The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990–2019: a systematic analysis of the Global Burden of Disease Study 2019

Azzopardi P.S. Kerr J.A. Francis K.L. Sawyer S.M. Kennedy E.C. Steer A.C. Graham S.M. Viner R.M. Ward J.L. Hennegan J. Pham M.D. Habito C.M.D. Kurji J. Cini K.I. Beeson J.G. Brown A. Murray C.J.L. Abbasi-Kangevari M. Abolhassani H. Adekanmbi V. Agampodi S.B. Ahmed M.B. Ajami M. Akbarialiabad H. Akbarzadeh-Khiavi M. AL-Ahdal T.M.A. Ali M.M. Samakkhah S.A. Alimohamadi Y. Alipour V. Al-Jumaily A. Amiri S. Amirzade-Iranaq M.H. Anoushiravani A. Anvari D. Arabloo J. Arab-Zozani M. Arkew M. Armocida B. Asadi-Pooya A.A. Asemi Z. Asgary S. Athari S.S. Azami H. Azangou-Khyavy M. Azizi H. Bagheri N. Bagherieh S. Barone-Adesi F. Barteit S. Basu S. Belete M.A. Belo L. Berhie A.Y. Bijani A. Bikbov B. Burkart K. Carreras G. Charalampous P. Abebe E.C. Cruz-Martins N. Dai X. Dandona L. Dandona R. Degualem S.M. Demetriades A.K. Demlash A.A. Desta A.A. Dianatinasab M. Doaei S. Dorostkar F. Effendi D.E. Emami A. Bain L.E. Eskandarieh S. Esmaeilzadeh F. Faramarzi A. Fatehizadeh A. Ferrara P. Fetensa G. Fischer F. Flor L.S. Forouhari A. Foroutan M. Gaihre S. Galehdar N. Gallus S. Gautam R.K. Gebrehiwot M. Gebremeskel T.G. Getacher L. Getachew M.E. Ghamari S.-H. Nour M.G. Goleij P. Golitaleb M. Gorini G. Gupta V.K. Hashemian M. Hassankhani H. Heidari M. Heyi D.Z. Isola G. Jaafari J. Javanmardi F. Jonas J.B. Jozwiak J.J. Jürisson M. Kabir A. Kabir Z. Kalankesh L.R. Kalhor R. Kauppila J.H. Kaur H. Kayode G.A. Keikavoosi-Arani L. Khammarnia M. Khan M.A.B. Khatab K. Kashani H.R.K. Kolahi A.-A. Koohestani H.R. Koyanagi A. Kumar G.A. Kurmi O.P. Kyu H.H. Vecchia C.L. Lallukka T. Lim S.S. Loureiro J.A. Mahjoub S. Mahmoudi R. Majeed A. Rad E.M. Maleki A. Mansour-Ghanaei F. Marjani A. Mathioudakis A.G. Mehri F. Mentis A.F. Mestrovic T. Mirica A. Misganaw A. Mohammadian-Hafshejani A. Mohammed H. Mohammed S. Mokdad A.H. Mokhtarzadehazar P. Monasta L. Moradi M. Moradzadeh M. Morovatdar N. Mueller U.O. Mulita F. Mulu G.B.B. Muthupandian S. Naik G.R. Nashwan A.J.J. Nejadghaderi S.A. Netsere H.B. Noor N.M. Noori M. Oancea B. Oguntade A.S. Okati-Aliabad H. Otoiu A. Padron-Monedero A. Pakzad R. Pandey A. Pardhan S. Parikh R.R. Patel J. Pensato U. Peprah P. Perico N. Poddighe D. Postma M.J. Rahim F. Rahimi-Movaghar V. Rahmani S. Rahmanian V. Rawaf S. Razeghian-Jahromi I. Regasa M.T. Remuzzi G. Rezaeian M. Riad A. Romero-Rodríguez E. Ronfani L. Pramanik K.R. Sabour S. Sadeghian S. Saeb M.R. Safary A. Sahebkar A. Sahiledengle B. Samadzadeh S. Sarveazad A. Sethi Y. Shahabi S. Shahraki-Sanavi F. Shams-Beyranvand M. Sharafi K. Sharew N.T. Sheikh A. Sheikhi R.A. Shiri R. Socea B. Soltani-Zangbar M.S. Tabarés-Seisdedos R. Tabatabai S. Soodejani M.T. Oliaee R.T. Tiyuri A. Tovani-Palone M.R. Tualeka A.R. Valizadeh R. Van den Eynde J. Vasankari T.J. Vos T. Walde M.T. Wang Y. Wei F.-L. Westerman R. Yadav V. Yaya S. Zare I. Zhu B. Zoladl M. Zumla A. Hay S.I. Patton G.C.
22 July 2023 Elsevier B.V.

The Lancet
2023 #402 Issue 10398 313 - 335 pp.

Background: Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies remain aligned with targets for intervention. This knowledge is especially important for policy and programmes in the context of the COVID-19 pandemic. We aimed to use the Global Burden of Disease (GBD) Study 2019 to systematically characterise the burden of communicable diseases across childhood and adolescence. Methods: In this systematic analysis of the GBD study from 1990 to 2019, all communicable diseases and their manifestations as modelled within GBD 2019 were included, categorised as 16 subgroups of common diseases or presentations. Data were reported for absolute count, prevalence, and incidence across measures of cause-specific mortality (deaths and years of life lost), disability (years lived with disability [YLDs]), and disease burden (disability-adjusted life-years [DALYs]) for children and adolescents aged 0–24 years. Data were reported across the Socio-demographic Index (SDI) and across time (1990–2019), and for 204 countries and territories. For HIV, we reported the mortality-to-incidence ratio (MIR) as a measure of health system performance. Findings: In 2019, there were 3·0 million deaths and 30·0 million years of healthy life lost to disability (as measured by YLDs), corresponding to 288·4 million DALYs from communicable diseases among children and adolescents globally (57·3% of total communicable disease burden across all ages). Over time, there has been a shift in communicable disease burden from young children to older children and adolescents (largely driven by the considerable reductions in children younger than 5 years and slower progress elsewhere), although children younger than 5 years still accounted for most of the communicable disease burden in 2019. Disease burden and mortality were predominantly in low-SDI settings, with high and high-middle SDI settings also having an appreciable burden of communicable disease morbidity (4·0 million YLDs in 2019 alone). Three cause groups (enteric infections, lower-respiratory-tract infections, and malaria) accounted for 59·8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence. HIV was the only cause for which disease burden increased over time, particularly in children and adolescents older than 5 years, and especially in females. Excess MIRs for HIV were observed for males aged 15–19 years in low-SDI settings. Interpretation: Our analysis supports continued policy focus on enteric infections and lower-respiratory-tract infections, with orientation to children younger than 5 years in settings of low socioeconomic development. However, efforts should also be targeted to other conditions, particularly HIV, given its increased burden in older children and adolescents. Older children and adolescents also experience a large burden of communicable disease, further highlighting the need for efforts to extend beyond the first 5 years of life. Our analysis also identified substantial morbidity caused by communicable diseases affecting child and adolescent health across the world. Funding: The Australian National Health and Medical Research Council Centre for Research Excellence for Driving Investment in Global Adolescent Health and the Bill & Melinda Gates Foundation.

