Kassebaum, Nicholas J2; Bertozzi-Villa, Amelia3; Coggeshall, Megan S3; Shackelford, Katya A3; Steiner, Caitlyn3; Heuton, Kyle R3; Gonzalez-Medina, Diego3; Barber, Ryan3; Huynh, Chantal3; Dicker, Daniel3; Templin, Tara3; Wolock, Timothy M3; Ozgoren, Ayse Abbasoglu4; Abd-Allah, Foad5; Abera, Semaw Ferede6; Abubakar, Ibrahim7; Achoki, Tom8; Adelekan, Ademola9; Ademi, Zanfina10; Adou, Arsène Kouablan11; Adsuar, José C12; Agardh, Emilie E13; Akena, Dickens14; Alasfoor, Deena15; Alemu, Zewdie Aderaw16; Alfonso-Cristancho, Rafael17; Alhabib, Samia18; Ali, Raghib19; Al Kahbouri, Mazin J15; Alla, François20; Allen, Peter J21; AlMazroa, Mohammad A22; Alsharif, Ubai23; Alvarez, Elena24; Alvis-Guzmán, Nelson25; Amankwaa, Adansi A26; Amare, Azmeraw T27; Amini, Hassan28; Ammar, Walid29; Antonio, Carl A T30; Anwari, Palwasha31; Arnlöv, Johan32; Arsenijevic, Valentina S Arsic33; Artaman, Ali34; Asad, Majed Masoud35; Asghar, Rana J36; Assadi, Reza37; Atkins, Lydia S38; Badawi, Alaa39; Balakrishnan, Kalpana40; Basu, Arindam41; Basu, Sanjay42; Beardsley, Justin43; Bedi, Neeraj44; Bekele, Tolesa45; Bell, Michelle L46; Bernabe, Eduardo47; Beyene, Tariku J48; Bhutta, Zulfiqar49; Bin Abdulhak, Aref50; Blore, Jed D10; Basara, Berrak Bora51; Bose, Dipan52; Breitborde, Nicholas53; Cárdenas, Rosario54; Castañeda-Orjuela, Carlos A55; Castro, Ruben Estanislao56; Catalá-López, Ferrán57; Cavlin, Alanur58; Chang, Jung-Chen59; Che, Xuan60; Christophi, Costas A61; Chugh, Sumeet S62; Cirillo, Massimo63; Colquhoun, Samantha M64; Cooper, Leslie Trumbull65; Cooper, Cyrus66; da Costa Leite, Iuri67; Dandona, Lalit68; Dandona, Rakhi69; Davis, Adrian70; Dayama, Anand71; Degenhardt, Louisa72; De Leo, Diego73; del Pozo-Cruz, Borja74; Deribe, Kebede48; Dessalegn, Muluken75; deVeber, Gabrielle A76; Dharmaratne, Samath D77; Dilmen, Uğur51; Ding, Eric L78; Dorrington, Rob E79; Driscoll, Tim R80; Ermakov, Sergei Petrovich81; Esteghamati, Alireza82; Faraon, Emerito Jose A30; Farzadfar, Farshad83; Felicio, Manuela Mendonca84; Fereshtehnejad, Seyed-Mohammad85; de Lima, Graça Maria Ferreira86; Forouzanfar, Mohammad H3; França, Elisabeth B87; Gaffikin, Lynne88; Gambashidze, Ketevan89; Gankpé, Fortuné Gbètoho90; Garcia, Ana C91; Geleijnse, Johanna M92; Gibney, Katherine B93; Giroud, Maurice94; Glaser, Elizabeth L95; Goginashvili, Ketevan96; Gona, Philimon97; González-Castell, Dinorah98; Goto, Atsushi99; Gouda, Hebe N100; Gugnani, Harish Chander101; Gupta, Rahul102; Gupta, Rajeev103; Hafezi-Nejad, Nima82; Hamadeh, Randah Ribhi104; Hammami, Mouhanad105; Hankey, Graeme J106; Harb, Hilda L29; Havmoeller, Rasmus85; Hay, Simon I19; Pi, Ileana B Heredia98; Hoek, Hans W107; Hosgood, H Dean108; Hoy, Damian G109; Husseini, Abdullatif110; Idrisov, Bulat T111; Innos, Kaire112; Inoue, Manami113; Jacobsen, Kathryn H114; Jahangir, Eiman115; Jee, Sun Ha116; Jensen, Paul N17; Jha, Vivekanand117; Jiang, Guohong118; Jonas, Jost B119; Juel, Knud290; Kabagambe, Edmond Kato121; Kan, Haidong122; Karam, Nadim E123; Karch, André124; Karema, Corine Kakizi125; Kaul, Anil126; Kawakami, Norito127; Kazanjan, Konstantin128; Kazi, Dhruv S129; Kemp, Andrew H130; Kengne, Andre Pascal131; Kereselidze, Maia132; Khader, Yousef Saleh133; Khalifa, Shams Eldin Ali Hassan134; Khan, Ejaz Ahmed135; Khang, Young-Ho136; Knibbs, Luke100; Kokubo, Yoshihiro137; Kosen, Soewarta138; Defo, Barthelemy Kuate139; Kulkarni, Chanda140; Kulkarni, Veena S141; Kumar, G Anil69; Kumar, Kaushalendra142; Kumar, Ravi B143; Kwan, Gene144; Lai, Taavi145; Lalloo, Ratilal146; Lam, Hilton147; Lansingh, Van