Meqdad Saleh Ahmed

59039407300

Publications - 5

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

The global, regional, and national burden of cancer, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023

Amani Alansari Ibukun Modupe Adesiyan Abdallah H.A. Abd Al Magied Mohammed Altigani Abdalla Arash Abdollahi Wael M. Abdel-Rahman Aminu Kende Abubakar Ahmed Abu-Zaid Kamoru Ademola Adedokun Nurudeen A. Adegoke Aanuoluwapo Adeyimika Afolabi Mohadese Ahmadzade Anisuddin Ahmed Fahmi Y. Al-Ashwal Dolapo Emmanuel Ajala Ashraf Nabiel Abdalla Raghu Ram Achar Eman Abu-Gharbieh Lisa C. Adams Muayyad M. Ahmad Maryam Abbasalipour bashash Mesfin Abebe Armita Abedi Sajjad Ahmad Syed Anees Ahmed Usha Adiga Faisal Ahmad Sajjad Ahmad A. Bhoomadevi Aqeel Ahmad Lisa M. Force Hasan Aalruz Kayleigh Bhangdia Jonathan M. Kocarnik Miranda L. May Feleke Doyore Agide Andrew Crist Williams Agyemang-Duah Roland Eghoghosoa Akhigbe Karolina Akinosoglou Omar Al Omari Alemwork Abie Hana J. Abukhadijah Muhammad Sohail Afzal Danish Ahmad Amir Mahmoud Ahmadzade Salah Al Awaidy Nasir Abbas Maryam Abbasalipour bashash Hanadi Al Hamad Syed Mahfuz Al Hasan Samar Abd Elhafeez Navidha Aggarwal Gasha Salih Ahmed Mehrunnisha Sharif Ahmed Meqdad Saleh Ahmed Muktar Beshir Ahmed Nesredin Ahmed Syed Anees Ahmed Marjan Ajami Mohammad Al Qadire Suneth Buddhika Agampodi Khurshid Ahmad César Agostinis Sobrinho Tauseef Ahmad Elham Ahmadi Ayman Ahmed Meriem Abdoun Salahdein Aburuz Yazan Al Thaher Zufishan Alam Lucas Guimarães Abreu Lawan Hassan Adamu Bhoomadevi A Louise Penberthy Natalie Pritchett Alistair Acheson Lee Deitesfeld Ahmed M. Afifi Bright Opoku Ahinkorah Fatemeh Afrashteh Qorinah Estiningtyas Sakilah Adnani Juan Manuel Acuna Hasan Aalruz Arman Abdous Auwal Abdullahi Bilyaminu Abubakar Isaac Yeboah Addo Syed Hani Abidi Olumide Abiodun Hassan Abolhassani Richard Gyan Aboagye Ulric Sena Abonie Habeeb Omoponle Adewuyi Parsa Abdi Wakgari Mosisa Abdisa Luai A. Ahmed Victor Adekanmbi Ibrar Ahmed Daba Abdissa Arya Afrooghe Omar Ali Mohammed Al Zaabi Khurshid Alam Leticia Akua Adzigbli Nasir Abbas Prince Owusu Adoma Khurshid Ahmad

Publication Name: Lancet

Publication Date: 2025-10-11

Volume: 406

Issue: 10512

Page Range: 1565-1586

Description:

