Aleksandr Y. Aravkin

35386103000

Publications - 6

Global, regional, and national burden of chronic kidney disease in adults, 1990–2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023

Mohamad Amin Bakhshali Shoshana H. Ballew Ovidiu Constantin Baltatu Maciej Banach Mainak Bardhan Ahmed Abdelrahman Abdelgalil Saurav Basu Bekalu Mekonen Belay Makda Abate Belew Aminu K. Bello Luis Belo Amiel Nazer C. Bermudez Nurudeen A. Adegoke Fahmi Y. Al-Ashwal Nelson Alvis-Guzman Yaser Mohammed Al-Worafi Adel Sharaf Al-Zubairi Masoud Aman Mohammadi Hubert Amu Abhishek Anil Sajjad Ahmad Sulaimon O. Araromi Geminn Louis Carace Apostol Walter Appati Neeraj Bedi Filippos Anagnostakis Rizwan Suliankatchi Abdulkader Anayochukwu Edward Anyasodor Hiba Jawdat Barqawi Amir Mahmoud Ahmadzade Salah Al Awaidy Syed Shujait Ali Omar Almidani Hanadi Al Hamad Syed Mahfuz Al Hasan Karem H. Alzoubi Maha Moh'd Wahbi Atout Samar Abd Elhafeez Sajjad Ahmad Nesredin Ahmed Marjan Ajami Ayman Ahmed Salahdein Aburuz Yazan Al Thaher Ashagre Molla Assaye Khursheed Aurangzeb Adedapo Wasiu Awotidebe Domenico Azzolino Lucas Guimarães Abreu Bright Opoku Ahinkorah Qorinah Estiningtyas Sakilah Adnani Olugbenga Olusola Abiodun Dmitry Abramov Hasan Aalruz Qorinah Estiningtyas Sakilah Adnani Bilyaminu Abubakar Isaac Yeboah Addo Qorinah Estiningtyas Sakilah Adnani Oyelola A. Adegboye Muhammad Badar Mohammad Mahdi Bastan Akshaya Srikanth Bhagavathula Sonu Bhaskar M. D.Abu Bashar Shahid Bashir Temitayo Esther Adeyeoluwa Johan Ärnlöv Bernard Kwadwo Yeboah Asiamah-Asare Hasan Aalruz Patrick B. Mark Lauryn K. Stafford Morgan E. Grams Hansani Madushika Abeywickrama Mohammed Mehdi Abrar Khabir Ahmad Ali Ahmadi Aram Mahmood Ahmed Priyadarshini Bhattacharjee Jasvinder Singh Bhatti Salahdein Aburuz Aleksandr Y. Aravkin Mohammed Z. Allouh Mohammadreza Akbari Oluwasefunmi Akeju Mohammed Ahmed Akkaif Ziyad Al-Aly Mohammed Albashtawy Shereen M. Aleidi Ali M. Alfalki Fadwa Naji Alhalaiqa Khalid A. Alhasan Endale Alemayehu Ali Rafat Ali Syed Yusuf Ali Maha Moh d.Wahbi Atout Mohammed Z. Allouh Wesam Taher Almagharbeh Sadat Abdulla Aziz Khaldoon Aied Alnawafleh Awais Altaf Samah W. Al-Jabi Najim Z. Alshahrani Jesu Arockiaraj Rizwan Suliankatchi Abdulkader Shahzaib Ahmed Syed Anees Ahmed Yuni Asri Ajay Nagesh Bhat Sadat Abdulla Aziz

Publication Name: Lancet

Publication Date: 2025-11-22

Volume: 406

Issue: 10518

Page Range: 2461-2482

Description:

Background Chronic kidney disease (CKD) is common and ranks among the leading causes of mortality and morbidity. This analysis aimed to present global CKD estimates using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 to inform evidence-based policies for CKD identification and treatment. Methods This analysis focused on adults aged 20 years and older over the period 1990 to 2023, from 204 countries and territories. Data sources used were published literature, vital registration systems, kidney failure treatment registries, and household surveys. Estimates of CKD burden, including deaths, incidence, prevalence, and disability-adjusted life-years (DALYs), were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool. A comparative risk assessment approach estimated the proportion of cardiovascular deaths attributable to impaired kidney function and estimated risk factors for CKD. Findings Globally, in 2023, 788 million (95% uncertainty interval 743–843) people aged 20 years and older were estimated to have CKD, up from 378 million (354–407) in 1990. The global age-standardised prevalence of CKD in adults was 14·2% (13·4–15·2), a relative rise of 3·5% (2·7–4·1) from 1990. The region with the highest age-standardised prevalence was north Africa and the Middle East (18·0%; 16·9–19·4). Most people had stage 1–3 CKD, with a combined prevalence of 13·9% (13·1–15·0). In 2023, CKD was the ninth leading cause of death globally, accounting for 1·48 million (1·30–1·65) deaths, and the 12th leading cause of DALYs, with an age-standardised DALY rate of 769·2 (691·8–857·4) per 100 000. Impaired kidney function as a risk factor accounted for 11·5% (8·4–14·5) of cardiovascular deaths. High fasting plasma glucose, body-mass index, and systolic blood pressure were all leading risk factors for CKD DALYs. Interpretation CKD is a major global health issue, with rising prevalence and increasing importance as a cause of death and as a risk factor for cardiovascular death. A better understating of aetiology, appropriate screening, and implementation programmes are needed to translate advances in CKD treatment into improved patient outcomes. Funding Gates Foundation, Wellcome, US National Kidney Foundation, and US National Institute of Diabetes and Digestive and Kidney Diseases.

