25 research outputs found
Post-Conservation Evaluation (PCE) framework for adaptive reuse museums: Case studies of George Town, Malaysia / Muhammad Firzan Abdul Aziz
No full textThe trend of converting historic buildings to museums has been found prevalent in the historic cities of Melaka and George Town, among the UNESCO World Heritage sites of Malaysia. However, adaptive reuse approach has not always brought in positive conservation impacts as some historic buildings turned dysfunctional after their conversion to museums. This scenario has called upon the needs for having an evaluation framework focusing on the post-conservation impacts of historic buildings converted to museums (adaptive reuse museums) within the UNESCO World Heritage of Malaysia context. Criteria of physical appropriateness, functional effectiveness and financial efficiency were scrutinised through literature review to conceptually form the Post-Conservation Evaluation (PCE). Case studies obtained through purposive sampling involving five historic buildings in the historic city of George Town were then used to test the operational and empirical capabilities of the conceptual PCE. Field work conducted at the case studies then led to the findings that the post-conservation impacts of adaptive reuse museums have been not convincing in the sense of physical appropriateness and also functionally ineffective in the sense of preserving sensitive collections. This evaluative research then contributed a PCE framework focusing on the impacts of adaptive reuse museums in the context of UNESCO World Heritage of Malaysia, based on validation via Delphi survey involving experts and stakeholders in the field of built heritage conservation
Green practice: an empirical investigation on the interiors of healthy restaurants in Penang / Shi Ying Chua and Muhammad Firzan Abdul Aziz
No full textGreen practices are typically categorised into four (4) areas: food and beverage, service, management, and the environment. The implementation of green practices, particularly those emphasising green interior design, however, is still in its infancy state and remains scarce. This study delves into the realm of green practices within the context of healthy restaurants, with two (2) primary objectives. First, to understand the interior design rationale of healthy restaurants in Penang, and second, to explore the perception of restaurateurs regarding the implementation of green practices for the interiors of their respective healthy restaurant. To gather primary data, the study conducted semi-structured, key informant interviews with restaurateurs in Penang, Malaysia, who met specific criteria which include the adoption of food-focused green practices, the presence of aesthetically pleasing interior designs, and the given positive reviews for both food quality and restaurant ambiance. The findings revealed that these restaurant owners effectively conveyed their concepts through their interior designs, using natural materials like wood, cement, and indoor plants. While they demonstrated awareness of environmental sustainability and health concerns, their understanding of green practices was somewhat basic. They were more focused on applying green practices to food and beverages than on creating a green interior ambiance
Physical space and end-user’s well-being: Perceptions of custodians from Youth Institutio in Penang
No full textThis paper identifies the physical space design that could influence the Penang youths’ state of well-being positively. The objectives of this study to comprehend the relationship between the psychological influence of physical space and the state of well-being of youths in the youth institution to determine the relationship between physical space and its significance in perpetuating end users’ state of well-being of Penang youths and enlighten on the understanding of physical space design that is influential to the state of well-being of Malaysian youths. This analysis will look onto aspects of physical space, including design elements, physical condition, and space sufficiency in youth’s current living space such as choices of colours, presence of daylighting, utilization of indoor landscape, open spaces concept, ventilation, and sense of privacy. The finding of this study generally helps to enlighten the understanding of physical space design that are influential to the state of well-being of youths in Penang
Transcultural Zen design frameworks for enhancing mental health through restorative spaces and user experience
No full textAbstract Zen aesthetics, rooted in Chinese Chan Buddhist philosophy, offers a universal framework for designing restorative spaces that transcend cultural boundaries. This study investigates how Zen principles—simplicity, natural harmony, spatial balance, and negative space—are adapted in tea room design across diverse cultural contexts and evaluates their impact on user experience. Through semi-structured focus group discussions with eight expert designers from East and Southeast Asia, complemented by case studies of Zen-inspired spaces in Europe and Scandinavia, the research identifies key strategies for balancing cultural authenticity with global applicability. Findings reveal that minimalist layouts, biophilic integration, and strategic use of negative space reduce self-reported stress by 22–35% and enhance cognitive focus, aligning with established stress recovery and attention restoration theories. Designers achieved cultural hybridity through material substitution, such as Nordic wool felt replacing traditional tatami mats, and ritual adaptation, such as reimagining tea ceremonies as barista-led pour-over rituals, while maintaining Zen’s philosophical core. The study advances a transcultural design framework that prioritizes locally sourced materials, modular spatial configurations, and participatory methodologies to address urban mental health challenges. By bridging Zen philosophy with evidence-based design practices, this work provides actionable insights for creating culturally resonant yet globally adaptable restorative environments in an interconnected world