Background: Cancer is a leading cause of death globally. Accurate cancer burden information is crucial for policy planning, but many countries do not have up-to-date cancer surveillance data. To inform global cancer-control efforts, we used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework to generate and analyse estimates of cancer burden for 47 cancer types or groupings by age, sex, and 204 countries and territories from 1990 to 2023, cancer burden attributable to selected risk factors from 1990 to 2023, and forecasted cancer burden up to 2050. Methods: Cancer estimation in GBD 2023 used data from population-based cancer registration systems, vital registration systems, and verbal autopsies. Cancer mortality was estimated using ensemble models, with incidence informed by mortality estimates and mortality-to-incidence ratios (MIRs). Prevalence estimates were generated from modelled survival estimates, then multiplied by disability weights to estimate years lived with disability (YLDs). Years of life lost (YLLs) were estimated by multiplying age-specific cancer deaths by the GBD standard life expectancy at the age of death. Disability-adjusted life-years (DALYs) were calculated as the sum of YLLs and YLDs. We used the GBD 2023 comparative risk assessment framework to estimate cancer burden attributable to 44 behavioural, environmental and occupational, and metabolic risk factors. To forecast cancer burden from 2024 to 2050, we used the GBD 2023 forecasting framework, which included forecasts of relevant risk factor exposures and used Socio-demographic Index as a covariate for forecasting the proportion of each cancer not affected by these risk factors. Progress towards the UN Sustainable Development Goal (SDG) target 3.4 aim to reduce non-communicable disease mortality by a third between 2015 and 2030 was estimated for cancer. Findings: In 2023, excluding non-melanoma skin cancers, there were 18·5 million (95% uncertainty interval 16·4 to 20·7) incident cases of cancer and 10·4 million (9·65 to 10·9) deaths, contributing to 271 million (255 to 285) DALYs globally. Of these, 57·9% (56·1 to 59·8) of incident cases and 65·8% (64·3 to 67·6) of cancer deaths occurred in low-income to upper-middle-income countries based on World Bank income group classifications. Cancer was the second leading cause of deaths globally in 2023 after cardiovascular diseases. There were 4·33 million (3·85 to 4·78) risk-attributable cancer deaths globally in 2023, comprising 41·7% (37·8 to 45·4) of all cancer deaths. Risk-attributable cancer deaths increased by 72·3% (57·1 to 86·8) from 1990 to 2023, whereas overall global cancer deaths increased by 74·3% (62·2 to 86·2) over the same period. The reference forecasts (the most likely future) estimate that in 2050 there will be 30·5 million (22·9 to 38·9) cases and 18·6 million (15·6 to 21·5) deaths from cancer globally, 60·7% (41·9 to 80·6) and 74·5% (50·1 to 104·2) increases from 2024, respectively. These forecasted increases in deaths are greater in low-income and middle-income countries (90·6% [61·0 to 127·0]) compared with high-income countries (42·8% [28·3 to 58·6]). Most of these increases are likely due to demographic changes, as age-standardised death rates are forecast to change by –5·6% (–12·8 to 4·6) between 2024 and 2050 globally. Between 2015 and 2030, the probability of dying due to cancer between the ages of 30 years and 70 years was forecasted to have a relative decrease of 6·5% (3·2 to 10·3). Interpretation: Cancer is a major contributor to global disease burden, with increasing numbers of cases and deaths forecasted up to 2050 and a disproportionate growth in burden in countries with scarce resources. The decline in age-standardised mortality rates from cancer is encouraging but insufficient to meet the SDG target set for 2030. Effectively and sustainably addressing cancer burden globally will require comprehensive national and international efforts that consider health systems and context in the development and implementation of cancer-control strategies across the continuum of prevention, diagnosis, and treatment. Funding: Gates Foundation, St Jude Children's Research Hospital, and St Baldrick's Foundation.

Open Access: Yes

DOI: 10.1016/S0140-6736(25)01635-6

Global, regional, and national burden of breast cancer among females, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023

Usha Adiga Meriem Abdoun Eman Abu-Gharbieh Anisuddin Ahmed Siddig Ibrahim Abdelwahab Roland Eghoghosoa Akhigbe Marjan Ajami Mohd Adnan Victor Adekanmbi Mehrandokht Abedini Reda Abdel-Hameed Samar Abd Elhafeez Rabail Alam Muhammad Sohail Afzal Jonathan M. Kocarnik Auwal Abdullahi Ukachukwu O. Abaraogu Khurshid Ahmad Rana Kamal Abu Farha Isaac Yeboah Addo Bilyaminu Abubakar Juan Manuel Acuna Nasir Abbas Hanadi Al Hamad César Agostinis Sobrinho Habeeb Omoponle Adewuyi Swetha Acharya Williams Agyemang-Duah Lisa C. Adams Fuad Hamdi A. Abuadas Dagninet Derebe Abie Ali Ahmadi Yazan Al Thaher Bright Opoku Ahinkorah Natalie Pritchett Nurudeen A. Adegoke Ayman Ahmed Deldar Morad Abdulah Kedir Hussein Abegaz Syed Mahfuz Al Hasan Mohammad Al Qadire Danish Ahmad Mohammed Albashtawy Feleke Doyore Agide Babatope Oluwadamilare Adebiyi Armita Abedi Dina Abushanab David Adedia Muktar Beshir Ahmed Kamoru Ademola Adedokun A. Bhoomadevi Muayyad M. Ahmad Aqeel Ahmad Qorinah Estiningtyas Sakilah Adnani Miracle Ayomikun Adesina Domenico Albano Ulric Sena Abonie Mai Abdel Haleem Abusalah Hasan Aalruz Kayleigh Bhangdia Temitayo Esther Adeyeoluwa Gasha Salih Ahmed Aanuoluwapo Adeyimika Afolabi Louise Penberthy Richard Gyan Aboagye Mesfin Abebe Mahnaz Ahmadi Hazim S. Ababneh Zhanar Abu Toufik Abdul-Rahman Naveed Ahmed Hana J. Abukhadijah Leticia Akua Adzigbli Alistair Acheson Alemwork Abie Mehrunnisha Sharif Ahmed Hassan Abolhassani Arash Abdollahi Dolapo Emmanuel Ajala Saheed Ayodeji Adekola Aminu Kende Abubakar Abebaw Alamrew Lee Deitesfeld Austin J. Ahlstrom Meqdad Saleh Ahmed None Abdullah Mohammed Mehdi Abrar Mohammad Ahmmad Mahmoud Al Zoubi Kulmira Abdykerimova Andrew Crist Miranda L. May Aram Mahmood Ahmed Sepideh Abdi Hasan Aalruz Syed Anees Ahmed Haroon Ahmed Zhanar Abu MD Faisal Ahmed Bhoomadevi A Salah Al Awaidy Wael M. Abdel-Rahman Olumide Abiodun Muhammad Nadeem Akhtar

