Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
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18 May 2024Elsevier B.V.
The Lancet
2024#403Issue 104402100 - 2132 pp.
Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation.
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Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
Department of Applied Mathematics, University of Washington, Seattle, WA, United States
Department of Global Health, University of Washington, Seattle, WA, United States
School of Medicine, University of Washington, Seattle, WA, United States
Department of Internal Medicine, University of Washington, Seattle, WA, United States
Department of Cardiology, University of Washington, Seattle, WA, United States
Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
Department of Pediatrics, University of Washington, Seattle, WA, United States
Department of Family Medicine, University of Washington, Seattle, WA, United States
Department of Neurology, University of Washington, Seattle, WA, United States
Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States
Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, United States
Henry M Jackson School of International Studies, University of Washington, Seattle, WA, United States
Division of Cardiology, University of Washington, Seattle, WA, United States
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Department of Neuroscience, Mashhad University of Medical Sciences, Mashhad, Iran
Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Orthodontics Department, 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 Medical Informatics, Mashhad University of Medical Sciences, Mashhad, Iran
Clinial Research Development Unit, Mashhad University of Medical Sciences, Mashhad, Iran
Department of Medical Genetics, Mashhad University of Medical Sciences, Mashhad, Iran
Radiation Oncology, Massachusetts General Hospital, Boston, MA, United States
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, United States
Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States
Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, United States
Department of Clinical Governance and Quality Improvement, Aleta Wondo Hospital, Aleta Wondo, Ethiopia
Department of Juridical and Economic Studies, La Sapienza University, Rome, Italy
Department of Public Health and Infectious Diseases, La Sapienza University, Rome, Italy
Doheny Eye Institute, University of California Los Angeles, Los Angeles, CA, United States
Doheny Image Reading and Research Lab (DIRRL), University of California Los Angeles, Los Angeles, CA, United States
Center for Social Medicine, University of California Los Angeles, Los Angeles, CA, United States
Department of Environmental Health Sciences, University of California Los Angeles, Los Angeles, CA, United States
Department of Health Policy Management, University of California Los Angeles, Los Angeles, CA, United States
General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA, United States
Department of Orthopedic Surgery, Harvard University, Boston, MA, United States
Department of Pediatrics, Harvard University, Boston, MA, United States
T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
Center for Primary Care, Harvard University, Boston, MA, United States
Harvard Business School, Harvard University, Boston, MA, United States
Department of Epidemiology, Harvard University, Boston, MA, United States
Department of Health Policy and Management, Harvard University, Boston, MA, United States
Division of Cardiology, Harvard University, Boston, MA, United States
Department of Neurological Surgery, Brigham and Womens Hospital, Harvard University, Boston, MA, United States
Department of Ophthalmology, Harvard University, Boston, MA, United States
Department of Global Health and Population, Harvard University, Boston, MA, United States
Department of Health Policy and Oral Epidemiology, Harvard University, Boston, MA, United States
Department of Global Health and Social Medicine, Harvard University, Boston, MA, United States
Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, United States
Division of General Internal Medicine, Harvard University, Boston, MA, United States
Department of Orthopaedic Surgery, Tehran, Iran
Department of Anesthesiology, Tehran, Iran
Department of Biotechnology, Tehran, Iran
National Nutrition and Food Technology Research Institute, Tehran, Iran
Urology Department, Tehran, Iran
Internal Medicine Department of SBMU, Tehran, Iran
School of Medicine, Tehran, Iran
Department of Community Nutrition, Tehran, Iran
Tehran, Iran
Cancer Research Center, Tehran, Iran
