein; Sahoo, Harihar; Sahoo, Soumya Swaroop; Saleh, Mohamed A.; Salehi, Sana; Salem, Marwa Rashad; Samy, Abdallah M.; Sanjeev, Rama Krishna; Sarikhani, Yaser; Sarode, Sachin C.; Satpathy, Maheswar; Sawhney, Monika; Saya, Ganesh Kumar; Saylan, Mete; Schlaich, Markus P.; Schneider, Ione Jayce Ceola; Schuermans, Art; Sengupta, Pallav; Senthilkumaran, Subramanian; Sepanlou, Sadaf G.; Serban, Dragos; SayedAlinaghi, SeyedAhmad; Seylani, Allen; Shafie, Mahan; Shah, Jaffer; Shah, Pritik A.; Shahid, Samiah; Shaikh, Masood Ali; Sham, Sunder; Shanawaz, Mohd; Shannawaz, Mohammed; Sharew, Mequannent Melaku; Sharma, Manoj; Shetty, Adithi; Shetty, B. Suresh Kumar; Shetty, Pavanchand H.; Shiri, Rahman; Shirkoohi, Reza; Shivalli, Siddharudha; Shool, Sina; Shorofi, Seyed Afshin; Shuja, Kanwar Hamza; Shuval, Kerem; Sibhat, Migbar Mekonnen; Sidamo, Negussie Boti; Silva, João Pedro; Simpson, Colin R.; Singh, Jasvinder A.; Singh, Paramdeep; Singh, Surjit; Skhvitaridze, Natia; Socea, Bogdan; Sohag, Abdullah Al Mamun; Soleimani, Hamidreza; Solomon, Yonatan; Song, Suhang; Song, Yi; Spartalis, Michael; Sreeramareddy, Chandrashekhar T.; Stergachis, Andy; Suleman, Muhammad; Sultana, Saima; Sun, Haitong Zhe; Sun, Jing; Szeto, Mindy D.; Tabarés-Seisdedos, Rafael; Tabatabai, Shima; Tabish, Mohammad; Taheri, Majid; Taheri Soodejani, Moslem; Tamuzi, Jacques Lukenze; Tan, Ker-Kan; Tarigan, Ingan Ukur; Oliaee, Razieh Tavakoli; Taye, Birhan Tsegaw; Tefera, Yibekal Manaye; Temsah, Mohamad-Hani; Teramoto, Masayuki; Tesfamariam, Wegen Beyene; Teye-Kwadjo, Enoch; Tharwat, Samar; Thavamani, Aravind; Thomas, Nihal; Titova, Mariya Vladimirovna; Tiyuri, Amir; Topor-Madry, Roman; Tovani-Palone, Marcos Roberto; Tripathy, Jaya Prasad; Tromans, Samuel Joseph; Ubah, Chukwudi S; Umair, Muhammad; Umakanthan, Srikanth; Unim, Brigid; Vaithinathan, Asokan Govindaraj; Valadan Tahbaz, Sahel; Valenti, Mario; Valizadeh, Rohollah; Van den Eynde, Jef; Varthya, Shoban Babu; Veroux, Massimiliano; Verras, Georgios-Ioannis; Villani, Leonardo; Violante, Francesco S.; Vlassov, Vasily; Walde, Mandaras Tariku; Wang, Fang; Wang, Shu; Wang, Yanqing; Wang, Yanzhong; Wassie, Emebet Gashaw; Weerakoon, Kosala Gayan; Wolde, Asrat Arja; Xu, Xiaoyue; Yadav, Vikas; Yang, Lin; Yano, Yuichiro; Yehualashet, Sisay Shewasinad; Yi, Siyan; Yiğit, Arzu; Yiğit, Vahit; Yip, Paul; Yonemoto, Naohiro; Zaki, Nazar; Zamagni, Giulia; Zaman, Burhan Abdullah; Zastrozhin, Michael; Zhang, Haijun; Zhang, Yunquan; Zhang, Zhi-Jiang; Zhao, Hanqing; Zhong, Claire Chenwen; Zielińska, Magdalena; Zuhriyah, Lilik; Hay, Simon I.; Naghavi, Mohsen; Murray, Christopher J.L.; Dandona, Rakhi; Kassebaum, Nicholas J.