Open Access: Yes

DOI: 10.1016/S0140-6736(25)01853-7

Disease burden attributable to intimate partner violence against females and sexual violence against children in 204 countries and territories, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Amani Alansari Rana Kamal Abu Farha Haroon Ahmed Kamoru Ademola Adedokun Nurudeen A. Adegoke Aanuoluwapo Adeyimika Afolabi Lisa C. Adams Muayyad M. Ahmad Mesfin Abebe Armita Abedi Hubert Amu Anayochukwu Edward Anyasodor Aqeel Ahmad Mohmmad Minwer Alnaeem Williams Agyemang-Duah Alemwork Abie Muhammad Sohail Afzal Danish Ahmad Rotimi Felix Afolabi Saira Afzal Seyyed Shamsadin Athari Samar Abd Elhafeez Mehrunnisha Sharif Ahmed Ayman Ahmed Meriem Abdoun Zufishan Alam Lucas Guimarães Abreu Bright Opoku Ahinkorah Qorinah Estiningtyas Sakilah Adnani Haroon Ahmed Roberto Ariel Abeldaño Zuñiga Asma Ahmed Meshack Achore Hasan Aalruz Bilyaminu Abubakar Sawsan Abuhammad Olumide Abiodun Richard Gyan Aboagye Habeeb Omoponle Adewuyi Mohammad Mahdi Bastan M. D.Abu Bashar Shahid Bashir Oluwatobi E. Adegbile Olumide Thomas Adeleke Miracle Ayomikun Adesina Leticia Akua Adzigbli Hasan Aalruz Aleksandr Y. Aravkin Roberto Ariel Abeldaño Zuñiga Oli Ahmed Elizabeth Oluwatoyin Akin-Odanye Wole Akosile Idorenyin Ubon Akpabio Rasmieh Mustafa Al-Amer Turki M. Alanzi Shereen M. Aleidi Melaku Birhanu Alemu Fadwa Naji Alhalaiqa Hamid Alinejad Rokny Md Al-Mamun Joseph Uy Almazan Mohmmad Minwer Alnaeem Siddig Ibrahim Abdelwahab Babatope Oluwadamilare Adebiyi Makinde Adebayo Adeniyi Mohammad Sharif Ibrahim Alyahya Tarek Tawfik Amin Saeed Amini Sohrab Amiri Jimoh Amzat Asma Ahmed Montaha Al-Iede Intima Alrimawi Saeid Anvari David B. Anderson Luisa S. Flor Cory N. Spencer Jack Cagney Gabriela Fernanda Gil Yonas Abebe Boluwatife Stephen Anuoluwa Jorge Arias de la Torre Benedetta Armocida Alejandra Arrieta Deepavalli Arumuganainar Wesam Taher Almagharbeh Bilal Aslam Prince Atorkey Sachin R. Atre Abadi Hailay Atsbaha Madhu Sudhan Atteraya Ahmed Y. Azzam B. Sheeba Khlood K. Baghlaf Najim Z. Alshahrani Jose Balmori-de-la-Miyar Soham Bandyopadhyay Julie Alaere Atta Asma Ahmed Atif Amin Baig Manish Barik Suzanne Lyn Barker-Collo Azadeh Bashiri Tahira Ashraf Yuni Asri Wondu Feyisa Balcha

Publication Name: Lancet

Publication Date: 2026-01-03

Volume: 407

Issue: 10523

Page Range: 31-52

Description:

