Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Mokdad, Ali H.; Forouzanfar, Mohammad H.; Daoud, Farah; Bcheraoui, Charbel El; Moradi‐Lakeh, Maziar; Khalil, Ibrahim; Afshin, Ashkan; Tuffaha, Marwa; Charara, Raghid; Barber, Ryan M; Wagner, Joseph A.; Cercy, Kelly; Kravitz, Hannah; Coates, Matthew M; Robinson, Margaret; Estep, Kara; Steiner, Caitlyn; Jaber, Sara; Mokdad, Ali A.; O'Rourke, Kevin F.; Chew, Adrienne; Kim, Pauline; Razek, Mohamed Magdy Abd El; Abdalla, Safa; Abd-Allah, Foad; Abraham, Jerry; Abu-Raddad, Laith J; Abu-Rmeileh, Niveen M E; Al-Nehmi, Abdulwahab A.; Akanda, A. S.; Ahmadi, Hanan Al; Khabouri, Mazin J Al; Lami, Faris; Rayess, Zulfa A. Al; Alasfoor, Deena; AlBuhairan, Fadia; Aldhahri, Saleh Fahed; Alghnam, Suliman; Alhabib, Samia; Al‐Hamad, Nawal; Ali, Raghib; Ali, Syed Danish; Alkhateeb, Mohammad; AlMazroa, Mohammad A.; Alomari, Mahmoud A.; Al-Raddadi, Rajaa; Alsharif, Ubai; Al-Sheyab, Nihaya; Alsowaidi, Shirina; Al-Thani, Mohamed H.; Altirkawi, Khalid A; Amare, Azmeraw T; Amini, Heresh; Ammar, Walid; Anwari, Palwasha; Asayesh, Hamid; Asghar, Rana Jawad; Assabri, Ali; Assadi, Reza; Bacha, Umar; Badawi, Alaa; Bakfalouni, Talal; Basulaiman, Mohammed; Bazargan‐Hejazi, Shahrzad; Bedi, Neeraj; Bhakta, Amit R.; Bhutta, Zulfiqar A; Abdulhak, Aref A. Bin; Boufous, Soufiane; Bourne, Rupert R A; Danawi, Hadi; Das, Jai K; Deribew, Amare; Ding, Eric L.; Durrani, Adnan M; Elshrek, Yousef M; Ibrahim, Mohamed Eid; Eshrati, Babak; Esteghamati, Alireza; Faghmous, Imad A.D.; Farzadfar, Farshad; Feigl, Andrea B; Fereshtehnejad, Seyed Mohammad; Filip, Irina; Fischer, Florian; Gankpé, Fortuné Gbètoho; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Gupta, Rahul; Habash, Rami; Hafezi-Nejad, Nima; Hamadeh, Randah Ribhi; Hamdouni, Hayet; Hamidi, Samer; Harb, Hilda L; Hassanvand, Mohammad Sadegh; Hedayati, Mohammad Taghi; Heydarpour, Pouria; Hsaïri, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Jha, Vivekanand; Jonas, Jost B.; Karam, Nadim E.; Kasaeian, Amir; Assefa, Nega; Kaul, Anil; Khader, Yousef; Khalifa, Shams Eldin Ali Hassan; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khoja, Tawfik; Khosravi, Ardeshir; Kinfu, Yohannes; Defo, Barthélémy Kuate; Balaji, Arjun Lakshmana; Lunevičius, Raimundas; Obermeyer, Carla Makhlouf; Malekzadeh, Reza; Mansourian, Morteza; Marcenes, Wagner; Farid, Habibolah Masoudi; Mehari, Alem; Mehio-Sibai, Abla; Memish, Ziad A.; Mensah, George A.; Mohammad, Karzan Abdulmuhsin; Nahas, Ziad; Nasher, Jamal; Nawaz, Haseeb; Nejjari, Chakib; Nisar, Imran; Omer, Saad B.; Parsaeian, Mahboubeh; Peprah, Emmanuel; Pervaiz, Aslam; Pourmalek, Farshad; Qato, Dima M.; Qorbani, Mostafa; Radfar, Amir; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Sajjad Ur; Rajesh, K R; Rana, Saleem M; Rao, Sowmya R.; Refaat, Amany; Resnikoff, Serge; Roshandel, Gholamreza; Saadé, Georges; Saeedi, Mohammad Y.; Sahraian, Mohammad Ali; Saleh, Shadi; Sànchez-Riera, Lídia; Satpathy, Maheswar; Sepanlou, Sadaf G; Setegn, Tesfaye; Shaheen, Amira; Shahraz, Saeid; Sheikhbahaei, Sara; Shishani, Kawkab; Sliwa, Karen; Tavakkoli, Mohammad; Terkawi, Abdullah Sulieman; Uthman, Olalekan A.; Westerman, Ronny; Younis, Mustafa Z; Zaki, Maysaa El Sayed; Zannad, Faı̈ez; Roth, Gregory A.; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Rabeeah, Abdullah A. Al; López, Alan D.; Murray, Christopher J L

doi:10.1016/s2214-109x(16)30168-1

Cited by 154 publications

(133 citation statements)

