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Objective Based on the global burden of disease (GBD) study data, to analyze the current situation and changing trend of refractive disorders in China by comparing Japan, India, the United States, the United Kingdom and the world. Methods The prevalence, years lived with disability (YLD) rate of refractive disorders from 1990 to 2019 were obtained from the global health exchange (GHDx）database. The disease burden and change trend of refractive disorders were analyzed using Joinpoint and other software. Results In 2019, the number of refractive disorders in China exceeded 27 million, with the prevalence and YLD rate were 19.18‰ and 89.40/100,000 respectively. From 1990 to 2019, the prevalence and YLD rate of refractive disorders showed an increasing trend globally (except India), with the largest increase in China (up by 53.21% and 53.96% respectively). The age standardized YLD rates in China, Japan, the United States, and the United Kingdom were all lower than the global average level, but China's age standardized YLD rates were higher than the developed countries (Japan, the United States, and the United Kingdom). Conclusion From 1990 to 2019, there was a certain gap between China and developed countries in the control of refractive disorders. Therefore, it is necessary to understand the disease status from a global perspective in order to better prevent and control refractive disorders in the future.
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Abstract INTRODUCTION Maternal death continues to be one of the most challenging public health problems that needs to be addressed in low and middle-income countries. The objective of this study was to describe the problem of maternal death in Brazil, using estimates from the Global Burden of Disease Study (GBD). METHODS This study used data from the GBD 2019 to show the numbers of deaths and the Maternal Mortality Ratio (MMR) - number of deaths/100,000 live births - in Brazil and its 27 Federated Units (FU), for ages 10 to 54 years, from 1990 to 2019. The annual variation of the MMR was estimated in 1990, 2010, and 2019. The MMR were shown for specific causes as well as for five-year age groups. The estimates were presented with 95% uncertainty intervals (UI). RESULTS The number of maternal deaths, as well as the MMR showed a 49% reduction from 1990 to 2019. This reduction occurred heterogeneously throughout the country, and the profile of the MMR for specific causes changed between 1990 and 2019: from hypertensive gestation diseases, to indirect maternal deaths, followed by hypertensive gestation diseases. In the extreme age groups, the MMR is higher, with mortality increasing exponentially in direct proportion with age. CONCLUSIONS Maternal deaths in Brazil have decreased substantially since 1990; however, the numbers still fall short of what was established by the World Health Organization (WHO). Indirect causes are the greatest problem in more than 60% of the FU, especially for hypertensive pregnancy diseases.
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OBJECTIVES: Transportation injuries are among the top ten causes of burden of disease in all age groups worldwide. The burden of transportation injuries among children and adolescents in Iran is higher than the world average and that of other developing countries. The aims of this study were to investigate the burden of transportation injuries in children and adolescents in the province of Fars in Iran from 2009 to 2013, and to report the burden of these kinds of injuries in children and adolescents in Iran from 1990 to 2010. METHODS: The number of deaths due to transportation injuries and the location of fatal injuries in the province of Fars in Iran from 2009 to 2013 were analyzed using data from the Fars Forensic Medicine Organization. The 20-year trend in the burden of transportation injuries in Iran was analyzed using data from the Institute for Health Metrics and Evaluation. RESULTS: Similarly to the long-term trend in Iran, the burden of transportation injuries among the male population of Fars province was generally higher than in females. Most fatal accident injuries occurred on roads (males: n=4151, 61.51%; females: n=1182, 65.95%) and in urban areas (males: n=1994, 29.54%; females: n=473, 26.40%). CONCLUSIONS: Considering that children and adolescents are high risk groups for transportation injuries, adopting an effective comprehensive multi-sectoral approach, including enacting and enforcing appropriate laws and regulations, developing general knowledge, and facilitating the availability of Personal protective equipment, could be helpful for reducing the burden of these injuries.