Background Violence against women and against children are human rights violations with lasting harms to survivors and societies at large. Intimate partner violence (IPV) and sexual violence against children (SVAC) are two major forms of such abuse. Despite their wide-reaching effects on individual and community health, these risk factors have not been adequately prioritised as key drivers of global health burden. Comprehensive x§and reliable estimates of the comparative health burden of IPV and SVAC are urgently needed to inform investments in prevention and support for survivors at both national and global levels. Methods We estimated the prevalence and attributable burden of IPV among females and SVAC among males and females for 204 countries and territories, by age and sex, from 1990 to 2023, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2023. We searched several global databases for data on self-reported exposure to IPV and SVAC and undertook a systematic review to identify the health outcomes associated with each of these risk factors. We modelled IPV and SVAC prevalence using spatiotemporal Gaussian process regression, applying data adjustments to account for measurement heterogeneity. We employed burden-of-proof methodology to estimate relative risks for outcomes associated with IPV and SVAC. These estimates informed the calculation of population attributable fractions, which were then used to quantify disability-adjusted life-years (DALYs) attributable to each risk factor. Findings Globally, in 2023, we estimated that 608 million (95% uncertainty interval 518–724) females aged 15 years and older had ever been exposed to IPV, and 1·01 billion (0·764–1·48) individuals aged 15 years and older had experienced sexual violence during childhood. 18·5 million (8·74–30·0) DALYs were attributed to IPV among females and 32·2 million (16·4–52·5) DALYs were attributed to SVAC among males and females in 2023. IPV and SVAC were among the top contributors to the global disease burden in 2023, particularly among females aged 15–49 years, ranking as the fourth and fifth leading risk factors, respectively, for DALYs in this group. Among the eight health outcomes found to be associated with IPV, anxiety disorders and major depressive disorder were the leading causes of IPV-attributed DALYs, accounting for 5·43 million (–1·25 to 14·6) and 3·96 million (1·71 to 6·92) DALYs in 2023, respectively. SVAC was associated with 14 health outcomes, including mental health disorder, substance use disorder, and chronic and infectious disease outcomes. Self-harm and schizophrenia were the leading causes of SVAC-attributed burden, with SVAC accounting for 6·71 million (2·00 to 12·7) DALYs due to self-harm and 4·15 million (–1·92 to 13·1) DALYs due to schizophrenia in 2023. Interpretation IPV and SVAC are substantial contributors to global health burden, and their health consequences span a variety of individual health outcomes. Importantly, mental health disorders account for the greatest share of disease burden among survivors. Investing in prevention of these avoidable risk factors has the potential to avert millions of DALYs and considerable premature mortality each year. Our findings represent strong evidence for global and national leaders to elevate IPV and SVAC among public health priorities. Sustained investments are needed to prevent IPV and SVAC and to implement interventions focused on supporting the complex social and health needs of survivors. Funding Gates Foundation.

Open Access: Yes

DOI: 10.1016/S0140-6736(25)02503-6

Global, regional, and national burden of headache disorders, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Sharareh Eskandarieh Andre Faro Giuseppina Affinito Yaser Mohammed Al-Worafi Abhishek Anil Mohammad Amin Aalipour Dariush Abtahi Hiba Jawdat Barqawi Danish Ahmad Syed Shujait Ali Karem H. Alzoubi Yasser Bustanji Salahdein Aburuz Khursheed Aurangzeb Qorinah Estiningtyas Sakilah Adnani Deldar Morad Abdulah Qorinah Estiningtyas Sakilah Adnani Richard Gyan Aboagye Jalal Arabloo Mohammad Mahdi Bastan Sonu Bhaskar Mohammad Al-Wardat Ganiyu Adeniyi Amusa Demelash Areda Mahsa Asadi Anar Sait Ashina Joseph Uy Almazan Ashraf Alhumaidi Mohammad Ahmmad Mahmoud Al Zoubi Negar Sadat Ahmadi Andreas Kattem Husøy Yvonne Yiru Xu Jaimie D. Steinmetz Samir Abu Rumeileh Ali Ahmed Sawsan Alabbad Yazan Al-Ajlouni Obed Adonteng-Kissi Gelana Fekadu Hasan Aalruz Jasvinder Singh Bhatti C. J. Sanjay Natalia Cruz-Martins Edoardo Caronna Ana Paula Carvalho-E-Silva Jeetendra Bhandari Bijit Biswas Aleksandr Y. Aravkin Omid Dadras Hongyuan Chu Josielli Comachio Arian Azadnia Youngoh Bae Rehana Basri Jina Behjati Daniela Contreras Gurjit Kaur Bhatti Rajbir Bhatti Emanuele D'Amico Anh Kim Dang Lucio D'Anna Bruno Bizzozero-Peroni Meriem Boukhiam Sindhura Deekonda Pouria Delbari Andreas K. Demetriades Emina Dervišević Lamiaa Labieb Mahmoud Ebraheim Ebrahim Eini Michael Ekholuenetale Vinoth Gnana Chellaiyan Devanbu Mohammad Asghari-Jafarabadi Razieh Bahreini Bibha Dhungel Maryam Bemanalizadeh Mohammed Albashtawy Fadwa Naji Alhalaiqa Joseph Uy Almazan Sohrab Amiri Asma Ahmed Montaha Al-Iede David B. Anderson C. J. Sanjay Natalia Cruz-Martins Valery L. Feigin Awais Altaf Ahmed Y. Azzam Mohammed Usman Ali Najim Z. Alshahrani Soham Bandyopadhyay Xueting Ding Huyen Phuc Do Ojas Prakashbhai Doshi Siddhartha Dutta Sandip Chakraborty Luis Alberto Cámera Azadeh Bashiri Vijay Kumar Chattu Amol S. Dhane Archith Boloor Patrick R. Ching Xiaochen Dai Anis Ahmad Chaudhary Shahzaib Ahmed