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“…Historically, the region has been able to maintain a good health performance due to factors like a growing private health sector and resilience of the population [11, 25, 26, 35, 36]. Indeed, this burden is likely to increase due to the unrest [37].…”

Section: Discussionmentioning

confidence: 99%

The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

et al. 2017

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The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25–49 age group, with a peak in the 35–39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of diseases in the region.

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Section: Discussionmentioning

confidence: 99%

The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

et al. 2017

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“…20 Political instability has also been hypothesised to affect research publications, as demonstrated in Uganda and Kenya. [21][22][23] Unfortunately, political unrest may result in a reduction in funding, massive in-and outmigration, strikes and violence. While no studies have yet systematically investigated the effect of political instability on research production in the Arab world, output trends from the current review revealed a clear drop in cancer-related publications from Iraq, Sudan and Bahrain coinciding with specific periods of civil unrest in these countries.…”

Section: Discussionmentioning

confidence: 99%

Cancer Research in the Arab World: A review of publications from seven countries between 2000–2013

Hamadeh¹,

Borgan²,

Sibai³

2017

SQUMJ

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from seven countries, including Bahrain, Kuwait, Iraq, Lebanon, Morocco, Palestine and Sudan. A total of 1,773 articles were identified, with a significant increase in yearly publications over time (P <0.005). Only 30.6% of the publications included subjects over the age of 50 years old. There was a dearth of cross-sectional/correlational studies (8.8%), randomised controlled trials (2.4%) and systematic reviews/meta-analyses (1.3%). Research exploring cancer associations mainly considered social and structural determinants of health (27.1%), followed by behavioural risk factors (14.1%), particularly tobacco use. Overall, more cancer research is needed in the Arab world, particularly analytical studies with high-quality evidence and those focusing on older age groups and associations with physical activity and diet.

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“…Different factors, such as change in cultures and food systems, sedentary lifestyle, and specific aspects of traditional culture (such as showing hospitality through providing large amounts of foods), contribute to the high prevalence of overweight and obesity (29). Weight control strategies are expected to decrease the burden of diabetes in all countries of the region (9,(30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

High Fasting Plasma Glucose, Diabetes, and Its Risk Factors in the Eastern Mediterranean Region, 1990–2013: Findings From the Global Burden of Disease Study 2013

et al. 2016

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OBJECTIVEThe prevalence of diabetes in the Eastern Mediterranean Region (EMR) is among the highest in the world. We used findings from the Global Burden of Disease 2013 study to calculate the burden of diabetes in the EMR. RESEARCH DESIGN AND METHODSThe burden of diabetes and burden attributable to high fasting plasma glucose (HFPG) were calculated for each of the 22 countries in the EMR between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, deaths, and disability-adjusted life years (DALYs). RESULTSThe diabetes death rate increased by 60.7%, from 12.1 per 100,000 population (95% uncertainty interval [UI]: 11.2-13.2) in 1990 to 19.5 per 100,000 population (95% UI: 17.4-21.5) in 2013. The diabetes DALY rate increased from 589.9 per 100,000 (95% UI: 498.0-698.0) in 1990 to 883.5 per 100,000 population (95% UI: 732.2-1,051.5) in 2013. In 2013, HFPG accounted for 4.9% (95% UI: 4.4-5.3) of DALYs from all causes. Total DALYs from diabetes increased by 148.6% during 1990-2013; population growth accounted for a 62.9% increase, and aging and increase in age-specific DALY rates accounted for 31.8% and 53.9%, respectively. CONCLUSIONSOur findings show that diabetes causes a major burden in the EMR, which is increasing. Aging and population growth do not fully explain this increase in the diabetes burden. Programs and policies are urgently needed to reduce risk factors for diabetes, increase awareness of the disease, and improve diagnosis and control of diabetes to reduce its burden.

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Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Abstract: Bill & Melinda Gates Foundation.

Cited by 154 publications

References 13 publications

The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

Cancer Research in the Arab World: A review of publications from seven countries between 2000–2013

High Fasting Plasma Glucose, Diabetes, and Its Risk Factors in the Eastern Mediterranean Region, 1990–2013: Findings From the Global Burden of Disease Study 2013

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