C148; Larsson, Anders32; Lee, Jong-Tae149; Leigh, James150; Leinsalu, Mall112; Leung, Ricky151; Li, Xiaohong152; Li, Yichong153; Li, Yongmei154; Liang, Juan155; Liang, Xiaofeng156; Lim, Stephen S3; Lin, Hsien-Ho157; Lipshultz, Steven E158; Liu, Shiwei159; Liu, Yang160; Lloyd, Belinda K93; London, Stephanie J161; Lotufo, Paulo A130; Ma, Jixiang162; Ma, Stefan163; Machado, Vasco Manuel Pedro164; Mainoo, Nana Kwaku165; Majdan, Marek166; Mapoma, Christopher Chabila167; Marcenes, Wagner168; Marzan, Melvin Barrientos169; Mason-Jones, Amanda J170; Mehndiratta, Man Mohan171; Mejia-Rodriguez, Fabiola98; Memish, Ziad A172; Mendoza, Walter173; Miller, Ted R174; Mills, Edward J175; Mokdad, Ali H3; Mola, Glen Liddell176; Monasta, Lorenzo177; de la Cruz Monis, Jonathan178; Hernandez, Julio Cesar Montañez98; Moore, Ami R179; Moradi-Lakeh, Maziar180; Mori, Rintaro181; Mueller, Ulrich O182; Mukaigawara, Mitsuru183; Naheed, Aliya184; Naidoo, Kovin S185; Nand, Devina186; Nangia, Vinay187; Nash, Denis188; Nejjari, Chakib189; Nelson, Robert G190; Neupane, Sudan Prasad191; Newton, Charles R192; Ng, Marie3; Nieuwenhuijsen, Mark J193; Nisar, Muhammad Imran194; Nolte, Sandra23; Norheim, Ole F195; Nyakarahuka, Luke14; Oh, In-Hwan196; Ohkubo, Takayoshi197; Olusanya, Bolajoko O198; Omer, Saad B199; Opio, John Nelson200; Orisakwe, Orish Ebere201; Pandian, Jeyaraj D202; Papachristou, Christina23; Park, Jae-Hyun203; Caicedo, Angel J Paternina204; Patten, Scott B205; Paul, Vinod K206; Pavlin, Boris Igor207; Pearce, Neil208; Pereira, David M209; Pesudovs, Konrad210; Petzold, Max211; Poenaru, Dan212; Polanczyk, Guilherme V130; Polinder, Suzanne213; Pope, Dan214; Pourmalek, Farshad215; Qato, Dima216; Quistberg, D Alex17; Rafay, Anwar217; Rahimi, Kazem19; Rahimi-Movaghar, Vafa218; ur Rahman, Sajjad219; Raju, Murugesan50; Rana, Saleem M220; Refaat, Amany221; Ronfani, Luca177; Roy, Nobhojit222; Pimienta, Tania Georgina Sánchez98; Sahraian, Mohammad Ali223; Salomon, Joshua A224; Sampson, Uchechukwu121; Santos, Itamar S130; Sawhney, Monika225; Sayinzoga, Felix226; Schneider, Ione J C227; Schumacher, Austin3; Schwebel, David C228; Seedat, Soraya229; Sepanlou, Sadaf G230; Servan-Mori, Edson E98; Shakh-Nazarova, Marina231; Sheikhbahaei, Sara82; Shibuya, Kenji232; Shin, Hwashin Hyun233; Shiue, Ivy234; Sigfusdottir, Inga Dora235; Silberberg, Donald H236; Silva, Andrea P237; Singh, Jasvinder A228; Skirbekk, Vegard238; Sliwa, Karen239; Soshnikov, Sergey S240; Sposato, Luciano A241; Sreeramareddy, Chandrashekhar T242; Stroumpoulis, Konstantinos243; Sturua, Lela244; Sykes, Bryan L129; Tabb, Karen M245; Talongwa, Roberto Tchio246; Tan, Feng247; Teixeira, Carolina Maria248; Tenkorang, Eric Yeboah249; Terkawi, Abdullah Sulieman250; Thorne-Lyman, Andrew L251; Tirschwell, David L252; Towbin, Jeffrey A253; Tran, Bach X254; Tsilimbaris, Miltiadis255; Uchendu, Uche S256; Ukwaja, Kingsley N257; Undurraga, Eduardo A111; Uzun, Selen Begüm258; Vallely, Andrew J259; van Gool, Coen H260; Vasankari, Tommi J261; Vavilala, Monica S17; Venketasubramanian, N262; Villalpando, Salvador98; Violante, Francesco S263; Vlassov, Vasiliy Victorovich264; Vos, Theo3; Waller, Stephen265; Wang, Haidong3; Wang, Linhong266; Wang, XiaoRong267; Wang, Yanping268; Weichenthal, Scott233; Weiderpass, Elisabete269; Weintraub, Robert G270; Westerman, Ronny271; Wilkinson, James D272; Woldeyohannes, Solomon Meseret273; Wong, John Q274; Wordofa, Muluemebet Abera275; Xu, Gelin276; Yang, Yang C277; Yano, Yuichiro278; Yentur, Gokalp Kadri51; Yip, Paul279; Yonemoto, Naohiro280; Yoon, Seok-Jun149; Younis, Mustafa Z281; Yu, Chuanhua282; Jin, Kim Yun283; El Sayed Zaki, Maysaa284; Zhao, Yong285; Zheng, Yingfeng286; Zhou, Maigeng287; Zhu, Jun288; Zou, Xiao Nong289; Lopez, Alan D10; Naghavi, Mohsen3; Murray, Christopher J L3; Lozano, Rafael98