BACKGROUND : Stillbirth is a devastating and often avoidable adverse pregnancy outcome. Monitoring stillbirth levels and trends—in a comprehensive manner that leaves no one uncounted—is imperative for continuing progress in pregnancy loss reduction. This analysis, completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, methodically accounted for different stillbirth definitions with the aim of comprehensively estimating all stillbirths at 20 weeks or longer for 204 countries and territories from 1990 to 2021. METHODS : We extracted data on stillbirths from 11 412 sources across 185 of 204 countries and territories, including 234 surveys, 231 published studies, 1633 vital statistics reports, and 10 585 unique location-year combinations from vital registration systems. Our final dataset comprised 11 different definitions, which were adjusted to match two gestational age thresholds: 20 weeks or longer (reference) and 28 weeks or longer (for comparisons). We modelled the ratio of stillbirth rate to neonatal mortality rate with spatiotemporal Gaussian process regression for each location and year, and then used final GBD 2021 assessments of fertility and all-cause neonatal mortality to calculate total stillbirths. Secondary analyses evaluated the number of stillbirths missed with the more restrictive gestational age definition, trends in stillbirths as a function of Socio-demographic Index, and progress in reducing stillbirths relative to neonatal deaths. FINDINGS : In 2021, the global stillbirth rate was 23·0 (95% uncertainty interval [UI] 19·7–27·2) per 1000 births (stillbirths plus livebirths) at 20 weeks' gestation or longer, compared to 16·1 (13·9–19·0) per 1000 births at 28 weeks' gestation or longer. The global neonatal mortality rate in 2021 was 17·1 (14·8–19·9) per 1000 livebirths, corresponding to 2·19 million (1·90–2·55) neonatal deaths. The estimated number of stillbirths occurring at 20 weeks' gestation or longer decreased from 5·08 million (95% UI 4·07–6·35) in 1990 to 3·04 million (2·61–3·62) in 2021, corresponding to a 39·8% (31·8–48·0) reduction, which lagged behind a global improvement in neonatal deaths of 45·6% (36·3–53·1) for the same period (down from 4·03 million [3·86–4·22] neonatal deaths in 1990). Stillbirths in south Asia and sub-Saharan Africa comprised 77·4% (2·35 million of 3·04 million) of the global total, an increase from 60·3% (3·07 million of 5·08 million) in 1990. In 2021, 0·926 million (0·792–1·10) stillbirths, corresponding to 30·5% of the global total (3·04 million), occurred between 20 weeks' gestation and 28 weeks' gestation, with substantial variation at the country level. INTERPRETATION : Despite the gradual global decline in stillbirths between 1990 and 2021, the overall number of stillbirths remains substantially high. Counting all stillbirths is paramount to progress, as nearly a third—close to 1 million in total—are left uncounted at the 28 weeks or longer threshold. Our findings draw attention to the differential progress in reducing stillbirths, with a high burden concentrated in countries with low development status. Scarce data availability and poor data quality constrain our capacity to precisely account for stillbirths in many locations. Addressing inequities in universal maternal health coverage, strengthening the quality of maternal health care, and improving the robustness of data systems are urgently needed to reduce the global burden of stillbirths.
Trends and levels of the global, regional, and national burden of appendicitis between 1990 and 2021 : findings from the Global Burden of Disease Study 2021
(Elsevier, 2024-09) Han, Hannah; Letourneau, Ian D.; Abate, Yohannes Habtegiorgis; Abdelmasseh, Michael; Abu-Gharbieh, Eman; Adane, Tigist Demssew; Ahinkorah, Bright Opoku; Ahmad, Aqeel; Ahmadi, Ali; Ahmed, Ayman; Alhalaiqa, Fadwa Naji; Al-Sabah, Salman Khalifah; Al-Worafi, Yaser Mohammed; Amu, Hubert; Andrei, Catalina Liliana; noushiravani, Amir A.; Arabloo, Jalal; Aravkin, Aleksandr Y.; Ashraf, Tahira; Azadnajafabad, Sina; Baghcheghi, Nayereh; Bagherieh, Sara; Bantie, Berihun Bantie; Bardhan, Mainak; Basile, Guido; Bayleyegn, Nebiyou Simegnew; Behnoush, Amir Hossein; Bekele, Alehegn; Bhojaraja, Vijayalakshmi S.; Bijani, Ali; Biondi, Antonio; Burkart, Katrin; Chu, Dinh-Toi; Chukwu, Isaac Sunday; Cruz-Martins, Natalia; Dai, Xiaochen; Demessa, Berecha Hundessa; Dhali, Arkadeep; Diaz, Daniel; Do, Thanh Chi; Dodangeh, Milad; Dongarwar, Deepa; Dsouza, Haneil Larson; Ekholuenetale, Michael; Ekundayo, Temitope Cyrus; El Sayed, Iman; Elhadi, Muhammed; Fagbamigbe, Adeniyi Francis; Fakhradiyev, Ildar Ravisovich; Ferrara, Pietro; Fetensa, Getahun; Fischer, Florian; Gebrehiwot, Mesfin; Getachew, Melaku; Golechha, Mahaveer; Gupta, Vivek Kumar; Habib, Joseph R.; Hadi, Najah R.; Haep, Nils; Haile, Teklehaimanot Gereziher; Hamilton, Erin