Royal Palace Location: The Case of The Sultanate of Perak
No full textPerak’s Malay Sultanate is known to have the longest root in the Malaysian Sultanate tradition with the most numbers of Sultans (35). Interestingly, 27 of them built a new palace, each for themselves, rather than using the inherited ones. However, those 27 locations of the royal palaces of the Perak’s Malay Sultanate are yet to be identified and recorded. This has called upon the needs to conduct a preliminary investigation on those locations based on scrutiny of secondary data (theoretically through old manuscripts and historical writings) and primary data (empirically through interviewing local people and utilising GIS technology). Analysis based on the data triangulations hence would provide a scientific and systematic inventory of the royal palaces of Perak’s Malay Sultanate
Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100 : a comprehensive demographic analysis for the Global Burden of Disease Study 2021
No full textNatalia V Bhattacharjee, Austin E Schumacher, Amirali Aali, Yohannes Habtegiorgis Abate, Rouzbeh Abbasgholizadeh, Mohammadreza Abbasian, Mohsen Abbasi-Kangevari, Hedayat Abbastabar, Samar Abd ElHafeez, Sherief Abd-Elsalam, Mohammad Abdollahi, Mohammad-Amin Abdollahifar, Meriem Abdoun, Auwal Abdullahi, Mesfin Abebe, Samrawit Shawel Abebe, Olumide Abiodun, Hassan Abolhassani, Meysam Abolmaali, Mohamed Abouzid, Girma Beressa Aboye, Lucas Guimarães Abreu, Woldu Aberhe Abrha, Michael R M Abrigo, Dariush Abtahi, Hasan Abualruz, Bilyaminu Abubakar, Eman Abu-Gharbieh, Niveen ME Abu-Rmeileh, Tadele Girum Girum Adal, Mesafint Molla Adane, Oluwafemi Atanda Adeagbo Adeagbo, Rufus Adesoji Adedoyin, Victor Adekanmbi, Bashir Aden, Abiola Victor Adepoju, Olatunji O Adetokunboh, Juliana Bunmi Adetunji, Daniel Adedayo Adeyinka, Olorunsola Israel Adeyomoye, Qorinah Estiningtyas Sakilah Adnani, Saryia Adra, Rotimi Felix Afolabi, Shadi Afyouni, Muhammad Sohail Afzal, Saira Afzal, Shahin Aghamiri, Antonella Agodi, Williams Agyemang-Duah, Bright Opoku Ahinkorah, Austin J Ahlstrom, Aqeel Ahmad, Danish Ahmad, Firdos Ahmad, Muayyad M Ahmad, Sajjad Ahmad, Tauseef Ahmad, Ali Ahmed, Ayman Ahmed, Haroon Ahmed, Luai A Ahmed, Meqdad Saleh Ahmed, Syed Anees Ahmed, Marjan Ajami, Budi Aji, Gizachew Taddesse Akalu, Hossein Akbarialiabad, Rufus Olusola Akinyemi, Mohammed Ahmed Akkaif, Sreelatha Akkala, Hanadi Al Hamad, Syed Mahfuz Al Hasan, Mohammad Al Qadire, Tareq Mohammed Ali AL-Ahdal, Samer O Alalalmeh, Tariq A Alalwan, Ziyad Al-Aly, Khurshid Alam, Rasmieh Mustafa Al-amer, Fahad Mashhour Alanezi, Turki M Alanzi, Almaza Albakri, Mohammed Albashtawy, Mohammad T AlBataineh, Hediyeh Alemi, Sharifullah Alemi, Yihun Mulugeta Alemu, Ayman Al-Eyadhy, Adel Ali Saeed Al-Gheethi, Khalid F Alhabib, Noora Alhajri, Fadwa Alhalaiqa Naji Alhalaiqa, Robert Kaba Alhassan, Abid Ali, Beriwan Abdulqadir Ali, Liaqat Ali, Mohammed Usman Ali, Rafat Ali, Syed Shujait Shujait Ali, Sheikh Mohammad Alif, Mohammad Aligol, Mehran Alijanzadeh, Mohammad A M Aljasir, Syed Mohamed Aljunid, Sabah Al-Marwani, Joseph Uy Almazan, Hesham M Al-Mekhlafi, Omar Almidani, Mahmoud A Alomari, Basem Al-Omari, Jaber S Alqahtani, Ahmed Yaseen Alqutaibi, Rajaa M Al-Raddadi, Salman Khalifah Al-Sabah, Awais Altaf, Jaffar A Al-Tawfiq, Khalid A Altirkawi, Deborah Oyine Aluh, Farrukh Jawad Alvi, Nelson Alvis-Guzman, Hassan Alwafi, Yaser Mohammed Al-Worafi, Hany Aly, Safwat Aly, Karem H Alzoubi, Edward Kwabena Ameyaw, Tarek Tawfik Amin, Alireza Amindarolzarbi, Mostafa Amini-Rarani, Sohrab Amiri, Irene Gyamfuah Ampomah, Dickson A Amugsi, Ganiyu Adeniyi Amusa, Robert Ancuceanu, Deanna Anderlini, Pedro Prata Andrade, Catalina Liliana Andrei, Tudorel Andrei, Abhishek Anil, Sneha Anil, Adnan Ansar, Alireza Ansari-Moghaddam, Catherine M Antony, Ernoiz Antriyandarti, Saeid Anvari, SALEHA ANWAR, Razique Anwer, Anayochukwu Edward Anyasodor, Jalal Arabloo, Razman Arabzadeh Bahri, Elshaimaa A Arafa, Mosab Arafat, Ana Margarida Araújo, Aleksandr Y Aravkin, Abdulfatai Aremu, Timur Aripov, Mesay Arkew, Benedetta Armocida, Johan Ärnlöv, Mahwish Arooj, Anton A Artamonov, Judie Arulappan, Raphael Taiwo Aruleba, Ashokan Arumugam, Mohsen Asadi-Lari, Zatollah Asemi, Saeed Asgary, Mona Asghariahmadabad, Mohammad Asghari-Jafarabadi, Mubarek Yesse Ashemo, Muhammad Ashraf, Tahira Ashraf, Marvellous O Asika, Seyyed Shamsadin Athari, Maha Moh'd Wahbi Atout, Alok Atreya, Avinash Aujayeb, Marcel Ausloos, Abolfazl Avan, Amlaku Mulat Aweke, Getnet Melaku Ayele, Seyed Mohammad Ayyoubzadeh, Sina Azadnajafabad, Rui M S Azevedo, Ahmed Y Azzam, Muhammad Badar, Ashish D Badiye, Soroush Baghdadi, Nasser Bagheri, Sara Bagherieh, Najmeh Bahmanziari, Ruhai Bai, Atif Amin Baig, Jennifer L Baker, Abdulaziz T Bako, Ravleen Kaur Bakshi, Madhan Balasubramanian, Ovidiu Constantin Baltatu, Kiran Bam, Maciej Banach, Soham Bandyopadhyay, Biswajit Banik, Palash Chandra Banik, Hansi Bansal, Mehmet Firat Baran, Martina Barchitta, Mainak Bardhan, Erfan Bardideh, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Francesco Barone-Adesi, Hiba Jawdat Barqawi, Amadou Barrow, Sandra Barteit, Zarrin Basharat, Asma'u I J Bashir, Hameed Akande Bashiru, Afisu Basiru, João Diogo Basso, Sanjay Basu, Abdul-Monim Mohammad Batiha, Kavita Batra, Bernhard T Baune, Mohsen Bayati, Tahmina Begum, Emad Behboudi, Amir Hossein Behnoush, Maryam Beiranvand, Diana Fernanda Bejarano Ramirez, Alehegn Bekele, Sefealem Assefa Belay, Uzma Iqbal Belgaumi, Michelle L