Publication Name: Lancet Oncology

Publication Date: 2026-03-01

Volume: 27

Issue: 3

Page Range: 302-326

Description:

Background Breast cancer is a leading cause of mortality and morbidity among females worldwide. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, we provided an updated comprehensive assessment of the epidemiological trends, disease burden, and risk factors associated with breast cancer globally, regionally, and nationally from 1990 to 2023. Methods Breast cancer incidence, mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) were estimated by age and sex for 204 countries and territories from 1990 to 2023. Mortality estimates were generated using GBD Cause of Death Ensemble models, leveraging data from population-based cancer registration systems, vital registration systems, and verbal autopsies. Mortality-to-incidence ratios were calculated to derive both mortality and incidence estimates. Prevalence was calculated by combining incidence and modelled survival estimates. YLLs were established by multiplying age-specific deaths with the GBD standard life expectancy at the age of death. YLDs were estimated by applying disability weights to prevalence estimates. The sum of YLLs and YLDs equalled the number of DALYs. Breast cancer burden attributable to seven risk factors was examined through the comparative risk assessment framework. The GBD forecasting framework was used to forecast breast cancer incidence and mortality from 2024 to 2050. Age-standardised rates were calculated for each metric using the GBD 2023 world standard population. Findings In 2023, there were an estimated 2·30 million (95% uncertainty interval [UI] 2·01 to 2·61) breast cancer incident cases, 764 000 deaths (672 000 to 854 000), and 24·1 million (21·3 to 27·5) DALYs among females globally. In the World Bank low-income group, where a low age-standardised incidence rate (ASIR) was estimated (44·2 per 100 000 person-years [31·2 to 58·4]), the age-standardised mortality rate (ASMR) was the highest (24·1 per 100 000 [16·8 to 31·9]). The highest ASIR was in the high-income group (75·7 per 100 000 [67·1 to 84·0]), and the lowest ASMR was in the upper-middle-income group (11·2 per 100 000 [10·2 to 12·3]). Between 1990 and 2023, the ASIR in the low-income group increased by 147·2% (38·1 to 271·7), compared with a 1·2% (–11·5 to 17·2) change in the high-income group. The ASMR decreased in the high-income group, changing by –29·9% (–33·6 to –25·9), but increased by 99·3% (12·5 to 202·9) in the low-income group. The increase in age-standardised DALY rates followed that of ASMRs. Risk factors such as dietary risks, tobacco use, and high fasting plasma glucose contributed to 28·3% (16·6 to 38·9) of breast cancer DALYs in 2023. The risk factors with a decrease in attributable DALYs between 1990 and 2023 were high alcohol use and tobacco. By 2050, the global incident cases of breast cancer among females were forecast to reach 3·56 million (2·29 to 4·83), with 1·37 million (0·841 to 2·02) deaths. Interpretation The stable incidence and declining mortality rates of female breast cancer in high-income nations reflect success in screening, diagnosis, and treatment. In contrast, the concurrent rise in incidence and mortality in other regions signals health system deficits. Without effective interventions, many countries will fall short of the WHO Global Breast Cancer Initiative's ambitious target of achieving an annual reduction of 2·5% in age-standardised mortality rates by 2040. The mounting breast cancer burden, disproportionately affecting some of the world's most vulnerable populations, will further exacerbate health inequalities across the globe without decisive immediate action. Funding Gates Foundation, St Jude Children's Research Hospital.

