umu.sePublications
Change search
Refine search result
2345 201 - 243 of 243
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 201.
    Santosa, Ailiana
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå Centre for Global Health Research.
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå Centre for Global Health Research.
    Fottrell, Edward
    Institute for Global Health, University College London, London, UK.
    Högberg, Ulf
    Department of Women’s and Children’s Health, Uppsala University, Uppsala.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå Centre for Global Health Research and MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    The development and experience of epidemiological transition theory over four decades: a systematic review2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, article id 23574Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Epidemiological transition (ET) theory, first postulated in 1971, has developed alongside changes in population structures over time. However, understandings of mortality transitions and associated epidemiological changes remain poorly defined for public health practitioners. Here, we review the concept and development of ET theory, contextualising this in empirical evidence, which variously supports and contradicts the original theoretical propositions.

    DESIGN: A Medline literature search covering publications over four decades, from 1971 to 2013, was conducted. Studies were included if they assessed human populations, were original articles, focused on mortality and health or demographic or ET and were in English. The reference lists of the selected articles were checked for additional sources.

    RESULTS: We found that there were changes in emphasis in the research field over the four decades. There was an increasing tendency to study wide-ranging aspects of the determinants of mortality, including risk factors, lifestyle changes, socio-economics, and macro factors such as climate change. Research on ET has focused increasingly on low- and middle-income countries rather than industrialised countries, despite its origins in industrialised countries. Countries have experienced different levels of progress in ET in terms of time, pace, and underlying mechanisms. Elements of ET are described for many countries, but observed transitions have not always followed pathways described in the original theory.

    CONCLUSIONS: The classic ET theory largely neglected the critical role of social determinants, being largely a theoretical generalisation of mortality experience in some countries. This review shows increasing interest in ET all over the world but only partial concordance between established theory and empirical evidence. Empirical evidence suggests that some unconsidered aspects of social determinants contributed to deviations from classic theoretical pathways. A better-constructed, revised ET theory, with a stronger basis in evidence, is needed.

  • 202.
    Son, Pham Thai
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Quang, Nguyen Ngoc
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Viet, Nguyen Lan
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Bonita, Ruth
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Effects of a 3-year community-based hypertension control programme in rural VietnamIn: Article in journal (Refereed)
  • 203.
    Son, Pham Thai
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Quang, Nguyen Ngoc
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Viet, Nguyen Lan
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Bonita, Ruth
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hypertension-related knowledge and healthcare seeking behaviour based on a national survey of Vietnamese adultsIn: Article in journal (Refereed)
  • 204.
    Stordalen, Gunhild A.
    et al.
    Stordalen Foundation, Oslo, Norway.
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Nilsson, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Only an integrated approach across academia, enterprise, governments, and global agencies can tackle the public health impact of climate change2013In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 6Article in journal (Refereed)
    Abstract [en]

    Background: Despite considerable global attention to the issues of climate change, relatively little priority has been given to the likely effects on human health of current and future changes in the global climate. We identify three major societal determinants that influence the impact of climate change on human health, namely the application of scholarship and knowledge; economic and commercial considerations; and actions of governments and global agencies. Discussion: The three major areas are each discussed in terms of the ways in which they facilitate and frustrate attempts to protect human health from the effects of climate change. Academia still pays very little attention to the effects of climate on health in poorer countries. Enterprise is starting to recognise that healthy commerce depends on healthy people, and so climate change presents long-term threats if it compromises health. Governments and international agencies are very active, but often face immovable vested interests in other sectors. Overall, there tends to be too little interaction between the three areas, and this means that potential synergies and co-benefits are not always realised. Conclusion: More attention from academia, enterprise, and international agencies needs to be given to the potential threats the climate change presents to human health. However, there needs to also be much closer collaboration between all three areas in order to capitalise on possible synergies that can be achieved between them.

  • 205. Streatfield, P Kim
    et al.
    Alam, Nurul
    Compaoré, Yacouba
    Rossier, Clementine
    Soura, Abdramane B
    Bonfoh, Bassirou
    Jaeger, Fabienne
    Ngoran, Eliezer K
    Utzinger, Juerg
    Gomez, Pierre
    Jasseh, Momodou
    Ansah, Akosua
    Debpuur, Cornelius
    Oduro, Abraham
    Williams, John
    Addei, Sheila
    Gyapong, Margaret
    Kukula, Vida A
    Bauni, Evasius
    Mochamah, George
    Ndila, Carolyne
    Williams, Thomas N
    Desai, Meghna
    Moige, Hellen
    Odhiambo, Frank O
    Ogwang, Sheila
    Beguy, Donatien
    Ezeh, Alex
    Oti, Samuel
    Chihana, Menard
    Crampin, Amelia
    Price, Alison
    Delaunay, Valérie
    Diallo, Aldiouma
    Douillot, Laetitia
    Sokhna, Cheikh
    Collinson, Mark A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Kahn, Kathleen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Tollman, Stephen M
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Herbst, Kobus
    Mossong, Joël
    Emina, Jacques B O
    Sankoh, Osman A
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Pregnancy-related mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, article id 25368Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Women continue to die in unacceptably large numbers around the world as a result of pregnancy, particularly in sub-Saharan Africa and Asia. Part of the problem is a lack of accurate, population-based information characterising the issues and informing solutions. Population surveillance sites, such as those operated within the INDEPTH Network, have the potential to contribute to bridging the information gaps.

    OBJECTIVE: To describe patterns of pregnancy-related mortality at INDEPTH Network Health and Demographic Surveillance System sites in sub-Saharan Africa and southeast Asia in terms of maternal mortality ratio (MMR) and cause-specific mortality rates.

    DESIGN: Data on individual deaths among women of reproductive age (WRA) (15-49) resident in INDEPTH sites were collated into a standardised database using the INDEPTH 2013 population standard, the WHO 2012 verbal autopsy (VA) standard, and the InterVA model for assigning cause of death.

    RESULTS: These analyses are based on reports from 14 INDEPTH sites, covering 14,198 deaths among WRA over 2,595,605 person-years observed. MMRs varied between 128 and 461 per 100,000 live births, while maternal mortality rates ranged from 0.11 to 0.74 per 1,000 person-years. Detailed rates per cause are tabulated, including analyses of direct maternal, indirect maternal, and incidental pregnancy-related deaths across the 14 sites.

    CONCLUSIONS: As expected, these findings confirmed unacceptably high continuing levels of maternal mortality. However, they also demonstrate the effectiveness of INDEPTH sites and of the VA methods applied to arrive at measurements of maternal mortality that are essential for planning effective solutions and monitoring programmatic impacts.

  • 206. Streatfield, P. Kim
    et al.
    Khan, Wasif A.
    Bhuiya, Abbas
    Alam, Nurul
    Sié, Ali
    Soura, Abdramane B.
    Bonfoh, Bassirou
    Ngoran, Eliezer K.
    Weldearegawi, Berhe
    Jasseh, Momodou
    Oduro, Abraham
    Gyapong, Margaret
    Kant, Shashi
    Juvekar, Sanjay
    Wilopo, Siswanto
    Williams, Thomas N.
    Odhiambo, Frank O.
    Beguy, Donatien
    Ezeh, Alex
    Kyobutungi, Catherine
    Crampin, Amelia
    Delaunay, Valérie
    Tollman, Stephen M.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Herbst, Kobus
    Chuc, Nguyen T. K.
    Sankoh, Osman A.
    Tanner, Marcel
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cause-specific mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, p. 25362-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Because most deaths in Africa and Asia are not well documented, estimates of mortality are often made using scanty data. The INDEPTH Network works to alleviate this problem by collating detailed individual data from defined Health and Demographic Surveillance sites. By registering all deaths over time and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available.

    OBJECTIVE: To build a large standardised mortality database from African and Asian sites, detailing the relevant methods, and use it to describe cause-specific mortality patterns.

    DESIGN: Individual demographic and verbal autopsy (VA) data from 22 INDEPTH sites were collated into a standardised database. The INDEPTH 2013 population was used for standardisation. The WHO 2012 VA standard and the InterVA-4 model were used for assigning cause of death.

    RESULTS: A total of 111,910 deaths occurring over 12,204,043 person-years (accumulated between 1992 and 2012) were registered across the 22 sites, and for 98,429 of these deaths (88.0%) verbal autopsies were successfully completed. There was considerable variation in all-cause mortality between sites, with most of the differences being accounted for by variations in infectious causes as a proportion of all deaths.

    CONCLUSIONS: This dataset documents individual deaths across Africa and Asia in a standardised way, and on an unprecedented scale. While INDEPTH sites are not constructed to constitute a representative sample, and VA may not be the ideal method of determining cause of death, nevertheless these findings represent detailed mortality patterns for parts of the world that are severely under-served in terms of measuring mortality. Further papers explore details of mortality patterns among children and specifically for NCDs, external causes, pregnancy-related mortality, malaria, and HIV/AIDS. Comparisons will also be made where possible with other findings on mortality in the same regions. Findings presented here and in accompanying papers support the need for continued work towards much wider implementation of universal civil registration of deaths by cause on a worldwide basis.