Publication Name: Lancet Neurology

Publication Date: 2025-12-01

Volume: 24

Issue: 12

Page Range: 1005-1015

Description:

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 estimates health loss from migraine, tension-type headache, and medication-overuse headache. This study presents updated results on headache-attributed burden from 1990 to 2023, along with clinical and public health implications. Methods: Data on the prevalence, incidence, or remission of migraine, tension-type headache, and medication-overuse headache were extracted from published population-based studies. We used hierarchical Bayesian meta-regression modelling to estimate global, regional, and country-level prevalence of headache disorders. For the first time in GBD 2023, age-specific and sex-specific estimates of time in symptomatic state were applied by meta-analysing individual participant data from 41 653 individuals from the general populations of 18 countries from all parts of the world. Disability weights were applied to calculate years lived with disability (YLDs). Since medication-overuse headache is a sequela of a mistreated primary headache (due to medication overuse), its burden was reattributed to migraine or tension-type headache, informed by a meta-analysis of three longitudinal studies. Findings: In 2023, 2·9 billion individuals (95% uncertainty interval 2·6–3·1) were affected by headache disorders, with a global age-standardised prevalence of 34·6% (31·6–37·5) and a YLD rate of 541·9 (373·4–739·9) per 100 000 population, with 487·5 (323·0–678·8) per 100 000 population attributed to migraine. The prevalence rates of these headache disorders have remained stable over the past three decades. YLD rates due to headache disorders were more than twice as high in females (739·9 [511·2–1011·5] per 100 000) as in males (346·1 [240·4–481·8] per 100 000). Medication-overuse headache contributed 58·9% of the YLD estimates for tension-type headache in males and 56·1% in females, as well as 22·6% of the YLD estimates for migraines in males and 14·1% in females. Interpretation: Headache disorders, in particular migraine, continue to be a major global health challenge, emphasising the need for effective management and prevention strategies. Much headache-attributed burden could be averted or eliminated by avoiding overuse of medication (including over-the-counter medication), underscoring the importance of public education. Funding: Gates Foundation.

Open Access: Yes

DOI: 10.1016/S1474-4422(25)00402-8

Global burden of cancer in children and adolescents aged 0–19 years, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Jasvinder Singh Bhatti Sayeh Ezzikouri Ali Hasanpour- Dehkordi Takeshi Fukumoto Seyyed Shamsadin Athari Hala Rashad Elhabashy Aleksandr Y. Aravkin Paul Narh Doku Dariush Haghmorad Theophilus I. Emeto Adeniyi Francis Fagbamigbe Nermin Ghith Anis Ahmad Chaudhary Mahwish Arooj Hamidreza Hasani Robert Kaba Alhassan Salahdein Aburuz Lucas Guimarães Abreu Saeid Anvari Muhammad Sohail Afzal Jonathan M. Kocarnik Mosab Arafat Morenike Oluwatoyin Folayan Hanadi Al Hamad Ayesha Fahim Mohammad Farahmand Lisa M. Force Adewale Oluwaseun Fadaka Nadia M. Hamdy Demelash Areda Veer Bala Gupta Maha Moh'd Wahbi Atout Natalie Pritchett Souad Bouaoud Ayman Ahmed Aso Mohammad Darwesh Cem Bilgin Dong Woo Choi Wafa A. Aldhaleei Awais Altaf Ferrán Catalá-López Danish Ahmad Bashir Dabo Rakhi Dandona Mohammed Albashtawy Mohamed Abouzid Omotayo Francis Fagbule Shirin Barati Soham Bandyopadhyay Ahmed Y. Azzam Abdulfatai Aremu Teferi Gebru Gebremeskel Arvin Haj-Mirzaian Catherine Bisignano Aragaw Tesfaw Desale Benedetta Armocida Hasan Aalruz Kayleigh Bhangdia Isaac Sunday Chukwu Md Kamrul Hasan Promit Ananyo Chakraborty Louise Penberthy Maryam Bemanalizadeh Robert Kokou Dowou Giulia Carreras Xiaochen Dai Maysaa El Sayed Zaki Johannes Haubold Mohammad Asghari-Jafarabadi Fatemeh Afrashteh John Dube Ali Hasanpour- Dehkordi Shahkaar Aziz Logan M. Glasstetter Genanew K. Getahun Sri Harsha Boppana Alistair Acheson Chiranjib Chakraborty Saroja Devi Geetha Razieh Bahreini Yohannes Habtegiorgis Abate Sabah Al-Marwani Mohammad Farahmand Mohammad Mahdi Bastan Samuel Demissie Darcho Thao Huynh Phuong Do Miglas Welay Gebregergis Lee Deitesfeld Abdel Rahman E'mar Mohammed Elshaer Lemessa Assefa A. Ayana Chadi Eltaha Awoke Derbie Habteyohannes Abid Ali Safwat Aly Nguyen Hoang Anh Andrew Crist Miranda L. May Maha Moh d.Wahbi Atout Hasan Aalruz Syed Anees Ahmed Demelash Areda Mohammad Farahmand Lalit Dandona Karem H. Alzoubi Yasser Bustanji