Open Access: Yes

DOI: 10.1016/S1470-2045(25)00730-2

Global, regional, and national sepsis incidence and mortality, 1990–2021: a systematic analysis

Usha Adiga Samah W. Al-Jabi Meriem Abdoun Quique Bassat Zulfiqar A. Bhutta Hany Aly Ashish Bhargava Hasan Yaser Alniss Razique Anwer Abdul Monim Batiha Asrat Agalu Abejew Samar Abd Elhafeez Mahwish Arooj Matteo Bauckneht Mohammad R. Alqudimat Alok Atreya Abdelazeem M. Algammal Saeid Anvari Auwal Abdullahi Tahira Ashraf Shereen M. Aleidi Mohammad R. Alosta Senthilkumar Balakrishnan Zarrin Basharat Montaha Al-Iede Nasir Abbas Syed Shujait Ali Williams Agyemang-Duah Sahel Majed Alrousan Lucien R. Swetschinski Sonu Bhaskar Anayochukwu Edward Anyasodor Lisa C. Adams Ahmad Naoras Bitar Madineh Abbasi Habib Benzian Intima Alrimawi Nicole Davis Weaver Mohammed Albashtawy Meshack Achore Domenico Azzolino Eve E. Wool Kamoru Ademola Adedokun Fahad A. Alhumaydhi Ahmad Alrawashdeh Aqeel Ahmad Simachew Animen Bante Nelson Alvis-Guzman Umar Muhammad Bello Rafat Ali Kevin S. Ikuta Qorinah Estiningtyas Sakilah Adnani Rajon Banik Amadou Barrow Mina Borran Wondu Feyisa Balcha Chieh Han Gasha Salih Ahmed Aanuoluwapo Adeyimika Afolabi Alaa Aboelnour Badran Anna Gershberg Hayoon Hamed Borhany Nikha Bhardwaj Ahmad Rajeh Al-Qudimat Najim Z. Alshahrani Fentahun Alemnew Mesfin Abebe Md Akib Al-Zubayer Ema Akter Ridwan Olamilekan Adesola Ali Azargoonjahromi Authia P. Gray Mahsa Ahadi Mohammed Usman Ali Zelalem Asmare Hana J. Abukhadijah Alemwork Abie Amani Alansari Asnake Gashaw Belayneh Yaser Mohammed Al-Worafi Filippos Anagnostakis Daniel T. Araki Hassan Abolhassani Sabah Al-Marwani Gokce Belge Bilgin Mohammad Mahdi Bastan Meqdad Saleh Ahmed Rebecca L. Hsu Abiye Assefa Berihun Erin Chung Hiba Jawdat Barqawi Julie Alaere Atta Nurila Aryntayeva Wakgari Mosisa Abdisa Qorinah Estiningtyas Sakilah Adnani Redeat Libanos Assefa Syed Anees Ahmed Haroon Ahmed Sadat Abdulla Aziz Avinash Aujayeb Tomislav Mestrovic

Publication Name: Lancet Global Health

Publication Date: 2025-12-01

Volume: 13

Issue: 12

Page Range: e2013-e2026

Description:

