Dataset Information

Health in times of uncertainty in the eastern Mediterranean region, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

ABSTRACT:

Background

The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013.

Methods

GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically.

Findings

The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60-80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred.

Interpretation

Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts.

Funding

Bill & Melinda Gates Foundation.

SUBMITTER: Mokdad AH

PROVIDER: S-EPMC6660972 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Health in times of uncertainty in the eastern Mediterranean region, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Mokdad Ali H AH Forouzanfar Mohammad Hossein MH Daoud Farah F El Bcheraoui Charbel C Moradi-Lakeh Maziar M Khalil Ibrahim I Afshin Ashkan A Tuffaha Marwa M Charara Raghid R Barber Ryan M RM Wagner Joseph J Cercy Kelly K Kravitz Hannah H Coates Matthew M MM Robinson Margaret M Estep Kara K Steiner Caitlyn C Jaber Sara S Mokdad Ali A AA O'Rourke Kevin F KF Chew Adrienne A Kim Pauline P El Razek Mohamed Magdy Abd MM Abdalla Safa S Abd-Allah Foad F Abraham Jerry P JP Abu-Raddad Laith J LJ Abu-Rmeileh Niveen M E NM Al-Nehmi Abdulwahab A AA Akanda Ali S AS Al Ahmadi Hanan H Al Khabouri Mazin J MJ Al Lami Faris H FH Al Rayess Zulfa A ZA Alasfoor Deena D AlBuhairan Fadia S FS Aldhahri Saleh F SF Alghnam Suliman S Alhabib Samia S Al-Hamad Nawal N Ali Raghib R Ali Syed Danish SD Alkhateeb Mohammad M AlMazroa Mohammad A MA Alomari Mahmoud A MA Al-Raddadi Rajaa R Al-Raddadi Rajaa R Alsharif Ubai U Al-Sheyab Nihaya N Alsowaidi Shirina S Al-Thani Mohamed M Altirkawi Khalid A KA Amare Azmeraw T AT Amini Heresh H Ammar Walid W Anwari Palwasha P Asayesh Hamid H Asghar Rana R Assabri Ali M AM Assadi Reza R Bacha Umar U Badawi Alaa A Bakfalouni Talal T Basulaiman Mohammed O MO Bazargan-Hejazi Shahrzad S Bedi Neeraj N Bhakta Amit R AR Bhutta Zulfiqar A ZA Bin Abdulhak Aref A AA Boufous Soufiane S Bourne Rupert R A RR Danawi Hadi H Das Jai J Deribew Amare A Ding Eric L EL Durrani Adnan M AM Elshrek Yousef Y Ibrahim Mohamed E ME Eshrati Babak B Esteghamati Alireza A Faghmous Imad A D IA Farzadfar Farshad F Feigl Andrea B AB Fereshtehnejad Seyed-Mohammad SM Filip Irina I Fischer Florian F Gankpé Fortuné G FG Ginawi Ibrahim I Gishu Melkamu Dedefo MD Gupta Rahul R Habash Rami M RM Hafezi-Nejad Nima N Hamadeh Randah R RR Hamdouni Hayet H Hamidi Samer S Harb Hilda L HL Hassanvand Mohammad Sadegh MS Hedayati Mohammad T MT Heydarpour Pouria P Hsairi Mohamed M Husseini Abdullatif A Jahanmehr Nader N Jha Vivekanand V Jonas Jost B JB Karam Nadim E NE Kasaeian Amir A Kassa Nega Assefa NA Kaul Anil A Khader Yousef Y Khalifa Shams Eldin A SE Khan Ejaz A EA Khan Gulfaraz G Khoja Tawfik T Khosravi Ardeshir A Kinfu Yohannes Y Defo Barthelemy Kuate BK Balaji Arjun Lakshmana AL Lunevicius Raimundas R Obermeyer Carla Makhlouf CM Malekzadeh Reza R Mansourian Morteza M Marcenes Wagner W Farid Habibolah Masoudi HM Mehari Alem A Mehio-Sibai Abla A Memish Ziad A ZA Mensah George A GA Mohammad Karzan A KA Nahas Ziad Z Nasher Jamal T JT Nawaz Haseeb H Nejjari Chakib C Nisar Muhammad Imran MI Omer Saad B SB Parsaeian Mahboubeh M Peprah Emmanuel K EK Pervaiz Aslam A Pourmalek Farshad F Qato Dima M DM Qorbani Mostafa M Radfar Amir A Rafay Anwar A Rahimi Kazem K Rahimi-Movaghar Vafa V Rahman Sajjad Ur SU Rai Rajesh K RK Rana Saleem M SM Rao Sowmya R SR Refaat Amany H AH Resnikoff Serge S Roshandel Gholamreza G Saade Georges G Saeedi Mohammad Y MY Sahraian Mohammad Ali MA Saleh Shadi S Sanchez-Riera Lidia L Satpathy Maheswar M Sepanlou Sadaf G SG Setegn Tesfaye T Shaheen Amira A Shahraz Saeid S Sheikhbahaei Sara S Shishani Kawkab K Sliwa Karen K Tavakkoli Mohammad M Terkawi Abdullah S AS Uthman Olalekan A OA Westerman Ronny R Younis Mustafa Z MZ El Sayed Zaki Maysaa M Zannad Faiez F Roth Gregory A GA Wang Haidong H Naghavi Mohsen M Vos Theo T Al Rabeeah Abdullah A AA Lopez Alan D AD Murray Christopher J L CJ

The Lancet. Global health 20160825 10

<h4>Background</h4>The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden o ...[more]

PMID: 27568068

Similar Datasets

Project description:ObjectivesUsing the findings of the Global Burden of Disease Study (GBD), we report the burden of primary headache disorders in the Eastern Mediterranean Region (EMR) from 1990 to 2016.MethodsWe modelled headache disorders using DisMod-MR 2.1 Bayesian meta-regression tool to ensure consistency between prevalence, incidence, and remission. Years lived with disability (YLDs) were calculated by multiplying prevalence and disability weight (DW) of migraine and tension-type headache (TTH). We assumed primary headache disorders as non-fatal, so their YLD is equal to disability-adjusted life years (DALYs).ResultsMigraine and TTH were the second and twentieth leading causes of YLDs in EMR. Between 1990 and 2016, the absolute YLD numbers of migraine and TTH increased from 2.3 million (95% uncertainty interval (UI): 1.5-3.2) to 4.7 million (95%UI: 3-6.5) and from 383 thousand (95%UI: 240-562) to 816 thousand (95%UI: 516-1221), respectively. During the same period, age-standardised YLD rates of migraine and TTH in EMR increased by 0.7% and 2.5%, respectively, in comparison to a small decrease in the global rates (0.2% decrease in migraine and TTH). The bulk of burden due to headache occurred in the 30-49 year age group, with a peak at ages 35-44 years. The age-standardised YLD rates of both headache disorders were higher in women with female to male ratio of 1.69 for migraine and 1.38 for TTH. All countries of the EMR except for Somalia and Djibouti had higher age-standardised YLD rates for migraine and TTH in compare to the global rates. Libya and Saudi Arabia had the highest increase in age-standardised YLD rates of migraine and TTH, respectively.ConclusionThe findings of this study show that primary headache disorders are a major and a growing cause of disability in EMR. Since 1990, burden of primary headache disorders has constantly been higher in EMR compared to rest of the world, which indicates that health systems in EMR must focus further on developing and implementing preventive and management strategies to control headache.

Project description:BackgroundInjury poses a major threat to health and longevity in adults aged 50 years or older. The increased life expectancy in the Eastern Mediterranean region warrants a further understanding of the ageing population's inevitable changing health demands and challenges. We aimed to examine injury-related morbidity and mortality among adults aged 50 years or older in 22 Eastern Mediterranean countries.MethodsDrawing on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we categorised the population into adults aged 50-69 years and adults aged 70 years and older. We examined estimates for transport injuries, self-harm injuries, and unintentional injuries for both age groups, with sex differences reported, and analysed the percentage changes from 1990 to 2019. We reported injury-related mortality rates and disability-adjusted life-years (DALYs). The Socio-demographic Index (SDI) and the Healthcare Access and Quality (HAQ) Index were used to better understand the association of socioeconomic factors and health-care system performance, respectively, with injuries and health status in older people. Healthy life expectancy (HALE) was compared with injury-related deaths and DALYs and to the SDI and HAQ Index to understand the effect of injuries on healthy ageing. Finally, risk factors for injury deaths between 1990 and 2019 were assessed. 95% uncertainty intervals (UIs) are given for all estimates.FindingsEstimated injury mortality rates in the Eastern Mediterranean region exceeded the global rates in 2019, with higher injury mortality rates in males than in females for both age groups. Transport injuries were the leading cause of deaths in adults aged 50-69 years (43·0 [95% UI 31·0-51·8] per 100 000 population) and in adults aged 70 years or older (66·2 [52·5-75·5] per 100 000 population), closely followed by conflict and terrorism for both age groups (10·2 [9·3-11·3] deaths per 100 000 population for 50-69 years and 45·7 [41·5-50·3] deaths per 100 000 population for ≥70 years). The highest annual percentage change in mortality rates due to injury was observed in Afghanistan among people aged 70 years or older (400·4% increase; mortality rate 1109·7 [1017·7-1214·7] per 100 000 population). The leading cause of DALYs was transport injuries for people aged 50-69 years (1798·8 [1394·1-2116·0] per 100 000 population) and unintentional injuries for those aged 70 years or older (2013·2 [1682·2-2408·7] per 100 000 population). The estimates for HALE at 50 years and at 70 years in the Eastern Mediterranean region were lower than global estimates. Eastern Mediterranean countries with the lowest SDIs and HAQ Index values had high prevalence of injury DALYs and ranked the lowest for HALE at 50 years of age and HALE at 70 years. The leading injury mortality risk factors were occupational exposure in people aged 50-69 years and low bone mineral density in those aged 70 years or older.InterpretationInjuries still pose a real threat to people aged 50 years or older living in the Eastern Mediterranean region, mainly due to transport and violence-related injuries. Dedicated efforts should be implemented to devise injury prevention strategies that are appropriate for older adults and cost-effective injury programmes tailored to the needs and resources of local health-care systems, and to curtail injury-associated risk and promote healthy ageing.FundingBill & Melinda Gates Foundation.

Dataset Information

Health in times of uncertainty in the eastern Mediterranean region, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background

Methods

Findings

Interpretation

Funding

Publications

Health in times of uncertainty in the eastern Mediterranean region, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets