Now showing items 1-20 of 24

A functional SNP in MIR124-1, a brain expressed miRNA gene, is associated with aggressiveness in a Colombian sample

González Giraldo, Y.; Camargo, A.; López León, S.; Adan, A.; Forero, D.A. (2015-06)

Background: Interpersonal violence and suicide are among the main causes of mortality and morbidity around the world. In several developing countries, such as Colombia, they are among the first five entities of public ...
Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

Griswold, M.G; Fullman, N.; Hawley, C.; Arian, N.; Zimsen, S.R.M; Tymeson, H.D; Venkateswaran, V.; Tapp, A.D (2018)

Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. ...
Ayudando al paciente diabético con actividad física

Gutiérrez Gómez, Catalina; González López, Luis Eduardo; Masso Calderón, Ana María (Bogotá : Universidad de Ciencias Aplicadas y Ambientales, 2016, 2016-07)

El aumento de la incidencia y la prevalencia de enfermedades metabólicas es una gran preocupación para las sociedades modernas debido a la mortalidad que causan. La promoción de la práctica de ejercicio físico regular como ...
Caracterización de la mortalidad materna por determinantes biopsicosociales en Boyacá durante los años 2007 - 2008.

Naranjo Zambrano, Yuri Johanna; Sanabria Gómez, Mabel (Facultad de Ciencias de la SaludMedicina, 2009)

Matemal mortality is a public health problem, with these deaths the result of biopsychosocial factors that pregnant women are exposed, in addition to the various problems conceming the accessibility and quality of health ...
Cuidado del paciente crónico complejo desde la perspectiva teórica de la comodidad

Veloza Gómez, Mónica del Mar; Agray Corredor, Mónica Rocio (Bogotá : Universidad de Ciencias Aplicadas y Ambientales, 2020, 2020-01)

De acuerdo con la Organización Mundial de la Salud (OMS), las enfermedades crónicas son la principal causa de muerte en el mundo, representando 38 millones (68%) de los 56 millones de defunciones registradas en 2012. ...
Efecto del cruzamiento entre dos líneas de tilapia roja ( oreochromisspp.) Sobre la mortalidad y la producción de larvas a los 30 dias de edad

Gallego Alarcón, Femando (Bogotá : Universidad de Ciencias Aplicadas y Ambientales, 2006, 2006-07)

La especie piscícola más importante en Colombia es la Tilapia Roja (Oreochromis spp.), híbrido conformado por el cruce entre cuatro especies del género. Su desempeño productivo puede estar comprometido por efectos de la ...
Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Roth, G.A.; Abate, D.; Abate, K.H.; Abay, S.M.; Abbafati, C.; Abbasi, N.; Abbastabar, H.; Abd Allah, F.; Abdela, J.; Abdelalim, A.; Abdollahpour, I.; Abdulkader, R.S.; Abebe, H.T. (2018)

GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease ...
Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

Wang,Haidong; Wolock ,Timothy M.; Nguyen, Grant; Gakidou, Emmanuela; Mills, Edward J.; Coates, Matthew M.; Mooney, Meghan D. (2016)

Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of ...
Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

Wang, Haidong; Wolock, Timothy M.; Carter, Austin A.; Nguyen, Grant; Gakidou, Emmanuela; Mills, Edward J.; Msemburi, William T. (2016)

Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of ...
Global mortality from firearms, 1990-2016

Nand, D.; Naghavi, M.; Marczak, L.B.; Kutz, M.; Shackelford, K.A.; Arora, M.; Miller Petrie, M.; Aichour, M.T.E. (2018)

IMPORTANCE Understanding global variation in firearm mortality rates could guide prevention policies and interventions. OBJECTIVE To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and ...
Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Roth, G.A.; Abate, D.; Abate, K.H.; Abay, S.M; Abbafati, C.; Abbasi, N.; Abbastabar, H. (2018)

GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease ...
Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017

Kyu, H.H.; Abate, D.; Abate, K.H.; Abay, S.M.; Abbafati, C.; Abbasi, N.; Abbastabar, H. (2018)

Background: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, ...
Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Kassebaum, Nicholas J.; Barber, Ryan M.; Dandona, Lalit; Hay, Simon I.; Larson, Heidi Jane; Lim, Stephen S.; Lopez, Alan D.; Mokdad, Ali H. (2016)

Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country ...
Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Wang, Haidong; Naghavi, Mohsen; Allen, Christine A.; Barber, Ryan M.; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J. (2016)

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a ...
Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: A systematic analysis for the Global Burden of Disease Study 2016

Wang, Haidong; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana y otros cincuenta (2017)

Systematic analysis for the Global Burden of Disease Study 2016GBD 2016 Mortality collaborators*SummaryBackground Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input ...
Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

Barber, Ryan M.; Fullman, Nancy; Sorensen, Reed J.D; Bollyky, Thomas J.; Nolte, Ellen y otros 100 (2017)

Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). ...
Incidencia y descripción geográfica de accidentes ofídicos en Colombia reportados al Sistema nacional de Vigilancia en Salud pública SIVIGILA 2014-2016

Díaz Córdoba, Jonnathan Andrés; Jaramillo Orjuela, Vanessa (Bogotá : Universidad de Ciencias Aplicadas y Ambientales, 2019Facultad de CienciasQuímica Farmacéutica, 2019)

At present, with the variety of fauna existing in Colombia, a tropical country with particular geographical, climatic and ecological characteristics, the ophidian accidents have increased the cases of morbidity and mortality ...
Irrigación de la Glándula Tiroides en una Muestra de Población Colombiana

Quijano Blanco, Yobany; Luque Bernal, Ricardo Miguel (2015-09)

La glándula tiroides es un sitio frecuente de patologías, que requiere abordaje quirúrgico. Dichas técnicas, aunque bien establecidas, generan ocasionalmente complicaciones que, por lo general, se presentan por inexperiencia ...
Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Local Burden of Disease HIV Collaborators (2021)

Background: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover ...
Mecanismos de patogénesis bacteriana en procesos respiratorios: bordetelosis

Gallego López, Carolina (Bogotá : Universidad de Ciencias Aplicadas y Ambientales, 2006, 2006-07)

Bordetella bronchiseptica is part of a complex of acute respiratory diseases which causes high morbidity and mortality in different animal species, including the rabbit. In this species B. bronchiseptica along with Pasten ...

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A functional SNP in MIR124-1, a brain expressed miRNA gene, is associated with aggressiveness in a Colombian sample
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González Giraldo, Y. | 2015-06

Background: Interpersonal violence and suicide are among the main causes of mortality and morbidity around the world. In several developing countries, such as Colombia, they are among the first five entities of public health concern. Aggressiveness is an important endophenotype for aggression and suicidal behavior, having a heritability of around 50%. Exploration of classical candidate genes, involved in serotoninergic and dopaminergic neurotransmission, has identified few consistent risk factors for aggressiveness. miRNAs are a novel class of molecules with a growing role in normal neural function and neuropsychiatric disorders; of special interest, miR-124 is a brain-specific miRNA that is key for neuronal plasticity. We evaluated the hypothesis that a functional polymorphism in MIR124-1 gene might be associated with aggressiveness in a Colombian sample. Methods: The Spanish adaptation of the refined version of the Aggression Questionnaire and the abbreviated Barratt Impulsiveness Scale were applied to 170 young subjects. The functional SNP in MIR124-1 (rs531564) was genotyped by a TaqMan assay. Results: We found a significant association between the MIR124-1 and aggressiveness in our sample, with G/G carriers having lower scores (P = 0.01). This association seemed to be specific for aggressiveness, as it was not significant for impulsiveness. Conclusions: We showed for the first time the association of a functional polymorphism in MIR124-1 and aggressiveness. Known targets of miR-124 (such as BDNF and DRD4 genes) could explain the effect of this miRNA on behavior. A future analysis of additional novel functional polymorphisms in other brain expressed miRNAs could be useful for a deeper understanding of aggression in humans.

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Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016
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Griswold, M.G | 2018

Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted lifeyears (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5-3·0) of age-standardised female deaths and 6·8% (5·8-8·0) of agestandardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2-4·3) of female deaths and 12·2% (10·8-13·6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2·3% (95% UI 2·0-2·6) and male attributable DALYs were 8·9% (7·8-9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0-1·7] of total deaths), road injuries (1·2% [0·7-1·9]), and self-harm (1·1% [0·6-1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2-33·3) of total alcohol-attributable female deaths and 18·9% (15·3-22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0-0·8) standard drinks per week. Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. Funding Bill & Melinda Gates Foundation.

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Ayudando al paciente diabético con actividad física
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Gutiérrez Gómez, Catalina | 2016-07

El aumento de la incidencia y la prevalencia de enfermedades metabólicas es una gran preocupación para las sociedades modernas debido a la mortalidad que causan. La promoción de la práctica de ejercicio físico regular como método de prevención primario aún no es comúnmente aceptada en todos los agentes de salud. Las iniciativas que existen para la introducción de hábitos de ejercicio físico en la población en general tienden enfocarse en beneficios de práctica que son convincentes, así la búsqueda de estrategias de intervención para desarrollarse, es fundamental para que la comunidad de las ciencias de la salud y los académicos aporten en una nueva forma, al transmitir la importancia del ejercicio físico para reforzar los hábitos saludables para estar activo y evitar problemas asociados al sedentarismo.

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Caracterización de la mortalidad materna por determinantes biopsicosociales en Boyacá durante los años 2007 - 2008.
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Naranjo Zambrano, Yuri Johanna | 2009

Matemal mortality is a public health problem, with these deaths the result of biopsychosocial factors that pregnant women are exposed, in addition to the various problems conceming the accessibility and quality of health services for this reason these deaths are considered as indicators of quality care health services and environmental conditions since most are preventable. We analyzed several clinical and biopsychosocial determinants of maternal deaths in the Boyacá department during the years 2007 and 2008. The method used for the analysis was the collection of information through the medical history the date of notification of the INS, Death Certificates and Visit the Country format with which to analyze each case. The results showed that the main cause of matemal death from medical conditions cas are hypertensive disorders, followed by bleeding disorders, and third or indirect causes that a¡e not associated with pregnancy. As the biopsychosocial factors found that most were deficient in antenatal checks such, low education, were unmarried, non-use planning methods and the majority belonged to the subsidized regime.

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Cuidado del paciente crónico complejo desde la perspectiva teórica de la comodidad
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Veloza Gómez, Mónica del Mar | 2020-01

De acuerdo con la Organización Mundial de la Salud (OMS), las enfermedades crónicas son la principal causa de muerte en el mundo, representando 38 millones (68%) de los 56 millones de defunciones registradas en 2012. Más del 40% de ellas (16 millones) fueron muertes prematuras, ocurridas antes de los 70 años (OMS, 2014). De otra parte, están relacionadas con la discapacidad y los años de vida productiva perdidos (AVPP) (Peñaloza Quintero et al. 2014). La enfermedad crónica es definida como la alteración del funcionamiento normal de la persona, durante un periodo de tiempo, mínimo de seis meses, en el que se vivencia un proceso percibido como amenazante o discapacitante, de naturaleza multicausal, que no puede ser rectificado en forma rápida o fácil y que tiende a la progresión (Röing & Sanner, 2015; Vargas Escobar, 2017). Las complicaciones, el dolor y otros síntomas físicos, la dependencia, la soledad, el duelo por lo perdido, las dificultades económicas, los fracasos de los tratamientos y el miedo al futuro, son solo algunos de los eventos que causan en el paciente crónico, una gran carga emocional (Montoya Juárez et al. 2006). Adicionalmente, su plan terapéutico se vuelve cada vez más complejo, aumentando la demanda de cuidados (Martínez Velilla et al. 2018). Ahora bien, respecto a la condición crónica compleja, hace referencia al conjunto de varias patologías crónicas o una suficientemente grave, con frecuenca, de curso progresivo, asociado a fragilidad funcional, clínica, cognitiva o social, que requiere de un abordaje multidisciplinar y de estrategias de atención integral (Gual et al. 2017). Para los equipos interprofesionales de atención en salud, el cuidado de estas personas, se constituye en un reto, pues la condición de cronicidad compleja requiere de un cuidado integral, del cual, hacen parte las dimensiones física, psicosocial, ambiental y espiritual del ser humano. El objetivo de este trabajo fue presentar una experiencia relacionada con el cuidado del paciente crónico complejo, identificada a través de la metodología del marco lógico (Muñoz de Rodríguez, 2016), en cuanto a la consideración de la comodidad desde la perspectiva teórica de Kolcaba, y en cuanto al cuidado relacionado con la integridad física, desde el punto de vista de la política institucional y de enfermería de atención humanizada.

