Imperial College London

PROFESSOR AZEEM MAJEED

Faculty of MedicineSchool of Public Health

Chair - Primary Care and Public Health & Head of Department
 
 
 
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Contact

 

+44 (0)20 7594 3368a.majeed Website

 
 
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Assistant

 

Mrs Pirkko Carmack +44 (0)20 7594 3368

 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Publication Type
Year
to

632 results found

Achana F, Petrou S, Khan K, Gaye A, Modi Net al., 2018, A methodological framework for assessing agreement between cost-effectiveness outcomes estimated using alternative sources of data on treatment costs and effects for trial-based economic evaluations, EUROPEAN JOURNAL OF HEALTH ECONOMICS, Vol: 19, Pages: 75-86, ISSN: 1618-7598

JOURNAL ARTICLE

Ahmad A, Laverty AA, Alexakis C, Cowling T, Saxena S, Majeed A, Pollok RCGet al., 2018, Changing nationwide trends in endoscopic, medical and surgical admissions for inflammatory bowel disease: 2003-2013, BMJ OPEN GASTROENTEROLOGY, Vol: 5, ISSN: 2054-4774

JOURNAL ARTICLE

Aljuaid M, Elmontsri M, Edvardsson D, Rawaf S, Majeed Aet al., 2018, Psychometric evaluation of the Arabic language person-centred climate questionnaire-staff version., J Nurs Manag, Vol: 26, Pages: 449-456

AIM: To evaluate the psychometric properties of the Arabic language person-centred climate questionnaire-staff version. BACKGROUND: There have been increasing calls for a person-centred rather than a disease-centred approach to health care. A limited number of tools measure the extent to which care is delivered in a person-centred manner, and none of these tools have been validated for us in Arab settings. METHOD: The validated form of the person-centred climate questionnaire-staff version was translated into Arabic and distributed to 152 health care staff in teaching and non-teaching hospitals in Saudi Arabia. Statistical estimates of validity and reliability were used for psychometric evaluation. RESULTS: Items on the Arabic form of the person-centred climate questionnaire-staff version had high reliability (Cronbach's alpha .98). Cronbach's alpha values for the three sub-scales (safety, everydayness and community), were .96, .97 and .95 respectively. Internal consistency was also high and measures of validity were very good. CONCLUSION: Arabic form of the person-centred climate questionnaire-staff version provides a valid and reliable way to measure the degree of perceived person-centredness. IMPLICATIONS FOR NURSING MANAGEMENT: The tool can be used for comparing levels of person-centredness between wards, units, and public and private hospitals. The tool can also be used to measure the extent of person-centredness in health care settings in other Arab countries.

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Alsharif U, El Bcheraoui C, Khalil I, Charara R, Moradi-Lakeh M, Afshin A, Collison M, Chew A, Krohn KJ, Daoud F, Dicker D, Foreman KJ, Frostad J, Kassebaum NJ, Kutz M, Wang H, Abyu GY, Adedeji IA, Ahmad Kiadaliri A, Ahmed MB, Al-Eyadhy A, Alam K, Alasfoor D, Ali R, Alizadeh-Navaei R, Al-Raddadi R, Altirkawi KA, Alvis-Guzman N, Amini E, Anber N, Anwari P, Artaman A, Asgedom SW, Atey TM, Awasthi A, Ba Saleem HO, Bacha U, Barac A, Bedi N, Bhutta ZA, Butt ZA, Castañeda-Orjuela CA, Chitheer AA, Danawi H, das Neves J, Davitoiu DV, Dey S, Dharmaratne SD, Djalalinia S, Do HP, Dubey M, Ebrahimi H, Ekwueme DU, Endries AY, Eshrati B, Esteghamati A, Farvid MS, Fereshtehnejad SM, Fischer F, Gebrehiwot TT, Gopalani SV, Hafezi-Nejad N, Hamadeh RR, Hamidi S, Hareri HA, Hay RJ, Horita N, Hsairi M, Jakovljevic MB, Jonas JB, Kasaeian A, Kassaw NA, Khader YS, Khan EA, Khan G, Kim D, Kinfu Y, Larson HJ, Latif AA, Linn S, Lunevicius R, Magdy Abd El Razek H, Magdy Abd El Razek M, Majeed A, Malekzadeh R, Malta DC, Markos D, Memiah P, Memish ZA, Mendoza W, Meretoja TJ, Miller TR, Mohammed S, Nangia V, Nguyen QL, Nguyen TH, Ogbo FA, Mahesh PA, Park EK, Patel Tet al., 2018, Burden of cancer in the Eastern Mediterranean Region, 2005–2015: findings from the Global Burden of Disease 2015 Study, International Journal of Public Health, Vol: 63, Pages: 151-164, ISSN: 1661-8556

© 2017, The Author(s). Objectives: To estimate incidence, mortality, and disability-adjusted life years (DALYs) caused by cancer in the Eastern Mediterranean Region (EMR) between 2005 and 2015. Methods: Vital registration system and cancer registry data from the EMR region were analyzed for 29 cancer groups in 22 EMR countries using the Global Burden of Disease Study 2015 methodology. Results: In 2015, cancer was responsible for 9.4% of all deaths and 5.1% of all DALYs. It accounted for 722,646 new cases, 379,093 deaths, and 11.7 million DALYs. Between 2005 and 2015, incident cases increased by 46%, deaths by 33%, and DALYs by 31%. The increase in cancer incidence was largely driven by population growth and population aging. Breast cancer, lung cancer, and leukemia were the most common cancers, while lung, breast, and stomach cancers caused most cancer deaths. Conclusions: Cancer is responsible for a substantial disease burden in the EMR, which is increasing. There is an urgent need to expand cancer prevention, screening, and awareness programs in EMR countries as well as to improve diagnosis, treatment, and palliative care services.