  • 207. Streatfield, P. Kim
    et al.
    Khan, Wasif A.
    Bhuiya, Abbas
    Hanifi, Syed M. A.
    Alam, Nurul
    Bagagnan, Cheik H.
    Sié, Ali
    Zabré, Pascal
    Lankoandé, Bruno
    Rossier, Clementine
    Soura, Abdramane B.
    Bonfoh, Bassirou
    Kone, Siaka
    Ngoran, Eliezer K.
    Utzinger, Juerg
    Haile, Fisaha
    Melaku, Yohannes A.
    Weldearegawi, Berhe
    Gomez, Pierre
    Jasseh, Momodou
    Ansah, Patrick
    Debpuur, Cornelius
    Oduro, Abraham
    Wak, George
    Adjei, Alexander
    Gyapong, Margaret
    Sarpong, Doris
    Kant, Shashi
    Misra, Puneet
    Rai, Sanjay K.
    Juvekar, Sanjay
    Lele, Pallavi
    Bauni, Evasius
    Mochamah, George
    Ndila, Carolyne
    Williams, Thomas N.
    Laserson, Kayla F.
    Nyaguara, Amek
    Odhiambo, Frank O.
    Phillips-Howard, Penelope
    Ezeh, Alex
    Kyobutungi, Catherine
    Oti, Samuel
    Crampin, Amelia
    Nyirenda, Moffat
    Price, Alison
    Delaunay, Valérie
    Diallo, Aldiouma
    Douillot, Laetitia
    Sokhna, Cheikh
    Gómez-Olivé, F. Xavier
    Kahn, Kathleen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Tollman, Stephen M.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Herbst, Kobus
    Mossong, Joël
    Chuc, Nguyen T. K.
    Bangha, Martin
    Sankoh, Osman A.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Adult non-communicable disease mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, article id 25365Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Mortality from non-communicable diseases (NCDs) is a major global issue, as other categories of mortality have diminished and life expectancy has increased. The World Health Organization's Member States have called for a 25% reduction in premature NCD mortality by 2025, which can only be achieved by substantial reductions in risk factors and improvements in the management of chronic conditions. A high burden of NCD mortality among much older people, who have survived other hazards, is inevitable. The INDEPTH Network collects detailed individual data within defined Health and Demographic Surveillance sites. By registering deaths and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available.

    OBJECTIVE: To describe patterns of adult NCD mortality from INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories, with separate consideration of premature (15-64 years) and older (65+ years) NCD mortality.

    DESIGN: All adult deaths at INDEPTH sites are routinely registered and followed up with VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provide person-time denominators for mortality rates.

    RESULTS: A total of 80,726 adult (over 15 years) deaths were documented over 7,423,497 person-years of observation. NCDs were attributed as the cause for 35.6% of these deaths. Slightly less than half of adult NCD deaths occurred in the 15-64 age group. Detailed results are presented by age and sex for leading causes of NCD mortality. Per-site rates of NCD mortality were significantly correlated with rates of HIV/AIDS-related mortality.

    CONCLUSIONS: These findings present important evidence on the distribution of NCD mortality across a wide range of African and Asian settings. This comes against a background of global concern about the burden of NCD mortality, especially among adults aged under 70, and provides an important baseline for future work.

  • 208. Streatfield, P Kim
    et al.
    Khan, Wasif A
    Bhuiya, Abbas
    Hanifi, Syed M A
    Alam, Nurul
    Diboulo, Eric
    Niamba, Louis
    Sié, Ali
    Lankoandé, Bruno
    Millogo, Roch
    Soura, Abdramane B
    Bonfoh, Bassirou
    Kone, Siaka
    Ngoran, Eliezer K
    Utzinger, Juerg
    Ashebir, Yemane
    Melaku, Yohannes A
    Weldearegawi, Berhe
    Gomez, Pierre
    Jasseh, Momodou
    Azongo, Daniel
    Oduro, Abraham
    Wak, George
    Wontuo, Peter
    Attaa-Pomaa, Mary
    Gyapong, Margaret
    Manyeh, Alfred K
    Kant, Shashi
    Misra, Puneet
    Rai, Sanjay K
    Juvekar, Sanjay
    Patil, Rutuja
    Wahab, Abdul
    Wilopo, Siswanto
    Bauni, Evasius
    Mochamah, George
    Ndila, Carolyne
    Williams, Thomas N
    Khaggayi, Christine
    Nyaguara, Amek
    Obor, David
    Odhiambo, Frank O
    Ezeh, Alex
    Oti, Samuel
    Wamukoya, Marylene
    Chihana, Menard
    Crampin, Amelia
    Collinson, Mark A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. INDEPTH Network, Accra, Ghana.
    Kabudula, Chodziwadziwa W
    Wagner, Ryan
    INDEPTH Network, Accra, Ghana.
    Herbst, Kobus
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. INDEPTH Network, Accra, Ghana.
    Mossong, Joël
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. INDEPTH Network, Accra, Ghana.
    Emina, Jacques B O
    Sankoh, Osman A
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Mortality from external causes in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System Sites2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, article id 25366Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Mortality from external causes, of all kinds, is an important component of overall mortality on a global basis. However, these deaths, like others in Africa and Asia, are often not counted or documented on an individual basis. Overviews of the state of external cause mortality in Africa and Asia are therefore based on uncertain information. The INDEPTH Network maintains longitudinal surveillance, including cause of death, at population sites across Africa and Asia, which offers important opportunities to document external cause mortality at the population level across a range of settings.

    OBJECTIVE: To describe patterns of mortality from external causes at INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories.

    DESIGN: All deaths at INDEPTH sites are routinely registered and followed up with VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provide person-time denominators for mortality rates.

    RESULTS: A total of 5,884 deaths due to external causes were documented over 11,828,253 person-years. Approximately one-quarter of those deaths were to children younger than 15 years. Causes of death were dominated by childhood drowning in Bangladesh, and by transport-related deaths and intentional injuries elsewhere. Detailed mortality rates are presented by cause of death, age group, and sex.

    CONCLUSIONS: The patterns of external cause mortality found here generally corresponded with expectations and other sources of information, but they fill some important gaps in population-based mortality data. They provide an important source of information to inform potentially preventive intervention designs.

  • 209. Streatfield, P. Kim
    et al.
    Khan, Wasif A.
    Bhuiya, Abbas
    Hanifi, Syed M. A.
    Alam, Nurul
    Diboulo, Eric
    Sié, Ali
    Yé, Maurice
    Compaoré, Yacouba
    Soura, Abdramane B.
    Bonfoh, Bassirou
    Jaeger, Fabienne
    Ngoran, Eliezer K.
    Utzinger, Juerg
    Melaku, Yohannes A.
    Mulugeta, Afework
    Weldearegawi, Berhe
    Gomez, Pierre
    Jasseh, Momodou
    Hodgson, Abraham
    Oduro, Abraham
    Welaga, Paul
    Williams, John
    Awini, Elizabeth
    Binka, Fred N.
    Gyapong, Margaret
    Kant, Shashi
    Misra, Puneet
    Srivastava, Rahul
    Chaudhary, Bharat
    Juvekar, Sanjay
    Wahab, Abdul
    Wilopo, Siswanto
    Bauni, Evasius
    Mochamah, George
    Ndila, Carolyne
    Williams, Thomas N.
    Hamel, Mary J.
    Lindblade, Kim A.
    Odhiambo, Frank O.
    Slutsker, Laurence
    Ezeh, Alex
    Kyobutungi, Catherine
    Wamukoya, Marylene
    Delaunay, Valérie
    Diallo, Aldiouma
    Douillot, Laetitia
    Sokhna, Cheikh
    Gómez-Olivé, F. Xavier
    Kabudula, Chodziwadziwa W.
    Mee, Paul
    Herbst, Kobus
    Mossong, Joël
    Chuc, Nguyen T. K.
    Arthur, Samuelina S.
    Sankoh, Osman A.
    Tanner, Marcel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Byass, Peter
    School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    Malaria mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, p. 25369-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Malaria continues to be a major cause of infectious disease mortality in tropical regions. However, deaths from malaria are most often not individually documented, and as a result overall understanding of malaria epidemiology is inadequate. INDEPTH Network members maintain population surveillance in Health and Demographic Surveillance System sites across Africa and Asia, in which individual deaths are followed up with verbal autopsies.

    OBJECTIVE: To present patterns of malaria mortality determined by verbal autopsy from INDEPTH sites across Africa and Asia, comparing these findings with other relevant information on malaria in the same regions.

    DESIGN: From a database covering 111,910 deaths over 12,204,043 person-years in 22 sites, in which verbal autopsy data were handled according to the WHO 2012 standard and processed using the InterVA-4 model, over 6,000 deaths were attributed to malaria. The overall period covered was 1992-2012, but two-thirds of the observations related to 2006-2012. These deaths were analysed by site, time period, age group and sex to investigate epidemiological differences in malaria mortality.

    RESULTS: Rates of malaria mortality varied by 1:10,000 across the sites, with generally low rates in Asia (one site recording no malaria deaths over 0.5 million person-years) and some of the highest rates in West Africa (Nouna, Burkina Faso: 2.47 per 1,000 person-years). Childhood malaria mortality rates were strongly correlated with Malaria Atlas Project estimates of Plasmodium falciparum parasite rates for the same locations. Adult malaria mortality rates, while lower than corresponding childhood rates, were strongly correlated with childhood rates at the site level.