Publication Name: Lancet

Publication Date: 2026-04-04

Volume: 407

Issue: 10536

Page Range: 1360-1373

Description:

Background Information on childhood cancer burden is crucial for effective cancer policy planning. Unfortunately, observed paediatric cancer data are not available in every country, and previous global burden estimates have not discretely reported several common cancers of childhood. We aimed to inform efforts to address childhood cancer burden globally by analysing results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, which now include nine additional cancer causes compared with previous GBD analyses. Methods GBD 2023 data sources for cancer estimation included population-based cancer registries, vital registration systems, and verbal autopsies. For childhood cancers (defined as those occurring at ages 0–19 years), mortality was estimated using cancer-specific ensemble models and incidence was estimated using mortality estimates and modelled mortality-to-incidence ratios (MIRs). Years of life lost (YLLs) were estimated by multiplying age-specific cancer deaths by the standard life expectancy at the age of death. Prevalence was estimated using survival estimates modelled from MIRs and multiplied by sequelae-specific disability weights to estimate years lived with disability (YLDs). Disability-adjusted life-years (DALYs) were estimated as the sum of YLLs and YLDs. Estimates are presented globally and by geographical and resource groupings, and all estimates are presented with 95% uncertainty intervals (UIs). Findings Globally, in 2023, there were an estimated 377 000 incident childhood cancer cases (95% UI 288 000–489 000), 144 000 deaths (131 000–162 000), and 11·7 million (10·7–13·2) DALYs due to childhood cancer. Deaths due to childhood cancer decreased by 27·0% (15·5–36·1) globally, from 197 000 (173 000–218 000) in 1990, but increased in the WHO African region by 55·6% (25·5–92·4), from 31 500 (24 900–38 500) to 49 000 (42 600–58 200) between 1990 and 2023. In 2023, age-standardised YLLs due to childhood cancer were inversely correlated with country-level Socio-demographic Index. Childhood cancer was the eighth-leading cause of childhood deaths and the ninth-leading cause of DALYs among all cancers in 2023. The percentage of DALYs due to uncategorised childhood cancers was reduced from 26·5% (26·5–26·5) in GBD 2017 to 10·5% (8·1–13·1) with the addition of the nine new cancer causes. Target cancers for the WHO Global Initiative for Childhood Cancer (GICC) comprised 47·3% (42·2–52·0) of global childhood cancer deaths in 2023. Interpretation Global childhood cancer burden remains a substantial contributor to global childhood disease and cancer burden and is disproportionately weighted towards resource-limited settings. The estimation of additional cancer types relevant in childhood provides a step towards alignment with WHO GICC targets. Efforts to decrease global childhood cancer burden should focus on addressing the inequities in burden worldwide and support comprehensive improvements along the childhood cancer diagnosis and care continuum. Funding St Jude Children's Research Hospital, Gates Foundation, and St Baldrick's Foundation.

Open Access: Yes

DOI: 10.1016/S0140-6736(26)00200-X

Global burden of metabolic dysfunction-associated steatotic liver disease, 1990–2023, and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2023

Jasvinder Singh Bhatti Usha Adiga Stephen E. Congly Neeraj Bhala Karolina Akinosoglou Saleh A. Alqahtani Seyyed Shamsadin Athari Juan Pablo Arab Aleksandr Y. Aravkin Bruce B. Duncan Archith Boloor Catalina Liliana Andrei Ahmed Abu-Zaid Fadwa Naji Alhalaiqa Oyewole Christopher Durojaiye Ferry Efendi Anis Ahmad Chaudhary Sushil Dohare Ajeet Singh Bhadoria Vijay Kumar Chattu Floriane Ausloos Muhammad Sohail Afzal Isaac Yeboah Addo Ashish D. Badiye Tahira Ashraf Yogesh Bahurupi Luis Antonio Diaz Nasir Abbas Anton A. Artamonov Hubert Amu Sheikh Mohammad Alif Charles Oluwaseun Adetunji Demelash Areda Wirawan Adikusuma Shady Abohashem Maha Moh'd Wahbi Atout Awais Altaf Deanna Anderlini Zahid A. Butt Walid A. Al-Zyoud Ismael Campos-Nonato Omid Dadras Foolad Eghbali Jalal Arabloo Narasimha M. Beeraka Nelson Alvis-Guzman Omar Ali Mohammed Al Zaabi Fariba Dorostkar Diana Fernanda Bejarano Ramirez Hasan Aalruz Amadou Barrow Isaac Sunday Chukwu Rajaa M. Al-Raddadi Robert Kokou Dowou Richard Gyan Aboagye Xiaochen Dai Arkadeep Dhali Najim Z. Alshahrani Menayit Tamrat Dresse Mohammed Ahmed Akkaif Patrick R. Ching Pankaj Bhardwaj Fatemeh Chichagi Shahkaar Aziz Bryan Chong Shewatatek Melaku Asefa Felix Busch Mainak Bardhan Ajay Nagesh Bhat Pojsakorn Danpanichkul Amani Alansari Joshua Chadwick Yaser Mohammed Al-Worafi Filippos Anagnostakis Behrad Eftekhari Soeun Kim Amol S. Dhane Khushboo Bisht Jiyeon Oh Mohammad Mahdi Bastan Melak Gedamu Beyene Ashel Chelsea Dsouza Sandip Chakraborty Abiye Assefa Berihun Abdel Rahman E’mar Mohammad Daud Ali Shahid Bashir Jae Il Shin Huyen Phuc Do Hasan Aalruz Syed Anees Ahmed Haroon Ahmed Abisola Esther Abdulmalik Omar Al Ta'ani Maha Moh'd Wahbi Atout Salah Al Awaidy Luis Alberto Cámera Giovanni Addolorato Márcia Carvalho Mohammad Khursheed Alam Yasser Bustanji Jaffar A. Al-Tawfiq