1 Research Programme on Health and Morbidity in Denmark, National Institute of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU2 Institute for Health Metrics and Evaluation, Seattle, WA, USA; Pediatric Anesthesiology and Pain Medicine, Seattle Children's Hospital, School of Medicine, Seattle, WA, USA. Electronic address: firstname.lastname@example.org Institute for Health Metrics and Evaluation, Seattle, WA, USA.4 Hacettepe University Institute of Population Studies, Ankara, Turkey.5 Faculty of Medicine, Cairo-University, Cairo, Egypt.6 School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.7 University College London8 Ministry of Health, Gaborone, Botswana.9 Public Health Promotion Alliance, Osogbp, Nigeria.10 University of Melbourne11 Association Ivoirienne Pour Le Bien Etre Familial, Abidjan, Côte d'Ivoire.12 University of Extremadura, Cáceres, Spain.13 Institution of Public Health Sciences, Stockholm, Sweden.14 Makerere University, Kampala, Uganda.15 Ministry of Health, Muscat, Oman.16 Debre Markos University, Debre Markos, Amhara, Ethiopia.17 University of Washington18 National Guard Health Affairs, Riyadh, Saudi Arabia.19 University of Oxford20 University of Lorraine21 Ministry of Health, Belmopan, Cayo, Belize.22 Saudi Ministry of Health, Riyadh, Saudi Arabia.23 Charité Universitätsmedizin24 Spanish Observatory on Drugs, Government Delegation for the National Plan on Drugs, Madrid, Spain; Ministry of Health, Social Services and Equality, Madrid, Spain.25 Universidad de Cartagena, Cartagena de Indias, Colombia.26 Albany State University, Albany, GA, USA.27 Department of Epidemiology, University of Groningen, Groningen, Netherlands; College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.28 Kurdistan Environmental Health Research Centre, Kurdistan University of Medical Sciences, Sanandaj, Kurdistan, Iran.29 Ministry of Public Health, Beirut, Lebanon.30 College of Public Health, University of the Philippines Manila, Manila, Philippines.31 UN Population Fund, Kabul, Afghanistan.32 Uppsala University33 Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Belgrade, Serbia.34 Median, Windsor, ON, Canada.35 Ministry of Health, Amman, Jordan.36 Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan.37 Mashhad University of Medical Sciences, Mashhad, Iran.38 Ministry Of Health, Wellness, Human Services and Gender Relations, Sans Souci, Castries, Saint Lucia.39 Public Health Agency of Canada, Toronto, ON, Canada.40 Sri Ramachandra University, Chennai, India.41 School of Health Sciences, University of Canterbury, Christchurch, New Zealand.42 Stanford University43 Oxford University, Ho Chi Minh City, Vietnam.44 College of Public Health and Tropical Medicine, Jazan, Saudi Arabia.45 Madawalabu University, Bale Goba, Oromia, Ethiopia.46 Yale University47 King's College London48 Addis Ababa University, Debre Zeit, Ethiopia.49 Aga Khan University Medical Centre, Karachi, Pakistan.50 University of Missouri51 General Directorate of Health Research, Ankara, Turkey.52 World Bank53 University of Arizona54 Universidad Autonoma Metropolitana, Mexico City, Mexico.55 Colombian National Health Observatory, Instituto Nacional de Salud, Bogota, Colombia.56 Universidad Diego Portales, Santiago, Chile.57 Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency, Madrid, Spain.58 Hacettepe University Institute of Population Studies, Ankara, Turkey.59 National Taiwan University60 National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.61 Cyprus University of Technology, Limassol, Cyprus.62 Cedars-Sinai Medical Centre, Los Angeles, CA, USA.63 University of Salerno, Baronissi, Italy.64 Centre for International Child Health, Melbourne, VIC, Australia.65 Mayo Clinic66 University of Southampton67 National School of Public Health (ENSP/Fiocruz), Rio de Janeiro, Brazil.68 Institute for Health Metrics and Evaluation, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India.69 Public Health Foundation of India, New Delhi, India.70 Public Health England, London, UK.71 School of Medicine, Atlanta, GA, USA.72 University of New South Wales73 Griffith University74 University of Auckland, Auckland, New Zealand.75 Africa Medical and Research Foundation in Ethiopia, Addis Ababa, Ethiopia.76 University of Toronto77 University of Peradeniya, Peradeniya, Sri Lanka.78 Harvard School of Public Health79 University of Cape Town, Cape Town, South Africa.80 Sydney School of Public Health, NSW, Australia.81 The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia.82 Endocrinology and Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran.83 Non-Communicable Diseases Research Centre, Tehran University of Medical Sciences, Tehran, Iran.84 Departamento de Saúde Pública, ARS Norte IP, Porto, Portugal.85 Karolinska Institutet, Stockholm, Sweden.86 Public Health Department, Unidade Local de Saúde de Matosinhos, Porto, Portugal.87 Federal University of Minas Gerais88 School of Medicine, Stanford, CA, USA.89 National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia.90 Clinique Coopérative de Parakou, Parakou, Borgou, Benin.91 Public Health Unit of Primary Health Care Group of Almada-Seixal, Almada, Setúbal, Portugal.92 Division of Human Nutrition, Wageningen University, Wageningen, Netherlands.93 Monash University94 University Hospital of Dijon, Dijon, France.95 Heller School for Social Policy and Management, Waltham, MA, USA.96 Ministry of Labour, Health and Social Affairs, Tbilisi, Georgia.97 University of Massachusetts Medical School, Worcester, MA, USA.98 National Institute of Public Health of Mexico99 Department of Diabetes Research, National Centre for Global Health and Medicine, Tokyo, Japan.100 University of Queensland101 Saint James School of Medicine, Kralendijk, Bonaire, Netherlands.102 Kanawha Charleston Health Department, Charleston, WV, USA.103 Fortis Escorts Hospital, Jaipur, India.104 Arabian Gulf University, Manama, Bahrain.105 Wayne County Department of Health and Human Services, Detroit, MI, USA.106 University of Western Australia107 Parnassia Psychiatric Institute, The Hague, Netherlands.108 Albert Einstein College of Medicine, Bronx, NY, USA.109 School of Population Health, QLD, Australia; Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia.110 Birzeit University, Birzeit, Ramallah, Palestine.111 Brandeis University, Waltham, MA, USA.112 National Institute for Health Development, Tallinn, Estonia.113 Graduate School of Medicine, Tokyo, Japan.114 George Mason University, Fairfax, VA, USA.115 Ochsner Medical Centre116 Yonsei University117 Postgraduate Institute of Medical Education and Research, Chandigarh, India.118 Tianjin Centres for Diseases Control and Prevention, Tianjin, China.119 Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.120 Health Promotion and