Publications by authors named "Adrienne Chew"

4 Publications

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Association between firearms and mortality in Brazil, 1990 to 2017: a global burden of disease Brazil study.

Popul Health Metr 2020 09 30;18(Suppl 1):19. Epub 2020 Sep 30.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Background: Brazil leads the world in number of firearm deaths and ranks sixth by country in rate of firearm deaths per 100,000 people. This study aims to analyze trends in and burden of mortality by firearms, according to age and sex, for Brazil, and the association between these deaths and indicators of possession and carrying of weapons using data from the global burden of diseases, injuries, and risk factors study (GBD) 2017.

Methods: We used GBD 2017 estimates of mortality due to physical violence and self-harm from firearms for Brazil to analyze the association between deaths by firearms and explanatory variables.

Results: Deaths from firearms increased in Brazil from 25,819 in 1990 to 48,493 in 2017. Firearm mortality rates were higher among men and in the 20-24 age group; the rate was 20 times higher than for women in the same age group. Homicide rates increased during the study period, while mortality rates for suicides and accidental deaths decreased. The group of Brazilian federation units with the highest firearm collection rate (median = 7.5) showed reductions in the rate of total violent deaths by firearms. In contrast, the group with the lowest firearm collection rate (median = 2.0) showed an increase in firearm deaths from 2000 to 2017. An increase in the rate of voluntary return of firearms was associated with a reduction in mortality rates of unintentional firearm deaths (r = -0.364, p < 0.001). An increase in socio-demographic index (SDI) was associated with a reduction in all firearm death rates (r = -0.266, p = 0.008). An increase in the composite index of firearms seized or collected was associated with a reduction in rates of deaths by firearm in the subgroup of females, children, and the elderly (r = -0.269, p = 0.005).

Conclusions: There was a change in the trend of firearms deaths after the beginning of the collection of weapons in 2004. Federation units that collected more guns have reduced rates of violent firearm deaths.
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http://dx.doi.org/10.1186/s12963-020-00222-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525968PMC
September 2020

Causes of death among children aged 5-14 years in the WHO European Region: a systematic analysis for the Global Burden of Disease Study 2016.

Lancet Child Adolesc Health 2018 May;2(5):321-337

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. Electronic address:

Background: The mortality burden in children aged 5-14 years in the WHO European Region has not been comprehensively studied. We assessed the distribution and trends of the main causes of death among children aged 5-9 years and 10-14 years from 1990 to 2016, for 51 countries in the WHO European Region.

Methods: We used data from vital registration systems, cancer registries, and police records from 1980 to 2016 to estimate cause-specific mortality using the Cause of Death Ensemble model.

Findings: For children aged 5-9 years, all-cause mortality rates (per 100 000 population) were estimated to be 46·3 (95% uncertainty interval [UI] 45·1-47·5) in 1990 and 19·5 (18·1-20·9) in 2016, reflecting a 58·0% (54·7-61·1) decline. For children aged 10-14 years, all-cause mortality rates (per 100 000 population) were 37·9 (37·3-38·6) in 1990 and 20·1 (18·8-21·3) in 2016, reflecting a 47·1% (43·8-50·4) decline. In 2016, we estimated 10 740 deaths (95% UI 9970-11 542) in children aged 5-9 years and 10 279 deaths (9652-10 897) in those aged 10-14 years in the WHO European Region. Injuries (road injuries, drowning, and other injuries) caused 4163 deaths (3820-4540; 38·7% of total deaths) in children aged 5-9 years and 4468 deaths (4162-4812; 43·5% of total) in those aged 10-14 years in 2016. Neoplasms caused 2161 deaths (1872-2406; 20·1% of total deaths) in children aged 5-9 years and 1943 deaths (1749-2101; 18·9% of total deaths) in those aged 10-14 years in 2016. Notable differences existed in cause-specific mortality rates between the European subregions, from a two-times difference for leukaemia to a 20-times difference for lower respiratory infections between the Commonwealth of Independent States (CIS) and EU15 (the 15 member states that had joined the European Union before May, 2004).

Interpretation: Marked progress has been made in reducing the mortality burden in children aged 5-14 years over the past 26 years in the WHO European Region. More deaths could be prevented, especially in CIS countries, through intervention and prevention efforts focusing on the leading causes of death, which are road injuries, drowning, and lower respiratory infections. The findings of our study could be used as a baseline to assess the effect of implementation of programmes and policies on child mortality burden.