Obesity Research Center, Tehran, Iran
Urology and Nephrology Research Center, Tehran, Iran
Ophtalmic Reserch Centre, Tehran, Iran
Department of Immunology, Tehran, Iran
Department of Health Policy and Management, Tehran, Iran
Safety Promotion and Injury Prevention Research Center, Tehran, Iran
Department of Neurosurgery, Tehran, Iran
Ophthalmology and Vision Science, Tehran, Iran
Social Determinants of Health Research Center, Tehran, Iran
Department of Epidemiology, Tehran, Iran
Traditional Medicine and Materia Medica Research Center, Tehran, Iran
Ophthalmic Research Center (ORC), Tehran, Iran
Emergency Department, Tehran, Iran
Department of Medical Education, Tehran, Iran
Shahid Beheshti University of Medical Sciences, Tehran, Iran
Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
Tehran Heart Center, 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 Health Information Management, Tehran University of Medical Sciences, Tehran, Iran
Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran
Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
Department of Health in Emergencies and Disasters, Tehran University of Medical Sciences, Tehran, Iran
Department of Virology, Tehran University of Medical Sciences, Tehran, Iran
Cardiac Primary Prevention Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Cardiac Electrophysiology, Tehran University of Medical Sciences, Tehran, Iran
Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
Childrens Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran
Department of Pediatric Cardiology, Tehran University of Medical Sciences, Tehran, Iran
Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran
Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
Sina Trauma Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran
Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Department of Pharmaceutical Care, Tehran University of Medical Sciences, Tehran, Iran
Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran
Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Department of Epidemiology, Alexandria University, Alexandria, Egypt
Biomedical Informatics and Medical Statistics Department, Alexandria University, Alexandria, Egypt
Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
Department of Tropical Health and Parasitology, Alexandria University, Alexandria, Egypt
Department of Pathology, Alexandria University, Alexandria, Egypt
Department of Surgery, Marshall University, Huntington, WV, United States
Department of Tropical Medicine and Infectious Diseases, Tanta University, Tanta, Egypt
Department of Internal Medicine, Baylor College of Medicine, Houston, TX, United States
Section of General Internal Medicine, Baylor College of Medicine, Houston, TX, United States
Department of Small Animal Clinical Sciences, University of Saskatchewan, Saskatoon, SK, Canada
Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
Department of Medicine, University of Setif Algeria, Setif, Algeria
Community and Maternity Nursing Unit, University of Duhok, Duhok, Iraq
Department of Pathology and Microbiology, University of Duhok, Duhok, Iraq
Department of Physiotherapy, Bayero University Kano, Kano, Nigeria
Department of Community Medicine, Bayero University Kano, Kano, Nigeria
Department of Nursing Science, Bayero University Kano, Kano, Nigeria
Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong
School of Nursing, Hong Kong Polytechnic University, Hong Kong
Department of Midwifery, Dilla University, Dilla, Ethiopia
Department of Public Health, Dilla University, Dilla, Ethiopia
Department of Public Health, Haramaya University, Harar, Ethiopia
Department of Medical Laboratory Sciences, Haramaya University, Harar, Ethiopia
School of Public Health, Haramaya University, Harar, Ethiopia
Department of Health Policy and Management, Haramaya University, Harar, Ethiopia
Health Sciences Department of Oncology Nursing, Haramaya University, Harar, Ethiopia
School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia
Department of Clinical Pharmacy, Haramaya University, Harar, Ethiopia
School of Medical Laboratory Sciences, Haramaya University, Harar, Ethiopia
Department of Neurosurgery, University of Southern California, Los Angeles, CA, United States
Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
Department of Radiology, University of Southern California, Los Angeles, CA, United States
Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States
Department of Biostatistics, Near East University, TRNC, Nicosia, Cyprus
Department of Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia
Department of Botany, Sree Narayana Guru College Chelannur, Kozhikode, India
Laboratory Technology Sciences Department, Yasuj University of Medical Sciences, Yasuj, Iran
Department of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
Department of Community Medicine, Babcock University, Ilishan-Remo, Nigeria
Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
Department of Population and Behavioural Sciences, University of Health and Allied Sciences, Ho, Ghana
Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
Department of Medical Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana
Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
Department of Microbiology and Immunology, University of Health and Allied Sciences, Ho, Ghana
Department of Medical Biochemistry and Biophysics, Shefa Neuroscience Research Center, Tehran, Iran
Department of Global Public Health, Shefa Neuroscience Research Center, Tehran, Iran
Department of Neurobiology, Care Sciences and Society, Shefa Neuroscience Research Center, Tehran, Iran
Department of Medical Epidemiology and Biostatistics, Shefa Neuroscience Research Center, Tehran, Iran
Department of Physiology and Pharmacology, Shefa Neuroscience Research Center, Tehran, Iran
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
Aging Research Centre, Karolinska Institute, Stockholm, Sweden
Department of Global Health and Health Security, Hebei University, Baoding, China
Department of Neurosurgery, Shefa Neuroscience Research Center, Tehran, Iran
Pars Advanced and Minimally Invasive Medical Manners Research Center, Shefa Neuroscience Research Center, Tehran, Iran
Health Management and Economics Research Center, Shefa Neuroscience Research Center, Tehran, Iran
Department of Epidemiology, Shefa Neuroscience Research Center, Tehran, Iran
Department of Health Information Management, Shefa Neuroscience Research Center, Tehran, Iran
School of Medicine, Shefa Neuroscience Research Center, Tehran, Iran
Department of Medical Laboratory Sciences, Shefa Neuroscience Research Center, Tehran, Iran
Preventive Medicine and Public Health Research Center, Shefa Neuroscience Research Center, Tehran, Iran
Department of Ophthalmology, Shefa Neuroscience Research Center, Tehran, Iran
Minimally Invasive Surgery Research Center, Shefa Neuroscience Research Center, Tehran, Iran
Endocrine Research Center, Shefa Neuroscience Research Center, Tehran, Iran
Department of Echocardiography, Shefa Neuroscience Research Center, Tehran, Iran
Eye Research Center, Shefa Neuroscience Research Center, Tehran, Iran
Educational Development Center, Shefa Neuroscience Research Center, Tehran, Iran
Department of Anesthesiology, Shefa Neuroscience Research Center, Tehran, Iran
Gastrointestinal and Liver Diseases Research Center, Shefa Neuroscience Research Center, Tehran, Iran
Department of Physiology, Shefa Neuroscience Research Center, Tehran, Iran
Physiology Research Center, Shefa Neuroscience Research Center, Tehran, Iran
Colorectal Research Center, Shefa Neuroscience Research Center, Tehran, Iran
Iran University of Medical Sciences, Shefa Neuroscience Research Center, Tehran, Iran
Khatam Al-anbia Hospital, Shefa Neuroscience Research Center, Tehran, Iran
Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznan, Poland
Department of Public Health, Madda Walabu University, Addis Ababa, Ethiopia
Department of Nutrition and Dietetics, Jimma University, Addis Ababa, Ethiopia
USAID-JSI Digital Health Activity, Jimma University, Addis Ababa, Ethiopia
Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Brazil
Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
Department of Clinical Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Clinical Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil
Centre of Telehealth, Federal University of Minas Gerais, Belo Horizonte, Brazil
Department of Infectious Diseases and Tropical Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Department of Adult Health Nursing, Aksum University, Aksum, Ethiopia
Department of Nursing, Aksum University, Aksum, Ethiopia
Department of Neurology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
Department of Nursing, Al Zaytoonah University of Jordan, Amman, Jordan
Department of Pharmacology and Toxicology, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
Department of Veterinary Microbiology, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
Department of Veterinary Public Health and Preventive Medicine, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
Nigerian Institute of Medical Research, Lagos, Nigeria
Clinical Sciences Department, Sharjah, United Arab Emirates
College of Medicine, Sharjah, United Arab Emirates
