SummaryBackgroundSeizures and their consequences contribute to the burden of epilepsy because they can cause health loss (premature mortality and residual disability). Data on the burden of epilepsy are needed for health-care planning and resource allocation. The aim of this study was to quantify health loss due to epilepsy by age, sex, year, and location using data from the Global Burden of Diseases, Injuries, and Risk Factors Study.MethodsWe assessed the burden of epilepsy in 195 countries and territories from 1990 to 2016. Burden was measured as deaths, prevalence, and disability-adjusted life-years (DALYs; a summary measure of health loss defined by the sum of years of life lost [YLLs] for premature mortality and years lived with disability), by age, sex, year, location, and Socio-demographic Index (SDI; a compound measure of income per capita, education, and fertility). Vital registrations and verbal autopsies provided information about deaths, and data on the prevalence and severity of epilepsy largely came from population representative surveys. All estimates were calculated with 95% uncertainty intervals (UIs).FindingsIn 2016, there were 45·9 million (95% UI 39·9–54·6) patients with all-active epilepsy (both idiopathic and secondary epilepsy globally; age-standardised prevalence 621·5 per 100 000 population; 540·1–737·0). Of these patients, 24·0 million (20·4–27·7) had active idiopathic epilepsy (prevalence 326·7 per 100 000 population; 278·4–378·1). Prevalence of active epilepsy increased with age, with peaks at 5–9 years (374·8 [280·1–490·0]) and at older than 80 years of age (545·1 [444·2–652·0]). Age-standardised prevalence of active idiopathic epilepsy was 329·3 per 100 000 population (280·3–381·2) in men and 318·9 per 100 000 population (271·1–369·4) in women, and was similar among SDI quintiles. Global age-standardised mortality rates of idiopathic epilepsy were 1·74 per 100 000 population (1·64–1·87; 1·40 per 100 000 population [1·23–1·54] for women and 2·09 per 100 000 population [1·96–2·25] for men). Age-standardised DALYs were 182·6 per 100 000 population (149·0–223·5; 163·6 per 100 000 population [130·6–204·3] for women and 201·2 per 100 000 population [166·9–241·4] for men). The higher DALY rates in men were due to higher YLL rates compared with women. Between 1990 and 2016, there was a non-significant 6·0% (−4·0 to 16·7) change in the age-standardised prevalence of idiopathic epilepsy, but a significant decrease in age-standardised mortality rates (24·5% [10·8 to 31·8]) and age-standardised DALY rates (19·4% [9·0 to 27·6]). A third of the difference in age-standardised DALY rates between low and high SDI quintile countries was due to the greater severity of epilepsy in low-income settings, and two-thirds were due to a higher YLL rate in low SDI countries.InterpretationDespite the decrease in the disease burden from 1990 to 2016, epilepsy is still an important cause of disability and mortality. Standardised collection of data on epilepsy in population representative surveys will strengthen the...

SummaryBackgroundPopulation estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods.MethodsWe estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories.FindingsFrom 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much ...

Introduction: Brucellosis is a global zoonotic disease and major public and animal health problem in many parts of the world, particularly in places where livestock is a major source of food and income. This cross-sectional study was conducted between November 2012 and May 2013 to determine the seroprevalence and assess potential risk factors of brucellosis in small ruminants in five export abattoirs at Debre Ziet and Modjo, Oromia Regional State, Ethiopia. Methodology: Serology and questionnaire were the methods used. In this investigation, 853 sera samples of 485 caprines and 368 ovines brought for slaughter were selected randomly. The Rose Bengal plate test and complement fixation test were conducted using sera samples at National Animal Health Diagnostic and Investigation Center (NAHDIC) serology laboratory. Data collection sheets were used to gather information on possible risk factors believed to influence the occurrence of Brucella infection in small ruminants such as age, species, breed, body condition score, and origin of small ruminants. Results: Brucellosis was found in 17 (1.99%) and 15 (1.76%) small ruminants using the Rose Bengal plate test and complement fixation test, respectively. The univariate and multivariate logistic regression analysis showed that age and body condition score of the animals were risk factors to Brucella infection (p = 0.008 and p = 0.001, respectively) in small ruminants. Conclusions: Based on this survey, brucellosis is a potential problem in small ruminants in Ethiopia that should be further explored.

BackgroundBrucellosis is one of the major zoonoses globally with great veterinary and public health importance, particularly in developing countries where people are having frequent contact with livestock and animal products. This cross sectional study was carried out from November 2013 to May 2014 to determine the seroprevalence and assess the potential risk factors of brucellosis in abattoir workers of five export abattoirs at Debre Ziet and Modjo, Central Ethiopia.MethodsSerology and structured questionnaire were the methods used. In this study, 156 abattoir workers participated in the questionnaire survey and among them, 149 agreed for blood sample collection. Rose Bengal Plate Test and Complement Fixation Test were conducted using sera samples at serology laboratory of the National Animal Health Diagnostic and Investigation Center. Data collection sheets were used to gather information on possible risk factors believed to influence the spread of Brucella infection in abattoir workers such as sex, age, marital status, duration on job, types of work, educational level, etc. and further information obtained include knowledge of brucellosis and other zoonotic diseases infection, symptoms of the disease, milk and meat consumption habits and work related risk factors. Chi-square and Fisher’s exact tests were used for data analysis.ResultsThe overall seroprevalence of brucellosis in abattoir workers was found to be 4.7 and 1.3% using Rose Bengal plate test and Compliment fixation test, respectively. Based on the questionnaire survey, 66 (44.2%) and 85 (53.21%) of abattoir workers were aware of brucellosis and other zoonotic diseases, and 29 (18.6%) and 21 (13.5%) were using gloves and cover their mouth while slaughtering, respectively.ConclusionBrucellosis in abattoir workers could be prevented by using protective closing and measures. Concerned body should educate occupationally exposed groups and the general public regarding e prevention and control of brucellosis and other zoonotic diseases.

Seroprevalence of Leptospira spp. in cattle is unknown in Uganda. The aim of this study was to estimate the seroprevalence of L. interrogans Icterohaemorrhagiae, Pomona, L. kirschneri Butembo, Grippotyphosa, L. borgpetersenii Nigeria, Hardjo, Wolfii, and Kenya and an overall seroprevalence in cattle from Kole and Mbale districts. Two hundred-seventy five bovine sera from 130 small holder farms from Kole (n = 159) and Mbale (n = 116), collected between January and July 2015, were tested for antibodies against eight Leptospira strains by Microscopic Agglutination Test. A titer of ≥100 was considered seropositive, indicating past exposure. Overall, the seroprevalence was 19.27% (95% CI 14.9–24.5%). Pomona seroprevalence was highest with 9.45% (6.4–13.7%), followed by Kenya 5.09% (2.9–8.6%), Nigeria 4.00% (2.1–7.2%), Wolfii 3.27% (1.6–6.3%), Butembo 1.86% (0.7–4.4%), Hardjo 1.45% (0.5–3.9%), and Icterohaemorragiae and Grippotyphosa with less than 1% positive. Seroprevalence did not differ between districts and gender (p ≥ 0.05). Seven animals had titers ≥400. Cross-reactions or exposure to ≥1 serovar was measured in 43% of serum samples. Seroprevalence of 19% implies exposure of cattle to leptospires.