Publication Name: Lancet Gastroenterology and Hepatology

Publication Date: 2026-06-01

Volume: 11

Issue: 6

Page Range: 463-494

Description:

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, is one of the most prevalent liver diseases globally, contributing to both economic and health-related challenges. We aimed to evaluate the global, regional, and national burden of MASLD from 1990 to 2023, quantify the contribution of identified modifiable risk factors, and project future prevalence up to the year 2050. Methods: Estimates of MASLD prevalence and disability-adjusted life-years (DALYs) were produced by age, sex, region, Socio-demographic Index (SDI), and Healthcare Access and Quality (HAQ) index across 204 countries and territories from 1990 to 2023 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023. The MASLD burden attributable to three risk factors (smoking, high BMI, and high fasting plasma glucose) was assessed as part of the GBD comparative risk assessment. As a secondary analysis, we used these estimates to forecast MASLD prevalence up to 2050 using fasting plasma glucose and mean BMI as predictors. Furthermore, to examine the relative contributions of population ageing, population growth, and changes in MASLD prevalence rate to the forecasted changes in case counts from 2023 to 2050, we conducted a decomposition analysis. Findings: In 2023, approximately 1·3 billion (95% uncertainty interval [UI] 1·2 to 1·4) individuals were estimated to be living with MASLD (ie, 16·1% of the global population), with an age-standardised prevalence rate of 14 429·3 (95% UI 13 268·3 to 15 990·6) per 100 000 population, representing a percentage increase of 142·7% (95% UI 139·2 to 146·7) in crude numbers from 1990 (0·5 billion [0·5 to 0·6]) and of 28·6% (27·8 to 29·5) in the rate (11 217·2 [10 276·8 to 12 467·0] per 100 000 in 1990). An estimated 3·6 million (2·8 to 4·5) total DALYs were attributable to MASLD worldwide in 2023, corresponding to an age-standardised DALY rate of 39·6 (31·2 to 49·9) per 100 000 population. Despite a 116·3% (93·3 to 139·4) increase in crude DALYs (from 1·7 million [1·3 to 2·1] in 1990), its age-standardised estimate remained consistent (1·8% [–8·6 to 12·8]) from 1990 (38·9 [30·1 to 49·8] per 100 000) to 2023. There was substantial variation in age-standardised estimates across regions. North Africa and the Middle East had the highest prevalence rate (29 246·1 [26 848·3 to 32 048·7] per 100 000) and Andean Latin America showed the highest DALY rate (152·3 [114·1 to 194·7] per 100 000). By contrast, the high-income Asia Pacific region had the lowest prevalence rate (8653·5 [7923·7 to 9592·8] per 100 000) and east Asia had the lowest DALY rate (16·3 [13·5 to 19·9] per 100 000) among all GBD regions. North Africa and the Middle East showed disproportionately higher prevalence rates relative to other regions with similar SDIs. Lower SDIs and HAQs were associated with higher age-standardised DALY rates. The age-standardised prevalence rate was consistently higher in males (15 616·4 [14 349·2 to 17 263·3] per 100 000 people in 2023) than in females (13 245·2 [12 132·0 to 14 692·6] per 100 000 people), and peaked at age 80–84 years in both sexes. The number of MASLD prevalent cases was the highest in younger adults, peaking at age 35–39 years for males and age 55–59 years for females. Among the risk factors for MASLD, high fasting plasma glucose presented the largest contribution to the age-standardised DALY rate of total MASLD in 2023 (2·2 [95% UI 1·6 to 3·1] per 100 000 people), followed by high BMI (1·4 [0·6 to 2·4] per 100 000 people) and smoking (1·0 [0·3 to 1·8] per 100 000 people). Our forecasting model estimates that 1·8 billion (95% UI 1·6 to 2·0) individuals are likely to have MASLD by 2050, representing a 42·0% increase from 2023. The age-standardised prevalence rate is expected to increase to 15 774·9 (95% UI 14 613·9 to 17 336·2) per 100 000 people in 2050, representing an average annual percentage change of 0·3% (95% UI 0·3–0·3). According to our decomposition analysis, this change will be primarily due to population growth, particularly in sub-Saharan Africa and North Africa and Middle East, and less by population ageing or epidemiological change. Interpretation: With a global prevalence of 16·1% and approximately 1·3 billion people already living with MASLD in 2023, the condition has and will continue to have substantial health and economic impacts worldwide. An inverse association between the HAQ Index and age-standardised DALY rates suggests that countries with lower health-care access and quality might be less well positioned to manage the growing MASLD burden, underscoring the need for strengthened health-system capacity in these settings. Funding: Gates Foundation.