Department of Pharmacy Practice and Pharmacotherapeutics, Sharjah, United Arab Emirates
Department of Physiotherapy, Sharjah, United Arab Emirates
Department of Basic Biomedical Sciences, Sharjah, United Arab Emirates
Sharjah Institute for Medical Research, Sharjah, United Arab Emirates
Department of Basic Medical Sciences, Sharjah, United Arab Emirates
Department of Clinical Nutrition and Dietetics, Sharjah, United Arab Emirates
Department of Finance and Economics, Sharjah, United Arab Emirates
Sharjah Institute of Medical Sciences, Sharjah, United Arab Emirates
Department of Medicinal Chemistry, Sharjah, United Arab Emirates
University of Sharjah, Sharjah, United Arab Emirates
Institute of Community and Public Health, Birzeit University, Ramallah, Palestine
Department of Therapeutics, United Arab Emirates University, Al Ain, United Arab Emirates
Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
Department of Medical Microbiology & Immunology, United Arab Emirates University, Al Ain, United Arab Emirates
Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
Department of Food, Nutrition and Health, United Arab Emirates University, Al Ain, United Arab Emirates
Department of Computer Science and Software Engineering, United Arab Emirates University, Al Ain, United Arab Emirates
College of Pharmacy, University of Jordan, Amman, Jordan
Department of Clinical Nursing, University of Jordan, Amman, Jordan
Department of Surgery, Alfaisal University, Riyadh, Saudi Arabia
College of Pharmacy, Alfaisal University, Riyadh, Saudi Arabia
College of Graduate Health Sciences, University of Tennessee, Memphis, TN, United States
Department of Neurology, University of Tennessee, Memphis, TN, United States
Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
Department of Clinical Research, Clinical Research Institute of Benin (IRCB), Abomey-Calavi, Benin
Department of Public Health, Wolkite University, Wolkite, Ethiopia
Department of Global Health, Stellenbosch University, Cape Town, South Africa
South African Centre for Epidemiological Modelling and Analysis (SACEMA), South Africa
Department of Epidemiology, Stellenbosch University, Cape Town, South Africa
Department of Industrial Psychology, Stellenbosch University, Cape Town, South Africa
Cochrane South Africa, Cape Town, South Africa
South African Medical Research Council, Cape Town, South Africa
Burden of Disease Research Unit, Cape Town, South Africa
Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
Risk and Resilience in Mental Disorders Unit, University of New South Wales, Sydney, NSW, Australia
Department of Emergency Medicine, Global Emergency Medicine Innovation and Implementation (GEMINI) Research Center, Durham, NC, United States
Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
School of Medicine, University of New South Wales, Sydney, NSW, Australia
School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
Centre for Primary Health Care and Equity (CPHCE), University of New South Wales, Sydney, NSW, Australia
School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
Quality and Systems Performance Unit, Cancer Institute NSW, Sydney, NSW, Australia
Internal Medicine and Alcohol Related Disease Unit, Fondazione Policlinico Universitario A Gemelli IRCCS (Agostino Gemelli University Polyclinic IRCCS), Rome, Italy
Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS (Agostino Gemelli University Polyclinic IRCCS), Rome, Italy
Department of Medical and Surgical Sciences, Universita Cattolica di Roma (Catholic University of Rome), Rome, Italy
Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
Department of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria
College of Medicine, University of Ibadan, Ibadan, Nigeria
Department of Medicine, University of Ibadan, Ibadan, Nigeria
Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Ibadan, Nigeria
Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, United States
Department of HIV and Infectious Diseases, Jhpiego, Abuja, Nigeria
Department of Adolescent Research and Care, Adolescent Friendly Research Initiative and Care, Ado Ekiti, Nigeria
Department of Microbiology, Edo State University Uzairue, Iyamho, Nigeria
Department of Biochemistry, Osun State University, Osogbo, Nigeria
Department of Biosciences and Biotechnology, University of Medical Sciences, Ondo, Ondo, Nigeria
Department of Physiology, University of Medical Sciences, Ondo, Ondo, Nigeria
Department of Microbiology, University of Medical Sciences, Ondo, Ondo, Nigeria
Department of Biological Sciences, University of Medical Sciences, Ondo, Ondo, Nigeria
Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
University of Gondar, Gondar, Ethiopia
Institute of Public Health, University of Gondar, Gondar, Ethiopia
Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia
Department of Pharmacology, University of Gondar, Gondar, Ethiopia
Faculty of Medicine, Universitas Padjadjaran (Padjadjaran University), Bandung, Indonesia
Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran (Padjadjaran University), Bandung, Indonesia
Department of Life Sciences, University of Management and Technology, Lahore, Pakistan
Department of Community Medicine, King Edward Memorial Hospital, Lahore, Pakistan
Department of Public Health, Public Health Institute, Lahore, Pakistan
Department of Community Medicine, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
Department of Parasitology, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
International Vaccine Institute, Seoul, South Korea
Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ, United States
Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States
Department of Pediatrics, Cleveland Clinic, Cleveland, OH, United States
Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
Department of Health Education and Health Promotion, Wachemo University, Hossana, Ethiopia
Department of Public Health, Wachemo University, Hossana, Ethiopia
Department of Medical and Surgical Sciences and Advanced Technologies, Gf Ingrassia University of Catania, Catania, Italy
Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
Trivedi School of Biosciences, Ashoka University, Haryana, Sonipat, 131029, India
Department of Geography and Planning, Queens University, Kingston, ON, Canada
Department of Biomedical and Molecular Sciences, Queens University, Kingston, ON, Canada
School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia
Department of Medical Biochemistry, Shaqra University, Shaqra, Saudi Arabia
Department of Pediatrics, Shaqra University, Shaqra, Saudi Arabia
Department of Pharmacology, Shaqra University, Shaqra, Saudi Arabia
School of Medicine and Psychology, Australian National University, Canberra, ACT, Australia
National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
Research School of Population Health, Australian National University, Canberra, ACT, Australia
Public Health Foundation of India, Gandhinagar, India
Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan
Department of Natural Sciences, Lebanese American University, Beirut, Lebanon
Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
Department of Medical Oncology, Miami Cancer Institute, Miami, FL, United States
Department of Medicine, Miami Cancer Institute, Miami, FL, United States
Department of Community Medicine and Preventive Health, King Edward Medical University Lahore, Lahore, Pakistan
Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China
School of Public Health, Imperial College London, London, United Kingdom
Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
Department of Pharmacy Practice, Riphah Institute of Pharmaceutical Sciences, Islamabad, Pakistan
Division of Infectious Diseases and Global Public Health (IDGPH), University of California, San Diego, CA, United States
Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
Unit of Basic Medical Sciences, University of Khartoum, Khartoum, Sudan
Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
Department of Biosciences, COMSATS Institute of Information Technology, Islamabad, Pakistan
Department of Nursing, Majmaah University, Al Majmaah, Saudi Arabia
Department of Epidemiology, Jimma University, Jimma, Ethiopia
Department of Surgery, Jimma University, Jimma, Ethiopia
Australian Center for Precision Health, University of South Australia, Adelaide, SA, Australia
Department of Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
Brody School of Medicine, Greenville, NC, United States
Department of Internal Medicine, Greenville, NC, United States
Department of Computer Science, Greenville, NC, United States
Department of Physiology, Greenville, NC, United States
Diabetes & Obesity Institute and Physiology, Greenville, NC, United States
East Carolina University, Greenville, NC, United States
Department of Food and Nutrition Policy and Planning Research, National Institute of Nutrition, Tehran, Iran
Faculty of Medicine and Public Health, Jenderal Soedirman University, Purwokerto, Indonesia
Moyen Mono Health District, Ministry of Health, Tohoun, Togo
Department of Internal Medicine, University of Patras, Patras, Greece
Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, Patras, Greece
Department of Population Health Sciences, Duke University, Durham, NC, United States
Duke Global Health Institute, Duke University, Durham, NC, United States
Department of Anesthesiology, Duke University, Durham, NC, United States
Center for the Study of Aging and Human Development, Duke University, Durham, NC, United States
Department of Cardiology, Fudan University, Shanghai, China
Yale School of Nursing, Yale University, New Haven, CT, United States
School of the Environment, Yale University, New Haven, CT, United States
School of Medicine, Yale University, New Haven, CT, United States
Department of Internal Medicine, Yale University, New Haven, CT, United States
Department of Dermatology, Yale University, New Haven, CT, United States
Department of Psychiatry, Yale University, New Haven, CT, United States
Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, United States
Department of Geriat
Institute for Health Metrics and Evaluation
Department of Applied Mathematics
Department of Global Health
School of Medicine
Department of Internal Medicine
Department of Cardiology
Department of Health Systems and Population Health
Department of Pediatrics
Department of Family Medicine
Department of Neurology
Department of Anesthesiology & Pain Medicine
Division of Plastic and Reconstructive Surgery
Henry M Jackson School of International Studies
Division of Cardiology
Faculty of Medicine
Department of Neuroscience
Dental Research Center
Orthodontics Department
Clinical Research Development Unit
Applied Biomedical Research Center
Biotechnology Research Center
Department of Medical Informatics
Clinial Research Development Unit
Department of Medical Genetics
Radiation Oncology
Department of Orthopaedic Surgery
Division of Cardiology
Department of Radiology
Cardiovascular Research Center
Department of Clinical Governance and Quality Improvement
Department of Juridical and Economic Studies
Department of Public Health and Infectious Diseases
Doheny Eye Institute
Doheny Image Reading and Research Lab (DIRRL)
Center for Social Medicine
Department of Environmental Health Sciences
Department of Health Policy Management
General Internal Medicine and Health Services Research
Department of Orthopedic Surgery
Department of Pediatrics
T.H. Chan School of Public Health
Center for Primary Care
Harvard Business School
Department of Epidemiology
Department of Health Policy and Management
Division of Cardiology
Department of Neurological Surgery
Department of Ophthalmology
Department of Global Health and Population
Department of Health Policy and Oral Epidemiology
Department of Global Health and Social Medicine
Beth Israel Deaconess Medical Center
Division of General Internal Medicine
Department of Orthopaedic Surgery
Department of Anesthesiology
Department of Biotechnology
National Nutrition and Food Technology Research Institute
Urology Department
Internal Medicine Department of SBMU
School of Medicine
Department of Community Nutrition
Tehran
Cancer Research Center
Obesity Research Center
Urology and Nephrology Research Center
Ophtalmic Reserch Centre
Department of Immunology
Department of Health Policy and Management
Safety Promotion and Injury Prevention Research Center
Department of Neurosurgery
Ophthalmology and Vision Science
Social Determinants of Health Research Center
Department of Epidemiology
Traditional Medicine and Materia Medica Research Center
Ophthalmic Research Center (ORC)
Emergency Department
Department of Medical Education
Shahid Beheshti University of Medical Sciences
Non-communicable Diseases Research Center
Advanced Diagnostic and Interventional Radiology Research Center
The Institute of Pharmaceutical Sciences (TIPS)
School of Pharmacy
Research Center for Immunodeficiencies
Tehran Heart Center
Universal Scientific Education and Research Network (USERN)
Digestive Diseases Research Institute
Department of Health Information Management
Translational Ophthalmology Research Center
School of Medicine
Iranian Research Center for HIV/AIDS
Multiple Sclerosis Research Center
Department of Ophthalmology
Department of Health in Emergencies and Disasters
Department of Virology
Cardiac Primary Prevention Research Center
Department of Cardiac Electrophysiology
Center for Research and Training in Skin Diseases and Leprosy
Urology Research Center
Sina Trauma and Surgery Research Center
Childrens Medical Center
Endocrinology and Metabolism Research Institute
Department of Cardiology
Department of Pediatric Cardiology
Department of Epidemiology and Biostatistics
Department of Physiotherapy
Research Center for War-affected People
Department of Pharmacology
Sina Trauma Research Center
Department of Neurology