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Centre for Adolescent Health, Population Health Theme, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
Infection and Immunity Theme, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
Maternal, Child and Adolescent Health Program, International Development Discipline, Burnet Institute, Melbourne, VIC, Australia
Adolescent Health and Wellbeing, Telethon Kids Institute, Adelaide, SA, Australia
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
School of Public Health and Preventive Medicine, Australia
Central Clinical School, Department of Microbiology, Monash University, Melbourne, VIC, Australia
UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
Medical Research Council Clinical Trials Unit, University College London, London, United Kingdom
Institute of Cardiovascular Science, United Kingdom
Department of Infection, University College London, London, United Kingdom
Department of Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
National Centre for Indigenous Genomics, Australian National University, Canberra, ACT, Australia
Department of Indigenous Genomics, Telethon Kids Institute, Adelaide, SA, Australia
Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Pediatric Cardiology, Tehran University of Medical Sciences, Tehran, Iran
Department of Environmental Health Engineering, Tehran University of Medical Sciences, Tehran, Iran
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Biosciences and Nutrition, Karolinska University Hospital, Huddinge, Sweden
Department of Obstetrics and Gynecology, University of Texas, Galveston, TX, United States
Department of Community Medicine, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
Department of New Initiatives, International Vaccine Institute, Seoul, South Korea
Department of Epidemiology, Jimma University, Jimma, Ethiopia
Department of Public Health, Jimma University, Jimma, Ethiopia
Australian Center for Precision Health, University of South Australia, Adelaide, SA, Australia
Department of Food and Nutrition Policy and Planning Research, National Institute of Nutrition, Tehran, Iran
National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Community Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Public Health and Community Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
Microbiology Department of Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Parasitology and Mycology, Shiraz University of Medical Sciences, Shiraz, Iran
Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Department of Immunology, Tabriz University of Medical Sciences, Tabriz, Iran
Institute of Global Health, Eijkman Institute for Molecular Biology, Heidelberg, Germany
School of Medical Laboratory Sciences, Hawassa University, Hawassa, Ethiopia
Department of Food Hygiene, Amol University of Special Modern Technologies, Amol, Iran
Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Health Management and Economics Research Center, Tehran, Iran
Department of Health Economics, Tehran, Iran
Department of Medical Laboratory Sciences, Tehran, Iran
Minimally Invasive Surgery Research Center, Tehran, Iran
Student Research Committee, Tehran, Iran
Colorectal Research Center, Tehran, Iran
Department of Epidemiology and Biostatistics, Tehran, Iran
Iran University of Medical Sciences, Tehran, Iran
School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, Australia
Information and Communication Sciences and Technologies Pole, Mathematics, Algorithms and Decision Team, ENSTA Bretagne, Brest, France
Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
Department of Parasitology, Iranshahr University of Medical Sciences, Iranshahr, Iran
Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
Department of Epidemiology and Biostatistics, Birjand University of Medical Sciences, Birjand, Iran
Department of Medical Laboratory Sciences, Haramaya University, Haramaya, Ethiopia
Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, National Institute of Health, Rome, Italy
Neurology Department, Thomas Jefferson University, Philadelphia, PA, United States
Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
National Agency for Strategic Research in Medical Education (NASRME), Ministry of Health and Medical Education, Tehran, Iran
Department of Immunology, Zanjan University of Medical Sciences, Zanjan, Iran
Department of Medical-Surgical Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
Department of Health in Disasters and Emergencies, Shahrekord University of Medical Sciences, Shahrekord, Iran
School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Department of Environmental Health Engineering, Isfahan University of Medical Sciences, Isfahan, Iran
Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
Emergency Department, Isfahan University of Medical Sciences, Isfahan, Iran
Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
Center for Primary Care, Harvard University, Boston, MA, United States
Division of General Internal Medicine, Harvard University, Boston, MA, United States
School of Public Health, Imperial College London, London, United Kingdom
Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
The George Institute for Global Health, Imperial College London, London, United Kingdom
Medical Laboratory Science, Wollo University, Dessie, Ethiopia
Department of Environmental Health, Wollo University, Dessie, Ethiopia
Biological Sciences Department
Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), University of Porto, Porto, Portugal
School of Health Science, Bahir Dar University, Bahir Dar, Ethiopia
College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
Cellular and Molecular Biology Research Center, Babol University of Medical Sciences, Babol, Iran
Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
Scientific-Tools.Org, Bergamo, Italy
Institute for Health Metrics and Evaluation, School of Medicine, University of Washington, Seattle, WA, United States
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
Oncological Network, Florence, Italy
Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
Department of Medical Biochemistry, Debre Tabor University, Debre Tabor, Ethiopia
Therapeutic and Diagnostic Technologies, Cooperativa de Ensino Superior Politécnico e Universitário (Polytechnic and University Higher Education Cooperative), Gandra, Portugal
National Institute for Health and Care Research- Biomedical Research Centre, University College London Hospitals, London, United Kingdom
Department of Research, Gurugram, India
Public Health Foundation of India, Gurugram, India
Indian Council of Medical Research, New Delhi, India
Department of Nursing, Arba Minch University, Arba Minch, Ethiopia
Department of Neurosurgery, University of Edinburgh, Edinburgh, United Kingdom
Global Health Governance Programme, University of Edinburgh, Edinburgh, United Kingdom
Centre for Medical Informatics, University of Edinburgh, Edinburgh, United Kingdom
Department of Neurosurgery, National Health Service (NHS) Scotland, Edinburgh, United Kingdom
Department of Surgical Nursing, University of Gondar, Gondar, Ethiopia
School of Nursing, University of Gondar, Gondar, Ethiopia
Department of Epidemiology, Maastricht University, Maastricht, Netherlands
School of Health, Guilan University of Medical Sciences, Rasht, Iran
Department of Environmental Health Engineering, Guilan University of Medical Sciences, Rasht, Iran
Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia (BRIN), Jakarta, Indonesia
Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, United Kingdom
Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
Research Center on Public Health, University of Milan Bicocca, Monza, Italy
Department of Nursing, Wollega University, Nekemte, Ethiopia
Department of Public Health, Wollega University, Nekemte, Ethiopia
Department of Midwifery, Wollega University, Nekemte, Ethiopia
Institute of Public Health, Finland
Department of Neurology, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany
Department of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
Department of Medical Parasitology, Abadan University of Medical Sciences, Abadan, Iran
Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
Institute of Applied Health Sciences, Aberdeen, United Kingdom
Department of Surgical Technology, Lorestan University of Medical Sciences, Khorramabad, Iran
Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
Department of Pharmacology, Indore Institute of Pharmacy, Indore, India
Discipline of Population Health, Flinders University, Adelaide, SA, Australia
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
Department of Reproductive Health, Aksum University, Aksum, Ethiopia
Department of Public Health, Debre Berhan University, Debre Berhan, Ethiopia
Department of Pediatrics and Child Health, Debre Berhan University, Debre Berhan, Ethiopia
Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia
E-Learning Center, Mashhad University of Medical Sciences, Mashhad, Iran
Clinical Research Development Unit, Mashhad University of Medical Sciences, Mashhad, Iran
Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Department of Genetics, Sana Institute of Higher Education, Sari, Iran
Department of Nursing, Arak University of Medical Sciences, Arak, Iran
Biorefining and Advanced Materials Research Center, Scotlands Rural College (SRUC), Edinburgh, United Kingdom
Biology Department, Utica University, Utica, NY, United States
Independent Consultant, Tabriz, Iran
Department of Public Health, Madda Walabu University, Bale Robe, Ethiopia
Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
Department of Ophthalmology, Heidelberg University, Mannheim, Germany
Department of Family Medicine and Public Health, University of Opole, Opole, Poland
Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
School of Public Health, University College Cork, Cork, Ireland
Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
Department of Food Hygiene and Safety, Qazvin University of Medical Sciences, Qazvin, Iran
Surgery Research Unit, University of Oulu, Oulu, Finland
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands
Department of Healthcare Services Management, Alborz University of Medical Sciences, Karaj, Iran