    CONCLUSIONS: The wide variations observed in malaria mortality, which were nevertheless consistent with various other estimates, suggest that population-based registration of deaths using verbal autopsy is a useful approach to understanding the details of malaria epidemiology.

  • 210. Streatfield, P Kim
    et al.
    Khan, Wasif A
    Bhuiya, Abbas
    Hanifi, Syed M A
    Alam, Nurul
    Millogo, Ourohiré
    Sié, Ali
    Zabré, Pascal
    Rossier, Clementine
    Soura, Abdramane B
    Bonfoh, Bassirou
    Kone, Siaka
    Ngoran, Eliezer K
    Utzinger, Juerg
    Abera, Semaw F
    Melaku, Yohannes A
    Weldearegawi, Berhe
    Gomez, Pierre
    Jasseh, Momodou
    Ansah, Patrick
    Azongo, Daniel
    Kondayire, Felix
    Oduro, Abraham
    Amu, Alberta
    Gyapong, Margaret
    Kwarteng, Odette
    Kant, Shashi
    Pandav, Chandrakant S
    Rai, Sanjay K
    Juvekar, Sanjay
    Muralidharan, Veena
    Wahab, Abdul
    Wilopo, Siswanto
    Bauni, Evasius
    Mochamah, George
    Ndila, Carolyne
    Williams, Thomas N
    Khagayi, Sammy
    Laserson, Kayla F
    Nyaguara, Amek
    Van Eijk, Anna M
    Ezeh, Alex
    Kyobutungi, Catherine
    Wamukoya, Marylene
    Chihana, Menard
    Crampin, Amelia
    Price, Alison
    Delaunay, Valérie
    Diallo, Aldiouma
    Douillot, Laetitia
    Sokhna, Cheikh
    Gómez-Olivé, F Xavier
    Mee, Paul
    Tollman, Stephen M
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Herbst, Kobus
    Mossong, Joël
    Chuc, Nguyen T K
    Arthur, Samuelina S
    Sankoh, Osman A
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, article id 25370Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data.

    OBJECTIVE: To present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB) and pneumonia.

    DESIGN: Deaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population.

    RESULTS: The dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates.

    CONCLUSIONS: Measuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS.

  • 211. Streatfield, P. Kim
    et al.
    Khan, Wasif A.
    Bhuiya, Abbas
    Hanifi, Syed M. A.
    Alam, Nurul
    Ouattara, Mamadou
    Sanou, Aboubakary
    Sié, Ali
    Lankoandé, Bruno
    Soura, Abdramane B.
    Bonfoh, Bassirou
    Jaeger, Fabienne
    Ngoran, Eliezer K.
    Utzinger, Juerg
    Abreha, Loko
    Melaku, Yohannes A.
    Weldearegawi, Berhe
    Ansah, Akosua
    Hodgson, Abraham
    Oduro, Abraham
    Welaga, Paul
    Gyapong, Margaret
    Narh, Clement T.
    Narh-Bana, Solomon A.
    Kant, Shashi
    Misra, Puneet
    Rai, Sanjay K.
    Bauni, Evasius
    Mochamah, George
    Ndila, Carolyne
    Williams, Thomas N.
    Hamel, Mary J.
    Ngulukyo, Emmanuel
    Odhiambo, Frank O.
    Sewe, Maquins
    Beguy, Donatien
    Ezeh, Alex
    Oti, Samuel
    Diallo, Aldiouma
    Douillot, Laetitia
    Sokhna, Cheikh
    Delaunay, Valérie
    Collinson, Mark A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Kabudula, Chodziwadziwa W.
    Kahn, Kathleen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Herbst, Kobus
    Mossong, Joël
    Chuc, Nguyen T. K.
    Bangha, Martin
    Sankoh, Osman A.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cause-specific childhood mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, article id 25363Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Childhood mortality, particularly in the first 5 years of life, is a major global concern and the target of Millennium Development Goal 4. Although the majority of childhood deaths occur in Africa and Asia, these are also the regions where such deaths are least likely to be registered. The INDEPTH Network works to alleviate this problem by collating detailed individual data from defined Health and Demographic Surveillance sites. By registering deaths and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available.

    OBJECTIVE: To present a description of cause-specific mortality rates and fractions over the first 15 years of life as documented by INDEPTH Network sites in sub-Saharan Africa and south-east Asia.

    DESIGN: All childhood deaths at INDEPTH sites are routinely registered and followed up with verbal autopsy (VA) interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provided person-time denominators for mortality rates. Cause-specific mortality rates and cause-specific mortality fractions are presented according to WHO 2012 VA cause groups for neonatal, infant, 1-4 year and 5-14 year age groups.

    RESULTS: A total of 28,751 childhood deaths were documented during 4,387,824 person-years over 18 sites. Infant mortality ranged from 11 to 78 per 1,000 live births, with under-5 mortality from 15 to 152 per 1,000 live births. Sites in Vietnam and Kenya accounted for the lowest and highest mortality rates reported.

    CONCLUSIONS: Many children continue to die from relatively preventable causes, particularly in areas with high rates of malaria and HIV/AIDS. Neonatal mortality persists at relatively high, and perhaps sometimes under-documented, rates. External causes of death are a significant childhood problem in some settings.

  • 212. Swaminathan, Soumya
    et al.
    Room, Robin S.
    Ivers, Louise C.
    Hillis, Graham
    Grais, Rebecca F.
    Bhutta, Zulficiar A.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. University of Aberdeen, Aberdeen, Scotland, United Kingdom; University of the Witwatersrand, Johannesburg, South Africa.
    What's coming for health science and policy in 2018?: Global experts look ahead in their field2018In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 15, no 1, article id e1002498Article in journal (Other academic)
  • 213. Tensou, Biruk
    et al.
    Araya, Tekebash
    Telake, Daniel S
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Berhane, Yemane
    Kebebew, Tolcha
    Sanders, Eduard J
    Reniers, Georges
    Evaluating the InterVA model for determining AIDS mortality from verbal autopsies in the adult population of Addis Ababa.2010In: Tropical medicine & international health, ISSN 1360-2276, E-ISSN 1365-3156, Vol. 15, no 5, p. 547-553Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the performance of a verbal autopsy (VA) expert algorithm (the InterVA model) for diagnosing AIDS mortality against a reference standard from hospital records that include HIV serostatus information in Addis Ababa, Ethiopia. METHODS: Verbal autopsies were conducted for 193 individuals who visited a hospital under surveillance during terminal illness. Decedent admission diagnosis and HIV serostatus information are used to construct two reference standards (AIDS vs. other causes of death and TB/AIDS vs. other causes). The InterVA model is used to interpret the VA interviews; and the sensitivity, specificity and cause-specific mortality fractions are calculated as indicators of the diagnostic accuracy of the InterVA model. RESULTS: The sensitivity and specificity of the InterVA model for diagnosing AIDS are 0.82 (95% CI: 0.74-0.89) and 0.76 (95% CI: 0.64-0.86), respectively. The sensitivity and specificity for TB/AIDS are 0.91 (95% CI: 0.85-0.96) and 0.78 (95% CI: 0.63-0.89), respectively. The AIDS-specific mortality fraction estimated by the model is 61.7% (95% CI: 54-69%), which is close to 64.7% (95% CI: 57-72%) in the reference standard. The TB/AIDS mortality fraction estimated by the model is 73.6% (95% CI: 67-80%), compared to 74.1% (95% CI: 68-81%) in the reference standard. CONCLUSION: The InterVA model is an easy to use and cheap alternative to physician review for assessing AIDS mortality in populations without vital registration and medical certification of causes of death. The model seems to perform better when TB and AIDS are combined, but the sample is too small to statistically confirm that.

  • 214.
    Tesfaye, Fikru
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Berhane, Y
    Bonita, R
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Association of Smoking and Khat (Catha edulis Forsk) Use With High Blood Pressure Among Adults in Addis Ababa, Ethiopia, 20062008In: Preventing chronic diseases, ISSN 1545-1151, Vol. 5, no 3Article in journal (Refereed)
    Abstract [en]

    Introduction We assessed the prevalence of substance use and its association with high blood pressure among adults in Addis Ababa, Ethiopia.

    Methods We employed a cross-sectional descriptive study design. The World Health Organization instrument for stepwise surveillance of risk factors for chronic diseases was applied on a probabilistic sample of 4001 men and women aged 25 to 64 years in Addis Ababa. We determined the prevalence of cigarette smoking, alcohol drinking, and khat (Catha edulis Forsk) chewing. We measured blood pressure by using a digital device and determined mean levels of systolic and diastolic blood pressure.

    Results Smoking cigarettes, drinking alcohol, and chewing khat were widely prevalent among men. Among men, the prevalence of current daily smoking was 11.0% (95% confidence interval [CI], 9.5%–12.5%). Binge drinking of alcohol was reported by 10.4% (95% CI, 9.0%–11.9%) of men. Similarly, 15.9% (95% CI, 14.1%–17.6%) of men regularly chewed khat. Consequently, 26.6% of men and 2.4% of women reported practicing one or more of the behaviors. Current daily smoking and regular khat chewing were significantly associated with elevated mean diastolic blood pressure (β = 2.1, P = .03 and β = 1.9, P = .02, respectively).

