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AuthorMokdad, Ali H
AuthorForouzanfar, Mohammad Hossein
AuthorDaoud, Farah
AuthorEl Bcheraoui, Charbel
AuthorMoradi-Lakeh, Maziar
AuthorKhalil, Ibrahim
AuthorAfshin, Ashkan
AuthorTuffaha, Marwa
AuthorCharara, Raghid
AuthorBarber, Ryan M
AuthorWagner, Joseph
AuthorCercy, Kelly
AuthorKravitz, Hannah
AuthorCoates, Matthew M
AuthorRobinson, Margaret
AuthorEstep, Kara
AuthorSteiner, Caitlyn
AuthorJaber, Sara
AuthorMokdad, Ali A
AuthorO'Rourke, Kevin F
AuthorChew, Adrienne
AuthorKim, Pauline
AuthorEl Razek, Mohamed Magdy Abd
AuthorAbdalla, Safa
AuthorAbd-Allah, Foad
AuthorAbraham, Jerry P
AuthorAbu-Raddad, Laith J
AuthorAbu-Rmeileh, Niveen M E
AuthorAl-Nehmi, Abdulwahab A
AuthorAkanda, Ali S
AuthorAl Ahmadi, Hanan
AuthorAl Khabouri, Mazin J
AuthorAl Lami, Faris H
AuthorAl Rayess, Zulfa A
AuthorAlasfoor, Deena
AuthorAlBuhairan, Fadia S
AuthorAldhahri, Saleh F
AuthorAlghnam, Suliman
AuthorAlhabib, Samia
AuthorAl-Hamad, Nawal
AuthorAli, Raghib
AuthorAli, Syed Danish
AuthorAlkhateeb, Mohammad
AuthorAlMazroa, Mohammad A
AuthorAlomari, Mahmoud A
AuthorAl-Raddadi, Rajaa
AuthorAlsharif, Ubai
AuthorAl-Sheyab, Nihaya
AuthorAlsowaidi, Shirina
AuthorAl-Thani, Mohamed
AuthorAltirkawi, Khalid A
AuthorAmare, Azmeraw T
AuthorAmini, Heresh
AuthorAmmar, Walid
AuthorAnwari, Palwasha
AuthorAsayesh, Hamid
AuthorAsghar, Rana
AuthorAssabri, Ali M
AuthorAssadi, Reza
AuthorBacha, Umar
AuthorBadawi, Alaa
AuthorBakfalouni, Talal
AuthorBasulaiman, Mohammed O
AuthorBazargan-Hejazi, Shahrzad
AuthorBedi, Neeraj
AuthorBhakta, Amit R
AuthorBhutta, Zulfiqar A
AuthorBin Abdulhak, Aref A
AuthorBoufous, Soufiane
AuthorBourne, Rupert R A
AuthorDanawi, Hadi
AuthorDas, Jai
AuthorDeribew, Amare
AuthorDing, Eric L
AuthorDurrani, Adnan M
AuthorElshrek, Yousef
AuthorIbrahim, Mohamed E
AuthorEshrati, Babak
AuthorEsteghamati, Alireza
AuthorFaghmous, Imad A D
AuthorFarzadfar, Farshad
AuthorFeigl, Andrea B
AuthorFereshtehnejad, Seyed-Mohammad
AuthorFilip, Irina
AuthorFischer, Florian
AuthorGankpé, Fortuné G
AuthorGinawi, Ibrahim
AuthorGishu, Melkamu Dedefo
AuthorGupta, Rahul
AuthorHabash, Rami M
AuthorHafezi-Nejad, Nima
AuthorHamadeh, Randah R
AuthorHamdouni, Hayet
AuthorHamidi, Samer
AuthorHarb, Hilda L
AuthorHassanvand, Mohammad Sadegh
AuthorHedayati, Mohammad T
AuthorHeydarpour, Pouria
AuthorHsairi, Mohamed
AuthorHusseini, Abdullatif
AuthorJahanmehr, Nader
AuthorJha, Vivekanand
AuthorJonas, Jost B
AuthorKaram, Nadim E
AuthorKasaeian, Amir
AuthorKassa, Nega Assefa
AuthorKaul, Anil
AuthorKhader, Yousef
AuthorKhalifa, Shams Eldin A
AuthorKhan, Ejaz A
AuthorKhan, Gulfaraz
AuthorKhoja, Tawfik
AuthorKhosravi, Ardeshir
AuthorKinfu, Yohannes
AuthorDefo, Barthelemy Kuate
AuthorBalaji, Arjun Lakshmana
AuthorLunevicius, Raimundas
AuthorObermeyer, Carla Makhlouf
AuthorMalekzadeh, Reza