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Efecto del cruzamiento entre dos líneas de tilapia roja ( oreochromisspp.) Sobre la mortalidad y la producción de larvas a los 30 dias de edad
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Gallego Alarcón, Femando | 2006-07

La especie piscícola más importante en Colombia es la Tilapia Roja (Oreochromis spp.), híbrido conformado por el cruce entre cuatro especies del género. Su desempeño productivo puede estar comprometido por efectos de la consanguinidad y por el uso de líneas o combinaciones deficientes. El presente trabajo evaluaron los efectos del cruzamiento y la heterosis en dos caracteres, al cruzar la línea Roja Jamaica (J) con una línea nacional (L). En la Estación Piscícola de Repelón en la Costa Atlántica colombiana en estanques en tierra, se establecieron cuatro genotipos correspondientes a dos líneas y dos cruces recíprocos. Para evaluar la mortalidad a los 30 días, se utilizaron 2400 larvas de cada grupo genético, distribuidas en cuatro replicaciones y cultivadas en jaulas flotantes. Se encontraron diferencias significativas entre los cruces y sus líneas parentales. La heterosis expresada fue de -27,3%. Entre cruces recíprocos no se presentaron diferencias estadísticamente significativas. La producción de larvas fue analizada con hembras de 200 días de edad durante dos ciclos consecutivos. El grupo genético fue causa de variación en el número de larvas producidas. La heterosis en este carácter fue de 32,8%. La superioridad del mejor cruce fue del 40%. La producción de larvas y su mortalidad son considerados caracteres reproductivos o de adaptación y, como tal, expresaron superioridad en los cruzamientos. Se recomienda utilizar hembras F, y larva J x L en lugar de reproductores de las líneas parentales para incrementar el número de alevinos que llegan a los períodos de levante y ceba.

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Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017
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Roth, G.A. | 2018

GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1736–88—The bottom row in figure 7 was cut off. This correction has been made to the online version as of Nov 9, 2018, and has been made to the printed Article.

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Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015
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Wang,Haidong | 2016

Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. Methods For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. Findings Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1–3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5–2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6–40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7–1·9 million) in 2005, to 1·2 million deaths (1·1–1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. Interpretation Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. Funding Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health.

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Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015
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Wang, Haidong | 2016

Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. Methods For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. Findings Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1–3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5–2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6–40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7–1·9 million) in 2005, to 1·2 million deaths (1·1–1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. Interpretation Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. Funding Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health.

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Global mortality from firearms, 1990-2016
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Nand, D. | 2018

IMPORTANCE Understanding global variation in firearm mortality rates could guide prevention policies and interventions. OBJECTIVE To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. DESIGN, SETTING, AND PARTICIPANTS This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths. EXPOSURES Firearm ownership and access. MAIN OUTCOMES AND MEASURES Cause-specific deaths by age, sex, location, and year. RESULTS Worldwide, it was estimated that 251 000 (95%uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5%(95%UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95%UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95%UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95%UI, 107 000-182 000]); additionally, 27%were firearm suicide deaths (67 500 [95%UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95%UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2%[95%UI, -0.8%to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6%(95%UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95%UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95%UI, 24 900-39 700] and for women, an estimated 3580 deaths [95%UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P <.001; R2 = 0.21) and homicide (P <.001; R2 = 0.35). CONCLUSIONS AND RELEVANCE This study estimated between 195 000 and 276 000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups.

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Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017
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Roth, G.A. | 2018

GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1736–88—The bottom row in figure 7 was cut off. This correction has been made to the online version as of Nov 9, 2018, and has been made to the printed Article.

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Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
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Kyu, H.H. | 2018

Background: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted lifeyears (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severityof ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-speci?c mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the ?ve leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health.

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Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015
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Kassebaum, Nicholas J. | 2016

Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1–4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980–2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age–sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, 5·8 million (95% uncertainty interval [UI] 5·7–6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7–53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3–43·6) to 2·6 million (2·6–2·7) neonatal deaths and 47·0% (35·1–57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6–3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Interpretation Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030. Funding Bill & Melinda Gates Foundation.

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Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015
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Wang, Haidong | 2016

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1% (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1–44·6), malaria (43·1%, 34·7–51·8), neonatal preterm birth complications (29·8%, 24·8–34·9), and maternal disorders (29·1%, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation.

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Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: A systematic analysis for the Global Burden of Disease Study 2016
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Wang, Haidong | 2017

Systematic analysis for the Global Burden of Disease Study 2016GBD 2016 Mortality collaborators*SummaryBackground Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016.Methods We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recentyears where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15–60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Findings Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5–24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates—a measure of relative inequality—increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7–87·2), and for men in Singapore, at 81·3 years (78·8–83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016.Interpretation Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled

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Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015
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Barber, Ryan M. | 2017

Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0-42·8) in 1990 to 53·7 (52·2-55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Copyright © The Author(s). Published by Elsevier Ltd.

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Incidencia y descripción geográfica de accidentes ofídicos en Colombia reportados al Sistema nacional de Vigilancia en Salud pública SIVIGILA 2014-2016
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Díaz Córdoba, Jonnathan Andrés | 2019

At present, with the variety of fauna existing in Colombia, a tropical country with particular geographical, climatic and ecological characteristics, the ophidian accidents have increased the cases of morbidity and mortality in the population that is caused by the bite of snakes that have and inoculate their poison with more than 100 toxins. Approximately 90-95% of the ophidic accident cases in our country are produced by snakes of the Bothrops genus and most of them occur in Antioquia and Chocó. Between 5-9% of accidents in Colombia are fatal and from 6 to 10% have sequelae data that are also corroborated since, by evaluating the data obtained, this species was also the most generating accidents and the one that most caused deaths. A study was made of the data found in the open data page of Colombia, finding cases of snake bites for the years 2014 to 2016, allowing to calculate the gross incidence with the data obtained, the mortality and lethality rate and draw conclusions from the same ones where it was evidenced that the departments that have large cities have a low gross incidence due to variables such as the population and the little presence of snakes, but in their departments, due to their high population, there are a lot of cases of ophidic accidents; the municipalities with the highest incidence were Carmen del Darién, Cubará, Dovio and Guadalupe because they have a low population and in the Amazon and Orinoquia regions the highest number of deaths are recorded in 2014 to 2016. Creating uncertainties such as why After that it is necessary and by law 1300, 1301 and 1303 it is like priority to transfer a victim with the greatest speed to the assistance center so that the serum or anti venom is administered to him since they still appear in the 3 years 99 dead and in departments like Vaupés, the highest mortality rate due to lack of concrete actions to attack this public health problem or lack of supply of antivenin serum. From there comes the importance that the population is informed as a great strategy to reduce, prevent and treat the ophidic accident and also for health professionals so that care is in the shortest time possible improving the chances of presenting serious health problems or death by the bite of the serpent.

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Irrigación de la Glándula Tiroides en una Muestra de Población Colombiana
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Quijano Blanco, Yobany | 2015-09

La glándula tiroides es un sitio frecuente de patologías, que requiere abordaje quirúrgico. Dichas técnicas, aunque bien establecidas, generan ocasionalmente complicaciones que, por lo general, se presentan por inexperiencia del cirujano o por variaciones anatómicas no previstas. El conocimiento y el estudio de estas variaciones son importantes, con el fin de limitar las complicaciones asociadas a procedimientos quirúrgicos de la glándula tiroides, disminuir la morbimortalidad asociada y mejorar la interpretación de las técnicas de imágenes diagnósticas. Se practicó un estudio descriptivo, con 67 bloques cervicocardiopulmonares y digestivos, en cadáveres de 64 hombres y 3 mujeres. Se realizó disección de la región cervical, a nivel de la glándula tiroides, identificando el origen, el trayecto y las relaciones de las arterias que irrigan a la glándula tiroides y, de igual manera, se buscó la presencia o no de la arteria tiroidea media (IMA). El total de 67 bloques estudiados evidenció que todos presentaban ambas arterias tiroideas bilateralmente. En todos los bloques analizados, la arteria tiroidea superior, se originó de la arteria carótida externa y siguió el recorrido clásico; la arteria tiroidea inferior, se inició en los 67 bloques del tronco tirocervical y, en 64 pacientes, el nervio laríngeo recurrente, se ubicó posterior a la arteria; solamente en 3 casos, se halló anteriormente. Se confirmó presencia de arteria tiroidea IMA en 4 pacientes, que corresponde al 6% de los bloques. Los hallazgos de este estudio mantienen una gran correlación con la descripción clásica de la irrigación de la glándula tiroides en poblaciones occidentales. Con un origen y trayecto de ambas arterias tiroideas, que guardan una adecuada correlación con lo descrito previamente. La presencia de arteria tiroidea IMA fue inferior a lo reportado en la mayoría de las series de estudios.

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Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems
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| 2021

Background: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods: We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results: All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions: Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths

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Mecanismos de patogénesis bacteriana en procesos respiratorios: bordetelosis
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Gallego López, Carolina | 2006-07

Bordetella bronchiseptica is part of a complex of acute respiratory diseases which causes high morbidity and mortality in different animal species, including the rabbit. In this species B. bronchiseptica along with Pasten relia multocida and their lipopolisaccharydes (LPS) can induce respi- ratory diseases such as rhinitis, pneumonía and septicemia, generating great economic losses, therefore it is important to know the mechanism of bacterial pathogenesis to identify strategies of control and treatment of the diseases in the future. The respiratory tract appears to be the site of habitual colonization of B. bronchiseptica, frorn where the bacteria reach the lung and extend massively to other nasal regions. B. bronchiseptica synthesizes several products necessary for disease induction, among them filamentous hemagglu-tinin, dermonecrotic toxin, flagella, pertactin, traqueal citotoxin, adenylate cyclase toxin and secretory system type III. With ex- ception of the tracheal cytotoxin, the expression of the genes that codify virulence factors are regulated positively by the proteins Bvg (Borde- tella virulence gene). The LPS of B. bronchiseptica is perhaps the main virulence factor; in volved in the induction of aa ajmple variety of immune responses in the host, such as the complement activation, the induction of synthesis of different interleukins, FNT-a and INF-y and in mucous cells it is able to induce the mucin synthesis.

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Browsing by Subject "Mortalidad"

A functional SNP in MIR124-1, a brain expressed miRNA gene, is associated with aggressiveness in a Colombian sample ﻿

Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016 ﻿

Ayudando al paciente diabético con actividad física ﻿

Caracterización de la mortalidad materna por determinantes biopsicosociales en Boyacá durante los años 2007 - 2008. ﻿

Cuidado del paciente crónico complejo desde la perspectiva teórica de la comodidad ﻿

Efecto del cruzamiento entre dos líneas de tilapia roja ( oreochromisspp.) Sobre la mortalidad y la producción de larvas a los 30 dias de edad ﻿

Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017 ﻿

Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015 ﻿

Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015 ﻿

Global mortality from firearms, 1990-2016 ﻿

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017 ﻿

Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017 ﻿

Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 ﻿

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015 ﻿

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: A systematic analysis for the Global Burden of Disease Study 2016 ﻿

Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015 ﻿

Incidencia y descripción geográfica de accidentes ofídicos en Colombia reportados al Sistema nacional de Vigilancia en Salud pública SIVIGILA 2014-2016 ﻿

Irrigación de la Glándula Tiroides en una Muestra de Población Colombiana ﻿

Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems ﻿

Mecanismos de patogénesis bacteriana en procesos respiratorios: bordetelosis ﻿

Envíos recientes

A functional SNP in MIR124-1, a brain expressed miRNA gene, is associated with aggressiveness in a Colombian sample

Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

Ayudando al paciente diabético con actividad física

Caracterización de la mortalidad materna por determinantes biopsicosociales en Boyacá durante los años 2007 - 2008.

Cuidado del paciente crónico complejo desde la perspectiva teórica de la comodidad

Efecto del cruzamiento entre dos líneas de tilapia roja ( oreochromisspp.) Sobre la mortalidad y la producción de larvas a los 30 dias de edad

Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

Global mortality from firearms, 1990-2016

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017

Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: A systematic analysis for the Global Burden of Disease Study 2016

Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

Incidencia y descripción geográfica de accidentes ofídicos en Colombia reportados al Sistema nacional de Vigilancia en Salud pública SIVIGILA 2014-2016

Irrigación de la Glándula Tiroides en una Muestra de Población Colombiana

Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Mecanismos de patogénesis bacteriana en procesos respiratorios: bordetelosis

A functional SNP in MIR124-1, a brain expressed miRNA gene, is associated with aggressiveness in a Colombian sample

Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

Ayudando al paciente diabético con actividad física

Caracterización de la mortalidad materna por determinantes biopsicosociales en Boyacá durante los años 2007 - 2008.

Cuidado del paciente crónico complejo desde la perspectiva teórica de la comodidad

Efecto del cruzamiento entre dos líneas de tilapia roja ( oreochromisspp.) Sobre la mortalidad y la producción de larvas a los 30 dias de edad

Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

Global mortality from firearms, 1990-2016

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017

Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: A systematic analysis for the Global Burden of Disease Study 2016

Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

Incidencia y descripción geográfica de accidentes ofídicos en Colombia reportados al Sistema nacional de Vigilancia en Salud pública SIVIGILA 2014-2016

Irrigación de la Glándula Tiroides en una Muestra de Población Colombiana

Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Mecanismos de patogénesis bacteriana en procesos respiratorios: bordetelosis