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dc.contributor.authorTroeger, Christopheren
dc.contributor.authorBlacker, Brigetteen
dc.contributor.authorKhalil, Ibrahim Aen
dc.contributor.authorRao, Puja Cen
dc.contributor.authorCao, Jackieen
dc.contributor.authorZimsen, Stephanie R Men
dc.contributor.authorAlbertson, Samuel Ben
dc.contributor.authorDeshpande, Aniruddhaen
dc.contributor.authorFarag, Tameren
dc.contributor.authorAbebe, Zegeyeen
dc.contributor.authorAdetifa, Ifedayo Morayo Oen
dc.contributor.authorAdhikari, Tara Ballaven
dc.contributor.authorAkibu, Mohammeden
dc.contributor.authorAl Lami, Faris Hasanen
dc.contributor.authorAl-Eyadhy, Aymanen
dc.contributor.authorAlvis-Guzman, Nelsonen
dc.contributor.authorAmare, Azmeraw Ten
dc.contributor.authorAmoako, Yaw Ampemen
dc.contributor.authorAntonio, Carl Abelardo Ten
dc.contributor.authorAremu, Olatundeen
dc.contributor.authorAsfaw, Ephrem Tsegayen
dc.contributor.authorAsgedom, Solomon Weldegebrealen
dc.contributor.authorAtey, Tesfay Meharien
dc.contributor.authorAttia, Engi Farouken
dc.contributor.authorAvokpaho, Euripide Frinel G Arthuren
dc.contributor.authorAyele, Henok Tadesseen
dc.contributor.authorAyuk, Tambe Betranden
dc.contributor.authorBalakrishnan, Kalpanaen
dc.contributor.authorBarac, Aleksandraen
dc.contributor.authorBassat, Quiqueen
dc.contributor.authorBehzadifar, Masouden
dc.contributor.authorBehzadifar, Meysamen
dc.contributor.authorBhaumik, Soumyadeepen
dc.contributor.authorBhutta, Zulfiqar Aen
dc.contributor.authorBijani, Alien
dc.contributor.authorBrauer, Michaelen
dc.contributor.authorBrown, Alexandriaen
dc.contributor.authorCamargos, Paulo A Men
dc.contributor.authorCastaneda-Orjuela, Carlos Aen
dc.contributor.authorColombara, Dannyen
dc.contributor.authorConti, Saraen
dc.contributor.authorDadi, Abel Fekaduen
dc.contributor.authorDandona, Laliten
dc.contributor.authorDandona, Rakhien
dc.contributor.authorDo, Huyen Phucen
dc.contributor.authorDubljanin, Eleonoraen
dc.contributor.authorEdessa, Dumessaen
dc.contributor.authorElkout, Hajeren
dc.contributor.authorEndries, Aman Yesufen
dc.contributor.authorFijabi, Daniel Obadareen
dc.contributor.authorForeman, Kyle Jen
dc.contributor.authorForouzanfar, Mohammad Hen
dc.contributor.authorFullman, Nancyen
dc.contributor.authorGarcia-Basteiro, Alberto Len
dc.contributor.authorGessner, Bradford Den
dc.contributor.authorGething, Peter Wen
dc.contributor.authorGupta, Rahulen
dc.contributor.authorGupta, Tarunen
dc.contributor.authorHailu, Gessessew Bugssaen
dc.contributor.authorHassen, Hamid Yimamen
dc.contributor.authorHedayati, Mohammad Ten
dc.contributor.authorHeidari, Mohsenen
dc.contributor.authorHibstu, Desalegn Tsegawen
dc.contributor.authorHorita, Nobuyukien
dc.contributor.authorSIlesanmi, Olayinkaen
dc.contributor.authorJakovljevic, Mihajlo Ben
dc.contributor.authorJamal, Amr Aen
dc.contributor.authorKahsay, Amahaen
dc.contributor.authorKasaeian, Amiren
dc.contributor.authorKassa, Dessalegn Haileen
dc.contributor.authorKhader, Yousef Salehen
dc.contributor.authorKhan, Ejaz Ahmaden
dc.contributor.authorKhan, Md Nuruzzamanen
dc.contributor.authorKhang, Young-Hoen
dc.contributor.authorKim, Yun Jinen
dc.contributor.authorKissoon, Niranjanen
dc.contributor.authorKnibbs, Luke Den
dc.contributor.authorKochhar, Sonalien
dc.contributor.authorKoul, Parvaiz Aen
dc.contributor.authorKumar, G Anilen
dc.contributor.authorLodha, Rakeshen
dc.contributor.authorEl Razek, Hassan Magdy Abden