B.; Hasan, Ikramul; Hasani, Hamidreza; Hassanzadeh, Sara; Haubold, Johannes; Hay, Simon I.; Hayat, Khezar; Ilesanmi, Olayinka Stephen; Inamdar, Sumant; Iwu, Chidozie Declan; Iyasu, Assefa N.; Jayarajah, Umesh; Jayaram, Shubha; Jokar, Mohammad; Jomehzadeh, Nabi; Joseph, Abel; Joseph, Nitin; Joshua, Charity Ehimwenma; Kabir, Ali; Kandel, Himal; Kauppila, Joonas H.; Kemp Bohan, Phillip M.; Khajuria, Himanshu; Khan, Maseer; Khatatbeh, Haitham; Kim, Min Seo; Kisa, Adnan; Kompani, Farzad; Koohestani, Hamid Reza; Kumar, Rakesh; Le, Thao Thi Thu; Lee, Munjae; Lee, Seung Won; Li, Ming-Chieh; Lim, Stephen S.; Lo, Chun-Han; Lunevicius, Raimundas; Malhotra, Kashish; Maugeri, Andrea; Mediratta, Rishi P.; Meretoja, Tuomo J.; Mestrovic, Tomislav; Mirza-Aghazadeh-Attari, Mohammad; Mohamed, Nouh Saad; Mokdad, Ali H.; Monasta, Lorenzo; Moni, Mohammad Ali; Moradi, Maryam; Mougin, Vincent; Mukoro, George Duke; Murillo-Zamora, Efren; Murray, Christopher J.L.; Naimzada, Mukhammad David; Najmuldeen, Hastyar Hama Rashid; Natto, Zuhair S.; Negoi, Ionut; Nguyen, Hien Quang; Nikolouzakis, Taxiarchis Konstantinos; Olufadewa, Isaac Iyinoluwa; Padubidri, Jagadish Rao; Pandey, Ashok; Parikh, Romil R.; Pham, Hoang Tran; Pollok, Richard C.G.; Rahimi, Mehran; Rahimi-Movaghar, Vafa; Rahman, Mosiur; Rahmani, Shayan; Rashidi; Rawaf, Salman; Rickard, Jennifer; Rouientan, Hamidreza; Roy, Simanta; Saddik, Basema Ahmad; Saeed, Umar; Saleh, Mohamed A.; Salehi, Sana; Samy, Abdallah M.; Sanabria, Juan; Sankararaman, Senthilkumar; Schumacher, Austin E.; Senthilkumaran, Subramanian; Shah, Pritik A.; Shool, Sina; Sibhat, Migbar Mekonnen; Sidamo, Negussie Boti; Singh, Jasvinder A; Socea, Bogdan; Solomon, Yonatan; Sreeram, Saraswathy; Tabatabaei, Seyyed Mohammad; Tan, Ker-Kan; Tavangar, Seyed Mohammad; Tefera, Yibekal Manaye; Thomas, Nikhil Kenny; Ticoalu, Jansje Henny Vera; Tsegay, Guesh Mebrahtom; Tsegaye, Dejen; Ullah, Sana; Usman, Abachebissa Nuru; Valizadeh, Rohollah; Veroux, Massimiliano; Verras, Georgios-Ioannis; Vos, Theo; Wang, Mei; Wang, Song; Wickramasinghe, Dakshitha Praneeth; Yahya, Galal; Zare, Iman; Zarrintan, Armin; Zhang, Zhi-Jiang; Dirac, M Ashworth
BACKGROUND : Appendicitis is a common surgical emergency that poses a large clinical and economic burden. Understanding the global burden of appendicitis is crucial for evaluating unmet needs and implementing and scaling up intervention services to reduce adverse health outcomes. This study aims to provide a comprehensive assessment of the global, regional, and national burden of appendicitis, by age and sex, from 1990 to 2021. METHODS : Vital registration and verbal autopsy data, the Cause of Death Ensemble model (CODEm), and demographic estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) were used to estimate cause-specific mortality rates (CSMRs) for appendicitis. Incidence data were extracted from insurance claims and inpatient discharge sources and analysed with disease modelling meta-regression, version 2.1 (DisMod-MR 2.1). Years of life lost (YLLs) were estimated by combining death counts with standard life expectancy at the age of death. Years lived with disability (YLDs) were estimated by multiplying incidence estimates by an average disease duration of 2 weeks and a disability weight for abdominal pain. YLLs and YLDs were summed to estimate disability-adjusted life-years (DALYs). FINDINGS : In 2021, the global age-standardised mortality rate of appendicitis was 0·358 (95% uncertainty interval [UI] 0·311-0·414) per 100 000. Mortality rates ranged from 1·01 (0·895-1·13) per 100 000 in central Latin America to 0·054 (0·0464-0·0617) per 100 000 in high-income Asia Pacific. The global age-standardised incidence rate of appendicitis in 2021 was 214 (174-274) per 100 000, corresponding to 17 million (13·8-21·6) new cases. The incidence rate was the highest in high-income Asia Pacific, at 364 (286-475) per 100 000 and the lowest in western sub-Saharan Africa, at 81·4 (63·9-109) per 100 000. The global age-standardised rates of mortality, incidence, YLLs, YLDs, and DALYs due to appendicitis decreased steadily between 1990 and 2021, with the largest reduction in mortality and YLL rates. The global annualised rate of decline in the DALY rate was greatest in children younger than the age of 10 years. Although mortality rates due to appendicitis decreased in all regions, there were large regional variations in the temporal trend in incidence. Although the global age-standardised incidence rate of appendicitis has steadily decreased between 1990 and 2021, almost half of GBD regions saw an increase of greater than 10% in their age-standardised incidence rates. INTERPRETATION : Slow but promising progress has been observed in reducing the overall burden of appendicitis in all regions. However, there are important geographical variations in appendicitis incidence and mortality, and the relationship between these measures suggests that many people still do not have access to quality health care. As the incidence of appendicitis is rising in many parts of the world, countries should prepare their health-care infrastructure for timely, high-quality diagnosis and treatment. Given the risk that improved diagnosis may counterintuitively drive apparent rising trends in incidence, these efforts should be coupled with improved data collection, which will also be crucial for understanding trends and developing targeted interventions.