Background: The global burden of sepsis, a life-threatening dysregulated host response to infection leading to organ dysfunction, remains challenging to quantify. We aimed to comprehensively estimate the global, regional, and national burden of sepsis, including the impact of the COVID-19 pandemic and underlying causes of sepsis-related deaths with co-occurring infectious syndromes. Methods: We used multiple cause-of-death, hospital, minimally invasive tissue sampling, and linked death certificate and hospital record data representing 149 million deaths, covering 4290 location-years with mortality estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to capture explicit and implicit sepsis cases and deaths. We estimated age-location-sex-specific fractions of sepsis-related deaths from 195 underlying causes of death and 22 infectious syndromes from 1990 to 2021 using binomial logistic regression models, and estimated sepsis-related deaths using GBD cause-specific mortality estimates. Using 250 million hospital admissions and 7·82 million deaths from hospital data, representing 1310 location-years, we modelled case fatality rates by use of binomial logistic regression, applied to sepsis death estimates to estimate sepsis incidence by age, location, and year. Findings: In 2021, we estimated 166 million (95% uncertainty interval 135–201) sepsis cases and 21·4 million (20·3–22·5) all-cause sepsis-related deaths globally, representing 31·5% of total global deaths. Sepsis-related deaths decreased between 1990 and 2019, followed by a surge in 2020 and 2021. As of 2021, individuals aged 15 years and older experienced increases across incidence (230%) and mortality (26·3%) since 1990. Those aged 70 years and older had the highest sepsis-related mortality in 2021 (9·28 million [8·74–9·86] deaths). Sepsis-related deaths from infectious underlying causes decreased from 11·8 million (11·1–12·5) in 1990 to 8·34 million (7·72–9·01) in 2019, then increased by 86·4% to 15·5 million (14·7–16·4) in 2021. Sepsis-related mortality due to non-infectious underlying causes of death increased from 4·69 million (4·35–5·05) in 1990 to 5·81 million (5·40–6·25) in 2021; the leading non-infectious underlying causes of death with sepsis were stroke, chronic obstructive pulmonary disease, and cirrhosis. In 2021, bloodstream infections inclusive of HIV and malaria (3·08 million [2·83–3·35]) and lower respiratory infections inclusive of COVID-19 (11·33 million [1·20–1·47]) were the most prominent infectious syndromes complicating sepsis-related deaths from non-infectious underlying causes, representing a consistent trend since 1990. Interpretation: The global burden of sepsis increased in 2020 and 2021, reversing progress from 1990. Sepsis incidence and mortality increased in people aged 15 years and older, especially those aged 70 years and older, and as a complication of non-infectious underlying causes of death such as stroke, primarily through bloodstream infections and lower respiratory infections. The global burden of sepsis is substantial, and sepsis is increasingly a complication of non-infectious causes of death. Funding: Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund.

Open Access: Yes

DOI: 10.1016/S2214-109X(25)00356-0

Updated trends in the global prevalence and burden of mental disorders, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Usha Adiga Thilini Chanchala Agampodi Rasmieh Mustafa Al-Amer Marjan Ajami Mohd Adnan Omar Al Omari Fadwa Naji Alhalaiqa Salahdein Aburuz Rufus Adesoji Adedoyin Khurshid Ahmad Rana Kamal Abu Farha Isaac Yeboah Addo Ahmad Y. Abuhelwa Wole Akosile Irfan Ali Nader Al-Dewik Obed Adonteng-Kissi Damian F. Santomauro Lawan Hassan Adamu César Agostinis Sobrinho Nadin M.I. Abdel Razeq Williams Agyemang-Duah Sarah Wulf Hanson Ana M. Mantilla Herrera Shady Abohashem Fahmi Y. Al-Ashwal Tariq A. Alalwan Ayman Ahmed Prince Agwu Fahad D. Algahtani Deldar Morad Abdulah Negar Sadat Ahmadi Makinde Adebayo Adeniyi John J. McGrath Holly E. Erskine Mohammed Albashtawy Khurshid Alam Meshack Achore Olumide Thomas Adeleke Babatope Oluwadamilare Adebiyi Olifan Zewdie Abil Sawsan Abuhammad Abdulelah Mastour Aldhahir David Adedia Rafat Ali Qorinah Estiningtyas Sakilah Adnani Miracle Ayomikun Adesina Sarah Wulf Hanson Hedayat Abbastabar Tauseef Ahmad Oli Ahmed Hasan Aalruz James G. Scott Sajjad Ahmad Zenaw Debasu Addisu Hailey Hagins Jamileh Shadid Giuseppina Affinito Richard Gyan Aboagye Mesfin Abebe Navidha Aggarwal Ali Abdolizadeh David Adzrago Ali M. Alfalki Kamran Ali Kasuni H.M. Akalanka Mohammed Usman Ali Hana J. Abukhadijah Abdullah Alarifi Abdullahi Tunde Aborode Khabir Ahmad Mohammad T. Abuawwad Amani Alansari Habeeb Abiodun Afolabi Ashley E. Akrami Saheed Ayodeji Adekola Moaz Elsayed Abouelmagd Aminu Kende Abubakar Meqdad Saleh Ahmed Paul Anthony Miller Anh Vo Habtamu Abebe Getahun Ashraf Alhumaidi Nuhu Lawan Adamu Nesredin Ahmed Abisola Esther Abdulmalik Mohammad Daud Ali Tajudeen Adesanmi Adebisi Mohammad Ahmmad Mahmoud Al Zoubi Ahmed Abdelrahman Abdelgalil Aram Mahmood Ahmed Hasan Aalruz Syed Anees Ahmed Adamu Adamu Ahmad Suhaib Ahmad Abisola Esther Abdulmalik Roberto Ariel Abeldaño Zuñiga Meklit Girma Abebe Dhikroh Oriyomi Adekola Fahmi Y. Al-Ashwal Darius Jake Roy Salah Al Awaidy Muhammad Nadeem Akhtar Ali Ahmed

Publication Name: Lancet

Publication Date: 2026-05-23

Volume: 407

Issue: 10543

Page Range: 2040-2064

Description:

Background The 2023 iteration of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimated prevalence, incidence, and health burden for 375 diseases and injuries, including 12 mental disorders. We assess past, current, and emerging trends in the prevalence and burden of mental disorders across sexes and age groups, for 21 regions, 204 countries and territories, and by Socio-demographic Index (SDI) quintile, from 1990 to 2023. Methods Mental disorders included in GBD 2023 were anxiety disorders, major depressive disorder, dysthymia, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, anorexia nervosa, bulimia nervosa, idiopathic developmental intellectual disability, and a residual category of other mental disorders. A literature review identified epidemiological data for each disorder. These were analysed via a Bayesian meta-regression to estimate prevalence by disorder, sex, age, location, and year. Disorder-specific prevalence was multiplied by disability weights representing the severity of health loss associated with each disorder to estimate years lived with disability (YLDs). Deaths due to anorexia nervosa were assessed with a Cause of Death Ensemble modelling strategy to estimate deaths by sex, age, location, and year, and then multiplied by the standard life expectancy at age of death to estimate years of life lost (YLLs). YLDs equalled disability-adjusted life-years (DALYs) for all mental disorders except anorexia nervosa (the only mental disorder considered as an underlying cause of death in GBD), for which DALYs represented the sum of YLDs and YLLs. We presented prevalence, deaths, YLDs, YLLs, and DALYs as counts, age-specific rates per 100 000 population, and age-standardised rates per 100 000 population. Findings We estimated 1·17 billion (95% uncertainty interval 1·06–1·31) prevalent cases of mental disorders globally in 2023, equivalent to an age-standardised prevalence rate of 14 210·7 cases (12 849·5–15 940·1) per 100 000 population. These estimates represented a 95·5% (75·0–121·2) increase in prevalent cases and 24·2% (11·4–41·4) increase in age-standardised prevalence rate between 1990 and 2023. All mental disorders showed increases in prevalent cases between 1990 and 2023, while notable increases were seen in age-standardised prevalence rates for anxiety disorders, major depressive disorder, dysthymia, anorexia nervosa, bulimia nervosa, schizophrenia, and conduct disorder. There were an estimated 171 million (127–228) DALYs due to mental disorders globally across sex and age in 2023, equivalent to an age-standardised DALY rate of 2070·5 DALYs (1519·1–2750·5) per 100 000 population. Mental disorders contributed to 6·1% (4·8–7·6) of all-cause DALYs in 2023, making them the fifth leading cause of global DALYs (up from 12th in 1990). DALYs were almost entirely composed of YLDs. Mental disorders were the leading cause of YLDs in 2023 (up from second in 1990), explaining 17·3% (14·8–20·6) of all-cause global YLDs. Leading causes of mental disorder DALYs were anxiety disorders (ranked 11th among the 304 diseases and injuries at Level 4 of the GBD cause hierarchy), major depressive disorder (15th), and schizophrenia (41st). Globally in 2023, mental disorder age-standardised DALY rates were higher among females (2239·6 [1643·7–3014·1] per 100 000) than among males (1900·2 [1399·8–2510·8] per 100 000), and peaked in the 15–19 years age group (2617·3 [1850·6–3696·8] per 100 000). All locations showed increased mental disorder DALY rates in 2023 compared with 1990, ranging across countries and territories from 1302·4 (952·7–1683·7) per 100 000 in Viet Nam to 3555·8 (2661·9–4715·0) per 100 000 in the Netherlands. Across SDI quintiles, DALY rates ranged from 1853·0 (1352·1–2469·3) per 100 000 for middle SDI to 2184·1 (1606·1–2890·3) per 100 000 for high SDI. Interpretation A significant health burden was imposed by mental disorders in all countries and territories in 2023, irrespective of the health resources available. In some instances, this burden has increased over time and is unevenly distributed across populations. Stronger surveillance systems, particularly in low-income and middle-income countries, are required. Additionally, we need more coordinated and inclusive policies to reduce the burden through early treatment and prevention, tailored to sex and age differences across locations. Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice. Funding Gates Foundation, Queensland Health, and University of Queensland.

Open Access: Yes

DOI: 10.1016/S0140-6736(26)00519-2