Funding: WHO and Bill & Melinda Gates Foundation.
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http://dx.doi.org/10.1016/S2352-4642(18)30095-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928398PMC
May 2018

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

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

Lancet Glob Health 2016 10 25;4(10):e704-13. Epub 2016 Aug 25.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Background: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013.

Methods: GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically.

Findings: The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60-80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred.

Interpretation: Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts.

Funding: Bill & Melinda Gates Foundation.
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http://dx.doi.org/10.1016/S2214-109X(16)30168-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660972PMC
October 2016

Global burden of diseases, injuries, and risk factors for young people's health during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Lancet 2016 Jun 9;387(10036):2383-401. Epub 2016 May 9.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Background: Young people's health has emerged as a neglected yet pressing issue in global development. Changing patterns of young people's health have the potential to undermine future population health as well as global economic development unless timely and effective strategies are put into place. We report the past, present, and anticipated burden of disease in young people aged 10-24 years from 1990 to 2013 using data on mortality, disability, injuries, and health risk factors.

Methods: The Global Burden of Disease Study 2013 (GBD 2013) includes annual assessments for 188 countries from 1990 to 2013, covering 306 diseases and injuries, 1233 sequelae, and 79 risk factors. We used the comparative risk assessment approach to assess how much of the burden of disease reported in a given year can be attributed to past exposure to a risk. We estimated attributable burden by comparing observed health outcomes with those that would have been observed if an alternative or counterfactual level of exposure had occurred in the past. We applied the same method to previous years to allow comparisons from 1990 to 2013. We cross-tabulated the quantiles of disability-adjusted life-years (DALYs) by quintiles of DALYs annual increase from 1990 to 2013 to show rates of DALYs increase by burden. We used the GBD 2013 hierarchy of causes that organises 306 diseases and injuries into four levels of classification. Level one distinguishes three broad categories: first, communicable, maternal, neonatal, and nutritional disorders; second, non-communicable diseases; and third, injuries. Level two has 21 mutually exclusive and collectively exhaustive categories, level three has 163 categories, and level four has 254 categories.

Findings: The leading causes of death in 2013 for young people aged 10-14 years were HIV/AIDS, road injuries, and drowning (25·2%), whereas transport injuries were the leading cause of death for ages 15-19 years (14·2%) and 20-24 years (15·6%). Maternal disorders were the highest cause of death for young women aged 20-24 years (17·1%) and the fourth highest for girls aged 15-19 years (11·5%) in 2013. Unsafe sex as a risk factor for DALYs increased from the 13th rank to the second for both sexes aged 15-19 years from 1990 to 2013. Alcohol misuse was the highest risk factor for DALYs (7·0% overall, 10·5% for males, and 2·7% for females) for young people aged 20-24 years, whereas drug use accounted for 2·7% (3·3% for males and 2·0% for females). The contribution of risk factors varied between and within countries. For example, for ages 20-24 years, drug use was highest in Qatar and accounted for 4·9% of DALYs, followed by 4·8% in the United Arab Emirates, whereas alcohol use was highest in Russia and accounted for 21·4%, followed by 21·0% in Belarus. Alcohol accounted for 9·0% (ranging from 4·2% in Hong Kong to 11·3% in Shandong) in China and 11·6% (ranging from 10·1% in Aguascalientes to 14·9% in Chihuahua) of DALYs in Mexico for young people aged 20-24 years. Alcohol and drug use in those aged 10-24 years had an annual rate of change of >1·0% from 1990 to 2013 and accounted for more than 3·1% of DALYs.

Interpretation: Our findings call for increased efforts to improve health and reduce the burden of disease and risks for diseases in later life in young people. Moreover, because of the large variations between countries in risks and burden, a global approach to improve health during this important period of life will fail unless the particularities of each country are taken into account. Finally, our results call for a strategy to overcome the financial and technical barriers to adequately capture young people's health risk factors and their determinants in health information systems.

Funding: Bill & Melinda Gates Foundation.
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http://dx.doi.org/10.1016/S0140-6736(16)00648-6DOI Listing
June 2016