    Conclusion Cigarette smoking and khat chewing among men in Addis Ababa were associated with high blood pressure, an established risk factor for cardiovascular disease. Health promotion interventions should aim to prevent proliferation of such behaviors among young people and adoption by women. Surveillance for risk factors for cardiovascular disease should be implemented nationwide to provide information for policy decisions and to guide prevention and control programs.

  • 215.
    Tesfaye, Fikru
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Concurrent comparison of energy intake and expenditure among adults in Butajira District, Ethiopia2008In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 11, no 7, p. 675-683Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To estimate and compare dietary energy intake (DEI) and total energy expenditure (TEE) among adults, using questionnaires. DESIGN: Comparative, cross-sectional study. SETTING: Community-based, at the demographic surveillance site (DSS) in Butajira District of Ethiopia. SUBJECTS: A total of 619 adults, 18-64 years of age, were randomly selected from among the urban and rural population of Butajira using the DSS sampling frame. Habitual dietary intake and physical activity were assessed using questionnaires. BMR was estimated using a regression equation, and TEE was calculated from BMR and the metabolic energy equivalent task (MET) and duration of reported activities. Physical activity level (PAL) was calculated as TEE/BMR, while food intake level (FIL) was calculated as DEI/BMR. The mean DEI:TEE ratio was used to evaluate reported DEI at the population level, while individual misreporters were identified by applying the Goldberg cut-off points at three levels of PAL. RESULTS: Based on the Goldberg method, 57% of the study participants were identified as acceptable reporters of DEI, among whom mean TEE was 8.21 (95% CI 8.01, 8.42) MJ (1963 (95% CI 1914, 2012) kcal), mean DEI was 8.13 (95% CI 7.93, 8.34) MJ (1944 (95% CI 1895, 1993) kcal) and mean DEI:TEE was 1.01 (95% CI 0.99, 1.04). CONCLUSION: The dietary history and physical activity questionnaires provide comparable estimates of mean energy intake and expenditure at a population level. Acceptable reporters have to be identified in order to obtain better estimates. Questionnaire-based estimates of energy intake should not be interpreted without an inherent system of comparison or validation.

  • 216.
    Tesfaye, Fikru
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    High blood pressure among adults in Addis Ababa: a silent epidemicManuscript (preprint) (Other academic)
  • 217.
    Tesfaye, Fikru
    et al.
    School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Population based prevalence of high blood pressure among adults in Addis Ababa: uncovering a silent epidemic2009In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 9, p. Article nr 39-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The prevention and control of high blood pressure or other cardiovascular diseases has not received due attention in many developing countries. This study aims to describe the epidemiology of high blood pressure among adults in Addis Ababa, so as to inform policy and lay the ground for surveillance interventions.

    METHODS: Addis Ababa is the largest urban centre and national capital of Ethiopia, hosting about 25% of the urban population in the country. A probabilistic sample of adult males and females, 25-64 years of age residing in Addis Ababa city participated in structured interviews and physical measurements. We employed a population based, cross sectional survey, using the World Health Organization instrument for stepwise surveillance (STEPS) of chronic disease risk factors. Data on selected socio-demographic characteristics and lifestyle behaviours, including physical activity, as well as physical measurements such as weight, height, waist and hip circumference, and blood pressure were collected through standardized procedures. Multiple linear regression analysis was performed to estimate the coefficient of variability of blood pressure due to selected socio-demographic and behavioural characteristics, and physical measurements.

    RESULTS: A total of 3713 adults participated in the study. About 20% of males and 38% of females were overweight (body-mass-index > or = 25 kg/m2), with 10.8 (9.49, 12.11)% of the females being obese (body-mass-index > or = 30 kg/m2). Similarly, 17% of the males and 31% of the females were classified as having low level of total physical activity. The age-adjusted prevalence (95% confidence interval) of high blood pressure, defined as systolic blood pressure (SBP) > or = 140 mmHg (millimetres of mercury) or diastolic blood pressure (DBP) > or = 90 mmHg or reported use of anti-hypertensive medication, was 31.5% (29.0, 33.9) among males and 28.9% (26.8, 30.9) among females.

    CONCLUSION: High blood pressure is widely prevalent in Addis Ababa and may represent a silent epidemic in this population. Overweight, obesity and physical inactivity are important determinants of high blood pressure. There is an urgent need for strategies and programmes to prevent and control high blood pressure, and promote healthy lifestyle behaviours primarily among the urban populations of Ethiopia.

  • 218.
    Tesfaye, Fikru
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Ng, Nawi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Van Minh, H
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Epidemiologi och folkhälsovetenskap.
    Berhane, Yemane
    Bonita, Ruth
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Epidemiologi och folkhälsovetenskap.
    Association between body mass index and blood pressure across three populations in Africa and Asia.2007In: Journal of Human Hypertension, ISSN 0950-9240, E-ISSN 1476-5527, Vol. 21, no 1, p. 28-37Article in journal (Refereed)
  • 219.
    Thanh, Nguyen Xuan
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hang, Hoang Minh
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Chuc, Nguyen Thi Kim
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Does poverty lead to non-fatal unintentional injuries in rural Vietnam?2005In: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, Vol. 12, no 1, p. 31-37Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify associations between poverty at the household level and unintentional injury morbidity. A cohort consisting of 24,874 person-time episodes, representing 24,776 people living in 5,801 households (classified into rich, middle income and poor by local authorities in 1999) was followed during 2000, in order to identify and assess non-fatal unintentional injuries. Incidence rate ratios were calculated using a Poisson regression model. The results showed that poverty was a risk factor for unintentional injuries generally. When looking at different types of injury, poverty was a risk for home, work and "other" injuries, protective for school injuries, while the risk of traffic injuries was not affected. The results also showed that communes in mountainous areas were at higher risk for home, work and other injuries. Overall, poverty was associated with unintentional injury morbidity. However, the relationship varied by sex, age and type of injury. Specifically, poverty increased the risk for children and elderly people being injured at home, and for adults (15-59 years) being affected by work injuries.

  • 220. Thomsen, Sarah
    et al.
    Hoa, Dinh Thi Phuong
    Målqvist, Mats
    Sanneving, Linda
    Saxena, Deepak
    Tana, Susilowati
    Yuan, Beibei
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Promoting equity to achieve maternal and child health2011In: Reproductive health matters, ISSN 0968-8080, E-ISSN 1460-9576, Vol. 19, no 38, p. 176-182Article in journal (Refereed)
    Abstract [en]

    Maternal and child mortality rates, the targets for two of the eight Millennium Development Goals, remain unacceptably high in many countries. Some countries have made significant advances in reducing deaths in pregnancy, childbirth, and childhood at the national level. However, on a sub-national basis most countries show wide disparities in health indices which are not necessarily reflected in national figures. This is a sign of inequitable access to and provision of health services. Yet there has been little attention to health equity in relation to the Millennium Development Goals. Instead, countries have focused on achieving national targets. This has led to an emphasis on utilitarian, as opposed to universalist, approaches to public health, which we discuss here. We recommend a policy of "proportionate universalism". In this approach, universal health care and a universal social policy are the ultimate goal, but in the interim actions are carried out with intensities proportionate to disadvantage. We also briefly describe an initiative that aims to promote evidence-based policy and interventions that will reduce inequity in access to maternal and child health care in China, India, Indonesia and Viet Nam.

  • 221. Tissera, H
    et al.
    Gunasena, S
    da Silva, D
    Sessions, O
    Palihawadana, P
    Amarasinghe, A
    Muthukuda, C
    Botheju, C
    Leong, W -Y
    Lohr, Wolfgang
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Wilder-Smith, Annelies
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
    Gubler, D
    Enhanced dengue sentinel surveillance in Sri Lanka2015In: Tropical medicine & international health, ISSN 1360-2276, E-ISSN 1365-3156, Vol. 20, no Suppl. 1, p. 133-133Article in journal (Other academic)
    Abstract [en]

    Introduction: Dengue poses a significant socioeconomic and disease burden in Sri Lanka, where the geographic spread, incidence and severity of disease has been increasing since the first dengue hemorrhagic fever (DHF) epidemic occurred in 1989. Periodic epidemics have become progressively larger, peaking in 2012 with 44 456 cases. Passive surveillance was established nationwide more than a decade ago but dengue notifications have been based on clinical diagnosis, with infrequent laboratory confirmation. To obtain more accurate data on the disease burden, a laboratory-based enhanced sentinel surveillance system was established in Colombo Municipality, the area with the highest dengue incidence. Here we describe the study design and the results of the first 2 years (2012–2014).

    Methods: Three government hospitals and two outpatient clinics in Colombo District were selected for the sentinel surveillance. All patients presenting with undifferentiated fever were enrolled, if consent given, capped at a maximum of 60 patients per week. Acute blood samples were taken from all enrolled subjects and tested by dengue-specific PCR, and NS1, and IgM – ELISA at the time of first presentation. A sub-set of 536 samples was sent to Duke-NUS Singapore for quality assurance, virus isolation and serotyping.

    Results: Between 1 April, 2012 and 31 March, 2014, 3127 patients were enrolled, 964 (30.9%) as outpatients and 2160 (69.1%) as inpatients. The mean age was 22.3 years (SD = 17.5) and the time of first presentation was at day 4 of illness. For inpatients, 1687 (78.1%) of all febrile cases had laboratory-confirmed dengue. For outpatients, the proportion of confirmed dengue was 237 (24.6%). The mean duration of hospitalization was 4.1 days (SD = 1.85). The proportion of DHF in lab-confirmed hospitalized dengue cases was 22.1% and 4 patients (0.21%) died. Serotypes 1 and 4 were the only viruses detected in this sample (serotype 1: 85%; serotype 4: 15%). The clinicians’ diagnosis for dengue at time of first presentation had a sensitivity of 92% and specificity of 23%.

    Conclusions: Dengue infection was responsible for a high proportion of febrile illnesses during 2012–2014, with serotypes 1 and 4 circulating. A significant proportion (22%) of hospitalized dengue cases developed DHF, but the case fatality rate was low. Clinicians’ judgment was associated with good sensitivity, but to enhance specificity it is important to add laboratory confirmation of dengue.

    Disclosure: This research was funded by the European Commission under the 7th Framework and conducted by DengueTools partners (www.denguetools.net).

  • 222.
    Tissera, Hasitha
    et al.
    Colombo, Sri Lanka.
    Amarasinghe, Ananda
    Colombo, Sri Lanka.
    Gunasena, Sunethra
    Colombo, Sri Lanka.
    DeSilva, Aruna Dharshan
    Colombo, Sri Lanka.
    Yee, Leong Wei
    Singapore, Singapore.
    Sessions, October
    Singapore, Singapore.
    Muthukuda, Chanaka
    Colombo, Sri Lanka.
    Palihawadana, Paba
    Colombo, Sri Lanka.
    Lohr, Wolfgang
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Gubler, Duane J
    Singapore, Singapore.
    Wilder-Smith, Annelies
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
    Laboratory-Enhanced Dengue Sentinel Surveillance in Colombo District, Sri Lanka: 2012-20142016In: PLoS Neglected Tropical Diseases, ISSN 1935-2727, E-ISSN 1935-2735, Vol. 10, no 2, article id e0004477Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Dengue has emerged as a significant public health problem in Sri Lanka. Historically surveillance was passive, with mandatory dengue notifications based on clinical diagnosis with only limited laboratory confirmation. To obtain more accurate data on the disease burden of dengue, we set up a laboratory-based enhanced sentinel surveillance system in Colombo District. Here we describe the study design and report our findings of enhanced surveillance in the years 2012-2014.

    METHODS: Three outpatient clinics and three government hospitals in Colombo District that covered most of the Colombo metropolitan area were selected for the sentinel surveillance system. Up to 60 patients per week presenting with an undifferentiated fever were enrolled. Acute blood samples from each patient were tested by dengue specific PCR, NS1 ELISA and IgM ELISA. A sub-set of samples was sent to Duke-NUS Singapore for quality assurance, virus isolation and serotyping. Trained medical research assistants used a standardized case report form to record clinical and epidemiological data. Clinical diagnoses by the clinicians-in-charge were recorded for hospitalized cases.

    RESULTS: Of 3,127 febrile cases, 43.6% were PCR and/or NS1 positive for dengue. A high proportion of lab confirmed dengue was observed from inpatients (IPD) (53.9%) compared to outpatient (clinics in hospitals and general practice) (7.6%). Dengue hemorrhagic fever (DHF) was diagnosed in 11% of patients at the time of first contact, and the median day of illness at time of presentation to the sentinel sites was 4. Dengue serotype 1 was responsible for 85% of the cases and serotype 4 for 15%. The sensitivity and specificity of the clinicians' presumptive diagnosis of dengue was 84% and 34%, respectively.

    CONCLUSION: DENV-1, and to a lesser degree DENV-4, infection were responsible for a high proportion of febrile illnesses in Colombo in the years 2012 to 2014. Clinicians' diagnoses were associated with high sensitivity, but laboratory confirmation is required to enhance specificity.

  • 223. Tissera, Hasitha
    et al.
    Gunasena, Sunethra
    De Silva, Dharshan
    Sessions, October
    Palihawadana, Paba
    Amarasinghe, Ananda
    Weeraman, Jayantha
    Chandrasoma, Oshane
    Leong, Yee
    Lohr, Wolfgang
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Wilder-Smith, Annellies
    Gubler, Duane
    Enhanced dengue sentinel surveillance in metropolitan Sri Lanka: 2012 to 20152017In: American Journal of Tropical Medicine and Hygiene, ISSN 0002-9637, E-ISSN 1476-1645, Vol. 95, no 5, p. 426-427Article in journal (Other academic)
  • 224. Todd, Jim
    et al.
    Slaymaker, Emma
    Zaba, Basia
    Mahy, Mary
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Measuring HIV-related mortality in the first decade of anti-retroviral therapy in sub-Saharan Africa2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, p. 24787-Article in journal (Refereed)
    Abstract [en]

    For the past 30 years, many communities and countries in sub-Saharan Africa have suffered from the ravages of the HIV epidemic. During this time the mortality rates in HIV-infected people have been 10–20 times higher than in HIV-uninfected people. Since the advent of anti-retroviral therapy (ART), mortality and morbidity have decreased considerably. However, it has been difficult to get reliable estimates of the impact of ART in population-based studies. The measurement of the impact of ART on mortality requires long-term follow-up in communities where regular HIV testing allows the estimation of mortality by HIV status, such as the population cohorts in the network for Analysing Longitudinal Population-based HIV data in Africa (ALPHA). An alternative estimation from verbal autopsy (VA) requires reliable tools and consistent interpretation of causes of death, which have been taken forward by recent standards from the World Health Organization (WHO) and the development of the corresponding InterVA-4 model for cause of death assignment.

  • 225. Van Minh, Hoang
    et al.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Chuc, Nguyen Thi Kim
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Patterns of health status and quality of life among older people in rural Viet Nam2010In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 3, no Supplement 2, p. 64-69Article in journal (Refereed)
    Abstract [en]

    The findings reveal problems of inequality in health status and QoL among older adults in the study setting by sex, age, education and socio-economic status. Given the findings, actions targeted towards improving the health of disadvantaged people (women, older people and lower education and economic status) are needed in this setting.

  • 226. Van Minh, Hoang
    et al.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Multilevel analysis of effects of individual characteristics and household factors on self-rated health among older adults in rural Vietnam2010In: Geriatrics & Gerontology International, ISSN 1444-1586, E-ISSN 1447-0594, Vol. 10, no 2, p. 209-215Article in journal (Refereed)
    Abstract [en]

    The findings reveal that there exist problems of inequality in health among older adults in the study setting by sex, age, education, wealth status and place of residence. We also found a considerable contribution of the household-level factors to SRH of the study populations.

  • 227. Van Minh, Hoang
    et al.
    Lan Huong, Dao
    Bao Giang, Kim
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Economic aspects of chronic diseases in Vietnam2009In: Global health action, ISSN 1654-9880, Vol. 2Article in journal (Refereed)
    Abstract [en]

    Given the evidence from this study, actions to prevent chronic diseases in Vietnam are clearly urgent. Further research findings are required to give greater insights into economic aspects of chronic diseases in Vietnam.

  • 228. Van Minh, Hoang
    et al.
    Ng, Nawi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Patterns of subjective quality of life among older adults in rural Vietnam and Indonesia.2012In: Geriatrics & Gerontology International, ISSN 1444-1586, E-ISSN 1447-0594, Vol. 12, p. 397-404Article in journal (Refereed)
    Abstract [en]

    Aim:  This paper aims to assess the subjective quality of life (SQOL) and its correlates among older adults in rural communities of Vietnam and Indonesia.

    Methods:  The paper uses the data from the INDEPTH/WHO Study on global aging and adult health (SAGE). The study was carried out in the FilaBavi Health and Demographic Surveillance System (HDSS) site in Vietnam and in Purworejo HDSS in Indonesia. All people aged 50 years and over who lived in these two HDSS areas were surveyed. Face-to-face household interviews were carried out by trained surveyors using the standardized summary version of the INDEPTH/WHO SAGE questionnaire. The SQOL was assessed by asking the respondents “How would you rate your overall quality of life?” The response set was a five-point scale where 1 = Very good, 2 = Good, 3 = Moderate, 4 = Bad, 5 = Very bad.

    Results:  In both countries, the SQOL was reported to be higher among (i) men; (ii) people with higher education; (iii) people who were in a marital partnership; (iv) people who lived with other family members; and (v) those with higher economic status, compared with that in those of other category(ies) of the same characteristic. In Vietnam, people who belonged to the second to fifth economic quintiles and had more than 6 years of education were sevenfold more likely to report very good/good quality of life compared with those who belonged to the first economic quintile (poorest) and had no formal education. The corresponding figure was 2.7 for Indonesia.

    Conclusions:  The patterns of sociodemographic determinants of SQOL show that inequality in quality of life exists among older adults in the two study settings.