Prevention, National Institute of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU121 Vanderbilt University, Nashville, TN, USA.122 Fudan University, Shanghai, China.123 University of Balamand, Beirut, Lebanon.124 Helmholtz Centre for Infection Research, Braunschweig, Germany.125 Malaria and Other Parasitic Diseases Division, Kigali, Rwanda.126 Oklahoma State University, Tulsa, OK, USA.127 School of Public Health, Tokyo, Japan.128 National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia.129 University of California130 University of Säo Paulo131 South African Medical Research Council, Cape Town, South Africa.132 National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia.133 Jordan University of Science and Technology134 Supreme Council of Health, Doha, Qatar.135 Health Services Academy, Islamabad, Pakistan.136 Seoul National University College of Medicine137 Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Centre, Suita, Japan.138 Centre for Community Empowerment, Health Policy and Humanities, National Institute of Health Research and Development, Jakarta, Indonesia.139 University of Montreal140 Rajrajeshwari Medical College and Hospital, Bangalore, India.141 Arkansas State University, Jonesboro, AR, USA.142 International Institute for Population Sciences, Mumbai, India.143 Indian Institute of Public Health, Public Health Foundation of India, Gurgaon, India.144 Boston Medical Centre, Boston, MA, USA.145 Fourth View Consulting, Tallinn, Estonia.146 Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry, University of Adelaide, Adelaide, SA, Australia.147 Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines.148 International Agency for the Prevention of Blindness and Vision 2020, Weston, FL, USA.149 Korea University, Seoul, South Korea.150 University of Sydney151 University at Albany, Rensselaer, NY, USA.152 National Centre for Birth Defects Monitoring of China, Chengdu, China.153 National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China.154 Genentech, South San Francisco, CA, USA.155 National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China.156 Chinese Centre for Disease Control and Prevention, Beijing, China.157 College of Public Health, Taipei, Taiwan.158 Wayne State University, Miami, FL, USA.159 National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China.160 University of the East Ramon Magsaysay Memorial Medical Centre, Quezon City, Philippines.161 National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.162 National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China.163 Ministry of Health Singapore, Singapore, Singapore.164 Northern Region Health Administration, Porto, Portugal.165 Xpharmconsult, Kumasi, Ghana.166 Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia.167 University of Zambia, Lusaka, Zambia.168 Queen Mary University of London, London, UK.169 University of the East Ramon Magsaysay Memorial Medical Centre, Quezon City, Philippines.170 University of York171 Janakpuri Super Specialty Hospital, New Delhi, India.172 Saudi Ministry of Health, Riyadh, Saudi Arabia.173 UN Population Fund, Lima, Peru.174 Pacific Institute for Research and Evaluation, Calverton, MD, USA.175 University of Ottowa176 University of Papua New Guinea, Port Moresby, Papua New Guinea.177 Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico Burlo Garofolo, Trieste, Italy.178 Bureau of International Health Cooperation, Manila City, Philippines.179 University of North Texas, Denton, TX, USA.180 Institute for Health Metrics