Department of Medicine
Department of Pharmaceutical Care
Research Center for Rational Use of Drugs
Cancer Research Center
Cancer Biology Research Center
Department of Pathology
Faculty of Medicine
Department of Epidemiology
Biomedical Informatics and Medical Statistics Department
Pediatric Dentistry and Dental Public Health Department
Department of Tropical Health and Parasitology
Department of Pathology
Department of Surgery
Department of Tropical Medicine and Infectious Diseases
Department of Internal Medicine
Section of General Internal Medicine
Department of Small Animal Clinical Sciences
Department of Community Health and Epidemiology
Department of Medicine
Community and Maternity Nursing Unit
Department of Pathology and Microbiology
Department of Physiotherapy
Department of Community Medicine
Department of Nursing Science
Department of Rehabilitation Sciences
School of Nursing
Department of Midwifery
Department of Public Health
Department of Public Health
Department of Medical Laboratory Sciences
School of Public Health
Department of Health Policy and Management
Health Sciences Department of Oncology Nursing
School of Nursing and Midwifery
Department of Clinical Pharmacy
School of Medical Laboratory Sciences
Department of Neurosurgery
Keck School of Medicine
Department of Radiology
Mark and Mary Stevens Neuroimaging and Informatics Institute
Department of Biostatistics
Department of Biostatistics and Health Informatics
Department of Botany
Laboratory Technology Sciences Department
Department of Nursing
Department of Community Medicine
Department of Family and Community Health
Department of Population and Behavioural Sciences
Department of Health Policy Planning and Management
Department of Medical Epidemiology and Biostatistics
Institute of Health Research
Department of Microbiology and Immunology
Department of Medical Biochemistry and Biophysics
Department of Global Public Health
Department of Neurobiology
Department of Medical Epidemiology and Biostatistics
Department of Physiology and Pharmacology
Department of Molecular Medicine and Surgery
Aging Research Centre
Department of Global Health and Health Security
Department of Neurosurgery
Pars Advanced and Minimally Invasive Medical Manners Research Center
Health Management and Economics Research Center
Department of Epidemiology
Department of Health Information Management
School of Medicine
Department of Medical Laboratory Sciences
Preventive Medicine and Public Health Research Center
Department of Ophthalmology
Minimally Invasive Surgery Research Center
Endocrine Research Center
Department of Echocardiography
Eye Research Center
Educational Development Center
Department of Anesthesiology
Gastrointestinal and Liver Diseases Research Center
Department of Physiology
Physiology Research Center
Colorectal Research Center
Iran University of Medical Sciences
Khatam Al-anbia Hospital
Department of Physical Pharmacy and Pharmacokinetics
Department of Public Health
Department of Nutrition and Dietetics
USAID-JSI Digital Health Activity
Department of Pediatric Dentistry
Department of Internal Medicine
Department of Nutrition
Department of Maternal and Child Nursing and Public Health
Department of Clinical Medicine
Clinical Hospital
Centre of Telehealth
Department of Infectious Diseases and Tropical Medicine
Department of Adult Health Nursing
Department of Nursing
Department of Neurology
Department of Nursing
Department of Pharmacology and Toxicology
Department of Veterinary Microbiology
Department of Veterinary Public Health and Preventive Medicine
Nigerian Institute of Medical Research
Clinical Sciences Department
College of Medicine
Department of Pharmacy Practice and Pharmacotherapeutics
Department of Physiotherapy
Department of Basic Biomedical Sciences
Sharjah Institute for Medical Research
Department of Basic Medical Sciences
Department of Clinical Nutrition and Dietetics
Department of Finance and Economics
Sharjah Institute of Medical Sciences
Department of Medicinal Chemistry
University of Sharjah
Institute of Community and Public Health
Department of Therapeutics
Institute of Public Health
College of Medicine and Health Sciences
Department of Medical Microbiology & Immunology
Family Medicine Department
Department of Food
Department of Computer Science and Software Engineering
College of Pharmacy
Department of Clinical Nursing
Department of Surgery
College of Pharmacy
College of Graduate Health Sciences
Department of Neurology
Department of Disease Control
Department of Infectious Disease Epidemiology
Department of Non-Communicable Disease Epidemiology
Department of Health Services Research and Policy