  • 229. Van Minh, Hoang
    et al.
    Ng, Nawi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Juvekar, Sanjay
    Razzaque, Abdur
    Ashraf, Ali
    Hadi, Abdullahel
    Soonthornthada, Kusol
    Kanungsukkasem, Uraiwan
    Bich, Tran Huu
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Self-reported prevalence of chronic diseases and their relation to selected sociodemographic variables:: a study in INDEPTH Asian sites, 2005.2008In: Preventing Chronic Disease, ISSN 1545-1151, E-ISSN 1545-1151, Vol. 5, no 3, p. A86-Article in journal (Refereed)
  • 230. Vergnano, Stefania
    et al.
    Fottrell, Edward
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Osrin, David
    Kazembe, Peter N
    Mwansambo, Charles
    Manandhar, Dharma S
    Munjanja, Stephan P
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lewycka, Sonia
    Costello, Anthony
    Adaptation of a probabilistic method (InterVA) of verbal autopsy to improve the interpretation of cause of stillbirth and neonatal death in Malawi, Nepal, and Zimbabwe.2011In: Population Health Metrics, ISSN 1478-7954, E-ISSN 1478-7954, Vol. 9, p. 48-Article in journal (Refereed)
    Abstract [en]

    Background

    Verbal autopsy (VA) is a widely used method for analyzing cause of death in absence of vital registration systems. We adapted the InterVA method to extrapolate causes of death for stillbirths and neonatal deaths from verbal autopsy questionnaires, using data from Malawi, Zimbabwe, and Nepal.

    Methods

    We obtained 734 stillbirth and neonatal VAs from recent community studies in rural areas: 169 from Malawi, 385 from Nepal, and 180 from Zimbabwe. Initial refinement of the InterVA model was based on 100 physician-reviewed VAs from Malawi. InterVA indicators and matrix probabilities for cause of death were reviewed for clinical and epidemiological coherence by a pediatrician-researcher and an epidemiologist involved in the development of InterVA. The modified InterVA model was evaluated by comparing population-level cause-specific mortality fractions and individual agreement from two methods of interpretation (physician review and InterVA) for a further 69 VAs from Malawi, 385 from Nepal, and 180 from Zimbabwe.

    Results

    Case-by-case agreement between InterVA and reviewing physician diagnoses for 69 cases from Malawi, 180 cases from Zimbabwe, and 385 cases from Nepal were 83% (kappa 0.76 (0.75 - 0.80)), 71% (kappa 0.41(0.32-0.51)), and 74% (kappa 0.63 (0.60-0.63)), respectively. The proportion of stillbirths identified as fresh or macerated by the different methods of VA interpretation was similar in all three settings. Comparing across countries, the modified InterVA method found that proportions of preterm births and deaths due to infection were higher in Zimbabwe (44%) than in Malawi (28%) or Nepal (20%).

    Conclusion

    The modified InterVA method provides plausible results for stillbirths and newborn deaths, broadly comparable to physician review but with the advantage of internal consistency. The method allows standardized cross-country comparisons and eliminates the inconsistencies of physician review in such comparisons.

  • 231.
    Wall, Stig
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Bindslev, Anne
    Sutton, Caroline
    Supplements used to advantage2010In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Global health action, ISSN 1654-9880, Vol. 3, p. Article nr 5166-Article in journal (Refereed)
    Abstract [en]

    A recent (January 2010) editorial in The Lancet addressing the “perils of journal and supplement publishing” states in no unclear terms that the publishing of commercially sponsored supplements is “firmly off the agenda” for The Lancet. The editorial notes that although supplements and custom publications are an established element in journal publishing, supplemental material “is usually much inferior to that of any parent title” and is generally problematic for editors and reviewers. On this note, The Lancet goes on to identify examples of commercial supplement publications that support this view, including a recent example that had fallen into their own hands.

  • 232. Wariri, Oghenebrume
    et al.
    D'Ambruoso, Lucia
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Centre for Global Development and Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    Twine, Rhian
    Ngobeni, Sizzy
    van der Merwe, Maria
    Spies, Barry
    Kahn, Kathleen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH, Accra, Ghana.
    Tollman, Stephen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH, Accra, Ghana.
    Wagner, Ryan G.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH, Accra, Ghana.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Centre for Global Development and Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    Initiating a participatory action research process in the Agincourt health and socio-demographic surveillance site2017In: Journal of Global Health, ISSN 2047-2978, E-ISSN 2047-2986, Vol. 7, no 1, article id 010413Article in journal (Refereed)
    Abstract [en]

    Background Despite progressive health policy, disease burdens in South Africa remain patterned by deeply entrenched social inequalities. Accounting for the relationships between context, health and risk can provide important information for equitable service delivery. The aims of the research were to initiate a participatory research process with communities in a low income setting and produce evidence of practical relevance. Methods We initiated a participatory action research (PAR) process in the Agincourt health and socio-demographic surveillance site (HDSS) in rural north-east South Africa. Three village-based discussion groups were convened and consulted about conditions to examine, one of which was under-5 mortality. A series of discussions followed in which routine HDSS data were presented and participants' subjective perspectives were elicited and systematized into collective forms of knowledge using ranking, diagramming and participatory photography. The process concluded with a priority setting exercise. Visual and narrative data were thematically analyzed to complement the participants' analysis. Results A range of social and structural root causes of under-5 mortality were identified: poverty, unemployment, inadequate housing, unsafe environments and shortages of clean water. Despite these constraints, single mothers were often viewed as negligent. A series of mid-level contributory factors in clinics were also identified: overcrowding, poor staffing, delays in treatment and shortages of medications. In a similar sense, pronounced blame and negativity were directed toward clinic nurses in spite of the systems constraints identified. Actions to address these issues were prioritized as: expanding clinics, improving accountability and responsiveness of health workers, improving employment, providing clean water, and expanding community engagement for health promotion. Conclusions We initiated a PAR process to gain local knowledge and prioritise actions. The process was acceptable to those involved, and there was willingness and commitment to continue. The study provided a basis from which to gain support to develop fuller forms of participatory research in this setting. The next steps are to build deeper involvement of participants in the process, expand to include the perspectives of those most marginalized and engage in the health system at different levels to move toward an ongoing process of action and learning from action.

  • 233. Watts, Nick
    et al.
    Adger, W Neil
    Agnolucci, Paolo
    Blackstock, Jason
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cai, Wenjia
    Chaytor, Sarah
    Colbourn, Tim
    Collins, Mat
    Cooper, Adam
    Cox, Peter M
    Depledge, Joanna
    Drummond, Paul
    Ekins, Paul
    Galaz, Victor
    Grace, Delia
    Graham, Hilary
    Grubb, Michael
    Haines, Andy
    Hamilton, Ian
    Hunter, Alasdair
    Jiang, Xujia
    Li, Moxuan
    Kelman, Ilan
    Liang, Lu
    Lott, Melissa
    Lowe, Robert
    Luo, Yong
    Mace, Georgina
    Maslin, Mark
    Nilsson, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Oreszczyn, Tadj
    Pye, Steve
    Quinn, Tara
    Svensdotter, My
    Venevsky, Sergey
    Warner, Koko
    Xu, Bing
    Yang, Jun
    Yin, Yongyuan
    Yu, Chaoqing
    Zhang, Qiang
    Gong, Peng
    Montgomery, Hugh
    Costello, Anthony
    Health and climate change: policy responses to protect public health2015In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 386, no 10006, p. 1861-1914Article in journal (Refereed)
    Abstract [en]

    The 2015 Lancet Commission on Health and Climate Change has been formed to map out the impacts of climate change, and the necessary policy responses, in order to ensure the highest attainable standards of health for populations worldwide. This Commission is multidisciplinary and international in nature, with strong collaboration between academic centres in Europe and China. The central finding from the Commission's work is that tackling climate change could be the greatest global health opportunity of the 21st century. The key messages from the Commission are summarised below, accompanied by ten underlying recommendations to accelerate action in the next 5 years.

  • 234. Watts, Nick
    et al.
    Adger, W Neil
    Ayeb-Karlsson, Sonja
    Bai, Yuqi
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Campbell-Lendrum, Diarmid
    Colbourn, Tim
    Cox, Peter
    Davies, Michael
    Depledge, Michael
    Depoux, Anneliese
    Dominguez-Salas, Paula
    Drummond, Paul
    Ekins, Paul
    Flahault, Antoine
    Grace, Delia
    Graham, Hilary
    Haines, Andy
    Hamilton, Ian
    Johnson, Anne
    Kelman, Ilan
    Kovats, Sari
    Liang, Lu
    Lott, Melissa
    Lowe, Robert
    Luo, Yong
    Mace, Georgina
    Maslin, Mark
    Morrissey, Karyn
    Murray, Kris
    Neville, Tara
    Nilsson, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Oreszczyn, Tadj
    Parthemore, Christine
    Pencheon, David
    Robinson, Elizabeth
    Schütte, Stefanie
    Shumake-Guillemot, Joy
    Vineis, Paolo
    Wilkinson, Paul
    Wheeler, Nicola
    Xu, Bing
    Yang, Jun
    Yin, Yongyuan
    Yu, Chaoqing
    Gong, Peng
    Montgomery, Hugh
    Costello, Anthony
    The Lancet Countdown: tracking progress on health and climate change2017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 389, no 10074, p. 1151-1164Article, review/survey (Refereed)
    Abstract [en]