and Evaluation, Seattle, WA, USA; Iran University of Medical Sciences, Department of Community Medicine, Tehran, Iran.181 National Centre for Child Health and Development, Setagaya, Tokyo, Japan.182 Philipps-University Marburg, Marburg, Germany.183 Tokyo Medical and Dental University, Tokyo, Japan.184 International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh.185 University of KwaZulu-Natal, Durban, South Africa.186 Ministry of Health Fiji, Suva, Fiji.187 Suraj Eye Institute, Nagpur, India.188 School of Public Health, State University of New York, New York, NY, USA.189 Faculty of Medicine, Fez, Morocco.190 National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA.191 University of Oslo192 Kenya Medical Research Institute Wellcome Trust Programme, Kilifi, Kenya.193 Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.194 Aga Khan University, Karachi, Pakistan.195 University of Bergen, Bergen, Norway.196 Kyung Hee Unversity, Seoul, South Korea.197 Teikyo University School of Medicine, Tokyo, Japan.198 Centre for Healthy Start Initiative, Lagos, Nigeria.199 Emory University200 Lira District Local Government, Lira Municipal Council, Lira, Uganda.201 Toxicology Unit, Faculty of Pharmacy, University of Port Harcourt, Port Harcourt, Nigeria.202 Christian Medical College Ludhiana, Ludhiana, India.203 Sungkyunkwan University School of Medicine, Suwon, South Korea.204 Universidad de Cartagena, Cartagena, Colombia.205 University of Calgary206 All India Institute of Medical Sciences (AIIMS), New Delhi, India.207 WHO, Waigani, Papua New Guinea.208 London School of Hygiene & Tropical Medicine, London, UK.209 3B's Research Group in Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, and ICVS/3B's PT Government Associate Laboratory, Braga Portugal.210 Flinders University, Adelaide, SA, Australia.211 University of Göthenburg212 McMaster University, Hamilton, ON, Canada.213 Erasmus Medical Center, Department of Public Health, Rotterdam, Netherlands.214 University of Liverpool, Liverpool215 University of British Columbia216 College of Pharmacy, Chicago, IL, USA.217 Contech International, Lahore, Pakistan.218 Sina Trauma and Surgery Research Centre, Tehran University of Medical Sciences, Tehran, Iran.219 Hamad Medical Corporation, Doha, Qatar.220 Department of Public Health, University of the Punjab, Lahore, Pakistan.221 Walden University, Minneapolis, MN, USA.222 Bhaba Atomic Research Center Hospital, Mumbai, India.223 MS Research Centre, Tehran University of Medical Sciences, Tehran, Iran.224 Harvard University225 Marshall University, Huntington, WV, USA.226 Ministry of Health, Kigali, Rwanda.227 Federal University of Santa Catarina228 University of Alabama at Birmingham, Birmingham, AL, USA.229 Stellenbosch University, Cape Town, South Africa.230 Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.231 National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia.232 University of Tokyo, Tokyo, Japan.233 Health Canada, Ottawa, ON, Canada.234 Heriot-Watt University, Edinburgh, UK.235 Reykjavik University236 University of Pennsylvania237 Instituto Nacional de Epidemiología Dr Juan H Jara, Mar del Plata, Buenos Aires, Argentina.238 Norwegian Institute of Public Health, Oslo, Norway.239 Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, Cape Town, South Africa.240 Federal Research Institute for Health Organisation and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia.241 Department of Clinical Neurological Sciences, Western University, London, ON, Canada.242 University Tunku Abdul Rahman, Kajang, Malaysia.243 Hellenic Centre for Disease Control and Prevention (KEELPNO) Greece, Athens, Greece.244 National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia.245 University of Illinois, Chicago, IL, USA.246 Ministry of Public Health, Yaounde, Cameroon.247 National Institute of Occupational Health and Poison Control, Beijing, China.248 Departamento de Saúde Pública, ARS Norte IP, Porto, Portugal.249 Memorial University, St John's, NL, Canada.250 Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA; Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia.251 The Earth Institute, Columbia University, New York, NY, USA.252 Department of Neurology, Seattle, WA, USA.253 Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, USA.254 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.255 Department of Medicine, University of Crete, Heraklion, Greece.256 Department of Veterans Affairs, Washington, DC, USA.257 Department of Internal Medicine, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria.258 Ministry of Health, Ankara, Turkey.259 The Kirby Institute, Sydney, NSW, Australia.260 National Institute for Public Health and the Environment, Bilthoven, Netherlands.261 UKK Institute for Health Promotion Research, Tampere, Finland.262 Neuroscience Centre, Raffles Hospital, Singapore.263 University of Bologna264 Higher School of Economics, Moscow, Russia.265 Uniformed Services University of Health Sciences, Bethesda, MD, USA.266 National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China.267 Shandong University Affiliated Jinan Central Hospital, Jinan, China.268 National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China.269 Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.270 University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.271 Philipps-University Marburg, Marburg, Germany.272 University of Miami, Miami, FL, USA.273 Institute of Public Health, University of Gondar, Gondar, Ethiopia.274 Ateneo School of Medicine and Public Health, City of Pasig, Manila, Philippines.275 Jimma University, Jimma, Ethiopia.276 Nanjing University School of Medicine, Jinling Hospital, Nanjing, China.277 University of North Carolina at Chapel Hill278 Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.279 University of Hong Kong, Hong Kong Special Administrative Region, China.280 National Centre of Neurology and Psychiatry, Kodaira, Japan.281 Jackson State University, Jackson, MS, USA.282 Wuhan University283 TCM Medical Tk, Nusajaya, Johor Bahru, Malaysia.284 Mansoura Faculty of Medicine, Mansoura, Egypt.285 Chongqing Medical University, Chongqing, China.286 Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China.287 National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China.288 National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China.289 Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China.290 Health Promotion and Prevention, National Institute of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU
a systematic analysis for the Global Burden of Disease Study 2013
BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland. INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. FUNDING: Bill & Melinda Gates Foundation.
Lancet, 2014, Vol 384, Issue 9947, p. 980-1004
Age Distribution; Cause of Death; Female; HIV Infections; Humans; Maternal Mortality; Models, Statistical; Organizational Objectives; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Socioeconomic Factors; Time Factors; World Health