Open Access: Yes

DOI: 10.1016/S2468-1253(26)00011-7

Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023

Catherine Bisignano Ashley A. Harris Amanda E. Smith Paulina A. Lindstedt Simeon Okechukwu Ajakwe Olivia D. Nesbit Taylor Noyes Noga Shalev Latera Tesfaye Olana Catherine M. Antony Nancy Fullman Sharareh Eskandarieh Mushood Ahmed Naveed Ahmed Rana Kamal Abu Farha Kamoru Ademola Adedokun Nurudeen A. Adegoke Aanuoluwapo Adeyimika Afolabi Giuseppina Affinito Dolapo Emmanuel Ajala Eman Abu-Gharbieh Reed J.D. Sorensen Chun Wei Yuan Stein Emil Vollset Stephen S. Lim Jonathan F. Mosser Andy Stergachis Farbod Khosravi Sonali Kochhar Armita Abedi Usha Adiga Mitra Abbasifard Mohammad Amin Aalipour Faezeh Abbaspour Tomislav Mestrovic Dariush Abtahi Ripon Kumar Adhikary Mohd Adnan Aqeel Ahmad Simon I. Hay Abdollah Jafarzadeh Williams Agyemang-Duah Hana J. Abukhadijah Danish Ahmad Amin Sharifan Rotimi Felix Afolabi Saira Afzal Emad M. Abdallah Samar Abd Elhafeez Meqdad Saleh Ahmed Muktar Beshir Ahmed Syed Anees Ahmed Suneth Buddhika Agampodi Khurshid Ahmad Tauseef Ahmad Sepehr Aghajanian Ayman Ahmed Ramy Mohamed Ghazy Meriem Abdoun Salahdein Aburuz Lucas Guimarães Abreu Alireza Shakeri Qorinah Estiningtyas Sakilah Adnani Emily Haeuser Sam Byrne Jason Nguyen Catalina Raggi Susan A. McLaughlin Hedayat Abbastabar Rana Kamal Abu Farha Sherief Abd-Elsalam Dmitry Abramov Adam Abdullahi Faezeh Abbaspour Reda Abdel-Hameed Samar Abd ElHafeez Atef Abdelkader Deldar Morad Abdulah Haroon Ahmed Lisa C. Adams Toufik Abdul-Rahman Constanza Elizabeth Aguilera Arriagada Mahsa Ahadi Rabbiya Ahmad Shoaib Ahmad Asrat Agalu Abejew Abdu A. Adamu Juliana Bunmi Adetunji Kulmira Abdykerimova Rahim Abo Kasem Nagah M. Abourashed Mohamed Abouzid Roberto Ariel Abeldaño Zuñiga Juan Manuel Acuna Anirudh Balakrishna Acharya Meshack Achore Ousman Adal Habeeb Abiodun Afolabi Hasan Aalruz Arman Abdous Auwal Abdullahi Bilyaminu Abubakar David Adedia Syed Hani Abidi Olumide Abiodun Hassan Abolhassani Richard Gyan Aboagye Ulric Sena Abonie Abdullahi Tunde Aborode Wakgari Mosisa Abdisa Oyelola A. Adegboye Mohammad Mahdi Bastan Dhiraj Motilal Agarwal Tajudeen Adesanmi Adebisi Oluwatobi E. Adegbile Olumide Thomas Adeleke Mache Tsadik Adhana Molalegne Bitew Feven Sahle Gebre Leticia Akua Adzigbli Alireza Mirkheshti Sohrab Salimi Seyed Mohammad Seyed Alshohadaei Hafsa Zia Gizachew Taddesse Akalu Jiawei He Prince Owusu Adoma Dorsa Salabat Mohamed Jalloh Vafa Rahimi-Movaghar Sina Shool Melika Jameie Jafar Karami Farzad Kompani Mohammad Ali Mansournia Abdolreza Mohammadi Amin Mohsenzadeh Aleksandr Y. Aravkin Omid Dadras Iman M. Talaat Ali H. Mokdad Xiaochen Dai Lalit Dandona Rakhi Dandona Sara Bagheri Fereshteh Baghizadeh Mahdis Bayat Minoo Heidari Almasi Ali Asghar Kolahi Ali Nikoobar Mohammad Mahdi Rashidi Firoozeh Madadi Mehdi Safari Mastooreh Sagharichi Maryam Shayan Georgia Smith Samuel James Herold Annie Haakenstad Christopher J.L. Murray Zahra Siavashpour Mohsen Rezaeian Shakiba Ghasemi Assl Atakan Orscelik Yigit Can Senol Michael Zastrozhin Hannah Elizabeth Robinson-Oden Amin Azizan Nazila Rezaei Pegah Salimi Pormehr Amin Sedigh Farshad Shahkarami Kazem Ghaffari Ghazal Arjmand Mahsa Asadi Anar Rasoul Ebrahimi Seyed Ataollah Madinezad Behnaz Niroomand Seyed Kiarash Sadat Rafiei Antonio Olivas-Martinez