Bell, Olorunjuwon Omolaja Bello, Apostolos Beloukas, Isabela M Bensenor, Zombor Berezvai, Alemshet Yirga Berhie, Amiel Nazer C Bermudez, Paulo J G Bettencourt, Akshaya Srikanth Bhagavathula, Nikha Bhardwaj, Pankaj Bhardwaj, Prarthna V Bhardwaj, Sonu Bhaskar, Vivek Bhat, Gurjit Kaur Bhatti, Jasvinder Singh Bhatti, Manpreet S Bhatti, Rajbir Bhatti, Antonio Biondi, Catherine Bisignano, Atanu Biswas, Raaj Kishore Biswas, Veera R Bitra, Tone Bjørge, Elye Bliss, Micheal Kofi Boachie, Anca Vasilica Bobirca, Virginia Bodolica, Aadam Olalekan Bodunrin, Eyob Ketema Bogale, Kassawmar Angaw Bogale, Milad Bonakdar Hashemi, Berrak Bora Basara, Souad Bouaoud, Dejana Braithwaite, Michael Brauer, Nicholas J K Breitborde, Dana Bryazka, Norma B Bulamu, Danilo Buonsenso, Katrin Burkart, Richard A Burns, Yasser Bustanji, Nadeem Shafique Butt, Zahid A Butt, Florentino Luciano Caetano dos Santos, Daniela Calina, Ismael R Campos-Nonato, Fan Cao, Shujin Cao, Angelo Capodici, Giulia Carreras, Andrea Carugno, Carlos A Castañeda-Orjuela, Giulio Castelpietra, Maria Sofia Cattaruzza, Arthur Caye, Luca Cegolon, Francieli Cembranel, Ester Cerin, Joshua Chadwick, Yaacoub Chahine, Chiranjib Chakraborty, Julian Chalek, Jeffrey Shi Kai Chan, Periklis Charalampous, Vijay Kumar Chattu, Sarika Chaturvedi, Malizgani Paul Chavula, An-Tian Chen, Haowei Chen, Simiao Chen, Gerald Chi, Fatemeh Chichagi, Ju-Huei Chien, Patrick R Ching, William C S Cho, Sungchul Choi, Bryan Chong, Hitesh Chopra, Sonali Gajanan Choudhari, Devasahayam J Christopher, Dinh-Toi Chu, Isaac Sunday Chukwu, Eric Chung, Sheng-Chia Chung, Zinhle Cindi, Iolanda Cioffi, Raffaela Ciuffreda, Rafael M Claro, Kaleb Coberly, Alyssa Columbus, Haley Comfort, Joao Conde, Michael H Criqui, Natália Cruz-Martins, Silvia Magali Cuadra-Hernández, Sriharsha Dadana, Omid Dadras, Tukur Dahiru, Zhaoli Dai, Bronte Dalton, Giovanni Damiani, Aso Mohammad Darwesh, Jai K Das, Saswati Das, Mohsen Dashti, Anna Dastiridou, Claudio Alberto Dávila-Cervantes, Kairat Davletov, Aklilu Tamire Debele, Shayom Debopadhaya, Somayeh Delavari, Ivan Delgado-Enciso, Dessalegn Demeke, Berecha Hundessa Demessa, Xinlei Deng, Edgar Denova-Gutiérrez, Kebede Deribe, Nikolaos Dervenis, Hardik Dineshbhai Desai, Rupak Desai, Vinoth Gnana Chellaiyan Devanbu, Arkadeep Dhali, Kuldeep Dhama, Meghnath Dhimal, Vishal R Dhulipala, Diana Dias da Silva, Daniel Diaz, Michael J Diaz, Adriana Dima, Delaney D Ding, M Ashworth Dirac, Thanh Chi Do, Thao Huynh Phuong Do, Camila Bruneli do Prado, Sushil Dohare, Wanyue Dong, Mario D'Oria, Wendel Mombaque dos Santos, Leila Doshmangir, Robert Kokou Dowou, Ashel Chelsea Dsouza, Haneil Larson Dsouza, Viola Dsouza, John Dube, Joe Duprey, Andre Rodrigues Duraes, Senbagam Duraisamy, Oyewole Christopher Durojaiye, Sulagna Dutta, Laura Dwyer-Lindgren, Paulina Agnieszka Dzianach, Arkadiusz Marian Dziedzic, Alireza Ebrahimi, Hisham Atan Edinur, Kristina Edvardsson, Ferry Efendi, Terje Andreas Eikemo, Michael Ekholuenetale, Maha El Tantawi, Noha Mousaad Elemam, Ghada Metwally Tawfik ElGohary, Muhammed Elhadi, Legesse Tesfaye Elilo, Omar Abdelsadek Abdou Elmeligy, Mohamed A Elmonem, Mohammed Elshaer, Ibrahim Elsohaby, Amir Emami Zeydi, Luchuo Engelbert Bain, Sharareh Eskandarieh, Francesco Esposito, Kara Estep, Farshid Etaee, Natalia Fabin, Adeniyi Francis Fagbamigbe, Saman Fahimi, Aliasghar Fakhri-Demeshghieh, Luca Falzone, Ali Faramarzi, MoezAlIslam Ezzat Mahmoud Faris, Sam Farmer, Andre Faro, Abidemi Omolara Fasanmi, Ali Fatehizadeh, Nelsensius Klau Fauk, Pooria Fazeli, Valery L Feigin, Seyed-Mohammad Fereshtehnejad, Abdullah Hamid Feroze, Pietro Ferrara, Nuno Ferreira, Getahun Fetensa, Irina Filip, Florian Fischer, Joanne Flavel, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Artem Alekseevich Fomenkov, Behzad Foroutan, Matteo Foschi, Kayode Raphael Fowobaje, Kate Louise Francis, Alberto Freitas, Takeshi Fukumoto, John E Fuller, Blima Fux, Peter Andras Gaal, Muktar A Gadanya, Abhay Motiramji Gaidhane, Yaseen Galali, Silvano Gallus, Aravind P Gandhi, Balasankar Ganesan, Mohammad Arfat Ganiyani, M.A. Garcia-Gordillo, Naval Garg, Rupesh K Gautam, Federica Gazzelloni, Semiu Olatunde Gbadamosi, Miglas W Gebregergis, Mesfin Gebrehiwot, Tesfay Brhane Gebremariam, Tesfay B B Gebremariam, Teferi Gebru Gebremeskel, Yohannes Fikadu Geda, Simona Roxana Georgescu, Urge Gerema, Habtamu Geremew, Motuma Erena Getachew, Peter W Gething, MohammadReza Ghasemi, Ghazal Ghasempour Dabaghi, Afsaneh Ghasemzadeh, Fariba Ghassemi, Ramy Mohamed Ghazy, Sailaja Ghimire, Asadollah Gholamian, Ali Gholamrezanezhad, Mahsa Ghorbani, Aloke Gopal Ghoshal, Arun Digambarrao Ghuge, Artyom Urievich Gil, Tiffany K Gill, Matteo Giorgi, Alem Girmay, James C Glasbey, Laszlo Göbölös, Amit Goel, Ali Golchin, Mahaveer Golechha, Pouya Goleij, Sameer Vali Gopalani, Houman Goudarzi, Alessandra C Goulart, Anmol Goyal, Simon Matthew Graham, Michal Grivna, Shi-Yang Guan, Giovanni Guarducci, Mohammed Ibrahim Mohialdeen Gubari, Mesay Dechasa Gudeta, Stefano Guicciardi, Snigdha Gulati, David Gulisashvili, Damitha Asanga Gunawardane, Cui Guo, Anish Kumar Gupta, Bhawna Gupta, Manoj Kumar Gupta, Mohak Gupta, Sapna Gupta, Veer Bala Gupta, Vijai Kumar Gupta, Vivek Kumar Gupta, Annie Haakenstad, Farrokh Habibzadeh, Najah R Hadi, Nils Haep, Ramtin Hajibeygi, Sebastian Haller, Rabih Halwani, Randah R Hamadeh, Nadia M Hamdy, Sajid Hameed, Samer Hamidi, Qiuxia Han, Alexis J Handal, Graeme J Hankey, Md Nuruzzaman Haque, Josep Maria Haro, Ahmed I Hasaballah, Ikramul Hasan, Mohammad Jahid Hasan, S.M. Mahmudul Hasan, Hamidreza Hasani, Md Saquib Hasnain, Amr Hassan, Ikrama Hassan, Soheil Hassanipour, Hadi Hassankhani, Simon I Hay, Jeffrey J Hebert, Omar E Hegazi, Mohammad Heidari, Bartosz Helfer, Mehdi Hemmati, Brenda Yuliana Herrera-Serna, Claudiu Herteliu, Kamran Hessami, Kamal Hezam, Yuta