Department of Clinical Research
Department of Public Health
Department of Global Health
South African Centre for Epidemiological Modelling and Analysis (SACEMA)
Department of Epidemiology
Department of Industrial Psychology
Cochrane South Africa
South African Medical Research Council
Burden of Disease Research Unit
Epidemiology and Cancer Registry Sector
Risk and Resilience in Mental Disorders Unit
Department of Emergency Medicine
Centre for Social Research in Health
St George and Sutherland Clinical School
National Drug and Alcohol Research Centre
School of Medicine
School of Psychiatry
School of Public Health and Community Medicine
Centre for Primary Health Care and Equity (CPHCE)
School of Optometry and Vision Science
Faculty of Medicine and Health
The George Institute for Global Health
Quality and Systems Performance Unit
Internal Medicine and Alcohol Related Disease Unit
Department of Woman and Child Health and Public Health
Department of Medical and Surgical Sciences
Department of Community Medicine
Department of Veterinary Medicine
Department of Epidemiology and Medical Statistics
Faculty of Public Health
Department of Health Promotion and Education
College of Medicine
Department of Medicine
Department of Community Medicine
Department of Medicine
Department of Oral and Maxillofacial Surgery
Department of Obstetrics and Gynecology
Department of HIV and Infectious Diseases
Department of Adolescent Research and Care
Department of Microbiology
Department of Biochemistry
Department of Biosciences and Biotechnology
Department of Physiology
Department of Microbiology
Department of Biological Sciences
Department of Public Health
University of Gondar
Institute of Public Health
Department of Environmental and Occupational Health and Safety
Department of Clinical Pharmacy
Department of Pharmacology
Faculty of Medicine
Center of Excellence in Higher Education for Pharmaceutical Care Innovation
Department of Life Sciences
Department of Community Medicine
Department of Public Health
Department of Community Medicine
Department of Parasitology
International Vaccine Institute
Department of Cardiovascular Medicine
Department of Internal Medicine
Department of Pediatrics
Lerner Research Institute
Department of Health Education and Health Promotion
Department of Public Health
Department of Medical and Surgical Sciences and Advanced Technologies
Department of Biomedical and Biotechnological Sciences
Department of General Surgery and Medical-Surgical Specialties
Department of Clinical and Experimental Medicine
Trivedi School of Biosciences
Department of Geography and Planning
Department of Biomedical and Molecular Sciences
School of Public Health
School of Nursing and Midwifery
Department of Medical Biochemistry
Department of Pediatrics
Department of Pharmacology
School of Medicine and Psychology
National Centre for Epidemiology and Population Health
Research School of Population Health
Public Health Foundation of India
Department of Health and Biological Sciences
Department of Natural Sciences
Gilbert and Rose-Marie Chagoury School of Medicine
Department of Medical Oncology
Department of Medicine
Department of Community Medicine and Preventive Health
Department of Epidemiology and Health Statistics
School of Public Health
Department of Primary Care and Public Health
WHO Collaborating Centre for Public Health Education and Training
Faculty of Pharmaceutical Sciences
Department of Pharmacy Practice
Division of Infectious Diseases and Global Public Health (IDGPH)
Institute of Endemic Diseases
Unit of Basic Medical Sciences
Swiss Tropical and Public Health Institute
Department of Biosciences
Department of Nursing
Department of Epidemiology
Department of Surgery
Australian Center for Precision Health
Department of Allied Health and Human Performance
Brody School of Medicine
Department of Internal Medicine
Department of Computer Science
Department of Physiology
Diabetes & Obesity Institute and Physiology
East Carolina University
Department of Food and Nutrition Policy and Planning Research
Faculty of Medicine and Public Health
Moyen Mono Health District
Department of Internal Medicine
Department of Internal Medicine and Infectious Diseases
Department of Population Health Sciences
Duke Global Health Institute
Department of Anesthesiology
Center for the Study of Aging and Human Development
Department of Cardiology
Yale School of Nursing
School of the Environment
School of Medicine
Department of Internal Medicine
Department of Dermatology
Department of Psychiatry
Department of Radiology and Biomedical Imaging
Department of Geriat
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