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Azzopardi P, Cini K, Kennedy E, Sawyer S, Elbcheraoui C, Charara R, Khalil I, Moradi-Lakeh M, Collison M, Afifi RA, Al-raiby J, Krohn KJ, Daoud F, Chew A, Afshin A, Foreman KJ, Kassebaum NJ, Kutz M, Kyu HH, Liu P, Olsen HE, Smith A, Stanaway JD, Wang H, Ärnlöv J, Ahmadkiadaliri A, Alam K, Alasfoor D, Ali R, Alizadeh-Navaei R, Al-Raddadi R, Altirkawi KA, Alvis-Guzman N, Anber N, Antonio CAT, Anwari P, Artaman A, Asayesh H, Barker-Collo SL, Bedi N, Beghi E, Bennett DA, Bensenor IM, Bhutta ZA, Butt ZA, Castañeda-Orjuela CA, Catalá-López F, Charlson FJ, Danawi H, Deleo D, Degenhardt L, Denno D, Deribe K, Desjarlais DC, Dey S, Dharmaratne SD, Djalalinia S, Erskine HE, Fereshtehnejad SM, Ferrari AJ, Fischer F, Gebrehiwot TT, Geleijnse JM, Gona PN, Gugnani HC, Gupta R, Hamadeh RR, Hamidi S, Haro JM, Hay RJ, Hearps SJC, Hendrie D, Hotez PJ, Hu G, Jonas JB, Karch A, Karimi SM, Kasaeian A, Kebede S, Kengne AP, Khan EA, Khosravi A, Khubchandani J, Kokubo Y, Kopec JA, Kosen S, Larson HJ, Larsson A, Leasher JL, Leung J, Li Y, Lotufo PA, Lunevicius R, Magdy Abd El Razek H, Majdzadeh R, Majeed A, Memiah P, Memish ZA, Mendoza W, Mhimbira FAet al., 2018, Adolescent health in the Eastern Mediterranean Region: findings from the global burden of disease 2015 study, International Journal of Public Health, Vol: 63, Pages: 79-96, ISSN: 1661-8556

© 2017, The Author(s). Objectives: The 22 countries of the East Mediterranean Region (EMR) have large populations of adolescents aged 10–24 years. These adolescents are central to assuring the health, development, and peace of this region. We described their health needs. Methods: Using data from the Global Burden of Disease Study 2015 (GBD 2015), we report the leading causes of mortality and morbidity for adolescents in the EMR from 1990 to 2015. We also report the prevalence of key health risk behaviors and determinants. Results: Communicable diseases and the health consequences of natural disasters reduced substantially between 1990 and 2015. However, these gains have largely been offset by the health impacts of war and the emergence of non-communicable diseases (including mental health disorders), unintentional injury, and self-harm. Tobacco smoking and high body mass were common health risks amongst adolescents. Additionally, many EMR countries had high rates of adolescent pregnancy and unmet need for contraception. Conclusions: Even with the return of peace and security, adolescents will have a persisting poor health profile that will pose a barrier to socioeconomic growth and development of the EMR.

JOURNAL ARTICLE

Barbaric J, Abbott R, Posadzki P, Car M, Gunn LH, Layton AM, Majeed A, Car Jet al., 2018, Light therapies for acne: abridged Cochrane systematic review including GRADE assessments, BRITISH JOURNAL OF DERMATOLOGY, Vol: 178, Pages: 61-75, ISSN: 0007-0963

JOURNAL ARTICLE

Bcheraoui CE, Charara R, Khalil I, Moradi-Lakeh M, Afshin A, Collison M, Daoud F, Krohn KJ, Chew A, Biryukov S, Casey D, Cercy K, Charlson FJ, Cornaby L, Dicker D, Erskine HE, Ferrari AJ, Fitzmaurice C, Foreman KJ, Fraser M, Frostad J, Godwin WW, Griswold M, Kassebaum NJ, Kemmer L, Kutz M, Kyu HH, Leung J, Liu P, Mikesell J, Nguyen G, Olsen HE, Reiner R, Reitsma M, Roth G, Santomauro D, Smith A, Stanaway JD, Sur P, Wang H, Whiteford HA, Afifi R, Kiadaliri AA, Ahmadi A, Ahmadieh H, Alam K, Alam N, Ali R, Alizadeh-Navaei R, Al-Raddadi R, Altirkawi KA, Anber N, Ansari H, Anwari P, Asayesh H, Asgedom SW, Atey TM, Bacha U, Bazargan-Hejazi S, Bedi N, Bhutta ZA, Bisanzio D, Butt ZA, Deribew A, Djalalinia S, Eshrati B, Esteghamati A, Farvid MS, Farzadfar F, Fereshtehnejad SM, Fischer F, Gebrehiwot TT, Hafezi-Nejad N, Hamadeh RR, Hamidi S, Hotez PJ, Hsairi M, Jonas JB, Kasaeian A, Khader YS, Khan EA, Khan G, Khoja ATA, Khoja TAM, Khubchandani J, Kopec JA, Larson HJ, Lunevicius R, Razek HMAE, Razek MMAE, Majdzadeh R, Majeed A, Malekzadeh R, Memish ZA, Mensah GA, Nasher JT, Obermeyer CM, Pourmalek F, Qorbani M, Radfar Aet al., 2018, Danger ahead: the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region, 1990–2015, International Journal of Public Health, Vol: 63, Pages: 11-23, ISSN: 1661-8556

© 2017, The Author(s). Objectives: The Eastern Mediterranean Region faces several health challenges at a difficult time with wars, unrest, and economic change. Methods: We used the Global Burden of Disease 2015 study to present the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region from 1990 to 2015. Results: Ischemic heart disease was the leading cause of death in the region in 2015, followed by cerebrovascular disease. Changes in total deaths ranged from a reduction of 25% for diarrheal diseases to an increase of about 42% for diabetes and tracheal, bronchus, and lung cancer. Collective violence and legal intervention increased by 850% during the time period. Diet was the leading risk factor for disability-adjusted life years (DALYs) for men compared to maternal malnutrition for females. Childhood undernutrition was the leading risk factor for DALYs in 1990 and 2005, but the second in 2015 after high blood pressure. Conclusions: Our study shows that the region is facing several health challenges and calls for global efforts to stabilise the region and to address the current and future burden of disease.

JOURNAL ARTICLE

Bottle A, Kim D, Aylin P, Cowie MR, Majeed A, Hayhoe Bet al., 2018, Routes to diagnosis of heart failure: observational study using linked data in England, HEART, Vol: 104, Pages: 600-605, ISSN: 1355-6037

JOURNAL ARTICLE

Cowling TE, Majeed A, Harris MJ, 2018, Patient experience of general practice and use of emergency hospital services in England: regression analysis of national cross-sectional time series data., BMJ Qual Saf

BACKGROUND: The UK Government has introduced several national policies to improve access to primary care. We examined associations between patient experience of general practice and rates of visits to accident and emergency (A&E) departments and emergency hospital admissions in England. METHODS: The study included 8124 general practices between 2011-2012 and 2013-2014. Outcome measures were annual rates of A&E visits and emergency admissions by general practice population, according to administrative hospital records. Explanatory variables included three patient experience measures from the General Practice Patient Survey: practice-level means of experience of making an appointment, satisfaction with opening hours and overall experience (on 0-100 scales). The main analysis used random-effects Poisson regression for cross-sectional time series. Five sensitivity analyses examined changes in model specification. RESULTS: Mean practice-level rates of A&E visits and emergency admissions increased from 2011-2012 to 2013-2014 (310.3-324.4 and 98.8-102.9 per 1000 patients). Each patient experience measure decreased; for example, mean satisfaction with opening hours was 79.4 in 2011-2012 and 76.6 in 2013-2014. In the adjusted regression analysis, an SD increase in experience of making appointments (equal to 9 points) predicted decreases of 1.8% (95% CI -2.4% to -1.2%) in A&E visit rates and 1.4% (95% CI -1.9% to -0.9%) in admission rates. This equalled 301 174 fewer A&E visits and 74 610 fewer admissions nationally per year. Satisfaction with opening hours and overall experience were not consistently associated with either outcome measure across the main and sensitivity analyses. CONCLUSIONS: Associations between patient experience of general practice and use of emergency hospital services were small or inconsistent. In England, realistic short-term improvements in patient experience of general practice may only have modest effects on A&

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Elmontsri M, Almashrafi A, Dubois E, Banarsee R, Majeed Aet al., 2018, Improving patient safety in Libya: insights from a British health system perspective, INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE, Vol: 31, Pages: 237-248, ISSN: 0952-6862

JOURNAL ARTICLE

Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Akinyemiju TF, Al Lami FH, Alam T, Alizadeh-Navaei R, Allen C, Alsharif U, Alvis-Guzman N, Amini E, Anderson BO, Aremu O, Artaman A, Asgedom SW, Assadi R, Atey TM, Avila-Burgos L, Awasthi A, Ba Saleem HO, Barac A, Bennett JR, Bensenor IM, Bhakta N, Brenner H, Cahuana-Hurtado L, Castañeda-Orjuela CA, Catalá-López F, Choi J-YJ, Christopher DJ, Chung S-C, Curado MP, Dandona L, Dandona R, das Neves J, Dey S, Dharmaratne SD, Doku DT, Driscoll TR, Dubey M, Ebrahimi H, Edessa D, El-Khatib Z, Endries AY, Fischer F, Force LM, Foreman KJ, Gebrehiwot SW, Gopalani SV, Grosso G, Gupta R, Gyawali B, Hamadeh RR, Hamidi S, Harvey J, Hassen HY, Hay RJ, Hay SI, Heibati B, Hiluf MK, Horita N, Hosgood HD, Ilesanmi OS, Innos K, Islami F, Jakovljevic MB, Johnson SC, Jonas JB, Kasaeian A, Kassa TD, Khader YS, Khan EA, Khan G, Khang Y-H, Khosravi MH, Khubchandani J, Kopec JA, Kumar GA, Kutz M, Lad DP, Lafranconi A, Lan Q, Legesse Y, Leigh J, Linn S, Lunevicius R, Majeed A, Malekzadeh R, Malta DC, Mantovani LG, McMahon BJ, Meier T, Melaku YA, Melku M, Memiah P, Mendoza W, Meretoja TJ, Mezgebe HB, Miller TR, Mohammed S, Mokdad AH, Moosazadeh M, Moraga P, Mousavi SM, Nangia V, Nguyen CT, Nong VM, Ogbo FA, Olagunju AT, Pa M, Park E-K, Patel T, Pereira DM, Pishgar F, Postma MJ, Pourmalek F, Qorbani M, Rafay A, Rawaf S, Rawaf DL, Roshandel G, Safiri S, Salimzadeh H, Sanabria JR, Santric Milicevic MM, Sartorius B, Satpathy M, Sepanlou SG, Shackelford KA, Shaikh MA, Sharif-Alhoseini M, She J, Shin M-J, Shiue I, Shrime MG, Sinke AH, Sisay M, Sligar A, Sufiyan MB, Sykes BL, Tabarés-Seisdedos R, Tessema GA, Topor-Madry R, Tran TT, Tran BX, Ukwaja KN, Vlassov VV, Vollset SE, Weiderpass E, Williams HC, Yimer NB, Yonemoto N, Younis MZ, Murray CJL, Naghavi Met al., 2018, Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis for the Global Burden of Disease Study., JAMA Oncol

Importance: The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. Objective: To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Evidence Review: Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. Findings: In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, -1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territor

JOURNAL ARTICLE

Hargreaves S, Nellums LB, Ramsay M, Saliba V, Majeed A, Mounier-Jack S, Friedland JSet al., 2018, Who is responsible for the vaccination of migrants in Europe?, LANCET, Vol: 391, Pages: 1752-1754, ISSN: 0140-6736

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Khalil I, Collison M, Elbcheraoui C, Charara R, Moradi-Lakeh M, Afshin A, Krohn KJ, Daoud F, Chew A, Kassebaum NJ, Colombara D, Cornaby L, Ehrenkranz R, Foreman KJ, Fraser M, Frostad J, Kemmer L, Kulikoff XR, Kutz M, Kyu HH, Liu P, Mikesell J, Nguyen G, Rao PC, Silpakit N, Sligar A, Smith A, Stanaway JD, Ärnlöv J, Abate KH, Ahmadkiadaliri A, Alam K, Alasfoor D, Ali R, Alizadeh-Navaei R, Al-Raddadi R, Altirkawi KA, Alvis-Guzman N, Anber N, Ansari H, Antonio CAT, Anwari P, Artaman A, Asayesh H, Asgedom SW, Azzopardi P, Bacha U, Barac A, Barker-Collo SL, Bedi N, Beghi E, Bennett DA, Bhutta ZA, Bisanzio D, Castañeda-Orjuela CA, Castro RE, Danawi H, Deribe K, Deribew A, Desjarlais DC, deVeber GA, Dey S, Dharmaratne SD, Djalalinia S, Do HP, Esteghamati A, Farvid MS, Fereshtehnejad SM, Fischer F, Gebrehiwot TT, Giussani G, Gona PN, Hafezi-Nejad N, Hamadeh RR, Hamidi S, Hoy DG, Hu G, John D, Jonas JB, Karimi SM, Kasaeian A, Khader YS, Khan EA, Khan G, Kim D, Kim YJ, Kinfu Y, Larson HJ, Latif AA, Leasher JL, Lunevicius R, Magdy Abd El Razek H, Magdyabdelrazek M, Majeed A, Malekzadeh R, Memish ZA, Mendoza W, Mezgebe HB, Miller TR, Monasta Let al., 2018, Neonatal, infant, and under-5 mortality and morbidity burden in the Eastern Mediterranean region: findings from the Global Burden of Disease 2015 study, International Journal of Public Health, Vol: 63, Pages: 63-77, ISSN: 1661-8556

© 2017, The Author(s). Objectives: Although substantial reductions in under-5 mortality have been observed during the past 35 years, progress in the Eastern Mediterranean Region (EMR) has been uneven. This paper provides an overview of child mortality and morbidity in the EMR based on the Global Burden of Disease (GBD) study. Methods: We used GBD 2015 study results to explore under-5 mortality and morbidity in EMR countries. Results: In 2015, 755,844 (95% uncertainty interval (UI) 712,064–801,565) children under 5 died in the EMR. In the early neonatal category, deaths in the EMR decreased by 22.4%, compared to 42.4% globally. The rate of years of life lost per 100,000 population under 5 decreased 54.38% from 177,537 (173,812–181,463) in 1990 to 80,985 (76,308–85,876) in 2015; the rate of years lived with disability decreased by 0.57% in the EMR compared to 9.97% globally. Conclusions: Our findings call for accelerated action to decrease child morbidity and mortality in the EMR. Governments and organizations should coordinate efforts to address this burden. Political commitment is needed to ensure that child health receives the resources needed to end preventable deaths.

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Khalil I, El Bcheraoui C, Charara R, Moradi-Lakeh M, Afshin A, Kassebaum NJ, Collison M, Daoud F, Chew A, Krohn KJ, Colombara D, Cornaby L, Ehrenkranz R, Graetz N, Kutz M, Troeger C, Wang H, Abate KH, Abd-Allah F, Abdulle AM, Abera SF, Ahmad Kiadaliri A, Ahmadi A, Ahmed MB, Alam K, Alasfoor D, Alghnam S, Ali R, Alizadeh-Navaei R, Al-Raddadi R, Alsharif U, Altirkawi KA, Anber N, Ansari H, Antonio CAT, Anwari P, Asayesh H, Atey TM, Avila-Burgos L, Barker-Collo SL, Bazargan-Hejazi S, Bedi N, Beyene AS, Bhutta ZA, Boufous S, Butt ZA, Castañeda-Orjuela CA, Chitheer AA, Dalal K, Danawi H, Davitoiu DV, Djalalinia S, Endries AY, Eshrati B, Esteghamati A, Faro A, Farvid MS, Fereshtehnejad SM, Fischer F, Gao W, Gebrehiwot SW, Gebrehiwot TT, Hafezi-Nejad N, Haghparast Bidgoli H, Hailu GB, Hamadeh RR, Hamidi S, Hendrie D, Heredia-Pi IB, Jacobsen KH, James SL, Jayatilleke AU, Jiang G, Jonas JB, Kasaeian A, Keiyoro PN, Khader YS, Khan EA, Khoja ATA, Khosravi A, Khubchandani J, Kim YJ, Kosen S, Defo BK, Larson HJ, Linn S, Lunevicius R, Magdy Abd El Razek H, Magdy Abd El Razek M, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Memiah P, Memish ZA, Mendoza W, Mengistie MA, Meretoja TJ, Miller TR, Mohammed Set al., 2018, Transport injuries and deaths in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 Study, International Journal of Public Health, Vol: 63, Pages: 187-198, ISSN: 1661-8556

© 2017, The Author(s). Objectives: Transport injuries (TI) are ranked as one of the leading causes of death, disability, and property loss worldwide. This paper provides an overview of the burden of TI in the Eastern Mediterranean Region (EMR) by age and sex from 1990 to 2015. Methods: Transport injuries mortality in the EMR was estimated using the Global Burden of Disease mortality database, with corrections for ill-defined causes of death, using the cause of death ensemble modeling tool. Morbidity estimation was based on inpatient and outpatient datasets, 26 cause-of-injury and 47 nature-of-injury categories. Results: In 2015, 152,855 (95% uncertainty interval: 137,900–168,100) people died from TI in the EMR countries. Between 1990 and 2015, the years of life lost (YLL) rate per 100,000 due to TI decreased by 15.5%, while the years lived with disability (YLD) rate decreased by 10%, and the age-standardized disability-adjusted life years (DALYs) rate decreased by 16%. Conclusions: Although the burden of TI mortality and morbidity decreased over the last two decades, there is still a considerable burden that needs to be addressed by increasing awareness, enforcing laws, and improving road conditions.

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Khalil I, Elbcheraoui C, Charara R, Moradi-Lakeh M, Afshin A, Kassebaum NJ, Collison M, Chew A, Krohn KJ, Daoud F, Colombara D, Foreman KJ, Godwin WW, Kutz M, Mirarefin M, Rao PC, Reiner R, Troeger C, Wang H, Abraha HN, Abu-Elyazeed R, Abu-Raddad LJ, Ahmadkiadaliri A, Ahmadi A, Ahmed MB, Alam K, Alizadeh-Navaei R, Al-Raddadi R, Altirkawi KA, Alvis-Guzman N, Anber N, Anwari P, Atey TM, Avokpaho EFGA, Bacha U, Bazargan-Hejazi S, Bedi N, Bensenor IM, Berhane A, Bessong PO, Beyene AS, Bhutta ZA, Buckle GC, Butt ZA, Danawi H, Deribew A, Djalalinia S, Dubey M, Endries AY, Eshrati B, Fereshtehnejad SM, Fischer F, Gebrehiwot TT, Gugnani HC, Hamadeh RR, Hamidi S, Husseini A, James SL, Jonas JB, Khader YS, Khan EA, Khan G, Khubchandani J, Kissoon N, Kopec JA, Koyanagi A, Kuatedefo B, Larson HJ, Latif AA, Lunevicius R, Magdyabdelrazek H, Magdyabdelrazek M, Majdzadeh R, Majeed A, Malekzadeh R, Memiah P, Memish ZA, Mendoza W, Mengistu DT, Mohammed S, Murthy S, Ngunjiri JW, Ogbo FA, Pourmalek F, Qorbani M, Radfar A, Rafay A, Rahimi-Movaghar V, Rai RK, Ram U, Rawaf DL, Rawaf S, Renzaho AMN, Rezaei S, Roshandel G, Safdarian M, Sahraian MA, Salamati P, Samy AM, Sanabria JRet al., 2018, Burden of diarrhea in the Eastern Mediterranean Region, 1990–2015: Findings from the Global Burden of Disease 2015 study, International Journal of Public Health, Vol: 63, Pages: 109-121, ISSN: 1661-8556

© 2017, The Author(s). Objectives: Diarrheal diseases (DD) are an important cause of disease burden, especially in children in low-income settings. DD can also impact children’s potential livelihood through growth faltering, cognitive impairment, and other sequelae. Methods: As part of the Global Burden of Disease study, we estimated DD burden, and the burden attributable to specific risk factors and etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2015. We calculated disability-adjusted life-years (DALYs)—the sum of years of life lost and years lived with disability—for both sexes and all ages. Results: We estimate that over 103,692 diarrhea deaths occurred in the EMR in 2015 (95% uncertainty interval: 87,018–124,692), and the mortality rate was 16.0 deaths per 100,000 persons (95% UI: 13.4–19.2). The majority of these deaths occurred in children under 5 (63.3%) (65,670 deaths, 95% UI: 53,640–79,486). DALYs per 100,000 ranged from 304 (95% UI 228–400) in Kuwait to 38,900 (95% UI 25,900–54,300) in Somalia. Conclusions: Our findings will guide evidence-based health policy decisions for interventions to achieve the ultimate goal of reducing the DD burden.

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Komwong D, Greenfield G, Zaman H, Majeed A, Hayhoe Bet al., 2018, Clinical pharmacists in primary care: a safe solution to the workforce crisis?, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, Vol: 111, Pages: 120-124, ISSN: 0141-0768

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Majeed A, Morgan P, 2018, We need a review of all sepsis deaths, not the conviction of health professionals, BMJ-British Medical Journal, Vol: 360, Pages: k629-k629, ISSN: 1756-1833

JOURNAL ARTICLE

Moradi-Lakeh M, Charara R, El Bcheraoui C, Khalil I, Afshin A, Kassebaum NJ, Collison M, Chew A, Krohn KJ, Daoud F, Colombara D, Graetz N, Kutz M, Wang H, Abd-Allah F, Abu-Raddad LJ, Ahmadkiadaliri A, Ahmed MB, Alam K, Alghnam S, Al-Raddadi R, Altirkawi KA, Anber N, Anwari P, Avila-Burgos L, Awasthi A, Barac A, Barker-Collo SL, Bedi N, Bhutta ZA, Borschmann R, Boufous S, Butt ZA, Castañeda-Orjuela CA, Dalal K, Danawi H, Deleo D, Dharmaratne SD, Djalalinia S, Doyle KE, Esteghamati A, Faro A, Farvid MS, Fereshtehnejad SM, Fischer F, Gebrehiwot TT, Gutiérrez RA, Hafezi-Nejad N, Hamadeh RR, Hamidi S, Haro JM, Hendrie D, Hu G, Jonas JB, Keiyoro PN, Khader YS, Khan EA, Khubchandani J, Kopec JA, Larson HJ, Latif AA, Leshargie CT, Lunevicius R, Magdy Abd El Razek M, Majeed A, Malekzadeh R, Memish ZA, Meretoja TJ, Miller TR, Mohammed S, Obermeyer CM, Ogbo FA, Phillips MR, Pourmalek F, Qorbani M, Radfar A, Rafay A, Rahimi-Movaghar A, Rahimi-Movaghar V, Rai RK, Rawaf DL, Rawaf S, Rezaei S, Rezai MS, Roshandel G, Safdarian M, Safiri S, Salamati P, Samy AM, Sartorius B, Seedat S, Sepanlou SG, Shaikh MA, Sobaih BHA, Tabb KM, Tehrani-Banihashemi A, Temsah MH, Terkawi AS, Topor-Madry R, Ukwaja KNet al., 2018, Intentional injuries in the Eastern Mediterranean Region, 1990–2015: findings from the Global Burden of Disease 2015 study, International Journal of Public Health, Vol: 63, Pages: 39-46, ISSN: 1661-8556

© 2017, The Author(s). Objectives: We used GBD 2015 findings to measure the burden of intentional injuries in the Eastern Mediterranean Region (EMR) between 1990 and 2015. Methods: The Global Burden of Disease (GBD) study defines intentional injuries as a combination of self-harm (including suicide), interpersonal violence, collective violence (war), and legal intervention. We estimated number of deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for each type of intentional injuries. Results: In 2015, 28,695 individuals (95% UI: 25,474–37,832) died from self-harm, 35,626 (95% UI: 20,947–41,857) from interpersonal violence, and 143,858 (95% UI: 63,554–223,092) from collective violence and legal interventions. In 2015, collective violence and legal intervention was the fifth-leading cause of DALYs in the EMR and the leading cause in Syria, Yemen, Iraq, Afghanistan, and Libya; they account for 49.7% of total DALYs in Syria. Conclusions: Our findings call for increased efforts to stabilize the region and assist in rebuilding the health systems, as well as increasing transparency and employing preventive strategies to reduce self-harm and interpersonal injuries.

JOURNAL ARTICLE

Moradi-Lakeh M, El Bcheraoui C, Charara R, Khalil I, Afshin A, Kassebaum NJ, Collison M, Daoud F, Chew A, Krohn KJ, Colombara D, Ehrenkranz R, Foreman KJ, Frostad J, Godwin WW, Kutz M, Rao PC, Reiner R, Troeger C, Wang H, Abajobir AA, Abbas KM, Abera SF, Abu-Raddad LJ, Adane K, Kiadaliri AA, Ahmadi A, Ahmed MB, Al-Eyadhy A, Alam K, Alam N, Alasfoor D, Alizadeh-Navaei R, Al-Maskari F, Al-Raddadi R, Alsharif U, Altirkawi KA, Anber N, Ansari H, Antonio CAT, Anwari P, Asayesh H, Asgedom SW, Atey TM, Arthur Avokpaho EFG, Bacha U, Barac A, Bazargan-Hejazi S, Bedi N, Bhutta ZA, Brauer M, Butt ZA, Castañeda-Orjuela CA, Danawi H, Djalalinia S, Endries AY, Eshrati B, Farvid MS, Fereshtehnejad SM, Fischer F, Garcia-Basteiro AL, Gebrehiwot KT, Gebrehiwot TT, Hailu GB, Hamadeh RR, Hambisa MT, Hamidi S, Hassanvand MS, Hedayati MT, Horita N, Husseini A, James SL, Javanbakht M, Jonas JB, Kasaeian A, Khader YS, Khan EA, Khan G, Khoja ATA, Khubchandani J, Kim YJ, Kissoon N, Larson HJ, Latif AA, Leshargie CT, Lunevicius R, Abd El Razek HM, Abd El Razek MM, Majdzadeh R, Majeed A, Malekzadeh R, Masoudi Farid H, Mehari A, Memish ZA, Mengistu DT, Mezgebe HB, Nakamura S, Oren E, Mahesh PA, Pourmalek Fet al., 2018, Burden of lower respiratory infections in the Eastern Mediterranean Region between 1990 and 2015: findings from the Global Burden of Disease 2015 study, International Journal of Public Health, Vol: 63, Pages: 97-108, ISSN: 1661-8556

© 2017, The Author(s). Objectives: We used data from the Global Burden of Disease 2015 study (GBD) to calculate the burden of lower respiratory infections (LRIs) in the 22 countries of the Eastern Mediterranean Region (EMR) from 1990 to 2015. Methods: We conducted a systematic analysis of mortality and morbidity data for LRI and its specific etiologic factors, including pneumococcus, Haemophilus influenzae type b, Respiratory syncytial virus, and influenza virus. We used modeling methods to estimate incidence, deaths, and disability-adjusted life-years (DALYs). We calculated burden attributable to known risk factors for LRI. Results: In 2015, LRIs were the fourth-leading cause of DALYs, causing 11,098,243 (95% UI 9,857,095–12,396,566) DALYs and 191,114 (95% UI 170,934–210,705) deaths. The LRI DALY rates were higher than global estimates in 2015. The highest and lowest age-standardized rates of DALYs were observed in Somalia and Lebanon, respectively. Undernutrition in childhood and ambient particulate matter air pollution in the elderly were the main risk factors. Conclusions: Our findings call for public health strategies to reduce the level of risk factors in each age group, especially vulnerable child and elderly populations.

JOURNAL ARTICLE

Moradi-Lakeh M, El Bcheraoui C, Khalil I, Charara R, Afshin A, Wang H, Collison M, Krohn KJ, Chew A, Daoud F, Blosser CD, Cornaby L, Foreman KJ, Kassebaum NJ, Kemmer L, Kutz M, Liu P, Zipkin B, Ärnlöv J, Abate KH, Ahmadi A, Ahmadieh H, Ahmed MB, Al-Aly Z, Alam K, Alasfoor D, Ali R, Alizadeh-Navaei R, Alkaabi JM, Alkerwi A, Al-Raddadi R, Altirkawi KA, Alvis-Guzman N, Amini E, Anber N, Anwari P, Asgedom SW, Atey TM, Avila-Burgos L, Awasthi A, Azzopardi P, Bärnighausen T, Bacha U, Barac A, Bazargan-Hejazi S, Bedi N, Berhe DF, Beyene AS, Bhutta ZA, Bikbov B, Birhanu MM, Butt ZA, Cahuana-Hurtado L, Carpenter DO, Carrero JJ, Choi JYJJ, Danawi H, Dharmaratne SD, Ding EL, Djalalinia S, Doyle KE, Ebrahimi H, Endries AY, Esteghamati A, Farvid MS, Fereshtehnejad SM, Feyissa TR, Fischer F, Gebrehiwot TT, Gona PN, Gopalani SV, Horino M, Hsairi M, Jonas MB, Jimenez-Corona A, John D, Jonas JB, Kasaeian A, Kengne AP, Khan EB, Kim D, Kim YJ, Kinfu Y, Kissimova-Skarbek KA, Koyanagi A, Larson HJ, Larsson A, Li Y, Lotufo PA, Lunevicius R, Majeed A, Malekzadeh R, Malta DC, Mazidi M, Memish ZA, Mendoza W, Mengistie MA, Mensah GA, Mezgebe HB, Miller TRet al., 2018, Diabetes mellitus and chronic kidney disease in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study, International Journal of Public Health, Vol: 63, Pages: 177-186, ISSN: 1661-8556

© 2017, The Author(s). Objectives: We used findings from the Global Burden of Disease 2015 study to update our previous publication on the burden of diabetes and chronic kidney disease due to diabetes (CKD-DM) during 1990–2015. Methods: We extracted GBD 2015 estimates for prevalence, mortality, and disability-adjusted life years (DALYs) of diabetes (including burden of low vision due to diabetes, neuropathy, and amputations and CKD-DM for 22 countries of the EMR from the GBD visualization tools. Results: In 2015, 135,230 (95% UI 123,034–148,184) individuals died from diabetes and 16,470 (95% UI 13,977–18,961) from CKD-DM, 216 and 179% increases, respectively, compared to 1990. The total number of people with diabetes was 42.3 million (95% UI 38.6–46.4 million) in 2015. DALY rates of diabetes in 2015 were significantly higher than the expected rates based on Socio-demographic Index (SDI). Conclusions: Our study showed a large and increasing burden of diabetes in the region. There is an urgency in dealing with diabetes and its consequences, and these efforts should be at the forefront of health prevention and promotion.

JOURNAL ARTICLE

Osama T, Brindley D, Majeed A, Murray KA, Shah H, Toumazos M, Van Velthoven M, Car J, Wells G, Meinert Eet al., 2018, Teaching the relationship between health and climate change: a systematic scoping review protocol., BMJ Open, Vol: 8

INTRODUCTION: The observed and projected impacts of climate change on human health are significant. While climate change has gathered global momentum and is taught frequently, the extent to which the relationships between climate change and health are taught remains uncertain. Education provides an opportunity to create public engagement on these issues, but the extent to which historical implementation of climate health education could be leveraged is not well understood. To address this gap, we propose to conduct a scoping review of all forms of teaching that have been used to illustrate the health effects of climate change between 2005 and 2017, coinciding with a turning point in the public health and climate change agendas following the 2005 Group of 7/8 (G7/8) Summit. METHODS AND ANALYSIS: Using Arksey/O'Malley's and Levac's methodological framework, MEDLINE/PubMed, Embase, Scopus, Education Resource Information Centre, Web of Science, Global Health, Health Management Information Consortium, Georef, Ebsco and PROSPERO will be systematically searched. Predetermined inclusion and exclusion criteria will be applied by two independent reviewers to determine study eligibility. Studies published in English and after 2005 only will be examined. Following selection of studies, data will be extracted and analysed. ETHICS AND DISSEMINATION: No ethical approval is required as exclusively secondary data will be used. Our findings will be communicated to the European Institute of Innovation & Technology Health-Knowledge and Innovation Communities to assist in the development of a FutureLearn Massive Open Online Course on the health effects of climate change.

JOURNAL ARTICLE

Owusu ESA, Samanta M, Shaw JE, Majeed A, Khunti K, Paul SKet al., 2018, Weight loss and mortality risk in patients with different adiposity at diagnosis of type 2 diabetes: a longitudinal cohort study., Nutr Diabetes, Vol: 8

BACKGROUND: Undiagnosed comorbid diseases that independently lead to weight loss before type 2 diabetes mellitus (T2DM) diagnosis could explain the observed increased mortality risk in T2DM patients with normal weight. OBJECTIVES: To evaluate the impact of weight change patterns before the diagnosis of T2DM on the association between body mass index (BMI) at diagnosis and mortality risk. METHODS: This was a longitudinal cohort study using 145,058 patients from UK primary care, with newly diagnosed T2DM from January 2000. Patients aged 18-70, without established disease history at diagnosis (defined as the presence of cardiovascular diseases, cancer, and renal diseases on or before diagnosis) were followed up to 2014. Longitudinal 6-monthly measures of bodyweight three years before (used to define groups of patients who lost bodyweight or not before diagnosis) and 2 years after diagnosis were obtained. The main outcome was all-cause mortality. RESULTS: At diagnosis, mean (SD) age was 52 (12) years, 56% were male, 52% were current or ex-smokers, mean BMI was 33 kg/m2, and 66% were obese. Normal weight and overweight patients experienced a small but significant reduction in body weight 6 months before diagnosis. Among all categories of obese patients, consistently increasing body weight was observed within the same time window. Among patients who did not lose body weight pre-diagnosis (n = 117,469), compared with the grade 1 obese, normal weight patients had 35% (95% CI of HR: 1.17, 1.55) significantly higher adjusted mortality risk. However, among patients experiencing weight loss before diagnosis (n = 27,589), BMI at diagnosis was not associated with mortality risk (all p > 0.05). CONCLUSIONS: Weight loss before the diagnosis of T2DM was not associated with the observed increased mortality risk in normal weight patients with T2DM. This emphasises the importance of addressing risk factors post diagnosis for excess mo

JOURNAL ARTICLE

Peters L, Greenfield G, Majeed A, Hayhoe Bet al., 2018, The impact of private online video consulting in primary care, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, Vol: 111, Pages: 162-166, ISSN: 0141-0768

JOURNAL ARTICLE

Razak Y, Newson R, Collins R, Thomas H, Hamid F, Willis T, Majeed Aet al., 2018, Key treatment target achievement in diabetes care uncorrelated to deprivation scores: A case study in West London, Diabetes UK Professional Conference 2018, Publisher: Wiley, Pages: 5-5, ISSN: 0742-3071

CONFERENCE PAPER

Rigby M, Kühne G, Greenfield R, Majeed A, Blair MEet al., 2018, Extent of use of electronic records in children's primary care and public health in Europe, Studies in Health Technology and Informatics, Vol: 247, Pages: 930-934, ISSN: 0926-9630

EHRs are widely seen as a key resource in modern health care. For children not only is primary care vital, but also case-based public health systems can help ensure that all children receive immunisation and other preventive programmes. A European study showed that in 2016 in the 30 EU and EEA countries, 19 countries had widespread use of EHRs in children's primary care, while 20 countries had case-based child public health systems. However, the results show a bias of disadvantage for poorer or smaller countries. More study is needed in this area.

JOURNAL ARTICLE

Rosenberg-Wohl S, Greenfield G, Majeed A, Hayhoe Bet al., 2018, Seven-day access to NHS primary care: how does England compare with Europe?, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, Vol: 111, Pages: 88-91, ISSN: 0141-0768

JOURNAL ARTICLE

Safi S, Ahmadieh H, Katibeh M, Yaseri M, Ramezani A, Shahraz S, Moradi-Lakeh M, Khalil I, Elbcheraoui C, Collison M, Chew A, Daoud F, Krohn KJ, Rankin Z, Afshin A, Kassebaum NJ, Olsen HE, Stanaway JD, Wang H, Wilson K, Abyu GY, Al-Eyadhy A, Alam K, Alasfoor D, Alizadeh-Navaei R, Al-Raddadi R, Alsharif U, Altirkawi KA, Anber N, Ansari H, Anwari P, Asayesh H, Asgedom SW, Atey TM, Bacha U, Barac A, Bedi N, Butt ZA, Chitheer AA, Djalalinia S, Do Phuc H, Eshrati B, Farvid MS, Farzadfar F, Fereshtehnejad SM, Fischer F, Gebrehiwot TT, Hamadeh RR, Hamidi S, Higazi TB, Hsairi M, Jimenez-Corona A, John D, Jonas JB, Kasaeian A, Khader YS, Khan EA, Larson HJ, Latif AA, Lunevicius R, Magdy Abd El Razek H, Magdyabdelrazek M, Majeed A, Malekzadeh R, McAlinden C, Memish ZA, Miller TR, Mohammadi SF, Nangia V, Nguyen CT, Le Nguyen Q, Ogbo FA, Pourmalek F, Qorbani M, Rafay A, Rahimi-Movaghar V, Rai RK, Rana SM, Rawaf DL, Rawaf S, Renzaho AMN, Rezaei S, Roshandel G, Safdarian M, Safiri S, Salamati P, Samy AM, Sartorius B, Sepanlou SG, Shaikh MA, Skiadaresi E, Sobaih BHA, Suliankatchiabdulkader R, Taylor HR, Tehrani-Banihashemi A, Temsah MH, Topor-Madry R, Tran BX, Tsilimbaris M, Ukwaja KNet al., 2018, Burden of vision loss in the Eastern Mediterranean region, 1990–2015: findings from the Global Burden of Disease 2015 study, International Journal of Public Health, Vol: 63, Pages: 199-210, ISSN: 1661-8556

© 2017, The Author(s). Objectives: To report the estimated trend in prevalence and years lived with disability (YLDs) due to vision loss (VL) in the Eastern Mediterranean region (EMR) from 1990 to 2015. Methods: The estimated trends in age-standardized prevalence and the YLDs rate due to VL in 22 EMR countries were extracted from the Global Burden of Disease (GBD) 2015 study. The association of Socio-demographic Index (SDI) with changes in prevalence and YLDs of VL was evaluated using a multilevel mixed model. Results: The age-standardized prevalence of VL in the EMR was 18.2% in 1990 and 15.5% in 2015. The total age-standardized YLDs rate attributed to all-cause VL in EMR was 536.9 per 100,000 population in 1990 and 482.3 per 100,000 population in 2015. For each 0.1 unit increase in SDI, the age-standardized prevalence and YLDs rate of VL showed a reduction of 1.5% (p  <  0.001) and 23.9 per 100,000 population (p  <  0.001), respectively. Conclusions: The burden of VL is high in the EMR; however, it shows a descending trend over the past 25 years. EMR countries need to establish comprehensive eye care programs in their health care systems.

JOURNAL ARTICLE

Tehrani-Banihashemi A, Moradi-Lakeh M, Elbcheraoui C, Charara R, Khalil I, Afshin A, Collison M, Daoud F, Krohn KJ, Chew A, Cornaby L, Foreman KJ, Frostad J, Kassebaum NJ, Kemmer L, Kutz M, Liu P, Mirarefin M, Nguyen G, Wang H, Zipkin B, Abajobir AA, Abouzeid M, Abu-Rmeileh NME, Ahmad Kiadaliri A, Ahmed MB, Aksut B, Alam K, Alasfoor D, Ali R, Alizadeh-Navaei R, Al-Raddadi R, Alsharif U, Altirkawi KA, Alvis-Guzman N, Anber N, Anwari P, Ärnlöv J, Asgedom SW, Atey TM, Awasthi A, Bärnighausen T, Bacha U, Barac A, Barker-Collo SL, Bedi N, Bennett DA, Berhe DF, Biadgilign S, Butt ZA, Carapetis JR, Castro RE, Chitheer AA, Davletov K, Dharmaratne SD, Djalalinia S, Do HP, Dubey M, Ebrahimi H, Eshrati B, Esteghamati A, Farvid MS, Fereshtehnejad SM, Fischer F, Gebrehiwot SW, Gebrehiwot TT, Gillum RF, Gona PN, Gupta R, Hafezi-Nejad N, Hamadeh RR, Hamidi S, Hsairi M, Jee SH, Jonas JB, Karimkhani C, Kasaeian A, Khader YS, Khan EA, Kim D, Lal DK, Larson HJ, Latif AA, Linn S, Lotufo PA, Lunevicius R, Magdyabdelrazek H, Majeed A, Malekzadeh R, Malta DC, Meier T, Memiah P, Memish ZA, Mendoza W, Mensah GA, Meretoja A, Miller TR, Mirrakhimov EM, Mohammed S, Nguyen QLet al., 2018, Burden of cardiovascular diseases in the Eastern Mediterranean Region, 1990–2015: findings from the Global Burden of Disease 2015 study, International Journal of Public Health, Vol: 63, Pages: 137-149, ISSN: 1661-8556

© 2017, The Author(s). Objectives: To report the burden of cardiovascular diseases (CVD) in the Eastern Mediterranean Region (EMR) during 1990–2015. Methods: We used the 2015 Global Burden of Disease study for estimates of mortality and disability-adjusted life years (DALYs) of different CVD in 22 countries of EMR. Results: A total of 1.4 million CVD deaths (95% UI: 1.3–1.5) occurred in 2015 in the EMR, with the highest number of deaths in Pakistan (465,116) and the lowest number of deaths in Qatar (723). The age-standardized DALY rate per 100,000 decreased from 10,080 in 1990 to 8606 in 2015 (14.6% decrease). Afghanistan had the highest age-standardized DALY rate of CVD in both 1990 and 2015. Kuwait and Qatar had the lowest age-standardized DALY rates of CVD in 1990 and 2015, respectively. High blood pressure, high total cholesterol, and high body mass index were the leading risk factors for CVD. Conclusions: The age-standardized DALY rates in the EMR are considerably higher than the global average. These findings call for a comprehensive approach to prevent and control the burden of CVD in the region.

JOURNAL ARTICLE

Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, Marczak L, Mokdad AH, Moradi-Lakeh M, Naghavi M, Salama JS, Vos T, Abate KH, Abbafati C, Ahmed MB, Al-Aly Z, Alkerwi A, Al-Raddadi R, Amare AT, Amberbir A, Amegah AK, Amini E, Amrock SM, Anjana RM, Arnlov J, Asayesh H, Banerjee A, Barac A, Baye E, Bennett DA, Beyene AS, Biadgilign S, Biryukov S, Bjertness E, Boneya DJ, Campos-Nonato I, Carrero JJ, Cecilio P, Cercy K, Ciobanu LG, Cornaby L, Damtew SA, Dandona L, Dandona R, Dharmaratne SD, Duncan BB, Eshrati B, Esteghamati A, Feigin VL, Fernandes JC, Furst T, Gebrehiwot TT, Gold A, Gona PN, Goto A, Habtewold TD, Hadush KT, Hafezi-Nejad N, Hay SI, Horino M, Islami F, Kamal R, Kasaeian A, Katikireddi SV, Kengne AP, Kesavachandran CN, Khader YS, Khang Y-H, Khubchandani J, Kim D, Kim YJ, Kinfu Y, Kosen S, Ku T, Defo BK, Kumar GA, Larson HJ, Leinsalu M, Liang X, Lim SS, Liu P, Lopez AD, Lozano R, Majeed A, Malekzadeh R, Malta DC, Mazidi M, McAlinden C, McGarvey ST, Mengistu DT, Mensah GA, Mensink GBM, Mezgebe HB, Mirrakhimov EM, Mueller UO, Noubiap JJ, Obermeyer CM, Ogbo FA, Owolabi MO, Patton GC, Pourmalek F, Qorbani M, Rafay A, Rai RK, Ranabhat CL, Reinig N, Safiri S, Salomon JA, Sanabria JR, Santos IS, Sartorius B, Sawhney M, Schmidhuber J, Schutte AE, Schmidt MI, Sepanlou SG, Shamsizadeh M, Sheikhbahaei S, Shin M-J, Shiri R, Shiue I, Roba HS, Silva DAS, Silverberg JI, Singh JA, Stranges S, Swaminathan S, Tabares-Seisdedos R, Tadese F, Tedla BA, Tegegne BS, Terkawi AS, Thakur JS, Tonelli M, Topor-Madry R, Tyrovolas S, Ukwaja KN, Uthman OA, Vaezghasemi M, Vasankari T, Vlassov VV, Vollset SE, Weiderpass E, Werdecker A, Wesana J, Westerman R, Yano Y, Yonemoto N, Yonga G, Zaidi Z, Zenebe ZM, Zipkin B, Murray CJLet al., 2017, Health Effects of Overweight and Obesity in 195 Countries over 25 Years, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 377, Pages: 13-27, ISSN: 0028-4793

JOURNAL ARTICLE

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