dc.contributor.authorMalta, Deborah Carvalhoen
dc.contributor.authorMathew, Joseph Len
dc.contributor.authorMengistu, Desalegn Tadeseen
dc.contributor.authorMezgebe, Haftay Berhaneen
dc.contributor.authorMohammad, Karzan Abdulmuhsinen
dc.contributor.authorMohammed, Mohammed Aen
dc.contributor.authorMomeniha, Fatemehen
dc.contributor.authorMurthy, Srinivasen
dc.contributor.authorNguyen, Cuong Taten
dc.contributor.authorNielsen, Katie Ren
dc.contributor.authorNingrum, Dina Nur Anggrainien
dc.contributor.authorNirayo, Yirga Legesseen
dc.contributor.authorOren, Eyalen
dc.contributor.authorOrtiz, Justin Ren
dc.contributor.authorPa, Maheshen
dc.contributor.authorPostma, Maarten Jen
dc.contributor.authorQorbani, Mostafaen
dc.contributor.authorQuansah, Reginalden
dc.contributor.authorRai, Rajesh Kumaren
dc.contributor.authorRana, Saleem Men
dc.contributor.authorRanabhat, Chhabi Lalen
dc.contributor.authorRay, Sarah Een
dc.contributor.authorRezai, Mohammad Sadeghen
dc.contributor.authorRuhago, George Mugambageen
dc.contributor.authorSafiri, Saeiden
dc.contributor.authorSalomon, Joshua Aen
dc.contributor.authorSartorius, Bennen
dc.contributor.authorSavic, Milojeen
dc.contributor.authorSawhney, Monikaen
dc.contributor.authorShe, Junen
dc.contributor.authorSheikh, Azizen
dc.contributor.authorShiferaw, Mekonnen Sisayen
dc.contributor.authorShigematsu, Mikaen
dc.contributor.authorSingh, Jasvinder Aen
dc.contributor.authorSomayaji, Ranjanien
dc.contributor.authorStanaway, Jeffrey Den
dc.contributor.authorSufiyan, Muawiyyah Babaleen
dc.contributor.authorTaffere, Getachew Redaeen
dc.contributor.authorTemsah, Mohamad-Hanien
dc.contributor.authorThompson, Matthew Jen
dc.contributor.authorTobe-Gai, Ruoyanen
dc.contributor.authorTopor-Madry, Romanen
dc.contributor.authorTran, Bach Xuanen
dc.contributor.authorTran, Tung Thanhen
dc.contributor.authorTuem, Kald Beshiren
dc.contributor.authorUkwaja, Kingsley Nnannaen
dc.contributor.authorVollset, Stein Emilen
dc.contributor.authorWalson, Judd Len
dc.contributor.authorWeldegebreal, Fitsumen
dc.contributor.authorWest, Andrea Werdecker T Eoinen
dc.contributor.authorYonemoto, Naohiroen
dc.contributor.authorZaki, Maysaa El Sayeden
dc.contributor.authorZhou, Leien
dc.contributor.authorZodpey, Sanjayen
dc.contributor.authorVos, Theoen
dc.contributor.authorNaghavi, Mohsenen
dc.contributor.authorLim, Stephen Sen
dc.contributor.authorMokdad, Ali Hen
dc.contributor.authorMurray, Christopher J Len
dc.contributor.authorHay, Simon Ien
dc.contributor.authorReiner Jr, Robert Cen
dc.date.accessioned2019-03-05T03:39:53Z
dc.date.available2019-03-05T03:39:53Z
dc.date.issued2018-09-19
dc.identifier.citationTroeger, C., Blacker, B., Khalil, I. A., Rao, P. C., Cao, J., Zimsen, S. R. M., … Reiner, R. C., Jr. (2018). Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Infectious Diseases, 18(11), 1191–1210. https://doi.org/10.1016/s1473-3099(18)30310-4en_US
dc.identifier.issn1473-3099
dc.identifier.urihttp://hdl.handle.net/2328/39068
dc.descriptionCopyright © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.en_US
dc.description.abstractBackground Lower respiratory infections are a leading cause of morbidity and mortality around the world. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, provides an up-to-date analysis of the burden of lower respiratory infections in 195 countries. This study assesses cases, deaths, and aetiologies spanning the past 26 years and shows how the burden of lower respiratory infection has changed in people of all ages. Methods We used three separate modelling strategies for lower respiratory infections in GBD 2016: a Bayesian hierarchical ensemble modelling platform (Cause of Death Ensemble model), which uses vital registration, verbal autopsy data, and surveillance system data to predict mortality due to lower respiratory infections; a compartmental meta-regression tool (DisMod-MR), which uses scientific literature, population representative surveys, and health-care data to predict incidence, prevalence, and mortality; and modelling of counterfactual estimates of the population attributable fraction of lower respiratory infection episodes due to Streptococcus pneumoniae, Haemophilus influenzae type b, influenza, and respiratory syncytial virus. We calculated each modelled estimate for each age, sex, year, and location. We modelled the exposure level in a population for a given risk factor using DisMod-MR and a spatio-temporal Gaussian process regression, and assessed the effectiveness of targeted interventions for each risk factor in children younger than 5 years. We also did a decomposition analysis of the change in LRI deaths from 2000–16 using the risk factors associated with LRI in GBD 2016. Findings In 2016, lower respiratory infections caused 652 572 deaths (95% uncertainty interval [UI] 586 475–720 612) in children younger than 5 years (under-5s), 1 080 958 deaths (943 749–1 170 638) in adults older than 70 years, and 2 377 697 deaths (2 145 584–2 512 809) in people of all ages, worldwide. Streptococcus pneumoniae was the leading cause of lower respiratory infection morbidity and mortality globally, contributing to more deaths than all other aetiologies combined in 2016 (1 189 937 deaths, 95% UI 690 445–1 770 660). Childhood wasting remains the leading risk factor for lower respiratory infection mortality among children younger than 5 years, responsible for 61·4% of lower respiratory infection deaths in 2016 (95% UI 45·7–69·6). Interventions to improve wasting, household air pollution, ambient particulate matter pollution, and expanded antibiotic use could avert one under-5 death due to lower respiratory infection for every 4000 children treated in the countries with the highest lower respiratory infection burden. Interpretation Our findings show substantial progress in the reduction of lower respiratory infection burden, but this progress has not been equal across locations, has been driven by decreases in several primary risk factors, and might require more effort among elderly adults. By highlighting regions and populations with the highest burden, and the risk factors that could have the greatest effect, funders, policy makers, and programme implementers can more effectively reduce lower respiratory infections among the world's most susceptible populations.en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.rightsCopyright © The Author(s).en_US
dc.subjectLower respiratory infectionsen_US
dc.subjectGlobal Burden of Diseases, Injuries, and Risk Factors (GBD)en_US
dc.subjectStreptococcus pneumoniaeen_US
dc.subjectmorbidityen_US
dc.subjectmortalityen_US
dc.titleEstimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016en_US
dc.typeArticleen_US
dc.identifier.doihttps://doi.org/10.1016/S1473-3099(18)30310-4en_US
dc.rights.holderThe Author(s).en_US
dc.rights.licenseCC-BY


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