Publication Name: Lancet

Publication Date: 2025-07-19

Volume: 406

Issue: 10500

Page Range: 235-260

Description:

Background: Since its inception in 1974, the Essential Programme on Immunization (EPI) has achieved remarkable success, averting the deaths of an estimated 154 million children worldwide through routine childhood vaccination. However, more recent decades have seen persistent coverage inequities and stagnating progress, which have been further amplified by the COVID-19 pandemic. In 2019, WHO set ambitious goals for improving vaccine coverage globally through the Immunization Agenda 2030 (IA2030). Now halfway through the decade, understanding past and recent coverage trends can help inform and reorient strategies for approaching these aims in the next 5 years. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2023, this study provides updated global, regional, and national estimates of routine childhood vaccine coverage from 1980 to 2023 for 204 countries and territories for 11 vaccine-dose combinations recommended by WHO for all children globally. Employing advanced modelling techniques, this analysis accounts for data biases and heterogeneity and integrates new methodologies to model vaccine scale-up and COVID-19 pandemic-related disruptions. To contextualise historic coverage trends and gains still needed to achieve the IA2030 coverage targets, we supplement these results with several secondary analyses: (1) we assess the effect of the COVID-19 pandemic on vaccine coverage; (2) we forecast coverage of select life-course vaccines up to 2030; and (3) we analyse progress needed to reduce the number of zero-dose children by half between 2023 and 2030. Findings: Overall, global coverage for the original EPI vaccines against diphtheria, tetanus, and pertussis (first dose [DTP1] and third dose [DTP3]), measles (MCV1), polio (Pol3), and tuberculosis (BCG) nearly doubled from 1980 to 2023. However, this long-term trend masks recent challenges. Coverage gains slowed between 2010 and 2019 in many countries and territories, including declines in 21 of 36 high-income countries and territories for at least one of these vaccine doses (excluding BCG, which has been removed from routine immunisation schedules in some countries and territories). The COVID-19 pandemic exacerbated these challenges, with global rates for these vaccines declining sharply since 2020, and still not returning to pre-COVID-19 pandemic levels as of 2023. Coverage for newer vaccines developed and introduced in more recent years, such as immunisations against pneumococcal disease (PCV3) and rotavirus (complete series; RotaC) and a second dose of the measles vaccine (MCV2), saw continued increases globally during the COVID-19 pandemic due to ongoing introductions and scale-ups, but at slower rates than expected in the absence of the pandemic. Forecasts to 2030 for DTP3, PCV3, and MCV2 suggest that only DTP3 would reach the IA2030 target of 90% global coverage, and only under an optimistic scenario. The number of zero-dose children, proxied as children younger than 1 year who do not receive DTP1, decreased by 74·9% (95% uncertainty interval 72·1–77·3) globally between 1980 and 2019, with most of those declines reached during the 1980s and the 2000s. After 2019, counts of zero-dose children rose to a COVID 19-era peak of 18·6 million (17·6–20·0) in 2021. Most zero-dose children remain concentrated in conflict-affected regions and those with various constraints on resources available to put towards vaccination services, particularly sub-Saharan Africa. As of 2023, more than 50% of the 15·7 million (14·6–17·0) global zero-dose children resided in just eight countries (Nigeria, India, Democratic Republic of the Congo, Ethiopia, Somalia, Sudan, Indonesia, and Brazil), emphasising persistent inequities. Interpretation: Our estimates of current vaccine coverage and forecasts to 2030 suggest that achieving IA2030 targets, such as halving zero-dose children compared with 2019 levels and reaching 90% global coverage for life-course vaccines DTP3, PCV3, and MCV2, will require accelerated progress. Substantial increases in coverage are necessary in many countries and territories, with those in sub-Saharan Africa and south Asia facing the greatest challenges. Recent declines will need to be reversed to restore previous coverage levels in Latin America and the Caribbean, especially for DTP1, DTP3, and Pol3. These findings underscore the crucial need for targeted, equitable immunisation strategies. Strengthening primary health-care systems, addressing vaccine misinformation and hesitancy, and adapting to local contexts are essential to advancing coverage. COVID-19 pandemic recovery efforts, such as WHO's Big Catch-Up, as well as efforts to bolster routine services must prioritise reaching marginalised populations and target subnational geographies to regain lost ground and achieve global immunisation goals. Funding: The Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance.

Open Access: Yes

DOI: 10.1016/S0140-6736(25)01037-2