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Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 57053

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Prof. Dr. Mihajlo (Michael) Jakovljevic

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1. Department Global Health Economics & Policy, University of Kragujevac, 34000 Kragujevac, Serbia
2. Institute of Comparative Economic Studies, Hosei University, Tokyo 102-8160, Japan
Interests: global health; global burden of disease project; big data; health care financing & expenditures; evaluation of policy; programs and health system performance; organisation of health care markets; health economics; emerging markets
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Special Issue Information

Dear Colleagues,

We are organizing a Special Issue entitled: “Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide” in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph.

The Global Burden of Disease Project developed in 1990 from WHO-supported efforts (https://www.who.int/healthinfo/global_burden_disease/about/en/) to provide in-depth epidemiological evidence with scale and depth unseen before that time in the professional literature. The core idea behind this multinational effort was that methodologically rigorous evidence on unmet medical needs in diverse world regions would create a solid, long-lasting, and evolving ground for informed policy making (http://www.healthdata.org/infographic/what-global-burden-disease-gbd). So far, it has become a strong success story, bringing value-based policy-making and evidence-driven health policies to diverse regions worldwide (http://www.healthdata.org/gbd/about).

Since the dawn of the first out of four consecutive industrial revolutions beginning in 18^th century Europe, global morbidity and mortality patterns have changed tremendously. This means that most contemporary nations experienced a transition from dominant infectious diseases, traumatism, and acute maternal and early childhood morbidity towards chronic non-communicable diseases. This profound change was driven to some extent by urbanization, changing lifestyle, and sexual revolution, but to a large degree was also due to the widespread phenomenon of population ageing.

All these transformations in population health are reflected heavily in the human societies across the globe. At first, the historical establishments of national health systems, regardless of their kind (Bismarck, Beveridge or Semashko), were all based on a demographic growth model. Consequently, a variety of nations—rich and poor alike—in the decades following WWII and the Cold War Era faced serious threats to the long-term financial sustainability of their health, social support, and pension systems.

In this sense, we are launching this Special Issue to address some of the core research questions related to mankind’s epidemiological evolution, such as:

The consequences of the spread of NCDs for national health systems;
Health expenditure long-term trends driven by these changes in OECD and leading emerging markets alike (BRICs, EM7);
Health policy and economic estimates in relation to global morbidity and mortality transition;
Evolving burden of disease in low- and middle-income countries (LMICs);
Rapid transformation of pharmaceutical markets led by Asia, attributable to GBD transition;
Transnational assessments of underlying health trends and forecasts for the future;
Comparisons of geopolitical groupings of countries sharing similar legacies of health care provision and financing;

We welcome the submission of Reviews, Original Research Articles, Short Communications, Editorial Letters, Systematic Reviews, Case Studies, and other kinds of articles targeting any of these core research questions and beyond. We would be delighted to attract as high diversity and heterogeneity of submissions across geographies and jurisdictions as possible.

Prof. Dr. Mihajlo (Michael) Jakovljevic
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

global burden of disease
health economics
health policy
population ageing
noncommunicable diseases (NCDs)
health spending (expenditure)
pharmaceuticals
emerging markets
trends
forecasts

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Published Papers (12 papers)

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Editorial

Jump to: Research

9 pages, 292 KiB

Open AccessEditorial

Corona-Triggered Global Macroeconomic Crisis of the Early 2020s

by Kristijan Krstic, Ronny Westerman, Vijay Kumar Chattu, Natalia V. Ekkert and Mihajlo Jakovljevic

Int. J. Environ. Res. Public Health 2020, 17(24), 9404; https://doi.org/10.3390/ijerph17249404 - 15 Dec 2020

Cited by 27 | Viewed by 3626

Abstract

Long-lasting economic recessions spreading from initial cradle markets worldwide should be a periodic event inherent to capitalism as a prevailing socio-economic model [...] Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

5 pages, 552 KiB

Open AccessEditorial

Analysis of the Financing of Russian Health Care over the Past 100 Years

by Vladimir Reshetnikov, Evgeny Arsentyev, Sergey Bolevich, Yuriy Timofeyev and Mihajlo Jakovljević

Int. J. Environ. Res. Public Health 2019, 16(10), 1848; https://doi.org/10.3390/ijerph16101848 - 24 May 2019

Cited by 27 | Viewed by 6790

Abstract

The evolution of epidemiological burden in Imperial Russia and, consecutively, the Union of Soviet Socialist Republics (USSR), took place mostly over the duration of the past century [...] Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

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Research

Jump to: Editorial

24 pages, 1795 KiB

Open AccessArticle

Validity and Reliability of the Beck Anxiety Inventory (BAI) for Family Caregivers of Children with Cancer

by Filiberto Toledano-Toledano, José Moral de la Rubia, Miriam Teresa Domínguez-Guedea, Laura A. Nabors, Blanca E. Barcelata-Eguiarte, Eduardo Rocha-Pérez, David Luna, Ahidée Leyva-López and Leonor Rivera-Rivera

Int. J. Environ. Res. Public Health 2020, 17(21), 7765; https://doi.org/10.3390/ijerph17217765 - 23 Oct 2020

Cited by 29 | Viewed by 9750

Abstract

Currently, information about the psychometric properties of the Beck Anxiety Inventory (BAI) in family caregivers of children with cancer is not available; thus, there is no empirical evidence of its validity and reliability to support its use in this population in Mexico or in other countries. This study examined the psychometric properties of the BAI in family caregivers of children with cancer and pursued four objectives: to determine the factor structure of the BAI, estimate its internal consistency reliability, describe the distribution of BAI scores and the level of anxiety in the sample and test its concurrent validity in relation to depression and resilience. This cross-sectional study was carried out with convenience sampling. A sociodemographic questionnaire, the BAI, the Beck Depression Inventory and the Measurement Scale of Resilience were administered to an incidental sample of 445 family caregivers of children with cancer hospitalized at the National Institute of Health in Mexico City. Confirmatory factor analysis using the maximum likelihood method was performed to determine the factor structure and exploratory factor analysis using axis factorization with oblique rotation was conducted. The two-, three- and four-factor models originally proposed for the BAI did not hold. The exploratory factor analysis showed a model of two correlated factors (physiological and emotional symptoms). Confirmatory factor analysis revealed a lack of discriminant validity between these two factors and supported a single-factor model. The internal consistency of the scale reduced to 11 items (BAI-11) was good (alpha = 0.89). The distribution of BAI-11 scores was skewed to the left. High levels of symptoms of anxiety were present in 49.4% of caregivers. The scale was positively correlated with depression and negatively correlated with resilience. These findings suggest that a reduced single-factor version of the BAI is valid for Mexican family caregivers of children with cancer. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

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16 pages, 841 KiB

Open AccessArticle

by Asborg A. Bjertnaes, Catherine Schwinger, Petur B. Juliusson, Tor A. Strand, Mads N. Holten-Andersen and Kjersti S. Bakken

Int. J. Environ. Res. Public Health 2020, 17(19), 7307; https://doi.org/10.3390/ijerph17197307 - 7 Oct 2020

Cited by 5 | Viewed by 2699

Abstract

The aim of this study was to explore the association between adolescent subjective social status (SSS) and body mass index (BMI) at two different time points and to determine whether this association was mediated by health-related behaviors. In 2002 (n = 1596) and 2017 (n = 1534), tenth-grade students (15–16 years old) in schools in the District of Oppland, Norway, completed a survey. Four categories of perceived family economy were measured as SSS, and structural equation modeling was performed, including a latent variable for unhealthy behavior derived from cigarette smoking, snuff-use, and alcohol-drinking as well as dietary and exercise as mediators. No linear association was found between SSS and BMI in 2002 (standardized ß −0.02, (95% confidence interval (CI) −0.07, 0.03)). However, an association was present in 2017 (standardized ß −0.05 (95% CI −0.10, −0.001)), indicating that BMI decreased by 0.05 standard deviations (0.05 × 3.1 = 0.16 BMI unit) for every one-category increase in SSS. This association was mediated by exercise (standardized ß −0.013 (95% CI −0.02, −0.004) and unhealthy behavior (standardized ß −0.009 (95% CI −0.002, −0.04)). In conclusion, a direct association between SSS and BMI was found in 2017 in this repeated cross-sectional survey of 15–16-year-old Norwegian adolescents. This association was mediated through health-related behavior. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

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13 pages, 339 KiB

Open AccessArticle

Oncological Diseases and Social Costs Considerations on Undertaken Health Policy Interventions

by Tomasz Holecki, Maria Węgrzyn, Aldona Frączkiewicz-Wronka and Karolina Sobczyk

Int. J. Environ. Res. Public Health 2020, 17(8), 2837; https://doi.org/10.3390/ijerph17082837 - 20 Apr 2020

Cited by 5 | Viewed by 2245

Abstract

The growing incidence and prevalence of civilization diseases is prompting national and transnational entities to seek instruments that would reverse epidemiological trends. Not without significance is the need to design such solutions that are going to provide an improved relation between the costs incurred to maintain health or recovery and the profit for citizens of continuing to function in good health. In its strategic documents, the European Union indicates the most important development goals in each financial perspective and the tools necessary to achieve them. In the Europe 2020 strategy, a cohesion policy was indicated as an important tool for the implementation of development goals, focusing on supporting activities leading to the equalisation of economic and social conditions in all regions of EU countries. The implementation of one of the three basic priorities of the Europe 2020 strategy, which is inclusive growth—supporting an economy with a high level of employment and ensuring social and territorial cohesion—assumes, among others, that in 2020, the population at risk of poverty and social exclusion will decrease by 20 million and that the employment rate in the EU will increase to 75%. Meeting the objectives will not be possible without a holistic coordinated approach to healthcare at the national and regional level in accordance with the principle of “health in all policies”. It also requires the involvement of various sources of financing, including structural funds. The EU’s prioritisation of the problems related to ensuring decent conditions for achieving health resulted in the mobilisation of structural funds for actions taken in the healthcare sector. Of particular importance are those actions which are taken to prevent, alleviate, and prevent oncological diseases. An additional contribution to undertaking actions aimed at preventing oncological diseases are the high and often neglected social costs incurred by societies. The goal of the article was to identify and evaluate actions taken in this area in Poland. It was achieved by analysing the literature on the subject and statistical data, and conducting induction based on the above-mentioned sources. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

13 pages, 317 KiB

Open AccessArticle

Patients’ Self-Reported Disability Weights of Top-Ranking Diseases in Thailand: Do They Differ by Socio-Demographic and Illness Characteristics?

by Jiraluck Nontarak, Sawitri Assanangkornchai and Sarah Callinan

Int. J. Environ. Res. Public Health 2020, 17(5), 1595; https://doi.org/10.3390/ijerph17051595 - 2 Mar 2020

Cited by 3 | Viewed by 2160

Abstract

Little is known about the impact of methodological decisions on estimating disability weights among patients with mental and physical disorders, and the effects of socio-demographic status on the estimation of these weights. A cross-sectional study was conducted in three hospitals in southern Thailand to describe the disability weights based on different valuation methods. Altogether, 150 patients with major depressive disorder, 150 with alcohol use disorder, and 150 with osteoarthritis with varying levels of severity were recruited. Using a face-to-face interview, all patients completed a visual analogue scale (VAS) and were randomly assigned to complete either the European Quality of Life-5 Dimensions (EQ-5D) or Time-trade-off (TTO) instrument to estimate their current utility score, which was consequently transformed to a disability weight. Significant differences were found between disability weights derived from the three instruments for the same disease, with the VAS providing the highest and EQ-5D the lowest weights. Patients with major depressive disorder had the highest disability weight while those with osteoarthritis had lowest by most methods. Patients’ socio-demographics do not affect how they perceive their disability or health condition. Our findings highlight the importance of carefully selecting methods of valuing disability weights, which can rely on disease specific conditions. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

13 pages, 500 KiB

Open AccessArticle

Alcohol Consumption among the Elderly Citizens in Hungary and Serbia—Comparative Assessment

by Natasa Mihailovic, Gergő József Szőllősi, Nemanja Rancic, Sándor János, Klára Boruzs, Attila Csaba Nagy, Yuriy Timofeyev, Viktorija Dragojevic-Simic, Marko Antunovic, Vladimir Reshetnikov, Róza Ádány and Mihajlo Jakovljevic

Int. J. Environ. Res. Public Health 2020, 17(4), 1289; https://doi.org/10.3390/ijerph17041289 - 17 Feb 2020

Cited by 13 | Viewed by 3944

Abstract

Studies in the alcohol consumption area are mostly related to the (ab)use of alcohol in young people. However, today, a growing number of researchers are emphasizing the clinical and public health significance of alcohol consumption in the elderly. In the WHO reports, harmful alcohol consumption is responsible for 5.3% of the global burden of the disease. The aim of this study was to investigate the prevalence of alcohol consumption among men and women aged 55 and over in Serbia and Hungary, leveraging data from the 2013 Serbian National Health Survey and from the 2014 Hungarian National Health Survey. Respondents aged 55 and over were analysed based on logistic multivariate models. The prevalence of alcohol consumption was 41.5% and 62.5% in Serbia and Hungary, respectively. It was higher among men in both countries, but among women, it was significantly higher in Hungary than in Serbia. The statistically significant predictors affecting alcohol consumption in Serbia included age, education, well-being index, long-term disease and overall health status, with marital status being an additional factor among men. In Hungary, education and long-term disease affected alcohol consumption in both sexes, while age and employment were additional factors among women. In both countries for both sexes, younger age, more significantly than primary education and good health, was associated with a higher likelihood of alcohol consumption. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

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9 pages, 342 KiB

Open AccessArticle

Patient-Controlled Intravenous Morphine Analgesia Combined with Transcranial Direct Current Stimulation for Post-Thoracotomy Pain: A Cost-Effectiveness Study and A Feasibility for Its Future Implementation

by Nemanja Rancic, Katarina Mladenovic, Nela V. Ilic, Viktorija Dragojevic-Simic, Menelaos Karanikolas, Tihomir V. Ilic and Dusica M. Stamenkovic

Int. J. Environ. Res. Public Health 2020, 17(3), 816; https://doi.org/10.3390/ijerph17030816 - 28 Jan 2020

Cited by 4 | Viewed by 3137

Abstract

This prospective randomized study aims to evaluate the feasibility and cost-effectiveness of combining transcranial direct current stimulation (tDCS) with patient controlled intravenous morphine analgesia (PCA-IV) as part of multimodal analgesia after thoracotomy. Patients assigned to the active treatment group (a-tDCS, n = 27) received tDCS over the left primary motor cortex for five days, whereas patients assigned to the control group (sham-tDCS, n = 28) received sham tDCS stimulations. All patients received postoperative PCA-IV morphine. For cost-effectiveness analysis we used data about total amount of PCA-IV morphine and maximum visual analog pain scale with cough (VASP-C_max). Direct costs of hospitalization were assumed as equal for both groups. Cost-effectiveness analysis was performed with the incremental cost-effectiveness ratio (ICER), expressed as the incremental cost (RSD or US$) per incremental gain in mm of VASP-C_max reduction. Calculated ICER was 510.87 RSD per VASP-C_max 1 mm reduction. Conversion on USA market (USA data 1.325 US$ for 1 mg of morphine) revealed ICER of 189.08 US$ or 18960.39 RSD/1 VASP-C_max 1 mm reduction. Cost-effectiveness expressed through ICER showed significant reduction of PCA-IV morphine costs in the tDCS group. Further investigation of tDCS benefits with regards to reduction of postoperative pain treatment costs should also include the long-term benefits of reduced morphine use. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

11 pages, 2163 KiB

Open AccessArticle

Burden of Disease in Coastal Areas of South Korea: An Assessment Using Health Insurance Claim Data

by Munkhzul Radnaabaatar, Young-Eun Kim, Dun-Sol Go, Yunsun Jung and Seok-Jun Yoon

Int. J. Environ. Res. Public Health 2019, 16(17), 3044; https://doi.org/10.3390/ijerph16173044 - 22 Aug 2019

Cited by 5 | Viewed by 3329

Abstract

Background: While measuring and monitoring disease morbidity, it is essential to focus on regions experiencing inequitable health outcomes, especially coastal populations. However, no research investigating population health outcomes in coastal areas has been conducted. Therefore, we aimed to investigate the burden of disease morbidity in coastal areas of South Korea. Methods: Using an administrative division map and the ArcGIS, we identified and included 496 coastal districts. In this observational study, years lived with disability (YLDs) were estimated using incidence-based approaches to calculate the burden of disease in 2015. Incidence and prevalence cases were collected using National Health Insurance Service (NHIS) medical claim data using a specialized algorithm. Results: Age-standardized years lived with disability (ASYLDs) in the coastal areas were 24,398 per 100,000 population, which is greater than the 22,613 YLDs observed nationwide. In coastal areas, the burden of disease morbidity was higher in females than in males. Diabetes mellitus was the leading specific disease of total YLDs per 100,000 population, followed by low back pain, chronic obstructive pulmonary disease, osteoarthritis, and ischemic stroke. Conclusion: In this study, the coastal areas of South Korea carry a higher burden than the national population. Additionally, chronic diseases compose the majority of the health burden in coastal areas. Despite the limitation of data, YLD was the best tool available for evaluating the health outcomes in specific areas, and has the advantage of simplicity and timely analysis. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

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15 pages, 1953 KiB

Open AccessFeature PaperArticle

Underlying Differences in Health Spending Within the World Health Organisation Europe Region—Comparing EU15, EU Post-2004, CIS, EU Candidate, and CARINFONET Countries

by Mihajlo Jakovljevic, Paula Odete Fernandes, João Paulo Teixeira, Nemanja Rancic, Yuriy Timofeyev and Vladimir Reshetnikov

Int. J. Environ. Res. Public Health 2019, 16(17), 3043; https://doi.org/10.3390/ijerph16173043 - 22 Aug 2019

Cited by 43 | Viewed by 4988

Abstract

This study examined the differences in health spending within the World Health Organization (WHO) Europe region by comparing the EU15, the EU post-2004, CIS, EU Candidate and CARINFONET countries. The WHO European Region (53 countries) has been divided into the following sub-groups: EU15, EU post-2004, CIS, EU Candidate countries and CARINFONET countries. The study period, based on the availability of WHO Global Health expenditure data, was 1995 to 2014. EU15 countries have exhibited the strongest growth in total health spending both in nominal and purchasing power parity terms. The dynamics of CIS members’ private sector expenditure growth as a percentage of GDP change has exceeded that of other groups. Private sector expenditure on health as a percentage of total government expenditure, has steadily the highest percentage point share among CARINFONET countries. Furthermore, private households’ out-of-pocket payments on health as a percentage of total health expenditure, has been dominated by Central Asian republics for most of the period, although, for the period 2010 to 2014, the latter have tended to converge with those of CIS countries. Western EU15 nations have shown a serious growth of health expenditure far exceeding their pace of real economic growth in the long run. There is concerning growth of private health spending among the CIS and CARINFONET nations. It reflects growing citizen vulnerability in terms of questionable affordability of healthcare. Health care investment capability has grown most substantially in the Russian Federation, Turkey and Poland being the classical examples of emerging markets. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

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13 pages, 1610 KiB

Open AccessArticle

Geodemographic Area Classification and Association with Mortality: An Ecological Study of Small Areas of Cyprus

by Demetris Lamnisos, Nicos Middleton, Nikoletta Kyprianou and Michael A. Talias

Int. J. Environ. Res. Public Health 2019, 16(16), 2927; https://doi.org/10.3390/ijerph16162927 - 15 Aug 2019

Cited by 11 | Viewed by 2956

Abstract

Geographical investigations are a core function of public health monitoring, providing the foundation for resource allocation and policies for reducing health inequalities. The aim of this study was to develop geodemographic area classification based on several area-level indicators and to explore the extent of geographical inequalities in mortality. A series of 19 area-level socioeconomic indicators were used from the 2011 national population census. After normalization and standardization of the geographically smoothed indicators, the k-means cluster algorithm was implemented to classify communities into groups based on similar characteristics. The association between geodemographic area classification and the spatial distribution of mortality was estimated in Poisson log-linear spatial models. The k-means algorithm resulted in four distinct clusters of areas. The most characteristic distinction was between the ageing, socially isolated, and resource-scarce rural communities versus metropolitan areas with younger population, higher educational attainment, and professional occupations. By comparison to metropolitan areas, premature mortality appeared to be 44% (95% Credible Intervals [CrI] of Rate Ratio (RR): 1.06–1.91) higher in traditional rural areas and 36% (95% CrI of RR: 1.13–1.62) higher in young semi-rural areas. These findings warrant future epidemiological studies investigating various causes of the urban-rural differences in premature mortality and implementation policies to reduce the mortality gap between urban and rural areas. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

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10 pages, 1033 KiB

Open AccessArticle

A Population Dynamic Model to Assess the Diabetes Screening and Reporting Programs and Project the Burden of Undiagnosed Diabetes in Thailand

by Wiriya Mahikul, Lisa J White, Kittiyod Poovorawan, Ngamphol Soonthornworasiri, Pataporn Sukontamarn, Phetsavanh Chanthavilay, Wirichada Pan-ngum and Graham F Medley

Int. J. Environ. Res. Public Health 2019, 16(12), 2207; https://doi.org/10.3390/ijerph16122207 - 21 Jun 2019

Cited by 10 | Viewed by 10277

Abstract

Diabetes mellitus (DM) is rising worldwide, exacerbated by aging populations. We estimated and predicted the diabetes burden and mortality due to undiagnosed diabetes together with screening program efficacy and reporting completeness in Thailand, in the context of demographic changes. An age and sex structured dynamic model including demographic and diagnostic processes was constructed. The model was validated using a Bayesian Markov Chain Monte Carlo (MCMC) approach. The prevalence of DM was predicted to increase from 6.5% (95% credible interval: 6.3–6.7%) in 2015 to 10.69% (10.4–11.0%) in 2035, with the largest increase (72%) among 60 years or older. Out of the total DM cases in 2015, the percentage of undiagnosed DM cases was 18.2% (17.4–18.9%), with males higher than females (p-value < 0.01). The highest group with undiagnosed DM was those aged less than 39 years old, 74.2% (73.7–74.7%). The mortality of undiagnosed DM was ten-fold greater than the mortality of those with diagnosed DM. The estimated coverage of diabetes positive screening programs was ten-fold greater for elderly compared to young. The positive screening rate among females was estimated to be significantly higher than those in males. Of the diagnoses, 87.4% (87.0–87.8%) were reported. Targeting screening programs and good reporting systems will be essential to reduce the burden of disease. Full article

(This article belongs to the Special Issue Global Burden of Disease: Diversity of Socioeconomic Consequences Worldwide)

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