Hiraike, Nguyen Quoc Hoan, Ramesh Holla, Nobuyuki Horita, Md Mahbub Hossain, Mohammad Bellal Hossain Hossain, Hassan Hosseinzadeh, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Mohamed Hsairi, Vivian Chia-rong Hsieh, Chengxi Hu, Junjie Huang, M Mamun Huda, Ayesha Humayun, Javid Hussain, Nawfal R Hussein, Hong-Han Huynh, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Pulwasha Maria Iftikhar, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Leeberk Raja Inbaraj, Afrin Iqbal, Md. Rabiul Islam, Nahlah Elkudssiah Ismail, Hiroyasu Iso, Gaetano Isola, Masao Iwagami, Mahalaxmi Iyer, Linda Merin J, Jalil Jaafari, Louis Jacob, Farhad Jadidi-Niaragh, Khushleen Jaggi, Kasra Jahankhani, Nader Jahanmehr, Haitham Jahrami, Akhil Jain, Nityanand Jain, Ammar Abdulrahman Jairoun, Mihajlo Jakovljevic, Elham Jamshidi, Sabzali Javadov, Tahereh Javaheri, Sathish Kumar Jayapal, Shubha Jayaram, Sun Ha Jee, Jayakumar Jeganathan, Anil K Jha, Ravi Prakash Jha, Heng Jiang, Mohammad Jokar, Jost B Jonas, Tamas Joo, Nitin Joseph, Charity Ehimwenma Joshua, Farahnaz Joukar, Jacek Jerzy Jozwiak, Mikk Jürisson, Vaishali K, Billingsley Kaambwa, Abdulkareem Kabir, Ali Kabir, Hannaneh Kabir, Zubair Kabir, Rizwan Kalani, Leila R Kalankesh, Feroze Kaliyadan, Sanjay Kalra, Rajesh Kamath, Sagarika Kamath, Tanuj Kanchan, Edmund Wedam Kanmiki, Kehinde Kazeem Kanmodi, Suthanthira Kannan S, Sushil Kumar Kansal, Rami S Kantar, Neeti Kapoor, Mehrdad Karajizadeh, Manoochehr Karami, Ibraheem M Karaye, Faizan Zaffar Kashoo, Hengameh Kasraei, Nicholas J Kassebaum, Molly B Kassel, Joonas H Kauppila, Foad Kazemi, sara Kazeminia, John H Kempen, Evie Shoshannah Kendal, Kamyab Keshtkar, Mohammad Keykhaei, Himanshu Khajuria, Amirmohammad Khalaji, Nauman Khalid, Anees Ahmed Khalil, Alireza Khalilian, Faham Khamesipour, Ajmal Khan, Asaduzzaman Khan, Ikramullah Khan, M Nuruzzaman Khan, Maseer Khan, Mohammad Jobair Khan, Moien AB Khan, Young-Ho Khang, Shaghayegh Khanmohammadi, Khaled Khatab, Armin Khavandegar, Hamid Reza Khayat Kashani, Feriha Fatima Khidri, Moein Khormali, Mohammad Ali Khosravi, Mahmood Khosrowjerdi, Wondwosen Teklesilasie Kidane, Zemene Demelash Kifle, Julie Sojin Kim, Min Seo Kim, Ruth W Kimokoti, Kasey E Kinzel, Girmay Tsegay Kiross, Adnan Kisa, Sezer Kisa, Ali-Asghar Kolahi, Farzad Kompani, Gerbrand Koren, Oleksii Korzh, Soewarta Kosen, Sindhura Lakshmi Koulmane Laxminarayana, Kewal Krishan, Varun Krishna, Vijay Krishnamoorthy, Barthelemy Kuate Defo, Connor M Kubeisy, Burcu Kucuk Bicer, Md Abdul Kuddus, Mohammed Kuddus, Ilari Kuitunen, Mukhtar Kulimbet, Harish Kumar, Satyajit Kundu, Kunle Rotimi Kunle, Om P Kurmi, Asep Kusnali, Dian Kusuma, Evans F Kyei, Ilias Kyriopoulos, Carlo La Vecchia, Ben Lacey, Muhammad Awwal Ladan, Lucie Laflamme, Chandrakant Lahariya, Daphne Teck Ching Lai, Dharmesh Kumar Lal, Ratilal Lalloo, Judit Lám, Demetris Lamnisos, Iván Landires, Francesco Lanfranchi, Berthold Langguth, Ariane Laplante-Lévesque, Heidi Jane Larson, Anders O Larsson, Savita Lasrado, Kamaluddin Latief, Kaveh Latifinaibin, Long Khanh Dao Le, Nhi Huu Hanh Le, Trang Diep Thanh Le, Caterina Ledda, Munjae Lee, Paul H Lee, Seung Won Lee, Yo Han Lee, Gebretsadik Kiros Lema, Elvynna Leong, Temesgen L Lerango, An Li, Ming-Chieh Li, Shanshan Li, Wei Li, Xiaopan Li, Virendra S Ligade, Stephen S Lim, Ro-Ting Lin, Paulina A Lindstedt, Stefan Listl, Gang Liu, Jue Liu, Xiaofeng Liu, Xuefeng Liu, Yuewei Liu, Erand Llanaj, Rubén López-Bueno, Platon D Lopukhov, László Lorenzovici, Paulo A Lotufo, Jailos Lubinda, Giancarlo Lucchetti, Alessandra Lugo, Raimundas Lunevicius, Hengliang Lv, Zheng Feei Ma, Kelsey Lynn Maass, Monika Machoy, Áurea M Madureira-Carvalho, Mohammed Magdy Abd El Razek, Azzam A Maghazachi, Soleiman Mahjoub, Mansour Adam Mahmoud, Azeem Majeed, Jeadran N Malagón-Rojas, Elaheh Malakan Rad, Kashish Malhotra, Ahmad Azam Malik, Iram Malik, Deborah Carvalho Malta, Abdullah A Mamun, Yosef Manla, Yasaman Mansoori, Ali Mansour, Borhan Mansouri, Zeinab Mansouri, Mohammad Ali Mansournia, Joemer C Maravilla, Mirko Marino, Abdoljalal Marjani, Gabriel Martinez, Ramon Martinez-Piedra, Francisco Rogerlândio Martins-Melo, Miquel Martorell, Sharmeen Maryam, Roy Rillera Marzo, Alireza Masoudi, Jishanth Mattumpuram, Richard James Maude, Andrea Maugeri, Erin A May, Mahsa Mayeli, Maryam Mazaheri, John J McGrath, Martin McKee, Anna Laura Wensel McKowen, Susan A McLaughlin, Steven M McPhail, Rahul Mehra, Kamran Mehrabani-Zeinabad, Entezar Mehrabi Nasab, Tesfahun Mekene Meto, Max Alberto Mendez Mendez-Lopez, Walter Mendoza, Ritesh G Menezes, George A Mensah, Alexios-Fotios A Mentis, Sultan Ayoub Meo, Mohsen Merati, Atte Meretoja, Tuomo J Meretoja, Abera M Mersha, Tomislav Mestrovic, Pouya Metanat, Kukulege Chamila Dinushi Mettananda, Sachith Mettananda, Adquate Mhlanga, Laurette Mhlanga, Tianyue Mi, Tomasz Miazgowski, Georgia Micha, Irmina Maria Michalek, Ted R Miller, Le Huu Nhat Minh, Mojgan Mirghafourvand, Erkin M Mirrakhimov, Mizan Kiros Mirutse, Moonis Mirza, Roya Mirzaei, Ashim Mishra, Sanjeev Misra, Philip B Mitchell, Chaitanya Mittal, Babak Moazen, Abdalla Z Mohamed, Ahmed Ismail Mohamed, Jama Mohamed, Mouhand F H Mohamed, Nouh Saad Mohamed, Sakineh Mohammad-Alizadeh-Charandabi, Soheil Mohammadi, Abdollah Mohammadian-Hafshejani, Mustapha Mohammed, Salahuddin Mohammed, Shafiu Mohammed, Ali H Mokdad, Peyman Mokhtarzadehazar, Hossein Molavi Vardanjani, Sabrina Molinaro, Lorenzo Monasta, Mohammad Ali Moni, Maryam Moradi, Yousef Moradi, Paula Moraga, Rafael Silveira Moreira, Negar Morovatdar, Shane Douglas Morrison, Jakub Morze, Abbas Mosapour, Elias Mossialos, Rohith Motappa, Parsa Mousavi, Amin Mousavi Khaneghah, Christine Mpundu-Kaambwa, Sumaira Mubarik, Lorenzo Muccioli, Francesk Mulita, Kavita Munjal, Efrén Murillo-Zamora, Jonah Musa, Fungai Musaigwa, Ana-Maria Musina, Sathish Muthu, Saravanan Muthupandian, Muhammad Muzaffar, Woojae Myung, Ahamarshan Jayaraman Nagarajan, Gabriele Nagel, Pirouz Naghavi, Ganesh R Naik, Gurudatta Naik, Mukhammad David Naimzada, Firzan Nainu, Vinay Nangia, Sreenivas Narasimha Swamy, Bruno Ramos Nascimento, Gustavo G Nascimento, Abdallah Y Naser, Mohammad Javad Nasiri, Zuhair S Natto, Javaid Nauman, Muhammad Naveed, Biswa Prakash Nayak, Vinod C Nayak, Rawlance Ndejjo, Sabina Onyinye Nduaguba, Hadush Negash, Chernet Tafere Negesse, Ionut Negoi, Ruxandra Irina Negoi, Seyed Aria Nejadghaderi, Chakib Nejjari, Samata Nepal, Henok Biresaw Netsere, Georges Nguefack-Tsague, Josephine W. 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Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021