School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
Primary Care Department, NHS North West London, London, United Kingdom
Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom
College of Arts and Sciences, Ohio University, Zanesville, OH, United States
Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
Biomedical Research Networking Center for Mental Health Network (CIBERSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
Department of Medicine, McMaster University, Hamilton, ON, Canada
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
Department of Public Health, University of Helsinki, Helsinki, Finland
School of Health, Polytechnic Institute of Porto, Porto, Portugal
Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
Department of Biochemistry, Golestan University of Medical Sciences, Gorgan, Iran
Joint, Bone, Connective Tissue, Rheumatology Research Center (JBCRC), Golestan University of Medical Sciences, Gorgan, Iran
Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom
Nutrition Health Research Center, Iran University of Medical Sciences, Hamadan, Iran
International Dx Department, BGI Genomics, Copenhagen, Denmark
University Centre Varazdin, University North, Varazdin, Croatia
Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
National Data Management Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Department of Public Health, Dire Dawa University, Dire Dawa, Ethiopia
Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
Department of Health Care Management, Technical University of Berlin, Berlin, Germany
School of Medicine, Urmia, Iran
Urmia University of Medical Sciences, Urmia, Iran
Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
Competence Center of Mortality-Follow-Up of the German National Cohort, Germany
Federal Institute for Population Research, Wiesbaden, Germany
Center for Population and Health, Wiesbaden, Germany
Department of Surgery, General University Hospital of Patras, Patras, Greece
School of Medicine, University of Thessaly, Larissa, Greece
Department of Medical Microbiology and Immunology, Mekelle University, Mekelle, Ethiopia
Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
Department of Engineering, Western Sydney University, Sydney, NSW, Australia
Department of Nursing Education and Research, Hamad Medical Corporation, Doha, Qatar
Department of Epidemiology, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran
Department of Gastroenterology, Cambridge University Hospitals, Cambridge, United Kingdom
Department of Applied Economics and Quantitative Analysis, University of Bucharest, Bucharest, Romania
Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
National School of Public Health, Institute of Health Carlos III, Madrid, Spain
Department of Epidemiology, Ilam University of Medical Sciences, Ilam, Iran
Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
Department of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN, United States
School of Dentistry, University of Leeds, Leeds, United Kingdom
Department of Neurology, IRCCS Humanitas Research Hospital, Milan, Italy
Centre for Primary Health Care and Equity, University of New South Wales, Kensington, NSW, Australia
Mario Negri Institute for Pharmacological Research, Bergamo, Italy
School of Medicine, Nazarbayev University, Astana, Kazakhstan
Clinical Academic Department of Pediatrics, University Medical Center (UMC), Astana, Kazakhstan
University Medical Center Groningen, Netherlands
Interdisciplinary Centre Psychopathology and Emotion Regulation (ICPE), University of Groningen, Groningen, Netherlands
Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran (Padjadjaran University), Bandung, Indonesia
Department of Anesthesia, Cihan University of Sulaimaniya, Sulaimaniya, Iraq
Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
Academic Public Health England, Public Health England, London, United Kingdom
Department of Epidemiology and Biostatistics, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
Department of Public Health, Masaryk University, Brno, Czech Republic
Czech National Centre for Evidence-based Healthcare and Knowledge Translation, Masaryk University, Brno, Czech Republic
Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
Department of Biostatistics and Epidemiology, International Institute for Population Sciences, Mumbai, India
Department of Pediatric Neurology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Department of Polymer Technology, Gdask University of Technology, Gdansk, Poland
Department of Neurology, University of Southern Denmark, Odense, Denmark
Department of Medicine and Surgery, Government Doon Medical College, Dehradun, India
Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
Finnish Institute of Occupational Health, Helsinki, Finland
Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Surgery, Sfântul Pantelimon Emergency Clinical Hospital Bucharest, Bucharest, Romania
Department of Medicine, University of Valencia, Valencia, Spain
Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
Department of Biostatistics and Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Modestum LTD, Eastbourne, United Kingdom
Department Occupational Health and Safety, Universitas Airlngga, Surabaya, Indonesia
Department of Cardiovascular Sciences, Katholieke Universiteit Leuven (University of Leuven), Leuven, Belgium
UKK Institute, Tampere, Finland
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
Department of Mental Health and Psychiatry, Haramaya University, Harar, Ethiopia
School of Population Health and Environmental Sciences, Kings College London, London, United Kingdom
Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xian, China
Department of Environmental Health and Epidemiology, National Institute for Research in Environmental Health, Bhopal, India
School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
Research and Development Department, Sina Medical Biochemistry Technologies, Shiraz, Iran
School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China

Centre for Adolescent Health
Department of Paediatrics
Melbourne School of Population and Global Health
Infection and Immunity Theme
Maternal
Adolescent Health and Wellbeing
Department of Psychological Medicine
School of Public Health and Preventive Medicine
Central Clinical School
UCL Great Ormond Street Institute of Child Health
Medical Research Council Clinical Trials Unit
Institute of Cardiovascular Science
Department of Infection
Department of Aboriginal Health Equity
School of Epidemiology and Public Health
National Centre for Indigenous Genomics
Department of Indigenous Genomics
Non-Communicable Diseases Research Center
Research Center for Immunodeficiencies
Universal Scientific Education and Research Network (USERN)
Digestive Diseases Research Institute
Department of Epidemiology and Biostatistics
Multiple Sclerosis Research Center
Department of Pediatric Cardiology
Department of Environmental Health Engineering
Sina Trauma and Surgery Research Center
Department of Biosciences and Nutrition
Department of Obstetrics and Gynecology
Department of Community Medicine
Department of New Initiatives
Department of Epidemiology
Department of Public Health
Australian Center for Precision Health
Department of Food and Nutrition Policy and Planning Research
National Nutrition and Food Technology Research Institute
Research Institute of Dental Sciences
Social Determinants of Health Research Center
Department of Community Nutrition
Department of Neurosurgery
School of Medicine
Department of Epidemiology
Department of Medical Education
Department of Public Health and Community Medicine
Epilepsy Research Center
Department of Epidemiology
Microbiology Department of Burn and Wound Healing Research Center
Student Research Committee
Department of Otolaryngology
Burn and Wound Healing Research Center
Cardiovascular Research Center
Health Policy Research Center
Department of Parasitology and Mycology
Basic Sciences in Infectious Diseases Research Center
Liver and Gastrointestinal Diseases Research Center
Research Center of Psychiatry and Behavioral Sciences
School of Nursing and Midwifery
Connective Tissue Diseases Research Center
Department of Immunology
Institute of Global Health
School of Medical Laboratory Sciences
Department of Food Hygiene
Health Research Center
Quran and Hadith Research Center
Health Management and Economics Research Center
Department of Health Economics
Department of Medical Laboratory Sciences
Minimally Invasive Surgery Research Center
Student Research Committee
Colorectal Research Center
Department of Epidemiology and Biostatistics
Iran University of Medical Sciences
School of Computing
Information and Communication Sciences and Technologies Pole
Department of Parasitology
Department of Parasitology
Social Determinants of Health Research Center
Department of Epidemiology and Biostatistics
Department of Medical Laboratory Sciences
Department of Cardiovascular
Neurology Department
Research Center for Biochemistry and Nutrition in Metabolic Diseases
National Agency for Strategic Research in Medical Education (NASRME)
Department of Immunology
Department of Medical-Surgical Nursing
Basic Health Sciences Institute
Community-Oriented Nursing Midwifery Research Center
Department of Epidemiology and Biostatistics
Department of Health in Disasters and Emergencies
School of Medicine
Department of Environmental Health Engineering
Department of Ophthalmology
Emergency Department
Department of Translational Medicine
Heidelberg Institute of Global Health
Center for Primary Care
Division of General Internal Medicine
School of Public Health
Department of Primary Care and Public Health
The George Institute for Global Health
Medical Laboratory Science
Department of Environmental Health
Biological Sciences Department
Research Unit on Applied Molecular Biosciences (UCIBIO)
Institute for Research and Innovation in Health
Laboratory for Process Engineering
School of Health Science
College of Medicine and Health Sciences
Social Determinants of Health Research Center
Cellular and Molecular Biology Research Center
Department of Clinical Biochemistry
Scientific-Tools.Org
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Department of Health Metrics Sciences
Oncological Network
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Department of Public Health
Department of Medical Biochemistry
Therapeutic and Diagnostic Technologies
National Institute for Health and Care Research- Biomedical Research Centre
Department of Research
Public Health Foundation of India
Indian Council of Medical Research
Department of Nursing
Department of Neurosurgery
Global Health Governance Programme
Centre for Medical Informatics
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School of Nursing
Department of Epidemiology
School of Health
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Gastrointestinal and Liver Diseases Research Center
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Research Center for Public Health and Nutrition
Lincoln International Institute for Rural Health
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Research Center on Public Health
Department of Nursing
Department of Public Health
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Institute of Public Health
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Department of Nursing
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Department of Genetics
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Independent Consultant
Department of Public Health
Department of General Surgery and Surgical-Medical Specialties
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Department of Ophthalmology
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Institute of Family Medicine and Public Health
School of Public Health
Social Determinants of Health Research Center
Institute for Prevention of Non-communicable Diseases
Health Services Management Department
Department of Food Hygiene and Safety
Surgery Research Unit
Department of Molecular Medicine and Surgery
International Research Center of Excellence
Julius Centre for Health Sciences and Primary Care
Department of Healthcare Services Management
School of Medicine
Health Promotion Research Center
Family Medicine Department
Primary Care Department
Faculty of Health and Wellbeing
College of Arts and Sciences
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Catalan Institution for Research and Advanced Studies (ICREA)
Faculty of Health and Life Sciences
Department of Medicine
Department of Clinical Sciences and Community Health
Department of Public Health
School of Health
Environmental Health Research Center
Department of Biochemistry
Joint
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North West Lung Centre
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International Dx Department
University Centre Varazdin
Department of Statistics and Econometrics
National Data Management Center for Health
Department of Public Health
Health Systems and Policy Research Unit
Department of Health Care Management
School of Medicine
Urmia University of Medical Sciences
Clinical Epidemiology and Public Health Research Unit
Competence Center of Mortality-Follow-Up of the German National Cohort
Federal Institute for Population Research
Center for Population and Health
Department of Surgery
School of Medicine
Department of Medical Microbiology and Immunology
Saveetha Dental College
Saveetha Dental College and Hospitals
Department of Engineering
Department of Nursing Education and Research
Department of Epidemiology
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Department of Medicine
National School of Public Health
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Vision and Eye Research Institute
Department of Epidemiology and Community Health
School of Dentistry
Department of Neurology
Centre for Primary Health Care and Equity
Mario Negri Institute for Pharmacological Research
School of Medicine
Clinical Academic Department of Pediatrics
University Medical Center Groningen
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Center of Excellence in Higher Education for Pharmaceutical Care Innovation
Department of Anesthesia
Department of Public Health
Academic Public Health England
Department of Epidemiology and Biostatistics
Department of Public Health
Czech National Centre for Evidence-based Healthcare and Knowledge Translation
Clinical and Epidemiological Research in Primary Care (GICEAP)
Department of Biostatistics and Epidemiology
Department of Pediatric Neurology
Department of Polymer Technology
Department of Neurology
Department of Medicine and Surgery
Research Center for Environmental Determinants of Health
Finnish Institute of Occupational Health
Department of General Surgery
Department of Surgery
Department of Medicine
Carlos III Health Institute
Department of Biostatistics and Epidemiology
Modestum LTD
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Department of Cardiovascular Sciences
UKK Institute
Faculty of Medicine and Health Technology
Department of Mental Health and Psychiatry
School of Population Health and Environmental Sciences
Department of Orthopaedics
Department of Environmental Health and Epidemiology
School of International Development and Global Studies
Research and Development Department
School of Public Health and Emergency Management

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