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Adolescente , Criança , Feminino , Humanos , Masculino , Países em Desenvolvimento , Medicina Legal , Irã (Geográfico) , Jurisprudência , Controle Social Formal , Meios de TransporteRESUMO
El 19,6% de los colombianos son adolescentes; esto exige una adecuada preparación médica para atender los problemas de salud de esta población. En Colombia, la mortalidad por causas externas es elevada para este grupo, pero estas causas de muerte son las principales en adolescentes a nivel mundial. El sentido de invulnerabilidad y las conductas exploratorias favorecen el consumo de sustancias tóxicas (alcohol, 65%, y tabaco, 35,8%), la precocidad sexual (embarazo, 21%) y la falta de autocontrol. La violencia, los accidentes, el suicidio y las alteraciones de la salud sexual tienen gran repercusión en la vida de jóvenes y familias. Ante la falta de instrumentos de la medición de riesgo y la débil influencia de las intervenciones en los problemas mencionados, el actuar médico con perspectiva de riesgo resulta fundamental. La prevención con el fortalecimiento de los factores protectores (familia, espiritualidad, deporte) cuenta con suficiente evidencia, pero requiere el desarrollo de habilidades y destrezas que no son parte de los procesos regulares de formación médica y tampoco de la práctica profesional rutinaria en Colombia...
Adolescents represent 19.6% of the Colombian population; this requires proper medical training to tackle health problems for this group of age. Violent mortality is high in Colombia but external causes are the most common cause of mortality among teenagers around the world. Invulnerability self-consciousness and exploratory behaviors are related to risk factors such as substance consumption (alcohol, 65%, and tobacco, 35,8%), unsafe sexual conducts (unexpected pregnancy, 21%), and lack of emotional control. Violence, púunintentional injuries, suicide, and sexual health related problems might have great impact on youth and family life. The scarcity of instruments for identifying risks and the lack of evidence regarding interventions for risk factor control challenge primary care services. Protective factors (familiar, spiritual, sports) are supported by scientific evidence as a preventive tool, but they require skills and competencies not regularly included in medical education or routine primary care practice in Colombia...
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Adolescente , Comorbidade , Fatores de RiscoRESUMO
Este trabajo se deriva, por un lado, de las experiencias obtenidas de un proyecto ramal concluido titulado “La carga de las enfermedades en Cuba”, y por otro, de los intereses de la Dirección Municipal de Salud del Cerro por estudiar el comportamiento de las principales causas de muerte en el territorio. Se trabajó la carga de las enfermedades en términos del indicador “años de vida potencial perdidos por muertes prematuras”, según la metodología establecida y se calcularon y presentaron sin descuento en el tiempo y sin ponderación por edad para el municipio Cerro y provincia Ciudad de La Habana. El indicador señalado y la mortalidad se obtuvieron para los años 1990, 1995 y 2000, lo que permitió estudiar sus tendencias en el tiempo. Se estudiaron un total de 20 (grupos de) enfermedades, entre ellas, enfermedades del corazón, tumores malignos, enfermedades de arterias, arteriolas y vasos capilares; accidentes, condiciones neuropsiquiátricas, enfermedades digestivas, y enfermedad pulmonar obstructiva crónica especificada y no especificada. Varias enfermedades mostraron un comportamiento diferente en ambos territorios estudiados, lo que precisa la eventual necesidad de adaptar las estrategias y acciones de salud de una determinada región a las especificidades de cada sub-territorio que lo compone; algunos grupos de enfermedades no manejadas usualmente como causa importante de muerte, como fueron las “condiciones neuropsiquiátricas”, tuvieron una carga, en ambos territorios, muy significativa. Los resultados de este trabajo aportaron resultados útiles para la toma de decisiones en el municipio Cerro en lo referido a la atención médica, docencia e investigaciones.
This paper stems, on one hand, from the experience accumulated in a branch project entitled “Burden of diseases in Cuba”, and on the other hand, from the interests of Health Municipal Division of Cerro municipality to study the behavior of the main causes of death in this territory. The burden of diseases was examined in terms of “potential years of life lost due to premature death” indicator, according to the methodology. They were estimated and submitted without time discount or age weighing for Cerro municipality and the City of Havana province. The mentioned indicator and mortality rates were taken from years 1990, 1995 and 2000, which allows studying their trends in the course of time. A total of 20 groups of diseases were discussed, namely: heart diseases, malignant tumors, artery, arterioles and capillary vessels diseases, accidents, neuropsychiatric conditions, digestive diseases, and specified and non-specified chronic obstructive pulmonary disease. Several diseases showed differences in behavior in both territories, which indicates the need of adapting the strategies and health actions of a certain region to the particularities of each territory being part of it. Some groups of diseases that are not usually seen as important cause of death such as “neuropsychiatric conditions” had very significant burden in both territories. The results of this paper were useful for the decision-making process in Cerro municipality regarding healthcare, medical education and research.