Medical Education - Research Publications

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Start date: 2020 × End date: 2022 × Author: Chin, Ken ×

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    Poor adherence and persistence to sodium glucose co-transporter 2 inhibitors in real-world settings: Evidence from a systematic review and meta-analysis
    Ofori-Asenso, R ; Sahle, BW ; Chin, KL ; Mazidi, M ; Ademi, Z ; De Bruin, ML ; Liew, D (WILEY, 2021-01)
    AIMS: Despite increasing prescription of sodium glucose co-transporter 2 (SGLT2) inhibitors, there is limited insight of the patterns of use among patients with diabetes prescribed these drugs. This study aimed to summarize available real-world data on the adherence and persistence to SGLT2 inhibitors. MATERIALS AND METHODS: A systematic review for observational studies reporting the adherence and persistence to SGLT2 inhibitors was performed in Medline, Embase, and Web of Science from their inception to October 2019. Data were analysed via random-effects meta-analysis. RESULTS: A total of 22 studies (31 cohorts) comprising 123 854 individuals prescribed SGLT2 inhibitors from eight countries were included. The pooled mean proportions of days covered [PDC] at six months and one year were 0.77 (95% confidence interval [CI] 0.72-0.82) and 0.72 (95% CI 0.66-0.77), respectively. The pooled proportions adherent (PDC ≥0.80) at six months and one year were 59.5% (95% CI 52.9-65.9) and 49.0% (95% CI 42.3-55.8), respectively. The pooled proportions of people persistent at six months, one year, and two years were 80.1% (95% CI 75.8-84.0), 61.8% (95% CI 57.8-65.7), and 45.9% (95% CI 35.5-56.5), respectively. When persistence was defined as the absence of ≥90-days gap, the equivalent pooled proportions persistent were 81.5% (95% CI 73.1-88.6), 58.9% (95% CI 53.1-64.6), and 34.7% (95% CI 33.6-35.8). Adherence and persistence appeared to vary across different SGLT2 inhibitors. CONCLUSIONS: Real-world adherence and persistence to SGLT2 inhibitors is poor. Hence, targets for improving treatment adherence and persistence need to be identified and appropriate interventions implemented.
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    Rethinking pandemic preparation: Global Health Security Index (GHSI) is predictive of COVID-19 burden, but in the opposite direction
    Aitken, T ; Chin, KL ; Liew, D ; Ofori-Asenso, R (W B SAUNDERS CO LTD, 2020-08)
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    Smell and Taste Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis
    Agyeman, AA ; Chin, KL ; Landersdorfer, CB ; Liew, D ; Ofori-Asenso, R (ELSEVIER SCIENCE INC, 2020-08)
    OBJECTIVE: To estimate the prevalence of olfactory and gustatory dysfunctions (OGDs) among patients infected with novel coronavirus disease 2019 (COVID-19). METHODS: A systematic review was conducted by searching MEDLINE, EMBASE, and the preprint server MedRxiv from their inception until May 11, 2020, using the terms anosmia or hyposmia or dysosmia or olfactory dysfunction or olfaction disorder or smell dysfunction or ageusia or hypogeusia or dysgeusia or taste dysfunction or gustatory dysfunction or neurological and COVID-19 or 2019 novel coronavirus or 2019-nCoV or SARS-CoV-2. The references of included studies were also manually screened. Only studies involving patients with diagnostic-confirmed COVID-19 infection were included. Random-effects meta-analysis was performed. RESULTS: Twenty-four studies with data from 8438 patients with test-confirmed COVID-19 infection from 13 countries were included. The pooled proportions of patients presenting with olfactory dysfunction and gustatory dysfunction were 41.0% (95% CI, 28.5% to 53.9%) and 38.2% (95% CI, 24.0% to 53.6%), respectively. Increasing mean age correlated with lower prevalence of olfactory (coefficient = -0.076; P=.02) and gustatory (coefficient = -0.073; P=.03) dysfunctions. There was a higher prevalence of olfactory dysfunctions with the use of objective measurements compared with self-reports (coefficient = 2.33; P=.01). No significant moderation of the prevalence of OGDs by sex was observed. CONCLUSION: There is a high prevalence of OGDs among patients infected with COVID-19. Routine screening for these conditions could contribute to improved case detection in the ongoing COVID-19 pandemic. However, to better inform population screening measures, further studies are needed to establish causality.
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    Early signs that COVID-19 is being contained in Australia
    Chin, KL ; Ofori-Asenso, R ; Jordan, KA ; Jones, D ; Liew, D (W B SAUNDERS CO LTD, 2020-08)
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    Rethinking pandemic preparation: Global Health Security Index (GHSI) is predictive of COVID-19 burden, but in the opposite direction.
    Aitken, T ; Chin, KL ; Liew, D ; Ofori-Asenso, R (Elsevier BV, 2020-08)
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    Retrospective study of idiosyncratic drug-induced liver injury from infliximab in an inflammatory bowel disease cohort: the IDLE study.
    Worland, T ; Chin, KL ; van Langenberg, D ; Garg, M ; Nicoll, A (Hellenic Society of Gastroenterology, 2020)
    BACKGROUND: Infliximab therapy may be associated with drug-induced liver injury (DILI), often resembling a drug-induced autoimmune hepatitis. However, the prevalence of DILI in patients receiving infliximab is unclear. Abnormal liver biochemistry is common in patients with inflammatory bowel disease (IBD) and definitive diagnosis may be difficult. The aim of this study was to describe the patterns of abnormal liver biochemistry in an IBD cohort. METHODS: In a retrospective cohort study of adult patients with IBD treated with infliximab through a single institution we used the Roussel Uclaf Causality Assessment Method (RUCAM) to evaluate liver biochemistry and possible DILI. All cases of abnormal liver biochemistry were ascribed a presumptive diagnosis from the electronic medical record. RESULTS: Fifty-seven of the 175 patients (149 Crohn's disease, 26 ulcerative colitis) had abnormal liver biochemistry. Of the 57 cases, one had highly probable, and 10 possible DILI due to infliximab. There were no significant differences regarding demographics, concomitant therapy/disease, indication for infliximab or outcomes between patients with normal and abnormal liver biochemistry, except for higher baseline alanine transaminase and alkaline phosphatase in the abnormal biochemistry group (P<0.001). Multivariate logistic regression showed male sex (odds ratio [OR] 2.49, 95% confidence interval [CI] 1.22-5.09; P=0.01) and background liver disease (OR 15.09, 95%CI 4.09-55.69; P<0.001) to be associated with the abnormal liver biochemistry group. CONCLUSIONS: Abnormal liver biochemistry is common in IBD patients on infliximab. Patients who are male, or have abnormal pre-therapy liver biochemistry or background liver disease, are more likely to develop worsening liver biochemistry during infliximab therapy. RUCAM scoring may help identify true cases of DILI.
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    The global distribution of lymphatic filariasis, 2000-18: a geospatial analysis.
    Local Burden of Disease 2019 Neglected Tropical Diseases Collaborators, (Elsevier BV, 2020-09)
    BACKGROUND: Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. METHODS: A global dataset of georeferenced surveyed locations was used to model annual 2000-18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000-18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. FINDINGS: We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174-234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6-5·7 million) in the region of the Americas to 107 million (91-134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43-63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. INTERPRETATION: Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. FUNDING: Bill & Melinda Gates Foundation.
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    Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17
    Wiens, KE ; Lindstedt, PA ; Blacker, BF ; Johnson, KB ; Baumann, MM ; Schaeffer, LE ; Abbastabar, H ; Abd-Allah, F ; Abdelalim, A ; Abdollahpour, I ; Abegaz, KH ; Abejie, AN ; Abreu, LG ; Abrigo, MRM ; Abualhasan, A ; Accrombessi, MMK ; Acharya, D ; Adabi, M ; Adamu, AA ; Adebayo, OM ; Adedoyin, RA ; Adekanmbi, V ; Adetokunboh, OO ; Adhena, BM ; Afarideh, M ; Ahmad, S ; Ahmadi, K ; Ahmed, AE ; Ahmed, MB ; Ahmed, R ; Akalu, TY ; Alahdab, F ; Al-Aly, Z ; Alam, N ; Alam, S ; Alamene, GM ; Alanzi, TM ; Alcalde-Rabanal, JE ; Ali, BA ; Alijanzadeh, M ; Alipour, V ; Aljunid, SM ; Almasi, A ; Almasi-Hashiani, A ; Al-Mekhlafi, HM ; Altirkawi, KA ; Alvis-Guzman, N ; Alvis-Zakzuk, NJ ; Amini, S ; Amit, AML ; Andrei, CL ; Anjomshoa, M ; Anoushiravani, A ; Ansari, F ; Antonio, CAT ; Antony, B ; Antriyandarti, E ; Arabloo, J ; Aref, HMA ; Aremu, O ; Armoon, B ; Arora, A ; Aryal, KK ; Arzani, A ; Asadi-Aliabadi, M ; Atalay, HT ; Athari, SS ; Athari, SM ; Atre, SR ; Ausloos, M ; Awoke, N ; Quintanilla, BPA ; Ayano, G ; Ayanore, MA ; Aynalem, YA ; Azari, S ; Azzopardi, PS ; Babaee, E ; Babalola, TK ; Badawi, A ; Bairwa, M ; Bakkannavar, SM ; Balakrishnan, S ; Bali, AG ; Banach, M ; Banoub, JAM ; Barac, A ; Barnighausen, TW ; Basaleem, H ; Basu, S ; Bay, VD ; Bayati, M ; Baye, E ; Bedi, N ; Beheshti, M ; Behzadifar, M ; Behzadifar, M ; Bekele, BB ; Belayneh, YM ; Bell, ML ; Bennett, DA ; Berbada, DA ; Bernstein, RS ; Bhat, AG ; Bhattacharyya, K ; Bhattarai, S ; Bhaumik, S ; Bhutta, ZA ; Bijani, A ; Bikbov, B ; Birihane, BM ; Biswas, RK ; Bohlouli, S ; Bojia, HA ; Boufous, S ; Brady, OJ ; Bragazzi, NL ; Briko, AN ; Briko, NI ; Britton, GB ; Nagaraja, SB ; Busse, R ; Butt, ZA ; Camera, LA ; Campos-Nonato, IR ; Cano, J ; Car, J ; Cardenas, R ; Carvalho, F ; Castaneda-Orjuela, CA ; Castro, F ; Chanie, WF ; Chatterjee, P ; Chattu, VK ; Chichiabellu, TY ; Chin, KL ; Christopher, DJ ; Chu, D-T ; Cormier, NM ; Costa, VM ; Culquichicon, C ; Daba, MS ; Damiani, G ; Dandona, L ; Dandona, R ; Dang, AK ; Darwesh, AM ; Darwish, AH ; Daryani, A ; Das, JK ; Das Gupta, R ; Dash, AP ; Davey, G ; Davila-Cervantes, CA ; Davis, AC ; Davitoiu, DV ; De la Hoz, FP ; Demis, AB ; Demissie, DB ; Demissie, GD ; Demoz, GT ; Demoz, GT ; Denova-Gutierrez, E ; Deribe, K ; Desalew, A ; Deshpande, A ; Dharmaratne, SD ; Dhillon, P ; Dhimal, M ; Dhungana, GP ; Diaz, D ; Dipeolu, IO ; Djalalinia, S ; Doyle, KE ; Dubljanin, E ; Duko, B ; Duraes, AR ; Kalan, ME ; Edinur, HA ; Effiong, A ; Eftekhari, A ; El Nahas, N ; El Sayed, I ; Zaki, MES ; El Tantawi, M ; Elema, TB ; Elhabashy, HR ; El-Jaafary, SI ; Elkout, H ; Elsharkawy, A ; Elyazar, IRF ; Endalamaw, A ; Endalew, DA ; Eskandarieh, S ; Esteghamati, A ; Esteghamati, S ; Etemadi, A ; Ezekannagha, O ; Fareed, M ; Faridnia, R ; Farzadfar, F ; Fazlzadeh, M ; Feigin, VL ; Fereshtehnejad, S-M ; Fernandes, E ; Filip, I ; Fischer, F ; Foigt, NA ; Folayan, MO ; Foroutan, M ; Franklin, RC ; Fukumoto, T ; Gad, MM ; Gayesa, RT ; Gebre, T ; Gebremedhin, KB ; Gebremeskel, GG ; Gesesew, HA ; Gezae, KE ; Ghadiri, K ; Ghashghaee, A ; Ghimire, PR ; Gill, PS ; Gill, TK ; Ginindza, TG ; Gomes, NGM ; Gopalani, SV ; Goulart, AC ; Goulart, BNG ; Grada, A ; Gubari, MIM ; Gugnani, HC ; Guido, D ; Guimaraes, RA ; Guo, Y ; Gupta, R ; Hafezi-Nejad, N ; Haile, DH ; Hailu, GB ; Haj-Mirzaian, A ; Haj-Mirzaian, A ; Hamadeh, RR ; Hamidi, S ; Handiso, DW ; Haririan, H ; Hariyani, N ; Hasaballah, AI ; Hasan, MM ; Hasanpoor, E ; Hasanzadeh, A ; Hassankhani, H ; Hassen, HY ; Hegazy, MI ; Heibati, B ; Heidari, B ; Hendrie, D ; Henry, NJ ; Herteliu, C ; Heydarpour, F ; de Hidru, HD ; Hird, TR ; Hoang, CL ; Rad, EH ; Hoogar, P ; Hoseini, M ; Hossain, N ; Hosseini, M ; Hosseinzadeh, M ; Househ, M ; Hsairi, M ; Hu, G ; Hussen, MM ; Ibitoye, SE ; Igumbor, EU ; Ilesanmi, OS ; Ilic, MD ; Imani-Nasab, MH ; Iqbal, U ; Irvani, SSN ; Islam, SMS ; Iwu, CJ ; Izadi, N ; Jaca, A ; Jahanmehr, N ; Jakovljevic, M ; Jalali, A ; Jayatilleke, AU ; Jha, RP ; Jha, V ; Ji, JS ; Jonas, JB ; Jozwiak, JJ ; Kabir, A ; Kabir, Z ; Kahsay, A ; Kalani, H ; Kanchan, T ; Matin, BK ; Karch, A ; Karim, MA ; Karki, HK-SS ; Kasaeian, A ; Kasahun, GG ; Kasahun, YC ; Kasaye, HK ; Kassa, GG ; Kassa, GM ; Kayode, GA ; Karyani, AK ; Kebede, MM ; Keiyoro, PN ; Kelbore, AG ; Kengne, AP ; Ketema, DB ; Khader, YS ; Khafaie, MA ; Khalid, N ; Khalilov, R ; Khan, EA ; Khan, J ; Khan, MN ; Khan, MS ; Khatab, K ; Khater, AM ; Khater, MM ; Khayamzadeh, M ; Khazaei, M ; Khazaei, S ; Khosravi, MH ; Khubchandani, J ; Kiadaliri, A ; Kim, YJ ; Kimokoti, RW ; Kisa, A ; Kisa, S ; Kissoon, N ; Shivakumar, KM ; Kochhar, S ; Kolola, T ; Komaki, H ; Kosen, S ; Koul, PA ; Koyanagi, A ; Kraemer, MUG ; Krishan, K ; Kugbey, N ; Kumar, GA ; Kumar, M ; Kumar, P ; Kusuma, VKD ; La Vecchia, C ; Lacey, B ; Lad, SD ; Lal, DK ; Lam, F ; Lami, FH ; Lamichhane, P ; Lansingh, VC ; Lasrado, S ; Laxmaiah, A ; Lee, PH ; LeGrand, KE ; Leili, M ; Lenjebo, TL ; Leshargie, CT ; Levine, AJ ; Li, S ; Linn, S ; Liu, S ; Liu, S ; Lodha, R ; Longbottom, J ; Lopez, JCF ; Abd El Razek, HM ; Abd El Razek, MM ; Prasad, DRM ; Mahasha, PW ; Mahotra, NB ; Majeed, A ; Malekzadeh, R ; Malta, DC ; Mamun, AA ; Manafi, N ; Manda, AL ; Manohar, NDD ; Mansournia, MA ; Mapoma, CC ; Maravilla, JC ; Martinez, G ; Martini, S ; Martins-Melo, FR ; Masaka, A ; Massenburg, BB ; Mathur, MR ; Mayala, BK ; Mazidi, M ; McAlinden, C ; Meharie, BG ; Mehndiratta, MM ; Mehta, KM ; Mekonnen, TC ; Meles, GG ; Memiah, PTN ; Memish, ZA ; Mendoza, W ; Menezes, RG ; Mereta, ST ; Meretoja, TJ ; Mestrovic, T ; Miazgowski, B ; Mihretie, KM ; Miller, TR ; Mini, GK ; Mirrakhimov, EM ; Moazen, B ; Mohajer, B ; Mohamadi-Bolbanabad, A ; Mohammad, DK ; Mohammad, KA ; Mohammad, Y ; Mezerji, NMG ; Mohammadibakhsh, R ; Mohammadifard, N ; Mohammed, JA ; Mohammed, S ; Mohebi, F ; Mokdad, AH ; Molokhia, M ; Monasta, L ; Moodley, Y ; Moore, CE ; Moradi, G ; Moradi, M ; Moradi-Joo, M ; Moradi-Lakeh, M ; Moraga, P ; Morales, L ; Velasquez, IM ; Mosapour, A ; Mouodi, S ; Mousavi, SM ; Mozaffor, M ; Muchie, KF ; Mulaw, GF ; Munro, SB ; Muriithi, MK ; Murray, CJL ; Murthy, GVS ; Musa, KI ; Mustafa, G ; Muthupandian, S ; Nabhan, AF ; Naderi, M ; Nagarajan, AJ ; Naidoo, KS ; Naik, G ; Najafi, F ; Nangia, V ; Nansseu, JR ; Nascimento, BR ; Nazari, J ; Ndwandwe, DE ; Negoi, I ; Netsere, HB ; Ngunjiri, JW ; Nguyen, CT ; Nguyen, HLT ; Nguyen, TH ; Nigatu, D ; Nigatu, SG ; Ningrum, DNA ; Nnaji, CA ; Nojomi, M ; Nong, VM ; Norheim, OF ; Noubiap, JJ ; Motlagh, SN ; Oancea, B ; Ogah, OS ; Ogbo, FA ; Oh, I-H ; Olagunju, AT ; Olagunju, TO ; Olusanya, BO ; Olusanya, JO ; Onwujekwe, OE ; Oren, E ; Ortega-Altamirano, DV ; Osarenotor, O ; Osei, FB ; Owolabi, MO ; Mahesh, PA ; Padubidri, JR ; Pakhale, S ; Patel, SK ; Paternina-Caicedo, AJ ; Pathak, A ; Patton, GC ; Paudel, D ; Paulos, K ; Pepito, VCF ; Pereira, A ; Perico, N ; Pervaiz, A ; Pescarini, JM ; Piroozi, B ; Pirsaheb, M ; Postma, MJ ; Pourjafar, H ; Pourmalek, F ; Pourshams, A ; Poustchi, H ; Prada, SI ; Prasad, N ; Preotescu, L ; Quintana, H ; Rabiee, N ; Radfar, A ; Rafiei, A ; Rahim, F ; Rahimi-Movaghar, A ; Rahimi-Movaghar, V ; Rahman, MHU ; Rahman, MA ; Rahman, S ; Rajati, F ; Rana, SM ; Ranabhat, CL ; Rasella, D ; Rawaf, DL ; Rawaf, S ; Rawal, L ; Rawasia, WF ; Renjith, V ; Renzaho, AMN ; Resnikoff, S ; Reta, MA ; Rezaei, N ; Rezai, MS ; Riahi, SM ; Ribeiro, AI ; Rickard, J ; Rios-Blancas, M ; Roever, L ; Ronfani, L ; Roro, EM ; Ross, JM ; Rubagotti, E ; Rubino, S ; Saad, AM ; Sabde, YD ; Sabour, S ; Sadeghi, E ; Safari, Y ; Safari-Faramani, R ; Sagar, R ; Sahebkar, A ; Sahraian, MA ; Sajadi, SM ; Salahshoor, MR ; Salam, N ; Salamati, P ; Salem, H ; Salem, MR ; Salimi, Y ; Salimzadeh, H ; Samy, AM ; Sanabria, J ; Santric-Milicevic, MM ; Jose, BPS ; Saraswathy, SYI ; Sarkar, K ; Sarker, AR ; Sarrafzadegan, N ; Sartorius, B ; Sathian, B ; Sathish, T ; Sawhney, M ; Saxena, S ; Schwebel, DC ; Senbeta, AM ; Senthilkumaran, S ; Sepanlou, SG ; Servan-Mori, E ; Shabaninejad, H ; Shafieesabet, A ; Shaikh, MA ; Shalash, AS ; Shallo, SA ; Shams-Beyranvand, M ; Shamsi, M ; Shamsizadeh, M ; Shannawaz, M ; Sharafi, K ; Sharifi, H ; Shehata, HS ; Sheikh, A ; Shetty, BSK ; Shibuya, K ; Shiferaw, WS ; Shifti, DM ; Shigematsu, M ; Il Shin, J ; Shiri, R ; Shirkoohi, R ; Siabani, S ; Siddiqi, TJ ; Silva, DAS ; Singh, A ; Singh, JA ; Singh, NP ; Singh, V ; Sisay, MM ; Skiadaresi, E ; Sobhiyeh, MR ; Sokhan, A ; Soltani, S ; Somayaji, R ; Soofi, M ; Sorrie, MB ; Soyiri, IN ; Sreeramareddy, CT ; Sudaryanto, A ; Sufiyan, MB ; Suleria, HAR ; Sultana, M ; Sunguya, BF ; Sykes, BL ; Tabares-Seisdedos, R ; Tabuchi, T ; Tadesse, DB ; Tarigan, IU ; Tasew, AA ; Tefera, YM ; Tekle, MG ; Temsah, M-H ; Tesfay, BE ; Tesfay, FH ; Tessema, B ; Tessema, ZT ; Thankappan, KR ; Thomas, N ; Toma, A ; Topor-Madry, R ; Tovani-Palone, MR ; Traini, E ; Tran, BX ; Tran, KB ; Ullah, I ; Unnikrishnan, B ; Usman, MS ; Uzochukwu, BSC ; Valdez, PR ; Varughese, S ; Violante, FS ; Vollmer, S ; Hawariat, FGW ; Waheed, Y ; Wallin, MT ; Wang, Y ; Wang, Y-P ; Weaver, M ; Weji, BG ; Weldesamuel, GT ; Welgan, CA ; Werdecker, A ; Westerman, R ; Wiangkham, T ; Wiysonge, CS ; Wolde, HF ; Wondafrash, DZ ; Wonde, TE ; Worku, GT ; Wu, A-M ; Xu, G ; Yadollahpour, A ; Jabbari, SHY ; Yamada, T ; Yatsuya, H ; Yeshaneh, A ; Yilgwan, CS ; Yilma, MT ; Yip, P ; Yisma, E ; Yonemoto, N ; Yoon, S-J ; Younis, MZ ; Yousefifard, M ; Yousof, H-ASA ; Yu, C ; Yusefzadeh, H ; Zadey, S ; Zaidi, Z ; Bin Zaman, S ; Zamani, M ; Zandian, H ; Zepro, NB ; Zerfu, TA ; Zhang, Y ; Zhao, X-JG ; Ziapour, A ; Zodpey, S ; Zuniga, YMH ; Hay, SI ; Reiner, RC (ELSEVIER SCI LTD, 2020-08-01)
    BACKGROUND: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. METHODS: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. FINDINGS: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. INTERPRETATION: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. FUNDING: Bill & Melinda Gates Foundation.
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    Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017
    Reiner, RC ; Wiens, KE ; Deshpande, A ; Baumann, MM ; Lindstedt, PA ; Blacker, BF ; Troeger, CE ; Earl, L ; Munro, SB ; Abate, D ; Abbastabar, H ; Abd-Allah, F ; Abdelalim, A ; Abdollahpour, I ; Abdulkader, RS ; Abebe, G ; Abegaz, KH ; Abreu, LG ; Abrigo, MRM ; Accrombessi, MMK ; Acharya, D ; Adabi, M ; Adebayo, OM ; Adedoyin, RA ; Adekanmbi, V ; Adetokunboh, OO ; Adham, D ; Adhena, BM ; Afarideh, M ; Ahmadi, K ; Ahmadi, M ; Ahmed, AE ; Ahmed, MB ; Ahmed, R ; Ajumobi, O ; Akal, CG ; Akalu, TY ; Akanda, AS ; Alamene, GM ; Alanzi, TM ; Albright, JR ; Rabanal, JEA ; Alemnew, BT ; Alemu, ZA ; Ali, BA ; Ali, M ; Alijanzadeh, M ; Alipour, V ; Aljunid, SM ; Almasi, A ; Almasi-Hashiani, A ; Al-Mekhlafi, HM ; Altirkawi, K ; Alvis-Guzman, N ; Alvis-Zakzuk, NJ ; Amare, AT ; Amini, S ; Amit, AML ; Andrei, CL ; Anegago, MT ; Anjomshoa, M ; Ansari, F ; Antonio, CAT ; Antriyandarti, E ; Appiah, SCY ; Arabloo, J ; Aremu, O ; Armoon, B ; Aryal, KK ; Arzani, A ; Asadi-Lari, M ; Ashagre, AF ; Atalay, HT ; Atique, S ; Atre, SR ; Ausloos, M ; Avila-Burgos, L ; Awasthi, A ; Awoke, N ; Quintanilla, BPA ; Ayano, G ; Ayanore, MA ; Ayele, AA ; Aynalem, YA ; Azari, S ; Babaee, E ; Badawi, A ; Bakkannavar, SM ; Balakrishnan, S ; Bali, AG ; Banach, M ; Barac, A ; Barnighausen, TW ; Basaleem, H ; Bassat, Q ; Bayati, M ; Bedi, N ; Behzadifar, M ; Behzadifar, M ; Bekele, YA ; Bell, ML ; Bennett, DA ; Berbada, DA ; Beyranvand, T ; Bhat, AG ; Bhattacharyya, K ; Bhattarai, S ; Bhaumik, S ; Bijani, A ; Bikbov, B ; Biswas, RK ; Bogale, KA ; Bohlouli, S ; Brady, OJ ; Bragazzi, NL ; Briko, AN ; Briko, NI ; Nagaraja, SB ; Butt, ZA ; Campos-Nonato, IR ; Rincon, JCC ; Cardenas, R ; Carvalho, F ; Castro, F ; Chansa, C ; Chatterjee, P ; Chattu, VK ; Chauhan, BG ; Chin, KL ; Christopher, DJ ; Chu, D-T ; Claro, RM ; Cormier, NM ; Costa, VM ; Damiani, G ; Daoud, F ; Dandona, L ; Dandona, R ; Darwish, AH ; Daryani, A ; Das, JK ; Das Gupta, R ; Dasa, TT ; Davila, CA ; Weaver, ND ; Davitoiu, DV ; De Neve, J-W ; Demeke, FM ; Demis, AB ; Demoz, GT ; Denova-Gutierrez, E ; Deribe, K ; Desalew, A ; Dessie, GA ; Dharmaratne, SD ; Dhillon, P ; Dhimal, M ; Dhungana, GP ; Diaz, D ; Ding, EL ; Diro, HD ; Djalalinia, S ; Do, HP ; Doku, DT ; Dolecek, C ; Dubey, M ; Dubljanin, E ; Adema, BD ; Dunachie, SJ ; Duraes, AR ; Duraisamy, S ; Effiong, A ; Eftekhari, A ; El Sayed, I ; Zaki, MES ; El Tantawi, M ; Elemineh, DA ; El-Jaafary, SI ; Elkout, H ; Elsharkawy, A ; Enany, S ; Endalamaw, A ; Endalew, DA ; Eskandarieh, S ; Esteghamati, A ; Etemadi, A ; Farag, TH ; Faraon, EJA ; Fareed, M ; Faridnia, R ; Farioli, A ; Faro, A ; Farzam, H ; Fazaeli, AA ; Fazlzadeh, M ; Fentahun, N ; Fereshtehnejad, S-M ; Fernandes, E ; Filip, I ; Fischer, F ; Foroutan, M ; Francis, JM ; Franklin, RC ; Frostad, JJ ; Fukumoto, T ; Gayesa, RT ; Gebremariam, KT ; Gebremedhin, KB ; Gebremeskel, GG ; Gedefaw, GA ; Geramo, YCD ; Geta, B ; Gezae, KE ; Ghashghaee, A ; Ghassemi, F ; Gill, PS ; Ginawi, IA ; Goli, S ; Gomes, NGM ; Gopalani, SV ; Goulart, BNG ; Grada, A ; Gugnani, HC ; Guido, D ; Guimaraes, RA ; Guo, Y ; Gupta, R ; Gupta, R ; Hafezi-Nejad, N ; Haile, MT ; Hailu, GB ; Haj-Mirzaian, A ; Haj-Mirzaian, A ; Hall, BJ ; Handiso, DW ; Haririan, H ; Hariyani, N ; Hasaballah, AI ; Hasan, MM ; Hasanzadeh, A ; Hassankhani, H ; Hassen, HY ; Hayelom, DH ; Heidari, B ; Henry, NJ ; Herteliu, C ; Heydarpour, F ; de Hidru, HD ; Hoang, CL ; Hoogar, P ; Hoseini-Ghahfarokhi, M ; Hossain, N ; Hosseini, M ; Hosseinzadeh, M ; Househ, M ; Hu, G ; Humayun, A ; Hussain, SA ; Ibitoye, SE ; Ilesanmi, OS ; Ilic, MD ; Inbaraj, LR ; Irvani, SSN ; Islam, SMS ; Iwu, CJ ; Jaca, A ; Balalami, NJ ; Jahanmehr, N ; Jakovljevic, M ; Jalali, A ; Jayatilleke, AU ; Jenabi, E ; Jha, RP ; Jha, V ; Ji, JS ; Jia, P ; Johnson, KB ; Jonas, JB ; Jozwiak, JJ ; Kabir, A ; Kabir, Z ; Kahsay, A ; Kalani, H ; Kanchan, T ; Matin, BK ; Karch, A ; Karki, S ; Kasaeian, A ; Kasahun, GG ; Kayode, GA ; Karyani, AK ; Keiyoro, PN ; Ketema, DB ; Khader, YS ; Khafaie, MA ; Khalid, N ; Khalil, AT ; Khalil, I ; Khalilov, R ; Khan, MN ; Khan, EA ; Khan, G ; Khan, J ; Khatab, K ; Khater, A ; Khater, MM ; Khatony, A ; Khayamzadeh, M ; Khazaei, M ; Khazaei, S ; Khodamoradi, E ; Khosravi, MH ; Khubchandani, J ; Kiadaliri, AA ; Kim, YJ ; Kimokoti, RW ; Kisa, A ; Kisa, S ; Kissoon, N ; Kondlahalli, SKM ; Kosek, MN ; Koyanagi, A ; Kraemer, MUG ; Krishan, K ; Kugbey, N ; Kumar, GA ; Kumar, M ; Kumar, P ; Kusuma, D ; La Vecchia, C ; Ben, L ; Lal, A ; Lal, DK ; Lami, FH ; Lansingh, VC ; Lasrado, S ; Lee, PH ; Leili, M ; Lenjebo, TL ; Levine, AJ ; Lewycka, S ; Li, S ; Linn, S ; Lodha, R ; Longbottom, J ; Lopukhov, PD ; Magdeldin, S ; Mahasha, PW ; Mahotra, NB ; Malta, DC ; Mamun, AA ; Manafi, F ; Manafi, N ; Manda, A-L ; Mansournia, MA ; Mapoma, CC ; Marami, D ; Marczak, LB ; Martins-Melo, FR ; Marz, W ; Masaka, A ; Mathur, MR ; Maulik, PK ; Mayala, BK ; McAlinden, C ; Mehndiratta, MM ; Mehrotra, R ; Mehta, KM ; Meles, GG ; Melese, A ; Memish, ZA ; Mena, AT ; Menezes, RG ; Mengesha, MM ; Mengistu, DT ; Mengistu, G ; Meretoja, TJ ; Miazgowski, B ; Mihretie, KMM ; Miller-Petrie, MK ; Mills, EJ ; Mir, SM ; Mirabi, P ; Mirrakhimov, EM ; Mohamadi-Bolbanabad, A ; Mohammad, DK ; Mohammad, KA ; Mohammad, Y ; Darwesh, AM ; Mezerji, NMG ; Mohammadifard, N ; Mohammed, AS ; Mohammed, JA ; Mohammed, S ; Mohebi, F ; Mokdad, AH ; Moodley, Y ; Moradi, G ; Moradi, M ; Moradi-Joo, M ; Moradi-Lakeh, M ; Moraga, P ; Mosapour, A ; Mouodi, S ; Mousavi, SM ; Mozaffor, M ; Muluneh, AG ; Muriithi, MK ; Murray, CJL ; Murthy, GVS ; Musa, KI ; Mustafa, G ; Muthupandian, S ; Naderi, M ; Nagarajan, AJ ; Naghavi, M ; Najafi, F ; Nangia, V ; Nazari, J ; Ndwandwe, DE ; Negoi, I ; Ngunjiri, JW ; Nguyen, CT ; Nguyen, QP ; Nguyen, TH ; Nigatu, D ; Ningrum, DNA ; Nnaji, CA ; Nojomi, M ; Noubiap, JJ ; Oh, I-H ; Okpala, O ; Olagunju, AT ; Bali, AO ; Onwujekwe, OE ; Ortega-Altamirano, DDV ; Osarenotor, O ; Osei, FB ; Owolabi, MO ; Mahesh, PA ; Padubidri, JR ; Pana, A ; Pashaei, T ; Pati, S ; Patle, A ; Patton, GC ; Paulos, K ; Pepito, VCF ; Pereira, A ; Perico, N ; Pesudovs, K ; Pigott, DM ; Piroozi, B ; Platts-Mills, JA ; Poljak, M ; Postma, MJ ; Pourjafar, H ; Pourmalek, F ; Pourshams, A ; Poustchi, H ; Prada, SI ; Preotescu, L ; Quintana, H ; Rabiee, M ; Rabiee, N ; Radfar, A ; Rafiei, A ; Rahim, F ; Rahimi-Movaghar, V ; Rahman, MA ; Rajati, F ; Ramezanzadeh, K ; Rana, SM ; Ranabhat, CL ; Rasella, D ; Rawaf, DL ; Rawal, SRL ; Remuzzi, G ; Renjith, V ; Renzaho, AMN ; Reta, MA ; Rezaei, S ; Ribeiro, AI ; Rickard, J ; Gonzalez, CMR ; Rios-Blancas, MJ ; Roever, L ; Ronfani, L ; Roro, EM ; Rostami, A ; Rothenbacher, D ; Rubagotti, E ; Rubino, S ; Saad, AM ; Sabour, S ; Sadeghi, E ; Safari, S ; Safdarian, M ; Sagar, R ; Sahraian, MA ; Sajadi, SM ; Salahshoor, MR ; Salam, N ; Salehi, F ; Zahabi, SS ; Salem, H ; Salem, MRR ; Salimi, Y ; Salimzadeh, H ; Sambala, EZ ; Samy, AM ; Sanabria, J ; Santos, IS ; Saraswathy, SYI ; Sarker, AR ; Sartorius, B ; Sathian, B ; Satpathy, M ; Sbarra, AN ; Schaeffer, LE ; Schwebel, DC ; Senbeta, AM ; Senthilkumaran, S ; Shabaninejad, H ; Shaheen, AA ; Shaikh, MA ; Shalash, AS ; Shallo, SA ; Shams-Beyranvand, M ; Shamsi, M ; Shamsizadeh, M ; Sharif, M ; Shey, MS ; Shibuya, K ; Shiferaw, WS ; Shigematsu, M ; Shil, A ; Il Shin, J ; Shiri, R ; Shirkoohi, R ; Siabani, SSS ; Singh, JA ; Singh, NP ; Sinha, DN ; Sisay, MM ; Skiadaresi, E ; Smith, DL ; Sobhiyeh, MR ; Sokhan, A ; Soofi, M ; Soriano, JB ; Sorrie, MB ; Soyiri, IN ; Sreeramareddy, CT ; Sudaryanto, A ; Sufiyan, MB ; Suleria, HAR ; Sykes, BL ; Tamirat, KS ; Tassew, AA ; Taveira, N ; Taye, B ; Tehrani-Banihashemi, A ; Temsah, M-H ; Tesfay, BE ; Tesfay, FH ; Tessema, ZT ; Thankappan, KR ; Thirunavukkarasu, S ; Thomas, N ; Tlaye, KG ; Tlou, B ; Tovani-Palone, MR ; Traini, E ; Tran, KB ; Trihandini, I ; Ullah, I ; Unnikrishnan, B ; Tahbaz, SV ; Valdez, PR ; Varughese, S ; Veisani, Y ; Violante, FS ; Vollmer, S ; Vos, T ; Wada, FW ; Waheed, Y ; Wang, Y ; Wang, Y-P ; Weldesamuel, GT ; Welgan, CA ; Westerman, R ; Wiangkham, T ; Wijeratne, T ; Wiysonge, CS ; Wolde, HF ; Wondafrash, DZ ; Wonde, TE ; Wu, A-M ; Xu, G ; Yadollahpour, A ; Jabbari, SHY ; Yamada, T ; Yaseri, M ; Yenesew, MA ; Yeshaneh, A ; Yilma, MT ; Yimer, EM ; Yip, P ; Yirsaw, BD ; Yisma, E ; Yonemoto, N ; Younis, MZ ; Yousof, H-ASA ; Yu, C ; Yusefzadeh, H ; Zamani, M ; Zambrana-Torrelio, C ; Zandian, H ; Zeleke, AJ ; Zepro, NB ; Zewale, TA ; Zhang, D ; Zhang, Y ; Zhao, X-J ; Ziapour, A ; Zodpey, S ; Hay, SI (ELSEVIER SCIENCE INC, 2020-06-06)
    BACKGROUND: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. METHODS: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. FINDINGS: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. INTERPRETATION: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. FUNDING: Bill & Melinda Gates Foundation.
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    Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
    Kinyoki, DK ; Ross, JM ; Lazzar-Atwood, A ; Munro, SB ; Schaeffer, LE ; Bhattacharjee, NV ; Collison, ML ; Cork, MA ; Cormier, N ; Weaver, ND ; Deshpande, A ; Dharmaratne, SD ; Earl, L ; Henry, NJ ; Hollerich, G ; Johnson, KB ; Kassebaum, NJ ; Krohn, KJ ; Letourneau, ID ; Marczak, LB ; Mayala, BK ; Mokdad, AH ; Mosser, JF ; Murray, CJL ; Naghavi, M ; Osgood-Zimmerman, AE ; Pickering, BV ; Pigott, DM ; Ray, SE ; Sbarra, AN ; Schipp, MF ; VanderHeide, J ; Wang, H ; Wiens, KE ; Afshin, A ; Hay, SI ; Kinyoki, DK ; Mokdad, AH ; Murray, CJL ; Naghavi, M ; Pigott, DM ; Sartorius, B ; Wang, H ; Afshin, A ; Hay, SI ; Ross, JM ; Khalil, IA ; Ross, JM ; Abbasalizad-Farhangi, M ; Hasankhani, M ; Abbasi, M ; Farzam, H ; Moradi, M ; Rezaeian, S ; Abbastabar, H ; Abdelalim, A ; El-Jaafary, SI ; Shehata, HS ; Abdoli, A ; Abdollahi, M ; Abdollahpour, I ; Abdulkader, RS ; Abebe, ND ; Deribe, K ; Abebe, ND ; Abebo, TA ; Abegaz, KH ; Abolhassani, H ; Rezaei, N ; Abreu, LG ; Abrigo, MRM ; Abushouk, AI ; Accrombessi, MMK ; Acharya, D ; Adabi, M ; Adebiyi, AO ; Ilesanmi, OS ; Adedeji, IA ; Adekanmbi, V ; Adeoye, AM ; Adetokunboh, OO ; Mahasha, PW ; Ndwandwe, DE ; Nnaji, CA ; Sambala, EZ ; Adham, D ; Aduroja, PE ; Dipeolu, IO ; Ibitoye, SE ; John-Akinola, YO ; Oluwasanu, MM ; Advani, SM ; Afarideh, M ; Esteghamati, A ; Ghajar, A ; Heidari, B ; Sayyah, M ; Aghaali, M ; Agrawal, A ; Ahmad, T ; Ahmadi, K ; Ahmadi, S ; Ahmed, MB ; Gebrehiwot, TT ; Gesesew, HA ; Ahmed, R ; Das Gupta, R ; Ajumobi, O ; Akal, CG ; Demeke, FM ; Melese, A ; Akalu, TY ; Baraki, AG ; Mekonnen, FA ; Sisay, MMM ; Tamirat, KS ; Tessema, ZT ; Wolde, HF ; Yeshaw, Y ; Akinyemiju, T ; Akombi, B ; Karki, S ; Al-Aly, Z ; Alam, S ; Alamene, GM ; Alanzi, TM ; Alcalde Rabanal, JE ; Cahuana-Hurtado, L ; Montero-Zamora, PA ; Alema, NM ; Araya, EM ; Kassaye, HG ; Ali, BA ; Mohammad, KA ; Ali, M ; Alijanzadeh, M ; Kalhor, R ; Alinia, C ; Yusefzadeh, H ; Alipour, V ; Arabloo, J ; Azari, S ; Rezapour, A ; Sheikhtaheri, A ; Moghadam, TZ ; Alipour, V ; Alizade, H ; Aljunid, SM ; Almasi, A ; Fattahi, N ; Matin, BK ; Karyani, AK ; Moradi, M ; Pirsaheb, M ; Rajati, F ; Sadeghi, E ; Safari, Y ; Sharafi, K ; Vasseghian, Y ; Almasi-Hashiani, A ; Moradzadeh, R ; Zamanian, M ; Al-Mekhlafi, HM ; Al-Raddadi, RM ; Altirkawi, K ; Alvis-Guzman, N ; Alvis-Zakzuk, NJ ; Amare, AT ; Gedefaw, GA ; Amegah, AK ; Amini, S ; Rarani, MA ; Amiri, F ; Amit, AML ; Anber, NH ; Andrei, CL ; Ansari, F ; Ansari-Moghaddam, A ; Anteneh, ZA ; Asrat, AA ; Bogale, KA ; Zewale, TA ; Antonio, CAT ; Antriyandarti, E ; Anvari, D ; Anwer, R ; Appiah, SCY ; Arab-Zozani, M ; Arefi, Z ; Aremu, O ; Arnlov, J ; Fereshtehnejad, S-M ; Arzani, A ; Jahani, MA ; Mouodi, S ; Asadi-Aliabadi, M ; Babaee, E ; Moradi-Lakeh, M ; Asadi-Pooya, AA ; Asgari, S ; Asghari, B ; Ashagre, AF ; Ataeinia, B ; Farzadfar, F ; Mohebi, F ; Atalay, HT ; Gebremeskel, GG ; Weldesamuel, GT ; Atnafu, DD ; Atout, MMW ; Ausloos, M ; Herteliu, C ; Pana, A ; Avokpaho, EFGA ; Awasthi, A ; Zodpey, S ; Quintanilla, BPA ; Ayanore, MA ; Aynalem, YAA ; Shiferaw, WS ; Azadmehr, A ; Azarian, G ; Khazaei, M ; Leili, M ; Azene, ZN ; Badawi, A ; Badiye, AD ; Kapoor, N ; Bahrami, MA ; Baig, AAA ; Bakhtiari, A ; Bakkannavar, SM ; Nayak, V ; Marami, D ; Bali, AG ; Banach, M ; Banik, PC ; Barua, L ; Baradaran-Seyed, Z ; Barboza, MA ; Baernighausen, TW ; De Neve, J-W ; Moazen, B ; Mohammed, S ; Dinsa, GD ; Basaleem, H ; Basu, S ; Saxena, S ; Bayati, M ; Bayih, MT ; Baynes, HW ; Bedi, N ; Behzadifar, M ; Behzadifar, M ; Bekele, YA ; Nigatu, D ; Bennett, DA ; Karim, MA ; Lacey, B ; Berbada, DA ; Geramo, YCD ; Hayelom, DH ; Meles, GG ; Sorrie, MB ; Berhe, K ; Gebremariam, H ; Gebretsadik, GGG ; Kahsay, A ; Berhe, AK ; Berman, AE ; Bernstein, RS ; Narayan, KMV ; Bhageerathy, R ; Bhandari, D ; Bharadwaj, P ; Syed, ZQ ; Bhattacharyya, K ; Bijani, A ; Bikbov, B ; Bilano, V ; Bililign, N ; Bin Sayeed, MS ; Lal, A ; Birara, S ; Kahssay, M ; Mohammed, JA ; Zepro, NB ; Birhane, MBB ; Birhanu, M ; Biswas, RK ; Bitew, ZW ; Bohlouli, S ; Bolla, SR ; Boloor, A ; Borzi, AM ; Vacante, M ; Borzouei, S ; Brady, OJ ; Bragazzi, NL ; Braithwaite, D ; Briko, NI ; Britton, G ; Castro, F ; Budhathoki, SS ; Nagaraja, SB ; Busse, R ; Butt, ZA ; Alberto Camera, L ; Campos-Nonato, IR ; Cano, J ; Car, J ; Cardenas, R ; Carrero, JJ ; Carvalho, F ; Costa, VM ; Castaldelli-Maia, JM ; Wang, Y-P ; Castaneda-Orjuela, CA ; Cerin, E ; Chansa, C ; Charan, J ; Chatterjee, P ; Chattu, VK ; Chauhan, BG ; Goli, S ; Kumar, P ; Chavshin, AR ; Chehrazi, M ; Chichiabellu, TY ; Chin, KL ; Christopher, DJ ; Dinh-Toi, C ; Cicuttini, FM ; Guo, Y ; Li, S ; Cortesi, PA ; Dadi, AFF ; Dagnew, B ; Dahlawi, SMA ; Damiani, G ; Darwish, AH ; Daryani, A ; Das, JK ; Das Gupta, R ; Davila-Cervantes, C ; De Leo, D ; Demis, AB ; Tlaye, KG ; Demissie, DB ; Demoz, GT ; Kasahun, GG ; Denova-Gutierrez, E ; Deribe, K ; Desai, R ; Desalegn, BB ; Desalew, A ; Dey, S ; Dharmaratne, SD ; Dhillon, P ; Dhimal, M ; Dhungana, GP ; Nasab, MD ; Diaz, D ; Forooshani, ZSD ; Dinsa, GD ; Djalalinia, S ; Hoa, TD ; Huyen, PD ; Chi, LH ; Doku, PN ; Dorostkar, F ; Doshmangir, L ; Dubey, M ; Adema, BD ; Dunachie, SJ ; Lewycka, S ; Duncan, BB ; Cousin, E ; Schmidt, MI ; Duraes, AR ; Leylabadlo, HE ; Eftekhari, A ; El Sayed, I ; Zaki, MES ; El-Sherbiny, YM ; El Tantawi, M ; Elbarazi, I ; Grivna, M ; Elemineh, DA ; El-Khatib, Z ; Elsharkawy, A ; El-Sherbiny, YM ; Elyazar, IRF ; Emamian, MH ; Enany, S ; Endalew, DA ; Endalifer, ML ; Eskandari, K ; Eskandarieh, S ; Sahraian, MA ; Esmaeilnejad, S ; Etemadi, A ; Etisso, AE ; Fanzo, J ; Farahmand, M ; Faraj, A ; Farashi, S ; Fareed, M ; Farioli, A ; Violante, FS ; Faro, A ; Fatima, SS ; Fauk, NK ; Gesesew, HA ; Fazaeli, AA ; Fentahun, N ; Ferede, TY ; Fereshtehnejad, S-M ; Fernandes, E ; Gomes, NGM ; Fernandes, JC ; Feyissa, GT ; Filip, I ; Fischer, F ; Flohr, C ; Foigt, NA ; Folayan, MO ; Fomenkov, AA ; Titova, MV ; Foroutan, M ; Foerster, J ; Francis, JM ; Fukumoto, T ; Gayesa, RT ; Kasaye, HK ; Geberemariyam, BS ; Handiso, DW ; Gebremariam, KT ; Gebreslassie, AAA ; Zepro, NB ; Gebremedhin, KBB ; Wondmieneh, AB ; Gebremeskel, GG ; Gedefaw, GA ; Geta, B ; Getenet, AB ; Yeshitila, YG ; Gezae, KE ; Ghaffarifar, F ; Pirestani, M ; Zaki, L ; Ghafourifard, M ; Ghajar, A ; Ghajarzadeh, M ; Ghashghaee, A ; Ghiasvand, H ; Gholamian, A ; Gilani, SA ; Gill, TK ; Ginawi, IA ; Goli, S ; Gomes, NGM ; Gopalani, SV ; Goudarzi, H ; Goulart, AC ; Govindakarnavar, A ; Grada, A ; Guimaraes, RA ; Guled, RA ; Guo, Y ; Gupta, R ; Gupta, R ; Hafezi-Nejad, N ; Haj-Mirzaian, A ; Shafaat, O ; Haile, MT ; Haj-Mirzaian, A ; Hall, BJ ; Halvaei, I ; Hamadeh, RR ; Hamidi, Y ; Hankey, GJ ; Haririan, H ; Hariyani, N ; Hasaballah, AI ; Hasan, MM ; Hasanpoor, E ; Hasanzadeh, A ; Hashemian, M ; Hassanipour, S ; Joukar, F ; Mansour-Ghanaei, F ; Hassen, HY ; Henok, A ; Havmoeller, R ; Hawkes, C ; Hayat, K ; Heidari-Soureshjani, R ; Hendrie, D ; Miller, TR ; Herrero, M ; Heydarpour, F ; Soleymani, B ; de Hidru, HD ; Hoek, HW ; Hole, MK ; Holla, R ; Rad, EH ; Hong, SH ; Hoogar, P ; Horino, M ; Hossain, N ; Hosseini, M ; Mansournia, MA ; Tohidinik, HR ; Hosseinzadeh, M ; Hostiuc, M ; Negoi, I ; Hostiuc, S ; Househ, M ; Hsairi, M ; Hu, G ; Huda, TM ; Karim, MA ; Bin Zaman, S ; Humayun, A ; Hwang, B-F ; Ilic, MD ; Imani-Nasab, MH ; Inbaraj, LR ; Iqbal, U ; Irvani, SSN ; Islam, SMS ; Iwu, CCD ; Iwu, CJ ; Izadi, N ; Riahi, SM ; Sabour, S ; Jaafari, J ; Jaca, A ; Jadidi-Niaragh, F ; Balalami, NJ ; Jafarinia, M ; Jakovljevic, M ; Jalali, A ; Jalilian, F ; Mirzaei-Alavijeh, M ; Salimi, Y ; Jayatilleke, AU ; Jeemon, P ; Mini, GK ; Jehan, F ; Jenabi, E ; Jha, RP ; Jha, V ; John, O ; Ji, JS ; Jia, P ; Jonas, JB ; Joseph, N ; Mithra, P ; Unnikrishnan, B ; Jozwiak, JJ ; Jungari, SB ; Jurisson, M ; Kabir, A ; Kabir, Z ; Kalani, H ; Kalankesh, LL ; Kalhor, R ; Kamiab, Z ; Kanchan, T ; Kapil, U ; Karami, M ; Khazaei, S ; Karch, A ; Karki, S ; Kasaeian, A ; Kassa, TD ; Kassebaum, NJ ; Karyani, AK ; Kianipour, N ; Kengne, AP ; Mensah, GA ; Noubiap, JJ ; Ketema, DB ; Wonde, TE ; Khader, YS ; Khafaie, MA ; Khaksarian, M ; Khalid, N ; Khalilov, R ; Khan, A ; Uddin, R ; Khan, EA ; Khan, MN ; Khan, MS ; Khan, MS ; Siddiqi, TJ ; Usman, MS ; Khatab, K ; Khater, A ; Khater, MM ; Yousof, H-ASA ; Khatib, MN ; Khayamzadeh, M ; Khazaei-Pool, M ; Khodayari, MT ; Khosravi, MH ; Khundkar, R ; Kiadaliri, A ; Kiirithio, DN ; Kim, YJ ; Kimokoti, RW ; Kisa, A ; Kisa, S ; Kolola, T ; Komaki, H ; Kondlahalli, SKM ; Koolivand, A ; Koul, PA ; Koyanagi, A ; Kraemer, MUG ; Krishan, K ; Kugbey, N ; Zotor, FB ; Asante, KO ; Kumar, M ; Kumar, V ; Kurmi, OP ; Olagunju, TO ; Kuti, O ; La Vecchia, C ; Lacey, B ; Lad, DP ; Lal, DK ; Lami, FH ; Lamichhane, P ; Lang, JJ ; Lansingh, VC ; Lasrado, S ; Lebedev, G ; Lee, PH ; Lee, SWH ; Lewycka, S ; Lim, L-L ; Linn, S ; Shuval, K ; Liu, S ; Liu, S ; Lodha, R ; Longbottom, J ; Lopez, JCF ; Lorkowski, S ; Macarayan, ERK ; Madadin, M ; Abd El Razek, HM ; Abd El Razek, MM ; Maghavani, DP ; Mahotra, NB ; Maled, V ; Maleki, A ; Pashaei, T ; Maleki, S ; Naderi, M ; Malta, DC ; Manafi, A ; Manafi, F ; Manafi, N ; Manohar, ND ; Mansouri, B ; Mapoma, CC ; Marrugo Arnedo, CA ; Rogerlandio Martins-Melo, F ; Masaka, A ; Massenburg, BB ; Maulik, PK ; Mayala, BK ; Mazidi, M ; Mehndiratta, MM ; Mehri, F ; Mehta, KM ; Meitei, WB ; Mekonnen, T ; Meles, HG ; Mendoza, W ; Menezes, RG ; Mengesha, MB ; Mensah, GA ; Meretoja, TJ ; Miazgowski, T ; Kostova, NM ; Miller, TR ; Mills, EJ ; Mini, GK ; Mir, SM ; Mosapour, A ; Parsian, H ; Miri, M ; Mirjalali, H ; Yadegar, A ; Mirrakhimov, EM ; Mirzaei, H ; Mirzaei, M ; Mirzaei, R ; Mohamadi, E ; Mohamadi-Bolbanabad, A ; Moradi, G ; Moradpour, F ; Piroozi, B ; Mohammad, KA ; Mohammad, Y ; Mohammad, DK ; Darwesh, AM ; Mezerji, NMG ; Mohammadian-Hafshejani, A ; Mohammadnia-Afrouzi, M ; Mohammadoo-Khorasani, M ; Mohammadpourhodki, R ; Mohammed, S ; Mohammed, S ; Mohammed, AS ; Mohebi, F ; Mokari, A ; Cesar Montanez, J ; Montero-Zamora, PA ; Moodley, Y ; Moossavi, M ; Moradi, G ; Moradi, Y ; Moradi-Joo, M ; Moraga, P ; Morrison, SD ; Mosapour, A ; Khaneghah, AM ; Mozaffarian, D ; Mueller, UO ; Werdecker, A ; Murthy, GVS ; Musa, KI ; Mustafa, G ; Muthupandian, S ; Nabavizadeh, B ; Nadkarni, GN ; Nagarajan, AJ ; Naheed, A ; Naik, G ; Najafi, F ; Salimi, Y ; Nansseu, JR ; Nascimento, BR ; Nazari, J ; Negoi, I ; Negoi, RI ; Ngunjiri, JW ; Cuong, TN ; Huong, LTN ; Vuong, MN ; Nigatu, YT ; Nikbakhsh, R ; Ningrum, DNA ; Nnaji, CA ; Nowak, C ; Oancea, B ; Ofori-Asenso, R ; Oghenetega, OB ; Oh, I-H ; Oladimeji, O ; Oladnabi, M ; Olagunju, AT ; Olusanya, BO ; Olusanya, JO ; Omer, MO ; Onwujekwe, OE ; Asante, KO ; Oren, E ; Orisakwe, OE ; Ortiz, A ; Osarenotor, O ; Owolabi, MO ; Mahesh, PA ; Padubidri, JR ; Rastogi, P ; Pakshir, K ; Zomorodian, K ; Pana, A ; Panda-Jonas, S ; Pasupula, DK ; Patel, SK ; Pathak, A ; Pathak, M ; Pati, S ; Patle, A ; Patton, GC ; Paulos, K ; Toroudi, HP ; Pepito, VCF ; Perico, N ; Remuzzi, G ; Petri, WA ; Pokhrel, KN ; Postma, MJ ; Pourjafar, H ; Pourmalek, F ; Kalhori, RP ; Pourshams, A ; Poustchi, H ; Roshandel, G ; Salimzadeh, H ; Prada, SI ; Preotescu, L ; Pribadi, DRA ; Rabiee, M ; Rabiee, N ; Radfar, A ; Rafiei, A ; Rahim, F ; Rahimi-Movaghar, V ; Rahman, MA ; ur Rahman, S ; Rai, RK ; Vollmer, S ; Rajabpour-Sanati, A ; Ramezanzadeh, K ; Rana, SM ; Ranabhat, CL ; Rao, SJ ; Rasella, D ; Rashedi, V ; Rathi, P ; Rawaf, S ; Rawaf, DL ; Rawal, L ; Renjith, V ; Renzaho, AMN ; Resnikoff, S ; Rezaei, N ; Rezai, MS ; Riahi, SM ; Ribeiro, AI ; Rickard, J ; Rodriguez, A ; Roever, L ; Roro, EM ; Yilma, MT ; Roshandel, G ; Rostami, A ; Rubagotti, E ; Saad, AM ; Saadatagah, S ; Sabde, YD ; Sadeghi, M ; Safari, S ; Safarpour, H ; Sagar, R ; Sahebkar, A ; Sajadi, SM ; Salahshoor, MR ; Salam, N ; Salehi, F ; Zahabi, SS ; Salem, H ; Salem, MRR ; Kafil, HS ; Samy, AM ; Santos, IS ; Sao Jose, BP ; Saraswathy, SYI ; Sarker, AR ; Sartorius, B ; Sarveazad, A ; Sathian, B ; Satpathy, M ; Schutte, AE ; Schwebel, DC ; Senbeta, AM ; Senthilkumaran, S ; Seyedmousavi, S ; Shaahmadi, F ; Shahabi, S ; Shaikh, MA ; Shalash, AS ; Shams-Beyranvand, M ; Shamshirian, A ; Shamsizadeh, M ; Shannawaz, M ; Sharif, M ; Sharma, R ; Sheikhtaheri, A ; Shibuya, K ; Shigematsu, M ; Shin, JI ; Shiri, R ; Shirkoohi, R ; Shiue, I ; Siabani, S ; Sigfusdottir, ID ; Santos Silva, DA ; Simonetti, B ; Singh, A ; Singh, P ; Singh, V ; Singh, JA ; Singh, PK ; Sinha, DN ; Sintayehu, Y ; Sisay, MMM ; Soheili, A ; Soltani, F ; Soltani, S ; Soriano, JB ; Soshnikov, S ; Soyiri, IN ; Spotin, A ; Sreeramareddy, CT ; Srivastava, RKK ; Starodubova, A ; Sudaryanto, A ; Sufiyan, MB ; Suleria, HAR ; Sulo, G ; Sunguya, BF ; Sykes, BL ; Tabares-Seisdedos, R ; Tabuchi, T ; Tadesse, BT ; Taherkhani, A ; Tassew, SG ; Taveira, N ; Teklehaimanot, BF ; Tekulu, GH ; Temsah, M-H ; Terkawi, AS ; Thomas, N ; Titova, MV ; Tohidinik, HR ; Tonelli, M ; Tovani-Palone, MR ; Traini, E ; Khanh, BT ; Tripathi, M ; Uddin, R ; Ullah, I ; Upadhyay, E ; Useh, U ; Uthman, OA ; Vaezghasemi, M ; Valdez, PR ; Varavikova, E ; Varughese, S ; Vasankari, TJ ; Veisani, Y ; Venkatesh, S ; Venketasubramanian, N ; Verma, M ; Vidale, S ; Violante, FS ; Vlassov, V ; Vollmer, S ; Vukovic, R ; Waheed, Y ; Wang, Y ; Yu, C ; Werdecker, A ; Wiangkham, T ; Wijeratne, T ; Wondafrash, DZ ; Wondmieneh, AB ; Wu, A-M ; Xu, G ; Yadollahpour, A ; Jabbari, SHY ; Yamada, T ; Yano, Y ; Yaya, S ; Yazdi-Feyzabadi, V ; Yeshaneh, A ; Yip, P ; Yonemoto, N ; Yoon, S-J ; Youm, Y ; Younis, MZ ; Yousefi, Z ; Yu, C ; Moghadam, TZ ; Zandian, H ; Bin Zaman, S ; Zamani, M ; Zandian, H ; Zarafshan, H ; Zerfu, TA ; Zhang, Y ; Zhang, Z-J ; Zhao, X-J (NATURE PUBLISHING GROUP, 2020-04-20)
    A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1-70.8) million) to 6.4% (58.3 (47.6-70.7) million), but is predicted to remain above the World Health Organization's Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8-38.5) million) in 2000 to 6.0% (55.5 (44.8-67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.