    The Lancet Countdown: tracking progress on health and climate change is an international, multidisciplinary research collaboration between academic institutions and practitioners across the world. It follows on from the work of the 2015 Lancet Commission, which concluded that the response to climate change could be "the greatest global health opportunity of the 21st century". The Lancet Countdown aims to track the health impacts of climate hazards; health resilience and adaptation; health co-benefits of climate change mitigation; economics and finance; and political and broader engagement. These focus areas form the five thematic working groups of the Lancet Countdown and represent different aspects of the complex association between health and climate change. These thematic groups will provide indicators for a global overview of health and climate change; national case studies highlighting countries leading the way or going against the trend; and engagement with a range of stakeholders. The Lancet Countdown ultimately aims to report annually on a series of indicators across these five working groups. This paper outlines the potential indicators and indicator domains to be tracked by the collaboration, with suggestions on the methodologies and datasets available to achieve this end. The proposed indicator domains require further refinement, and mark the beginning of an ongoing consultation process-from November, 2016 to early 2017-to develop these domains, identify key areas not currently covered, and change indicators where necessary. This collaboration will actively seek to engage with existing monitoring processes, such as the UN Sustainable Development Goals and WHO's climate and health country profiles. The indicators will also evolve over time through ongoing collaboration with experts and a range of stakeholders, and be dependent on the emergence of new evidence and knowledge. During the course of its work, the Lancet Countdown will adopt a collaborative and iterative process, which aims to complement existing initiatives, welcome engagement with new partners, and be open to developing new research projects on health and climate change.

  • 235. Watts, Nick
    et al.
    Amann, Markus
    Arnell, Nigel
    Ayeb-Karlsson, Sonja
    Belesova, Kristine
    Berry, Helen
    Bouley, Timothy
    Boykoff, Maxwell
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cai, Wenjia
    Campbell-Lendrum, Diarmid
    Chambers, Jonathan
    Daly, Meaghan
    Dasandi, Niheer
    Davies, Michael
    Depoux, Anneliese
    Dominguez-Salas, Paula
    Drummond, Paul
    Ebi, Kristie L
    Ekins, Paul
    Montoya, Lucia Fernandez
    Fischer, Helen
    Georgeson, Lucien
    Grace, Delia
    Graham, Hilary
    Hamilton, Ian
    Hartinger, Stella
    Hess, Jeremy
    Kelman, Ilan
    Kiesewetter, Gregor
    Kjellstrom, Tord
    Kniveton, Dominic
    Lemke, Bruno
    Liang, Lu
    Lott, Melissa
    Lowe, Rachel
    Sewe, Maquins Odhiambo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Martinez-Urtaza, Jaime
    Maslin, Mark
    McAllister, Lucy
    Mikhaylov, Slava Jankin
    Milner, James
    Moradi-Lakeh, Maziar
    Morrissey, Karyn
    Murray, Kris
    Nilsson, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Neville, Tara
    Oreszczyn, Tadj
    Owfi, Fereidoon
    Pearman, Olivia
    Pencheon, David
    Pye, Steve
    Rabbaniha, Mahnaz
    Robinson, Elizabeth
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Saxer, Olivia
    Schütte, Stefanie
    Semenza, Jan C
    Shumake-Guillemot, Joy
    Steinbach, Rebecca
    Tabatabaei, Meisam
    Tomei, Julia
    Trinanes, Joaquin
    Wheeler, Nicola
    Wilkinson, Paul
    Gong, Peng
    Montgomery, Hugh
    Costello, Anthony
    The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come2018In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 392, no 10163, p. 2479-2514Article, review/survey (Refereed)
  • 236. Watts, Nick
    et al.
    Amann, Markus
    Arnell, Nigel
    Ayeb-Karlsson, Sonja
    Belesova, Kristine
    Boykoff, Maxwell
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Cai, Wenjia
    Campbell-Lendrum, Diarmid
    Capstick, Stuart
    Chambers, Jonathan
    Dalin, Carole
    Daly, Meaghan
    Dasandi, Niheer
    Davies, Michael
    Drummond, Paul
    Dubrow, Robert
    Ebi, Kristie L.
    Eckelman, Matthew
    Ekins, Paul
    Escobar, Luis E.
    Montoya, Lucia Fernandez
    Georgeson, Lucien
    Graham, Hilary
    Haggar, Paul
    Hamilton, Ian
    Hartinger, Stella
    Hess, Jeremy
    Kelman, Ilan
    Kiesewetter, Gregor
    Kjellstrom, Tord
    Kniveton, Dominic
    Lemke, Bruno
    Liu, Yang
    Lott, Melissa
    Lowe, Rachel
    Sewe, Maquins Odhiambo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Martinez-Urtaza, Jaime
    Maslin, Mark
    McAllister, Lucy
    McGushin, Alice
    Mikhaylov, Slava Jankin
    Milner, James
    Moradi-Lakeh, Maziar
    Morrissey, Karyn
    Murray, Kris
    Munzert, Simon
    Nilsson, Maria
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Neville, Tara
    Oreszczyn, Tadj
    Owfi, Fereidoon
    Pearman, Olivia
    Pencheon, David
    Phung, Dung
    Pye, Steve
    Quinn, Ruth
    Rabbaniha, Mahnaz
    Robinson, Elizabeth
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Semenza, Jan C.
    Sherman, Jodi
    Shumake-Guillemot, Joy
    Tabatabaei, Meisam
    Taylor, Jonathon
    Trinanes, Joaquin
    Wilkinson, Paul
    Costello, Anthony
    Gong, Peng
    Montgomery, Hugh
    The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate2019In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 394, no 10211, p. 1836-1878Article, review/survey (Refereed)
  • 237. Watts, Nick
    et al.
    Amann, Markus
    Ayeb-Karlsson, Sonja
    Belesova, Kristine
    Bouley, Timothy
    Boykoff, Maxwell
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cai, Wenjia
    Campbell-Lendrum, Diarmid
    Chambers, Jonathan
    Cox, Peter M
    Daly, Meaghan
    Dasandi, Niheer
    Davies, Michael
    Depledge, Michael
    Depoux, Anneliese
    Dominguez-Salas, Paula
    Drummond, Paul
    Ekins, Paul
    Flahault, Antoine
    Frumkin, Howard
    Georgeson, Lucien
    Ghanei, Mostafa
    Grace, Delia
    Graham, Hilary
    Grojsman, Rébecca
    Haines, Andy
    Hamilton, Ian
    Hartinger, Stella
    Johnson, Anne
    Kelman, Ilan
    Kiesewetter, Gregor
    Kniveton, Dominic
    Liang, Lu
    Lott, Melissa
    Lowe, Robert
    Mace, Georgina
    Odhiambo Sewe, Maquins
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Maslin, Mark
    Mikhaylov, Slava
    Milner, James
    Latifi, Ali Mohammad
    Moradi-Lakeh, Maziar
    Morrissey, Karyn
    Murray, Kris
    Neville, Tara
    Nilsson, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Oreszczyn, Tadj
    Owfi, Fereidoon
    Pencheon, David
    Pye, Steve
    Rabbaniha, Mahnaz
    Robinson, Elizabeth
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Schütte, Stefanie
    Shumake-Guillemot, Joy
    Steinbach, Rebecca
    Tabatabaei, Meisam
    Wheeler, Nicola
    Wilkinson, Paul
    Gong, Peng
    Montgomery, Hugh
    Costello, Anthony
    The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health2018In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 391, no 10120, p. 581-630Article, review/survey (Refereed)
    Abstract [en]

    The Lancet Countdown tracks progress on health and climate change and provides an independent assessment of the health effects of climate change, the implementation of the Paris Agreement, 1 and the health implications of these actions. It follows on from the work of the 2015 Lancet Commission on Health and Climate Change, 2 which concluded that anthropogenic climate change threatens to undermine the past 50 years of gains in public health, and conversely, that a comprehensive response to climate change could be "the greatest global health opportunity of the 21st century". The Lancet Countdown is a collaboration between 24 academic institutions and intergovernmental organisations based in every continent and with representation from a wide range of disciplines. The collaboration includes climate scientists, ecologists, economists, engineers, experts in energy, food, and transport systems, geographers, mathematicians, social and political scientists, public health professionals, and doctors. It reports annual indicators across five sections: climate change impacts, exposures, and vulnerability; adaptation planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. The key messages from the 40 indicators in the Lancet Countdown's 2017 report are summarised below.

  • 238.
    Wilder-Smith, Annelies
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    The elusive global burden of dengue2016In: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 16, no 6, p. 629-631Article in journal (Other academic)
  • 239.
    Wilder-Smith, Annelies
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Heidelberg Univ, Sch Med, Inst Publ Hlth, Heidelberg, Germany.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Olanratmanee, Phanthip
    Maskhao, Pongsri
    Sringernyuang, Luechai
    Logan, James G.
    Lindsay, Steve W.
    Banks, Sarah
    Gubler, Duane
    Louis, Valerie R.
    Tozan, Yesim
    Kittayapong, Pattamaporn
    The impact of insecticide-treated school uniforms on dengue infections in school-aged children: study protocol for a randomised controlled trial in Thailand2012In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 13, article id 212Article in journal (Refereed)
    Abstract [en]

    Background: There is an urgent need to protect children against dengue since this age group is particularly sensitive to the disease. Since dengue vectors are active mainly during the day, a potential target for control should be schools where children spend a considerable amount of their day. School uniforms are the cultural norm in most developing countries, worn throughout the day. We hypothesise that insecticide-treated school uniforms will reduce the incidence of dengue infection in school-aged children. Our objective is to determine the impact of impregnated school uniforms on dengue incidence.

