45 research outputs found
Global Access to Handwashing : Implications for COVID-19 Control in Low-Income Countries
No full textBACKGROUND: Low-income countries have reduced health care system capacity and are therefore at risk of substantially higher COVID-19 case fatality rates than those currently seen in high-income countries. Handwashing is a key component of guidance to reduce transmission of the SARS-CoV2 virus, responsible for the COVID-19 pandemic. Prior systematic reviews have indicated the effectiveness of handwashing to reduce transmission of
respiratory viruses. In low-income countries, reduction of transmission is of paramount importance, but social distancing is challenged by high population densities and access to handwashing facilities with soap and water is limited.
OBJECTIVES: Our objective was to estimate global access to handwashing with soap and water to inform use of handwashing in the prevention of
COVID-19 transmission.
METHODS: We utilized observational surveys and spatiotemporal Gaussian process regression modeling in the context of the Global Burden of Diseases,
Injuries, and Risk Factors Study to estimate access to a handwashing station with available soap and water for 1,062 locations from 1990 to 2019.
RESULTS: Despite overall improvements from 1990 {33.6% [95% uncertainty interval (UI): 31.5, 35.6] without access} to 2019, globally in 2019,
2.02 (95% UI: 1.91, 2.14) billion people, 26.1% (95% UI: 24.7, 27.7) of the global population, lacked access to handwashing with available soap and
water. More than 50% of the population in sub-Saharan Africa and Oceania were without access to handwashing in 2019, and in eight countries,
50 million or more persons lacked access.
DISCUSSION: For populations without handwashing access, immediate improvements in access or alternative strategies are urgently needed, and disparities in handwashing access should be incorporated into COVID-19 forecasting models when applied to low-income countries. Reproduced with permission from Environmental Health Perspectives.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofReviewedFacultyResearche
Genetic Candidate Variants in Two Multigenerational Families with Childhood Apraxia of Speech
No full textabstract: Childhood apraxia of speech (CAS) is a severe and socially debilitating form of speech sound disorder with suspected genetic involvement, but the genetic etiology is not yet well understood. Very few known or putative causal genes have been identified to date, e.g., FOXP2 and BCL11A. Building a knowledge base of the genetic etiology of CAS will make it possible to identify infants at genetic risk and motivate the development of effective very early intervention programs. We investigated the genetic etiology of CAS in two large multigenerational families with familial CAS. Complementary genomic methods included Markov chain Monte Carlo linkage analysis, copy-number analysis, identity-by-descent sharing, and exome sequencing with variant filtering. No overlaps in regions with positive evidence of linkage between the two families were found. In one family, linkage analysis detected two chromosomal regions of interest, 5p15.1-p14.1, and 17p13.1-q11.1, inherited separately from the two founders. Single-point linkage analysis of selected variants identified CDH18 as a primary gene of interest and additionally, MYO10, NIPBL, GLP2R, NCOR1, FLCN, SMCR8, NEK8, and ANKRD12, possibly with additive effects. Linkage analysis in the second family detected five regions with LOD scores approaching the highest values possible in the family. A gene of interest was C4orf21 (ZGRF1) on 4q25-q28.2. Evidence for previously described causal copy-number variations and validated or suspected genes was not found. Results are consistent with a heterogeneous CAS etiology, as is expected in many neurogenic disorders. Future studies will investigate genome variants in these and other families with CAS.The article is published at http://journals.plos.org/plosone/article?id=10.1371/journal.pone.015386
Response to “Comment on ‘Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries’”
No full textErratum: Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries
No full textAuthor Correction: Multi-ancestry meta-analysis of genome-wide association studies discovers 67 new loci associated with chronic back pain
No full textEstimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C and hepatitis B:findings from the Global Burden of Disease Study 2013
No full textBackground: Previous estimates of the burden of HIV, hepatitis B (HBV) and hepatitis C (HCV) among people who inject drugs have not included estimates of the burden attributable to the consequences of past injecting. We provided these estimates in the Global Burden of Disease (GBD) 2013 study. Methods: We modelled HBV and HCV burden (including cirrhosis and liver cancer burden) and HIV at the country, regional, and global level. We extracted data on the proportion of notified HIV cases by transmission route and estimated the contribution of IDU to HBV and HCV disease burden using a cohort method that injecting drug use (IDU) to HBV and HCV disease burden using a cohort method that recalibrated individuals’ history of IDU, and accumulated risk of HBV and HCV due to IDU. We estimated data on current IDU from a meta-analysis of HBV and HCV incidence among injectors; and country-level data on the incidence of HBV and HCV between 1990 and 2013. We calculated estimates of burden of disease through three metrics: years of life lost (YLL), years of life lived with disability (YLD), deaths, and disability-adjusted life-years (DALYs).Findings: In 2013, an estimated 10.08 million DALYs were attributable to previous exposure to HIV, HBV and HCV via IDU, a four-fold increase since 1990. In 2013, IDU was estimated to cause 4.0% (2.82 million DALYs (95% uncertainty interval (95%UI) 2.4-3.8 million DALYs), 1.1% (216,000; 101,000-338,000) and 39.1% (7.05 million; 5.88-8.15 million) of total DALYs due to HIV, HBV and HCV, respectively. IDU-attributable HCV burden was 2.5 times that for HIV. IDU-attributable HIV burden was highest in low- to middle-income countries, and IDU-attributable HCV burden highest in high-income countries.Conclusions: IDU is a major contributor to GBD. There is a need to scale up efficacious interventions to prevent and treat these important causes of health burden
Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis
No full textBACKGROUND: Liver cirrhosis is a major yet largely preventable and underappreciated cause of global health loss. Variations in cirrhosis mortality at the country level reflect differences in prevalence of risk factors such as alcohol use and hepatitis B and C infection. We estimated annual age-specific mortality from liver cirrhosis in 187 countries between 1980 and 2010. METHODS: We systematically collected vital registration and verbal autopsy data on liver cirrhosis mortality for the period 1980 to 2010. We corrected for misclassification of deaths, which included deaths attributed to improbable or nonfatal causes. We used ensemble models to estimate liver cirrhosis mortality with uncertainty by age, sex, country and year. We used out-of-sample predictive validity to select the optimal model. RESULTS: Global liver cirrhosis deaths increased from around 676,000 (95% uncertainty interval: 452,863 to 1,004,530) in 1980 to over 1 million (1,029,042; 670,216 to 1,554,530) in 2010 (about 2% of the global total). Over the same period, the age-standardized cirrhosis mortality rate decreased by 22%. This was largely driven by decreasing cirrhosis mortality rates in China, the US and countries in Western Europe. In 2010, Egypt, followed by Moldova, had the highest age-standardized cirrhosis mortality rates, 72.7 and 71.2 deaths per 100,000, respectively, while Iceland had the lowest. In Egypt, almost one-fifth (18.1%) of all deaths in males 45- to 54-years old were due to liver cirrhosis. Liver cirrhosis mortality in Mexico is the highest in Latin America. In France and Italy, liver cirrhosis mortality fell by 50% to 60%; conversely, in the United Kingdom, mortality increased by about one-third. Mortality from liver cirrhosis was also comparatively high in Central Asia countries, particularly Mongolia, Uzbekistan and Kyrgyzstan, and in parts of sub-Saharan Africa, notably Gabon. CONCLUSIONS: Liver cirrhosis is a significant cause of global health burden, with more than one million deaths in 2010. Our study identifies areas with high and/or rapidly increasing mortality where preventive measures to control and reduce liver cirrhosis risk factors should be urgently strengthened
The global burden of non-typhoidal salmonella invasive disease: a systematic analysis for the Global Burden of Disease Study 2017
No full textBackground Non-typhoidal salmonella invasive disease is a major cause of global morbidity and mortality. Malnourished children, those with recent malaria or sickle-cell anaemia, and adults with HIV infection are at particularly high risk of disease. We sought to estimate the burden of disease attributable to non-typhoidal salmonella invasive disease for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017.
Methods We did a systematic review of scientific databases and grey literature, and estimated non-typhoidal salmonella invasive disease incidence and mortality for the years 1990 to 2017, by age, sex, and geographical location using DisMod-MR, a Bayesian meta-regression tool. We estimated case fatality by age, HIV status, and sociodemographic development. We also calculated the HIV-attributable fraction and estimated health gap metrics, including disability-adjusted life-years (DALYs).
Findings We estimated that 535 000 (95% uncertainty interval 409 000-705 000) cases of non-typhoidal salmonella invasive disease occurred in 2017, with the highest incidence in sub-Saharan Africa (34.5 [26.6-45.0] cases per 100 000 person-years) and in children younger than 5 years (34.3 [23.2-54.7] cases per 100 000 person-years). 77 500 (46 400-123 000) deaths were estimated in 2017, of which 18 400 (12 000-27 700) were attributable to HIV. The remaining 59 100 (33 300-98 100) deaths not attributable to HIV accounted for 4.26 million (2.38-7.38) DALYs in 2017. Mean all-age case fatality was 14.5% (9.2-21.1), with higher estimates among children younger than 5 years (13.5% [8.4-19.8]) and elderly people (51.2% [30.2-72.9] among those aged >= 70 years), people with HIV infection (41.8% [30.0-54.0]), and in areas of low sociodemographic development (eg, 15.8% [10.0-22.9] in sub-Saharan Africa).
Interpretation We present the first global estimates of non-typhoidal salmonella invasive disease that have been produced as part of GBD 2017. Given the high disease burden, particularly in children, elderly people, and people with HIV infection, investigating the sources and transmission pathways of non-typhoidal salmonella invasive disease is crucial to implement effective preventive and control measures.
Funding Bill & Melinda Gates Foundation. Copyright (c) 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Keywords: 195 COUNTRIES; CLINICAL PRESENTATION; TERRITORIES; RESISTANCE; EPIDEMIOLOGY; INFECTIONS; DISABILITY; INJURIES; OUTCOME
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Author Correction: Genetic regulation of serum IgA levels and susceptibility to common immune, infectious, kidney, and cardio-metabolic traits
No full textAuthor Correction: Genetic regulation of serum IgA levels and susceptibility to common immune, infectious, kidney, and cardio-metabolic traits
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