Fediša Modikologo : breaking the intergenerational cycle of violence against women and children. Theoretical framework and protocol for a prospective cohort study
(F1000 Research, 2025-08) Jewkes, Rachel; Ramsoomar, Leane; Nothling, Jani; Willan, Samantha; Mbowane, Venice; Chirwa, Esnat; Mhlongo, Shibe; Phakoe, Maureen; Pass, Desiree; Zembe, Amanda; Sibiya, Louis; Seocharan, Ishen; Paile, Charntel; Washington, Laura; Woollett, Nataly; Dekel, Bianca; Jama-Shai, Nwabisa; Machisa, Mercilene; Mahlangu, Pinky; Seepamore, Boitumelo; Christofides, Nicola; Glass, Tracy; Govindasamy, Darshini; Carries, Stanley; Ketelo, Asiphe; Abrahams, Naeemah
In South Africa, after two decades of national femicide surveillance, we know comparatively little about what places women who experience intimate partner violence (IPV) at risk of intimate partner femicide. Further we have not mapped the multi-generational health, social and economic impact of severe IPV on women subjected to it, and their children, nor the consequences of help-seeking, nor described what helps, STET recovery trajectories. This study aims to deepen understanding of risk factors for femicide and the health, social and economic impacts of severe IPV on women and their families, including understanding risk and resilience to intergenerational cycling of violence. It further aims to describe how statutory and community measures operate to enable recovery and safety. Following pilot research, we developed a prospective questionnaire-based cohort study with three components, and plan for nested qualitative research. The primary cohort will enrol 12,000 women experiencing severe IPV, recruited using non-probabilistic methods (mostly referral from services and community members, and chain-recruitment). Following a baseline interview, participants will complete annual on-line surveys to track key outcomes for five years. The main questionnaire will measure exposure to range of different forms of IPV in the past year, lifetime trauma exposure history, childhood background, health, social and economic circumstances and help-seeking practices. A sub-cohort of the women (a 20% sub-sample), will be followed more intensively over 3 years. Among these, the children aged 6 years and over, of consenting mothers, will also be followed for three years. Deaths in the cohorts will be tracked through the National Population Register through participants’ national identity numbers. Mixed-methods verbal autopsies will be conducted with friends or family members of deceased participants. Results will guide femicide prevention nationally, and will build understanding of what is needed to prevent intergenerational cycling of violence and enable recovery of exposed women and children. PLAIN LANGUAGE SUMMARY ‘Fediša Modikologo: breaking the intergenerational cycle of violence against women and children. Theoretical framework and protocol for a prospective cohort study’ describes the plans for research that will be conducted by the South African Medical Research Council and partners in four diverse sites in South Africa with women who have experienced severe intimate partner violence and their children. This study aims to help us to understand what places women at risk of the most severe impacts of intimate partner violence, including loss of life, and to describe the myriad of ways in which their experiences, and attempts to protect themselves and their families, impact their health, social circumstances and finances. It also aims to help us understand how children are impacted by growing up in a home with violence and what may influence whether they go on to use violence themselves in their lives. We are recruiting 12,000 women who have recently experienced severe intimate partner violence into the study and we will interview them with a questionnaire, and provide counselling, over 5 years. We will as k a sub-group of these women to come for more intensive interviews, and if they agree, to invite their children, aged 6 years and over, as well. We will identify and investigate any deaths. The results will guide femicide prevention nationally, and will build understanding of what is needed to prevent the worst outcomes and enable recovery among exposed women and children.
Predictors of unsuppressed HIV viral load and low CD4 count among ZIMPHIA 2020 survey participants
(Texila International Journal, 2024-12-27) Mukwenha, Solomon; Dzinamarira, Tafadzwa; Mapingure, Munyaradzi; Chingombe, Innocent; Makota, Rutendo Birri; Mbunge, Elliot; Moyo, Enos; Chemhaka, Garikayi; Batani, John; Moyo, Brian; Musuka, Godfrey
Unsuppressed Viral load and low CD4 counts pose a significant challenge to HIV/AIDS management. Understanding the predictors of unsuppressed viral load and CD4 is critical for developing strategies to mitigate its impact. This study aimed to identify predictors of unsuppressed HIV viral load and low CD4 counts among Zimbabwe population-based HIV impact assessment survey (ZIMPHIA 2020) study participants. We analysed data from the ZIMPHIA 2020 survey. Data collection was done using structured interviews, home-based HIV testing and laboratory testing. Blood samples from participants were tested for HIV and those positive were analysed for CD4 counts and Viral load tests. We then calculated odds ratios for predictors of unsuppressed viral load (viral load ≥1000 copies/mL) and low CD4 counts (CD4< 350). The prevalence of unsuppressed viral load and low CD4 count were 20.7% and 34.7%, respectively. Males were more likely to be virally unsuppressed (25.1%) than females (18.8%) adjusted odds ratio (aOR) (95% confidence interval) 1.74 (1.43-2.11) p-value < 0.001. The odds of having a low CD4 count were higher among males (41%) than females (19%) aOR (95% confidence interval) 3.07 (2.57-3.66). Urban dwellers were more likely to have a low CD4 count (31.1%0 than rural dwellers (23.8%) aOR (95% confidence interval) 1.45 (1.21-1.73) p-value <0.001. The common predictors of both unsuppressed viral load and low CD4 were gender, never tested for HIV and never had a viral load test.
Household fuel use and severe asthma symptoms among preschool children in Gauteng province, South Africa : a cross-sectional study
(BMJ Publishing Group, 2024-12) Bhuda, Mandla; Wichmann, Janine; Shirinde, Joyce
BACKGROUND : Household air pollution continues to be a major public health hazard due to the continued use of household fuel sources. Globally, approximately 4 million people die prematurely each year due to exposure to household air pollution sources. Children are more susceptible to health effects associated with air pollution because their immune systems and lungs are not fully developed. OBJECTIVE : The objective of the study was to investigate the association between household fuel use and current severe asthma symptoms among preschool children in Gauteng province, South Africa. METHODS : This was a cross-sectional study conducted in the City of Tshwane Metropolitan Municipality in Gauteng province, South Africa. A total of 1844 parents and guardians of preschool children completed the modified International Study of Asthma and Allergies in Childhood questionnaire. However, a total of four questionnaires were discarded due to incorrect completion. Therefore, a total of 1840 questionnaires were included in the data analysis. Data were analysed using multiple logistic regression analysis. RESULTS : The prevalence of current severe asthma symptoms was 15.4%. The use of gas for cooking or heating significantly increased the likelihood of current severe asthma symptoms among preschool children (OR=3.20;95% CI 2.08 to 4.91; p<0.001). The use of open fire sources (paraffin, wood or coal) increased the likelihood of severe asthma symptoms among preschool children by 87% (95% CI 0.98 to 3.55; p=0.057). CONCLUSION : The study observed that using gas and open fire sources for cooking or heating was associated with current severe asthma symptoms among preschool children in Gauteng, South Africa. Household air quality regulations should be developed to mitigate child exposure to household air pollution in the study setting.
Schools of public health as a cornerstone for pandemic preparedness and response : the Africa COVID-19 experience
(BioMed Central, 2024-11-21) Ndejjo, Rawlance; Mitonga, Honore Kabwebwe; Amde, Woldekidan; Lubega, Grace Biyinzika; Muula, Adamson S.; Mariam, Damen Haile; Kabwama, Steven N.; Haufiku, Desderius; Amour, Maryam; Bosonkie, Marc; Mukama, Trasias; Bello, Segun; Dwomoh, Duah; Nja, Glory Mbe Egom; Bulafu, Douglas; Halake, Galgalo; Frumence, Gasto; Leye, Mamadou Makhtar Mbacke; Katangolo-Nakashwa, Ndasilohenda; Abaya, Samson Wakuma; Diallo, Issakha; Egbende, Landry; Worku, Netsanet; Bassoum, Oumar; Mbunga, Branly; Musoke, David; Mohamed, Hussein; Seck, Ibrahima; Fobil, Julius; Kiwanuka, Suzanne N.; Fawole, Olufunmilayo I.; Mapatano, Mala Ali; Alfven, Tobias; Gilson, Lucy; Muinde, Jacinta Victoria Syombua; Van Marwijk, Harm; Lehmann, Uta; Speybroeck, Niko; Kaseje, Margaret; Wanyenze, Rhoda K.; Patrick, Sean Mark
BACKGROUND : The Coronavirus disease (COVID-19) pandemic caused significant morbidity and mortality in Africa, in addition to other socio-economic consequences. Across the continent, Schools of Public Health (SPHs) played several roles in supporting national, regional, and global response to the pandemic. Following a published and grey literature search, this paper reviews and analyses the contribution of SPHs in Africa during the COVID-19 pandemic. CONTRIBUTION OF THE SCHOOLS OF PUBLIC HEALTH : SPH faculty in most countries contributed their expertise through COVID-19 task forces and advisory committees where they guided and supported decision-making. Faculty also supported the identification, review, and synthesis of rapidly evolving global and local evidence, adapting it to the local context to guide policy decisions. Through research, SPHs contributed to a better understanding of the disease epidemiology, response interventions, as well as prevention and control measures. SPHs engaged in training field epidemiologists, frontline health workers, and district response teams. SPH staff, students and field epidemiology trainees also supported field activities including surveillance, contact tracing, as well as managing quarantine facilities and points of entry. SPHs engaged in public education and awareness-raising initiatives to share information and dispel misinformation. In partnership with other stakeholders, SPHs also developed important innovations and technologies. CONCLUSION : SPHs are a critical pillar for pandemic prevention, preparedness, and response, that support health systems with important functions. To further enhance their capacity, efforts to improve coordination of SPHs, strengthen collaboration among schools, harmonize training and curricula, and enhance capacity for advanced research are needed. There is also a need to bridge the inequities in capacity and resources that exist among SPHs across regions and countries.
Paternal factors affecting under-five immunization status in Sub-Saharan Africa : a systematic review and meta-analysis
(Elsevier, 2025-10) Musuka, Godfrey; Moyo, Enos; Mano, Oscar; Madziva, Roda; Pierre, Gashema; Iradukunda, Patrick Gad; Sayem, Abu Sadat Mohammad; Dhliwayo, Tapiwa; Herrera, Helena; Mutata, Constantine; Dzinamarira, Tafadzwa
Please read abstract in the article.
Factors contributing to extended length of stay in the emergency department and potential strategies for improving patient flow in a central hospital in the Gauteng Province, South Africa
(Elsevier, 2025-12) Motimele, Lerato; Lalloo, Vidya; Sefala, T.; Engelbrecht, Andreas; Majake-Mogoba, L.; Basu, Debashis; lerato.motimele@up.ac.za
BACKGROUND : Length of stay (LOS) is an integral part of inpatient care in hospitals, particularly in Emergency Departments (EDs). It is an essential performance indicator for the National Indicator Data Set in South Africa. Multiple studies have indicated a correlation between an increased LOS and worse patient outcomes in a variety of acute medical conditions. The study aims to establish the key factors of LOS in the ED at a central hospital in the Gauteng Province of South Africa. METHODOLOGY : A cross-sectional study was conducted over seventeen months (Aug 2023 to Dec 2024) based on 2927 entries of patients admitted at the ED for more than 48 hours. No intervention was done as part of this study. RESULTS : The median LOS was 2.81 days (IQR: 2-3) with a minimum of 2 days and a maximum of 12 days. A regression analysis demonstrated that the most significant determinants for prolonged LOS were gender and disease group of boarded patients awaiting ward transfer.Significant differences (p < 0.001) in the LOS between clinical disciplines were noted, with medical (45%) and surgical departments (46%) accounting for most boarding patients compared to all other clinical disciplines. CONCLUSIONS : Data demonstrated that 80% of patients in the ED wait an average of 3 days before transfer into the wards. This extended ALOS in the ED has consequences for patient outcomes and the quality of healthcare provided. Based on the findings of this study, strategies to improve patient flow are essential in facilitating timeous discharge from wards and to prioritise the forward flow of patients waiting in ED.
SARS-CoV-2 seroprevalence and COVID-19 vaccination coverage in two states of Nigeria from a population based household survey
(Nature Research, 2025-08) Enyereibe, Nwachukwu William; Ilori, Elsie; Steinhardt, Laura; Stafford, Kristen; Dan-Nwafor, Chioma; Ochu, Chinwe Lucia; Ibrahim, Dalhatu; Alagi, Matthias; Ibrahim, Baffa Sule; Iwara, Iwara Emem; Mba, Nwand; Ibrahim, Zainab; Ahmed, Rabiatu Aliyu; Botson, Iliya; Ogbonna, Stanley Uche; Igumbor, Ehimario Uche; Abubakar, Jafiya; Ahmed, Nasir; Nwiyi, Gloria Ogochukwu; Ihemeje, Chima Emmanuel; Okoi, Catherine; John, Doris; Ashikeni, Matthew; Muhammad, Basheer Lawan; Iriemenam, Nnaemeka C.; Okunoye, Olumide; Greby, Stacie M.; Bassey, Orji; Okoye, Mcpaul; Blanco, Natalia; Mitchell, Andrew; Ipadeola, Oladipupo; Antonza, Gladys S.; Mpamugo, Augustine; Makava, Favour; Charurat, Manhattan; Adebajo, Sylvia; Swaminathan, Mahesh; Ifedayo, Adetifa; Ihekweazu, Chikwe
SARS-CoV-2 population-based seroprevalence surveys are useful for estimating the extent of SARS-CoV-2 infections, which may be underestimated by COVID-19 case counts. Surveys conducted in October 2020 in four Nigerian states showed that SARS-CoV-2 seroprevalence ranged from 9.3% in Gombe (northeast) to 25.2% in Enugu (southeast) after the first COVID-19 wave, more than 100 and 700 times higher than the official number of COVID-19 cases in these two states, respectively. We conducted a serosurvey after the second COVID-19 wave to evaluate the extent of SARS-CoV-2 infections, attitudes to COVID-19 vaccines, and COVID-19 vaccination coverage in two regions of Nigeria. Using the World Health Organization (WHO) Unity protocol, 34 enumeration areas (EAs) each in the Federal Capital Territory (FCT) (Northcentral Zone) and Kano State (Northwest Zone) were sampled in June 2021, using probability proportional to estimated size; 20 households in one EA were randomly selected. All consenting and assenting members of a household were asked about risk behaviors; adults who were 18 years and above (the eligible population for COVID-19 vaccination in Nigeria) responded to questions on COVID-19 vaccine attitudes and receipt. Blood and nasal/oropharyngeal samples were taken from all consenting and assenting household members. Blood samples collected were tested with the Luminex xMAP® SARS-CoV-2 Multi-Antigen IgG Assay and swabs by reverse-transcriptase-PCR (RT-PCR). Overall response rates were 76.8% in the FCT (n = 1,505 blood draws) and 80.4% in Kano State (n = 2,178 blood draws). Following the second COVID-19 wave in Nigeria, more than 40% of residents in the FCT (40.3%, 95% CI: 34.7–45.9) and Kano State (42.6%, 95% CI: 39.4–45.8) had evidence of prior SARS-CoV-2 infection. There were no active SARS-CoV-2 infections detected by RT-PCR in either the FCT or Kano State. In the FCT and Kano State, 3.4% and 1.6% of people surveyed reported receipt of any COVID-19 vaccine, three months after vaccines were available in country. In the FCT, 77.5% of adults were aware of COVID-19 vaccines, of whom 46.9% reported willingness to receive them. In Kano State, 48.7% of adults were aware of COVID-19 vaccines, of whom 61.1% were willing to receive them. In both regions, about 84% of those reporting unwillingness to accept COVID-19 vaccines cited concerns over vaccine safety. “Serosurvey findings revealed that SARS-CoV-2 infection was far more widespread in both the Federal Capital Territory and Kano State than indicated by reported case numbers. Despite high awareness, COVID-19 vaccine uptake remained low, primarily due to concerns about vaccine safety. These results highlight the urgent need for targeted risk communication to address vaccine hesitancy and improve coverage. Serosurveys provide valuable insights that can guide public health interventions and future pandemic preparedness in Nigeria.”
Low-level viremia among adults living with HIV on dolutegravir-based first-line antiretroviral therapy is a predictor of virological failure in Botswana
(MDPI, 2024-05-01) Bareng, Ontlametse T.; Moyo, Sikhulile; Mudanga , Mbatshi; Sebina , Kagiso; Koofhethile , Catherine K.; Choga, Wonderful T.; Moraka , Natasha O.; Maruapula , Dorcas; Gobe , Irene; Motswaledi, Modisa S.; Musonda, Rosemary; Nkomo , Bornapate; Ramaabya , Dinah; Chebani , Tony; Makuruetsa, Penny; Makhema , Joseph; Shapiro , Roger; Lockman, Shahin; Gaseitsiwe, Simani
We evaluated subsequent virologic outcomes in individuals experiencing low-level virem ia (LLV) on dolutegravir (DTG)-based first-line antiretroviral therapy (ART) in Botswana. We used a national dataset from 50,742 adults who initiated on DTG-based first-line ART from June 2016-December 2022. Individuals with at least two viral load (VL) measurements post three months on DTG-based first-line ART were evaluated for first and subsequent episodes of LLV (VL:51-999 copies/mL). LLV was sub-categorized as low-LLV (51-200 copies/mL), medium-LLV (201-400 copies/mL) and high-LLV (401-999 copies/mL). The study outcome was virologic failure (VF) (VL ≥ 1000 copies/mL): virologic non-suppression defined as single-VF and confirmed-VF defined as two-consecutive VF measurements after an initial VL < 1000 copies/mL. Cox regression analysis identified predictive factors of subsequent VF. The prevalence of LLV was only statistically different at timepoints >6-12 (2.8%) and >12-24 (3.9%) (p-value < 0.01). LLV was strongly associated with both virologic non-suppression (adjusted hazards ratio [aHR] = 2.6; 95% CI: 2.2-3.3, p-value ≤ 0.001) and confirmed VF (aHR = 2.5; 95% CI: 2.4-2.7, p-value ≤ 0.001) compared to initially virally suppressed PLWH. High-LLV (HR = 3.3; 95% CI: 2.9-3.6) and persistent-LLV (HR = 6.6; 95% CI: 4.9-8.9) were associated with an increased hazard for virologic non-suppression than low-LLV and a single-LLV episode, respectively. In a national cohort of PLWH on DTG-based first-line ART, LLV > 400 copies/mL and persistent-LLV had a stronger association with VF. Frequent VL testing and adherence support are warranted for individuals with VL > 50 copies/mL.
High prevalence of hepatitis B virus drug resistance mutations to lamivudine among people with HIV/HBV coinfection in rural and peri-urban communities in Botswana
(MDPI, 2024-04-11) Phinius , Bonolo B.; Anderson , Motswedi; Gobe , Irene; Mokomane , Margaret; Choga, Wonderful T.; Phakedi , Basetsana; Ratsoma , Tsholofelo; Mpebe , Gorata; Makhema , Joseph; Shapiro, Roger; Lockman , Shahin; Musonda, Rosemary; Moyo, Sikhulile; Gaseitsiwe, Simani
BACKGROUND : We aimed to determine the prevalence of hepatitis B virus (HBV) resistance-associated mutations (RAMs) in people with HBV and human immunodeficiency virus (HBV/HIV) in Botswana. METHODS : We sequenced HBV deoxyribonucleic acid (DNA) from participants with HBV/HIV from the Botswana Combination Prevention Project study (2013-2018) using the Oxford Nanopore GridION platform. Consensus sequences were analyzed for genotypic and mutational profiles. RESULTS : Overall, 98 HBV sequences had evaluable reverse transcriptase region coverage. The median participant age was 43 years (IQR: 37, 49) and 66/98 (67.4%) were female. Most participants, i.e., 86/98 (87.8%) had suppressed HIV viral load (VL). HBV RAMs were identified in 61/98 (62.2%) participants. Most RAMs were in positions 204 (60.3%), 180 (50.5%), and 173 (33.3%), mostly associated with lamivudine resistance. The triple mutations rtM204V/L180M/V173L were the most predominant (17/61 [27.9%]). Most participants (96.7%) with RAMs were on antiretroviral therapy for a median duration of 7.5 years (IQR: 4.8, 10.5). Approximately 27.9% (17/61) of participants with RAMs had undetectable HBV VL, 50.8% (31/61) had VL < 2000 IU/mL, and 13/61 (21.3%) had VL ≥ 2000 IU/mL. CONCLUSIONS : The high prevalence of lamivudine RAMs discourages the use of ART regimens with 3TC as the only HBV-active drug in people with HIV/HBV.

Browse

Recent Submissions