No full textFunding: Bill & Melinda Gates Foundation.Peer ReviewedArticle signat per 1420 autors/es. Membres del GBD 2021 Forecasting Collaborators:
Stein Emil Vollset*, Hazim S Ababneh, Yohannes Habtegiorgis Abate, Cristiana Abbafati, Rouzbeh Abbasgholizadeh, Mohammadreza Abbasian, Hedayat Abbastabar, Abdallah H A Abd Al Magied, Samar Abd ElHafeez, Atef Abdelkader, Michael Abdelmasseh, Sherief Abd-Elsalam, Parsa Abdi, Mohammad Abdollahi, Meriem Abdoun, Auwal Abdullahi, Mesfin Abebe, Olumide Abiodun, Richard Gyan Aboagye, Hassan Abolhassani, Mohamed Abouzid, Girma Beressa Aboye, Lucas Guimarães Abreu, Abdorrahim Absalan, Hasan Abualruz, Bilyaminu Abubakar, Hana Jihad Jihad Abukhadijah, Giovanni Addolorato, Victor Adekanmbi, Charles Oluwaseun Adetunji, Juliana Bunmi Adetunji, Temitayo Esther Adeyeoluwa, Rishan Adha, Ripon Kumar Adhikary, Qorinah Estiningtyas Sakilah Adnani, Leticia Akua Adzigbli, Fatemeh Afrashteh, Muhammad Sohail Afzal, Saira Afzal, Faith Agbozo, Antonella Agodi, Anurag Agrawal, Williams Agyemang-Duah, Bright Opoku Ahinkorah, Austin J Ahlstrom, Aqeel Ahmad, Firdos Ahmad, Muayyad M Ahmad, Sajjad Ahmad, Shahzaib 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R. Mahadeshwara Prasad, Mehrdad Mahalleh, Phetole Walter Mahasha, Mansour Adam Mahmoud, Elham Mahmoudi, Golnaz Mahmoudvand, Maureen Makama, Elaheh Malakan Rad, Kashish Malhotra, Ahmad Azam Malik, Deborah Carvalho Malta, Yosef Manla, Ali Mansour, Mohammad Hadi Mansouri, Pejman Mansouri, Vahid Mansouri, Marjan Mansourian, Mohammad Ali Mansournia, Bishnu P Marasini, Hamid Reza Marateb, Joemer C Maravilla, Parham Mardi, Abdoljalal Marjani, Hamed Markazi Moghadam, Carlos Alberto Marrugo Arnedo, Gabriel Martinez, Ramon Martinez-Piedra, Francisco Rogerlândio Martins-Melo, Miquel Martorell, Wolfgang Marx, Roy Rillera Marzo, Sahar Masoudi, Yasith Mathangasinghe, Alexander G Mathioudakis, Medha Mathur, Navgeet Mathur, Neeta Mathur, Fernanda Penido Matozinhos, Jishanth Mattumpuram, Richard James Maude, Andrea Maugeri, Mahsa Mayeli, Mohsen Mazidi, Antonio Mazzotti, John J McGrath, Martin McKee, Anna Laura W McKowen, Michael A McPhail, Steven M McPhail, Asim Mehmood, Kamran Mehrabani-Zeinabad, Sepideh Mehravar, Tesfahun Mekene Meto, Endalkachew Belayneh Melese, Max Alberto Mendez Mendez-Lopez, Walter Mendoza, Ritesh G Menezes, George A Mensah, Laverne G Mensah, Alexios-Fotios A Mentis, Sultan Ayoub Meo, Atte Meretoja, Tuomo J Meretoja, Abera M Mersha, Tomislav Mestrovic, Kukulege Chamila Dinushi Mettananda, Sachith Mettananda, Adquate Mhlanga, Laurette Mhlanga, Tomasz Miazgowski, Irmina Maria Michalek, Ana Carolina Micheletti Gomide Nogueira de Sá, Ted R Miller, Le Huu Nhat Minh, Alireza Mirahmadi, Antonio Mirijello, Erkin M Mirrakhimov, Roya Mirzaei, Philip B Mitchell, Chaitanya Mittal, Madeline E Moberg, Atousa Moghadam Fard, Seyedehfatemeh Mohajelin, Ashraf Mohamadkhani, Ahmed Ismail Mohamed, Jama Mohamed, Mouhand F H Mohamed, Nouh Saad Mohamed, Ameen Mosa Mohammad, Soheil Mohammadi, Hussen Mohammed, Mustapha Mohammed, Shafiu Mohammed, Ali H Mokdad, Mariam Molokhia, Shaher Mohammad Momani, Sara Momtazmanesh, Lorenzo Monasta, Stefania Mondello, Mohammad Ali Moni, Fateme Montazeri, AmirAli Moodi Ghalibaf, Maryam Moradi, Yousef Moradi, Paula Moraga, Lidia Morawska, Rafael Silveira Moreira, Negar Morovatdar, Shane Douglas Morrison, Abbas Mosapour, Jonathan F Mosser, Elias Mossialos, Rohith Motappa, Vincent Mougin, Parsa Mousavi, Matías Mrejen, Sumaira Mubarik, Ulrich Otto Mueller, Francesk Mulita, Kavita Munjal, Efrén Murillo-Zamora, Khaled M Musallam, Ana-Maria Musina, Ghulam Mustafa, Woojae Myung, Ayoub Nafei, Ahamarshan Jayaraman Nagarajan, Pirouz Naghavi, Ganesh R Naik, Gurudatta Naik, Firzan Nainu, Soroush Najdaghi, Noureddin Nakhostin Ansari, Vinay Nangia, Sreenivas Narasimha Swamy, Shumaila Nargus, Delaram Narimani Davani, Bruno Ramos Nascimento, Gustavo G Nascimento, Abdallah Y Naser, Abdulqadir J Nashwan, Zuhair S Natto, Javaid Nauman, Samidi N K Navaratna, Muhammad Naveed, Nawsherwan , Biswa Prakash Nayak, Vinod C Nayak, Hadush Negash, Ionut Negoi, Ruxandra Irina Negoi, Seyed Aria Nejadghaderi, Chakib Nejjari, Soroush Nematollahi, Henok Biresaw Netsere, Marie Ng, Georges Nguefack-Tsague, Josephine W Ngunjiri, Anh Hoang Nguyen, Dang H Nguyen, Duc Hoang Nguyen, Hau Thi Hien Nguyen, Nhan Nguyen, Nhien Ngoc Y Nguyen, Phat Tuan Nguyen, QuynhAnh P Nguyen, Van Thanh Nguyen, Duc Nguyen Tran Minh, Robina Khan Niazi, Yeshambel T Nigatu, Mahdieh Niknam, Ali Nikoobar, Amin Reza Nikpoor, Nasrin Nikravangolsefid, Efaq Ali Noman, Shuhei Nomura, Syed Toukir Ahmed Noor, Nafise Noroozi, Mehran Nouri, Majid Nozari, Chisom Adaobi Nri-Ezedi, George Ntaios, Mengistu H Nunemo, Dieta Nurrika, Jerry John Nutor, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Kehinde O Obamiro, Ismail A Odetokun, Michael Safo Oduro, Oluwaseun Adeolu Ogundijo, Adesola Adenike Ogunfowokan, Abiola Ogunkoya, Ayodipupo Sikiru Oguntade, In-Hwan Oh, Tolulope R Ojo-Akosile, Hassan Okati-Aliabad, Akinkunmi Paul Okekunle, Osaretin Christabel Okonji, Andrew T Olagunju, Matthew Idowu Olatubi, Gláucia Maria Moraes Oliveira, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Yinka Doris Oluwafemi, Hany A Omar, Goran Latif Omer, Sokking Ong, Sandersan Onie, Obinna E Onwujekwe, Abdulahi Opejin Opejin, Michal Ordak, Verner N Orish, Alberto Ortiz, Esteban Ortiz-Prado, Wael M S Osman, Sergej M Ostojic, Samuel M Ostroff, Uchechukwu Levi Osuagwu, Adrian Otoiu, Stanislav S Otstavnov, Amel Ouyahia, Mayowa O Owolabi, Oyetunde T Oyeyemi, Ahmad Ozair, Mahesh Padukudru P A, Alicia Padron-Monedero, Jagadish Rao Padubidri, Pramod Kumar Pal, Tamás Palicz, Feng Pan, Hai-Feng Pan, Songhomitra Panda-Jonas, Anamika Pandey, Victoria Pando-Robles, Helena Ullyartha Pangaribuan, Georgios D Panos, Leonidas D Panos, Ioannis Pantazopoulos, Anca Mihaela Pantea Stoian, Romil R Parikh, Eun-Kee Park, Seoyeon Park, Sungchul Park, Nicholas Parsons, Ashwaghosha Parthasarathi, Maja Pasovic, Roberto Passera, Jay Patel, Aslam Ramjan Pathan, Shankargouda Patil, Dimitrios Patoulias, Shrikant Pawar, Hamidreza Pazoki Toroudi, Spencer A Pease, Amy E Peden, Paolo Pedersini, Umberto Pensato, Veincent Christian Filipino Pepito, Prince Peprah, Marcos Pereira, Maria Odete Pereira, Arokiasamy Perianayagam, Norberto Perico, Simone Perna, Konrad Pesudovs, Fanny Emily Petermann-Rocha, Hoang Tran Pham, Anil K Philip, Michael R Phillips, Manon Pigeolet, Michael A Piradov, Enrico Pisoni, Evgenii Plotnikov, Dimitri Poddighe, Roman V Polibin, Ramesh Poluru, Ville T Ponkilainen, Djordje S Popovic, Maarten J Postma, Ahmad Pour-Rashidi, Disha Prabhu, Sergio I Prada, Jalandhar Pradhan, Pranil Man Singh Pradhan, Akila Prashant, Elton Junio Sady Prates, Tina Priscilla, Hery Purnobasuki, Bharathi M Purohit, Jagadeesh Puvvula, Nameer Hashim Qasim, Ibrahim Qattea, Asma Saleem Qazi, Gangzhen Qian, Mehrdad Rabiee Rad, Venkatraman Radhakrishnan, Hadi Raeisi Shahraki, Quinn Rafferty, Alberto Raggi, Cat Raggi, Nasiru Raheem, Fakher Rahim, Md Jillur Rahim, Sarvenaz Rahimibarghani, Md Mijanur Mijanur Rahman Rahman, Mosiur Rahman, Muhammad Aziz Rahman, Tafhimur Rahman, Amir Masoud Rahmani, Mohammad Rahmanian, Nazanin Rahmanian, Rahem Rahmati, Setyaningrum Rahmawaty, Diego Raimondo, Adarsh Raja, Prashant Rajput, Majed Ramadan, Shakthi Kumaran Ramasamy, Sheena Ramazanu, Pramod W Ramteke, Kritika Rana, Rishabh Kumar Rana, Chhabi Lal Ranabhat, Amey Rane, Chythra R Rao, Mithun Rao, Davide Rasella, Vahid Rashedi, Ahmed Mustafa Rashid, Ashkan Rasouli-Saravani, Prateek Rastogi, Azad Rasul, Devarajan Rathish, Giridhara Rathnaiah Babu, Santosh Kumar Rauniyar, Ramin Ravangard, David Laith Rawaf, Salman Rawaf, Rabail Zehra Raza, Elrashdy Moustafa Mohamed Redwan, Lennart Reifels, Marissa B Reitsma, Giuseppe Remuzzi, Kannan RR Rengasamy, Bhageerathy Reshmi, Serge Resnikoff, Stefano Restaino, Luis Felipe Reyes, Nazila Rezaei, Negar Rezaei, Zahra Sadat Rezaei, Mohsen Rezaeian, Taeho Gregory Rhee, Jennifer Rickard, Toshana Robalik, Hannah Elizabeth Robinson-Oden, Hermano Alexandre Lima Rocha, Mónica Rodrigues, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Debby Syahru Romadlon, Luca Ronfani, Moustaq Karim Khan Rony, Gholamreza Roshandel, Kunle Rotimi, Himanshu Sekhar Rout, Bedanta Roy, Enrico Rubagotti, Guilherme de Andrade Ruela, Susan Fred Rumisha, Tilleye Runghien, Michele Russo, Aly M A Saad, Korosh Saber, Maha Mohamed Saber-Ayad, Cameron John Sabet, Siamak Sabour, Perminder S Sachdev, Adam Saddler, Bashdar Abuzed Sadee, Masoumeh Sadeghi, Mohammad Reza Saeb, Umar Saeed, Sher Zaman Safi, Rajesh Sagar, Alireza Saghafi, Dominic Sagoe, Amirhossein Sahebkar, Pragyan Monalisa Sahoo, Mirza Rizwan Sajid, Nasir Salam, Payman Salamati, Afeez Abolarinwa Salami, Mohamed A Saleh, Leili Salehi, Marwa Rashad Salem, Aanuoluwa James Salemcity, Sohrab Salimi, Hossein Samadi Kafil, Saad Samargandy, Yoseph Leonardo Samodra, Abdallah M Samy, Juan Sanabria, Francesca Sanna, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Aswini Saravanan, Rodrigo Sarmiento-Suárez, Gargi Sachin Sarode, Sachin C Sarode, Benn Sartorius, Maheswar Satpathy, Abu Sayeed, Nikolaos Scarmeas, Benedikt Michael Schaarschmidt, Christophe Schinckus, Art Schuermans, Austin E Schumacher, Aletta Elisabeth Schutte, David C Schwebel, Falk Schwendicke, Siddharthan Selvaraj, Mohammad H Semreen, Sabyasachi Senapati, Pallav Sengupta, Subramanian Senthilkumaran, Dragos Serban, Yashendra Sethi, All
Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground: Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations. Methods: GBD 2023 produced estimates for 292 causes of death disaggregated by age-sex-location-year in 204 countries and territories and 660 subnational locations for each year from 1990 until 2023. We used a modelling tool developed for GBD, the Cause of Death Ensemble model (CODEm), to estimate cause-specific death rates for most causes. We computed YLLs as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. Probability of death was calculated as the chance of dying from a given cause in a specific age period, for a specific population. Mean age at death was calculated by first assigning the midpoint age of each age group for every death, followed by computing the mean of all midpoint ages across all deaths attributed to a given cause. We used GBD death estimates to calculate the observed mean age at death and to model the expected mean age across causes, sexes, years, and locations. The expected mean age reflects the expected mean age at death for individuals within a population, based on global mortality rates and the population's age structure. Comparatively, the observed mean age represents the actual mean age at death, influenced by all factors unique to a location-specific population, including its age structure. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 250-draw distribution for each metric. Findings are reported as counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2023 include a correction for the misclassification of deaths due to COVID-19, updates to the method used to estimate COVID-19, and updates to the CODEm modelling framework. This analysis used 55 761 data sources, including vital registration and verbal autopsy data as well as data from surveys, censuses, surveillance systems, and cancer registries, among others. For GBD 2023, there were 312 new country-years of vital registration cause-of-death data, 3 country-years of surveillance data, 51 country-years of verbal autopsy data, and 144 country-years of other data types that were added to those used in previous GBD rounds. Findings: The initial years of the COVID-19 pandemic caused shifts in long-standing rankings of the leading causes of global deaths: it ranked as the number one age-standardised cause of death at Level 3 of the GBD cause classification hierarchy in 2021. By 2023, COVID-19 dropped to the 20th place among the leading global causes, returning the rankings of the leading two causes to those typical across the time series (ie, ischaemic heart disease and stroke). While ischaemic heart disease and stroke persist as leading causes of death, there has been progress in reducing their age-standardised mortality rates globally. Four other leading causes have also shown large declines in global age-standardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. Other causes of death showed disparate patterns between sexes, notably for deaths from conflict and terrorism in some locations. A large reduction in age-standardised rates of YLLs occurred for neonatal disorders. Despite this, neonatal disorders remained the leading cause of global YLLs over the period studied, except in 2021, when COVID-19 was temporarily the leading cause. Compared to 1990, there has been a considerable reduction in total YLLs in many vaccine-preventable diseases, most notably diphtheria, pertussis, tetanus, and measles. In addition, this study quantified the mean age at death for all-cause mortality and cause-specific mortality and found noticeable variation by sex and location. The global all-cause mean age at death increased from 46·8 years (95% UI 46·6-47·0) in 1990 to 63·4 years (63·1-63·7) in 2023. For males, mean age increased from 45·4 years (45·1-45·7) to 61·2 years (60·7-61·6), and for females it increased from 48·5 years (48·1-48·8) to 65·9 years (65·5-66·3), from 1990 to 2023. The highest all-cause mean age at death in 2023 was found in the high-income super-region, where the mean age for females reached 80·9 years (80·9-81·0) and for males 74·8 years (74·8-74·9). By comparison, the lowest all-cause mean age at death occurred in sub-Saharan Africa, where it was 38·0 years (37·5-38·4) for females and 35·6 years (35·2-35·9) for males in 2023. Lastly, our study found that all-cause 70q0 decreased across each GBD super-region and region from 2000 to 2023, although with large variability between them. For females, we found that 70q0 notably increased from drug use disorders and conflict and terrorism. Leading causes that increased 70q0 for males also included drug use disorders, as well as diabetes. In sub-Saharan Africa, there was an increase in 70q0 for many non-communicable diseases (NCDs). Additionally, the mean age at death from NCDs was lower than the expected mean age at death for this super-region. By comparison, there was an increase in 70q0 for drug use disorders in the high-income super-region, which also had an observed mean age at death lower than the expected value. Interpretation: We examined global mortality patterns over the past three decades, highlighting-with enhanced estimation methods-the impacts of major events such as the COVID-19 pandemic, in addition to broader trends such as increasing NCDs in low-income regions that reflect ongoing shifts in the global epidemiological transition. This study also delves into premature mortality patterns, exploring the interplay between age and causes of death and deepening our understanding of where targeted resources could be applied to further reduce preventable sources of mortality. We provide essential insights into global and regional health disparities, identifying locations in need of targeted interventions to address both communicable and non-communicable diseases. There is an ever-present need for strengthened health-care systems that are resilient to future pandemics and the shifting burden of disease, particularly among ageing populations in regions with high mortality rates. Robust estimates of causes of death are increasingly essential to inform health priorities and guide efforts toward achieving global health equity. The need for global collaboration to reduce preventable mortality is more important than ever, as shifting burdens of disease are affecting all nations, albeit at different paces and scales. Funding: Gates Foundation
Global burden of lower respiratory infections and aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground: Lower respiratory infections (LRIs) remain the world’s leading infectious cause of death. This analysis
from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides global, regional, and
national estimates of LRI incidence, mortality, and disability-adjusted life-years (DALYs), with attribution to
26 pathogens, including 11 newly modelled pathogens, across 204 countries and territories from 1990 to 2023. With
new data and revised modelling techniques, these estimates serve as an update and expansion to GBD 2021. Through
these estimates, we also aimed to assess progress towards the 2025 Global Action Plan for the Prevention and
Control of Pneumonia and Diarrhoea (GAPPD) target for pneumonia mortality in children younger than 5 years.
Methods: Mortality from LRIs, defined as physician-diagnosed pneumonia or bronchiolitis, was estimated using
the Cause of Death Ensemble model with data from vital registration, verbal autopsy, surveillance, and minimally
invasive tissue sampling. The Bayesian meta-regression tool DisMod-MR 2.1 was used to model overall morbidity
due to LRIs. DALYs were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs) for
all locations, years, age groups, and sexes. We modelled pathogen-specific case-fatality ratios (CFRs) for each age
group and location using splined binomial regression to create internally consistent estimates of incidence and
mortality proportions attributable to viral, fungal, parasitic, and bacterial pathogens. Progress was assessed
towards the GAPPD target of less than three deaths from pneumonia per 1000 livebirths, which is roughly
equivalent to a mortality rate of less than 60 deaths per 100 000 children younger than 5 years.
Findings: In 2023, LRIs were responsible for 2·50 million (95% uncertainty interval [UI] 2·24–2·81) deaths and
98·7 million (87·7–112) DALYs, with children younger than 5 years and adults aged 70 years and older carrying the
highest burden. LRI mortality in children younger than 5 years fell by 33·4% (10·4–47·4) since 2010, with a global
mortality rate of 94·8 (75·6–116·4) per 100000 person-years in 2023. Among adults aged 70 years and older, the burden
remained substantial with only marginal declines since 2010. A mortality rate of less than 60 deaths per 100000 for
children younger than 5 years was met by 129 of the 204 modelled countries in 2023. At a super-regional level, subSaharan Africa had an aggregate mortality rate in children younger than 5 years (hereafter referred to as under-5
mortality rate) furthest from the GAPPD target. Streptococcus pneumoniae continued to account for the largest number
of LRI deaths globally (634000 [95% UI 565000–721000] deaths or 25·3% [24·5–26·1] of all LRI deaths), followed by
Staphylococcus aureus (271000 [243000–298000] deaths or 10·9% [10·3–11·3]), and Klebsiella pneumoniae (228000
[204000–261000] deaths or 9·1% [8·8–9·5]). Among pathogens newly modelled in this study, non-tuberculous
mycobacteria (responsible for 177000 [95% UI 155000–201000] deaths) and Aspergillus spp (responsible for 67800
[59900–75900] deaths) emerged as important contributors. Altogether, the 11 newly modelled pathogens accounted for
approximately 22% of LRI deaths.
Interpretation: This comprehensive analysis underscores both the gains achieved through vaccination and the
challenges that remain in controlling the LRI burden globally. Furthermore, it demonstrates persistent disparities
in disease burden, with the highest mortality rates concentrated in countries in sub-Saharan Africa. Globally, as
well as in these high-burden locations, the under-5 LRI mortality rate remains well above the GAPPD target.
Progress towards this target requires equitable access to vaccines and preventive therapies—including newer
interventions such as respiratory syncytial virus monoclonal antibodies—and health systems capable of early
diagnosis and treatment. Expanding surveillance of emerging pathogens, strengthening adult immunisation
programmes, and combating vaccine hesitancy are also crucial. As the global population ages, the dual challenge
of sustaining gains in child survival while addressing the rising vulnerability in older adults will shape future
pneumonia control strategies
Global, regional, and national burden of HIV/AIDS, 1990–2021, and forecasts to 2050, for 204 countries and territories: the Global Burden of Disease Study 2021
No full textBackgroundAs set out in Sustainable Development Goal 3.3, the target date for ending the HIV epidemic as a public health threat is 2030. Therefore, there is a crucial need to evaluate current epidemiological trends and monitor global progress towards HIV incidence and mortality reduction goals. In this analysis, we assess the current burden of HIV in 204 countries and territories and forecast HIV incidence, prevalence, and mortality up to 2050 to allow countries to plan for a sustained response with an increasing number of people living with HIV globally. MethodsWe used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 analytical framework to compute age-sex-specific HIV mortality, incidence, and prevalence estimates for 204 countries and territories (1990–2021). We aimed to analyse all available data sources, including data on the provision of HIV programmes reported to UNAIDS, published literature on mortality among people on antiretroviral therapy (ART) identified by a systematic review, household surveys, sentinel surveillance antenatal care clinic data, vital registration data, and country-level case report data. We calibrated a mechanistic simulation of HIV infection and natural history to available data to estimate HIV burden from 1990 to 2021 and generated forecasts to 2050 through projection of all simulation inputs into the future. Historical outcomes (1990–2021) were simulated at the 1000-draw level to support propagation of uncertainty and reporting of uncertainty intervals (UIs). Our approach to forecasting utilised the transmission rate as the basis for projection, along with new rate-of-change projections of ART coverage. Additionally, we introduced two new metrics to our reporting: prevalence of unsuppressed viraemia (PUV), which represents the proportion of the population without a suppressed level of HIV (viral load <1000 copies per mL), and period lifetime probability of HIV acquisition, which quantifies the hypothetical probability of acquiring HIV for a synthetic cohort, a simulated population that is aged from birth to death through the set of age-specific incidence rates of a given time period. FindingsGlobal new HIV infections decreased by 21·9% (95% UI 13·1–28·8) between 2010 and 2021, from 2·11 million (2·02–2·25) in 2010 to 1·65 million (1·48–1·82) in 2021. HIV-related deaths decreased by 39·7% (33·7–44·5), from 1·19 million (1·07–1·37) in 2010 to 718 000 (669 000–785 000) in 2021. The largest declines in both HIV incidence and mortality were in sub-Saharan Africa and south Asia. However, super-regions including central Europe, eastern Europe, and central Asia, and north Africa and the Middle East experienced increasing HIV incidence and mortality rates. The number of people living with HIV reached 40·0 million (38·0–42·4) in 2021, an increase from 29·5 million (28·1–31·0) in 2010. The lifetime probability of HIV acquisition remains highest in the sub-Saharan Africa super-region, where it declined from its 1995 peak of 21·8% (20·1–24·2) to 8·7% (7·5–10·7) in 2021. Four of the seven GBD super-regions had a lifetime probability of less than 1% in 2021. In 2021, sub-Saharan Africa had the highest PUV of 999·9 (857·4–1154·2) per 100 000 population, but this was a 64·5% (58·8–69·4) reduction in PUV from 2003 to 2021. In the same period, PUV increased in central Europe, eastern Europe, and central Asia by 116·1% (8·0–218·2). Our forecasts predict a continued global decline in HIV incidence and mortality, with the number of people living with HIV peaking at 44·4 million (40·7–49·8) by 2039, followed by a gradual decrease. In 2025, we projected 1·43 million (1·29–1·59) new HIV infections and 615 000 (567 000–680 000) HIV-related deaths, suggesting that the interim 2025 targets for reducing these figures are unlikely to be achieved. Furthermore, our forecasted results indicate that few countries will meet the 2030 target for reducing HIV incidence and HIV-related deaths by 90% from 2010 levels. InterpretationOur forecasts indicate that continuation of current levels of HIV control are not likely to attain ambitious incidence and mortality reduction targets by 2030, and more than 40 million people globally will continue to require lifelong ART for decades into the future. The global community will need to show sustained and substantive efforts to make the progress needed to reach and sustain the end of AIDS as a public threat. FundingThe Bill & Melinda Gates Foundation and the National Institute of Allergy and Infectious Diseases