AuthorMansourian, Morteza
AuthorMarcenes, Wagner
AuthorFarid, Habibolah Masoudi
AuthorMehari, Alem
AuthorMehio-Sibai, Abla
AuthorMemish, Ziad A
AuthorMensah, George A
AuthorMohammad, Karzan A
AuthorNahas, Ziad
AuthorNasher, Jamal T
AuthorNawaz, Haseeb
AuthorNejjari, Chakib
AuthorNisar, Muhammad Imran
AuthorOmer, Saad B
AuthorParsaeian, Mahboubeh
AuthorPeprah, Emmanuel K
AuthorPervaiz, Aslam
AuthorPourmalek, Farshad
AuthorQato, Dima M
AuthorQorbani, Mostafa
AuthorRadfar, Amir
AuthorRafay, Anwar
AuthorRahimi, Kazem
AuthorRahimi-Movaghar, Vafa
AuthorRahman, Sajjad Ur
AuthorRai, Rajesh K
AuthorRana, Saleem M
AuthorRao, Sowmya R
AuthorRefaat, Amany H
AuthorResnikoff, Serge
AuthorRoshandel, Gholamreza
AuthorSaade, Georges
AuthorSaeedi, Mohammad Y
AuthorSahraian, Mohammad Ali
AuthorSaleh, Shadi
AuthorSanchez-Riera, Lidia
AuthorSatpathy, Maheswar
AuthorSepanlou, Sadaf G
AuthorSetegn, Tesfaye
AuthorShaheen, Amira
AuthorShahraz, Saeid
AuthorSheikhbahaei, Sara
AuthorShishani, Kawkab
AuthorSliwa, Karen
AuthorTavakkoli, Mohammad
AuthorTerkawi, Abdullah S
AuthorUthman, Olalekan A
AuthorWesterman, Ronny
AuthorYounis, Mustafa Z
AuthorEl Sayed Zaki, Maysaa
AuthorZannad, Faiez
AuthorRoth, Gregory A
AuthorWang, Haidong
AuthorNaghavi, Mohsen
AuthorVos, Theo
AuthorAl Rabeeah, Abdullah A
AuthorLopez, Alan D
AuthorMurray, Christopher J L
Available date2016-10-17T05:19:43Z
Publication Date2016-10
Publication NameThe Lancet Global Health
Identifierhttp://dx.doi.org/10.1016/S2214-109X(16)30168-1
CitationAli H Mokdad, Mohammad Hossein Forouzanfar, Farah Daoud, et al. "Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013", The Lancet Global Health, Volume 4, Issue 10, October 2016, Pages e704-e713,
ISSN2214109X
URIhttp://www.sciencedirect.com/science/article/pii/S2214109X16301681
URIhttp://hdl.handle.net/10576/4893
AbstractBackground: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods: GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings: The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation: Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding: Bill & Melinda Gates Foundation.
SponsorBill & Melinda Gates Foundation. Qatar National Research Fund (NPRP 9-040-3-008). The Brien Holden Vision Institute. Oklahoma Council for Advancement of Science & Technology. UK National Institute for Health Research Oxford Biomedical Research Centre, National Institute for Health Research Career Development Fellowship, and Oxford Martin School.
Languageen
PublisherElsevier, Ltd
SubjectMediterranean region
life expectancy
Health conditions
Cause of death
TitleHealth in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
TypeArticle
Issue Number10
Volume Number4
Open Access user License http://creativecommons.org/licenses/by/4.0/


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