    Methods: A randomised controlled trial will be conducted in eastern Thailand in a group of schools with approximately 2,000 students aged 7-18 years. Pre-fabricated school uniforms will be commercially treated to ensure consistent, high-quality insecticide impregnation with permethrin. A double-blind, randomised, crossover trial at the school level will cover two dengue transmission seasons.

    Discussion: Practical issues and plans concerning intervention implementation, evaluation, analysing and interpreting the data, and possible policy implications arising from the trial are discussed.

  • 240.
    Wilder-Smith, Annelies
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Renhorn, Karl-Erik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Tissera, Hasitha
    Abu Bakar, Sazaly
    Alphey, Luke
    Kittayapong, Pattamaporn
    Lindsay, Steve
    Logan, James
    Hatz, Christoph
    Reiter, Paul
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Louis, Valerie R.
    Tozan, Yesim
    Massad, Eduardo
    Tenorio, Antonio
    Lagneau, Christophe
    L'Ambert, Gregory
    Brooks, David
    Wegerdt, Johannah
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Gubler, Duane
    DengueTools: innovative tools and strategies for the surveillance and control of dengue2012In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 5, p. 17273-Article in journal (Refereed)
    Abstract [en]

    Dengue fever is a mosquito-borne viral disease estimated to cause about 230 million infections worldwide every year, of which 25,000 are fatal. Global incidence has risen rapidly in recent decades with some 3.6 billion people, over half of the world's population, now at risk, mainly in urban centres of the tropics and subtropics. Demographic and societal changes, in particular urbanization, globalization, and increased international travel, are major contributors to the rise in incidence and geographic expansion of dengue infections. Major research gaps continue to hamper the control of dengue. The European Commission launched a call under the 7th Framework Programme with the title of 'Comprehensive control of Dengue fever under changing climatic conditions'. Fourteen partners from several countries in Europe, Asia, and South America formed a consortium named 'DengueTools' to respond to the call to achieve better diagnosis, surveillance, prevention, and predictive models and improve our understanding of the spread of dengue to previously uninfected regions (including Europe) in the context of globalization and climate change. The consortium comprises 12 work packages to address a set of research questions in three areas: Research area 1: Develop a comprehensive early warning and surveillance system that has predictive capability for epidemic dengue and benefits from novel tools for laboratory diagnosis and vector monitoring. Research area 2: Develop novel strategies to prevent dengue in children. Research area 3: Understand and predict the risk of global spread of dengue, in particular the risk of introduction and establishment in Europe, within the context of parameters of vectorial capacity, global mobility, and climate change. In this paper, we report on the rationale and specific study objectives of 'DengueTools'. DengueTools is funded under the Health theme of the Seventh Framework Programme of the European Community, Grant Agreement Number: 282589 Dengue Tools.

  • 241.
    Wilder-Smith, Annelies
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Tissera, Hasitha
    AbuBakar, Sazaly
    Kittayapong, Pattamaporn
    Logan, James
    Neumayr, Andreas
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Louis, Valerie R.
    Tozan, Yesim
    Massad, Eduardo
    Preet, Raman
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Novel tools for the surveillance and control of dengue: findings by the dengueTools research consortium2018In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, no 1, article id 1549930Article, review/survey (Refereed)
    Abstract [en]

    Background: Dengue fever persists as a major global disease burden, and may increase as a consequence of climate change. Along with other measures, research actions to improve diagnosis, surveillance, prevention, and predictive models are highly relevant. The European Commission funded the DengueTools consortium to lead a major initiative in these areas, and this review synthesises the outputs and findings of this work conducted from 2011 to 2016. Research areas: DengueTools organised its work into three research areas, namely [1] Early warning and surveillance systems; [2] Strategies to prevent dengue in children; and [3] Predictive models for the global spread of dengue. Research area 1 focused on case-studies undertaken in Sri Lanka, including developing laboratory-based sentinel surveillance, evaluating economic impact, identifying drivers of transmission intensity, evaluating outbreak prediction capacity and developing diagnostic capacity. Research area 2 addressed preventing dengue transmission in school children, with case-studies undertaken in Thailand. Insecticide-treated school uniforms represented an intriguing potential approach, with some encouraging results, but which were overshadowed by a lack of persistence of insecticide on the uniforms with repeated washing. Research area 3 evaluated potential global spread of dengue, particularly into dengue-naive areas such as Europe. The role of international travel, changing boundaries of vectors, developing models of vectorial capacity under different climate change scenarios and strategies for vector control in outbreaks was all evaluated. Concluding remarks: DengueTools was able to make significant advances in methods for understanding and controlling dengue transmission in a range of settings. These will have implications for public health agendas to counteract dengue, including vaccination programmes. Outlook: Towards the end of the DengueTools project, Zika virus emerged as an unexpected epidemic in the central and southern America. Given the similarities between the dengue and Zika viruses, with vectors in common, some of the DengueTools thinking translated readily into the Zika situation.

  • 242. Yohannes, Mekonnen
    et al.
    Haile, Mituku
    Ghebreyesus, Tedros A
    Witten, Karen H
    Getachew, Asefaw
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lindsay, Steve W
    Can source reduction of mosquito larval habitat reduce malaria transmission in Tigray, Ethiopia?2005In: Trop Med Int Health, ISSN 1360-2276, Vol. 10, no 12, p. 1274-85Article in journal (Refereed)
  • 243.
    Zaba, Basia
    et al.
    London School of Hygiene & Tropical Medicine, London, UK.
    Calvert, Clara
    London School of Hygiene & Tropical Medicine, London, UK.
    Marston, Milly
    London School of Hygiene & Tropical Medicine, London, UK.
    Isingo, Raphael
    National Institute for Medical Research, Tanzania, Mwanza, Tanzania.
    Nakiyingi-Miiro, Jessica
    MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
    Lutalo, Tom
    Rakai Health Sciences Program, Rakai, Uganda.
    Crampin, Amelia
    Karonga Prevention Study, Karonga, Malawi and London School of Hygiene & Tropical Medicine, London, UK.
    Robertson, Laura
    INDEPTH Network, Accra, Ghana.
    Herbst, Kobus
    Africa Centre for Health and Population Studies, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.
    Newell, Marie-Louise
    Africa Centre for Health and Population Studies, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.
    Todd, Jim
    London School of Hygiene & Tropical Medicine, London, UK.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. INDEPTH Network, Accra, Ghana.
    Boerma, Ties
    WHO, Geneva, Switzerland.
    Ronsmans, Carine
    London School of Hygiene & Tropical Medicine, London, UK.
    Effect of HIV infection on pregnancy-related mortality in sub-Saharan Africa: secondary analyses of pooled community-based data from the network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA)2013In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 381, no 9879, p. 1763-1771Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Model-based estimates of the global proportions of maternal deaths that are in HIV-infected women range from 7% to 21%, and the effects of HIV on the risk of maternal death is highly uncertain. We used longitudinal data from the Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA) network to estimate the excess mortality associated with HIV during pregnancy and the post-partum period in sub-Saharan Africa.

    METHODS: The ALPHA network pooled data gathered between June, 1989 and April, 2012 in six community-based studies in eastern and southern Africa with HIV serological surveillance and verbal-autopsy reporting. Deaths occurring during pregnancy and up to 42 days post partum were defined as pregnancy related. Pregnant or post-partum person-years were calculated for HIV-infected and HIV-uninfected women, and HIV-infected to HIV-uninfected mortality rate ratios and HIV-attributable rates were compared between pregnant or post-partum women and women who were not pregnant or post partum.

    FINDINGS: 138,074 women aged 15-49 years contributed 636,213 person-years of observation. 49,568 women had 86,963 pregnancies. 6760 of these women died, 235 of them during pregnancy or the post-partum period. Mean prevalence of HIV infection across all person-years in the pooled data was 17.2% (95% CI 17.0-17.3), but 60 of 118 (50.8%) of the women of known HIV status who died during pregnancy or post partum were HIV infected. The mortality rate ratio of HIV-infected to HIV-uninfected women was 20.5 (18.9-22.4) in women who were not pregnant or post partum and 8.2 (5.7-11.8) in pregnant or post-partum women. Excess mortality attributable to HIV was 51.8 (47.8-53.8) per 1000 person-years in women who were not pregnant or post partum and 11.8 (8.4-15.3) per 1000 person-years in pregnant or post-partum women.

    INTERPRETATION: HIV-infected pregnant or post-partum women had around eight times higher mortality than did their HIV-uninfected counterparts. On the basis of this estimate, we predict that roughly 24% of deaths in pregnant or post-partum women are attributable to HIV in sub-Saharan Africa, suggesting that safe motherhood programmes should pay special attention to the needs of HIV-infected pregnant or post-partum women.

2345 201 - 243 of 243
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf