Wakgari Mosisa Abdisa

59998578600

Publications - 6

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 Cardiovascular Diseases and Risk Factors in 204 Countries and Territories, 1990-2023

Nermeen Abu-Elala Rana Kamal Abu Farha Madineh Abbasi Abdallah H.A. Abd Al Magied Kamoru Ademola Adedokun Nurudeen A. Adegoke Eman Abu-Gharbieh Lisa C. Adams Mesfin Abebe Armita Abedi Mohammad Amin Aalipour A. Bhoomadevi Bedru J. Abafita Ukachukwu O. Abaraogu Dariush Abtahi Ripon Kumar Adhikary Mohd Adnan Hasan Aalruz E. S. Abhilash Hana J. Abukhadijah Muhammad Sohail Afzal Nasir Abbas Bedru J. Abafita Tanin Adl Parvar César Agostinis Sobrinho Saira Afzal Samar Abd Elhafeez Navidha Aggarwal Olorunsola Israel Adeyomoye Nermeen Abu-Elala Prof Bhoomadevi A Benjamin A. Stark Nicole K. DeCleene Prerna Agarwal Emily C. Desai Johnathan M. Hsu Catherine O. Johnson Laura Lara-Castor Suneth Buddhika Agampodi Sepehr Aghajanian Prof Ahmed Abdelalim Salahdein Aburuz Omar M. Abdelfattah Prof Reda Abdel-Hameed Prof Wael M Abdel-Rahman Mahmoud Abdelnabi Lucas Guimarães Abreu Prof Olumide Abiodun Rui Adão Mujahid Abdullah Apurba Acharya Aminu Kende Kende Abubakar Ibrahim Jatau Abubakar Swetha Acharya Charles Oluwaseun Adetunji Rishan Adha Wirawan Adikusuma Lawan Hassan Adamu Qorinah Estiningtyas Sakilah Adnani Gina Agarwal Ahmed M. Afifi Fatemeh Afrashteh Hedayat Abbastabar Samar Abd ElHafeez Asrat Agalu Abejew Kulmira Abdykerimova Aidin Abedi Olugbenga Olusola Abiodun Shady Abohashem Rahim Abo Kasem Nagah M. Abourashed Dmitry Abramov Anirudh Balakrishna Acharya Meshack Achore Ousman Adal Habeeb Abiodun Afolabi Hasan Aalruz Arman Abdous Auwal Abdullahi Isaac Yeboah Addo David Adedia Hassan Abolhassani Richard Gyan Aboagye Ulric Sena Abonie Abdullahi Tunde Aborode Parsa Abdi Wakgari Mosisa Abdisa Victor Adekanmbi Kate E. LeGrand Mohammad Abavisani Oladimeji Muritala Adebayo Oyelola A. Adegboye Daba Abdissa Mohammadreza Abbasian Arya Afrooghe Dhiraj Motilal Agarwal Temesgen Anjulo Ageru Dina Abushanab Tajudeen Adesanmi Adebisi Oluwatobi E. Adegbile Olumide Thomas Adeleke David Adzrago Leticia Akua Adzigbli Nasir Abbas Prince Owusu Adoma Kishor Adhikari Salahdein Aburuz

Publication Name: Journal of the American College of Cardiology

Publication Date: 2025-12-02

Volume: 86

Issue: 22

Page Range: 2167-2243

Description:

Background: Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging. Objectives: We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure. Methods: The Global Burden of Disease (GBD) 2023 study, a multinational collaborative research study, quantified burden due to 375 diseases including CVD burden and identified drivers of change from 1990 to 2023 using all available data and statistical models. GBD 2023 estimated the population-level burden of diseases in 204 countries and territories from 1990 to 2023. Results: CVDs were the leading cause of disability-adjusted life years (DALYs) and deaths estimated in the GBD. As of 2023, there were 437 million (95% UI: 401 to 465 million) CVD DALYs globally, a 1.4-fold increase from the number in 1990 of 320 million (292 to 344 million). Ischemic heart disease, intracerebral hemorrhage, ischemic stroke, and hypertensive heart disease were the leading cardiovascular causes of DALYs in 2023 globally. As of 2023, age-standardized CVD DALY rates were highest in low and low-middle Socio-demographic Index (SDI) settings and lowest in high SDI settings. The number of CVD deaths increased globally from 13.1 million (95% UI: 12.2 to 14.0 million) in 1990 to 19.2 million (95% UI: 17.4 to 20.4 million) in 2023. The number of prevalent cases of CVD more than doubled since 1990, with 311 million (95% UI: 294 to 333 million) prevalent cases of CVD in 1990 and 626 million (95% UI: 591 to 672 million) prevalent cases in 2023 globally. A total of 79.6% (95% UI: 75.7% to 82.5%) of CVD burden is attributable to modifiable risk factors 347 million [95% UI: 318 to 373 million] DALYs in 2023). Globally, high systolic blood pressure, dietary risks, high low-density lipoprotein cholesterol, and air pollution were the modifiable risks responsible for most attributable CVD burden in 2023. Since 1990, changes in exposure to modifiable risk factors have had mixed effects on CVD burden, with increases in high body mass index, high fasting plasma glucose, and low physical activity leading to higher burden, while reductions in tobacco usage have mitigated some of these increases. Population growth and population aging were the main drivers of the increasing burden since 1990, adding 128 million (95% UI: 115 to 139 million) and 139 million (95% UI: 126 to 151 million) CVD DALYs to the increase in CVD burden since 1990. Conclusions: CVD remains the leading cause of disease burden and death worldwide with the greatest burden in low, low-middle, and middle SDI regions. Large variation exists in CVD burden even for countries at similar levels of development, a gap explained substantially by known, modifiable risk factors that are inadequately controlled. The decades-long increase in CVD burden was the result of population growth, population aging, and increased exposure to a subset of risk factors led by metabolic risks. Countries will need to adopt effective health system and public health strategies if they are to progress in achieving global goals to reduce the burden of CVD.

Open Access: Yes

DOI: 10.1016/j.jacc.2025.08.015

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

Global burden of enteric infectious diseases, diarrhoeal diseases, and corresponding aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Usha Adiga Emad M. Abdallah Dariush Abtahi Eman Abu-Gharbieh Amr Selim Abu Lila Siddig Ibrahim Abdelwahab Rashad Abdul-Ghani Anirudh Balakrishna Acharya Mohd Adnan Lorainne Tudor Car Victor Adekanmbi Reda Abdel-Hameed Asrat Agalu Abejew Ayo Stephen Adebowale Samar Abd Elhafeez Jeza Muhamad Abdul Aziz Ripon Kumar Adhikary Muhammad Sohail Afzal Nermeen Abu-Elala Auwal Abdullahi Rana Kamal Abu Farha Isaac Yeboah Addo Ahmad Y. Abuhelwa Victor Ibukun Agbajelola Zeleke Dutamo Agde Obed Adonteng-Kissi Piyush Agrawal Swetha Acharya Charles Oluwaseun Adetunji Lisa C. Adams Fuad Hamdi A. Abuadas Madineh Abbasi Omar Ahmed Abdelwahab Nurudeen A. Adegoke Jiawei He Makinde Adebayo Adeniyi Austin Carter Abdu A. Adamu Rezheen Fatah Abdulrahman Olumide Thomas Adeleke Feleke Doyore Agide Babatope Oluwadamilare Adebiyi Olifan Zewdie Abil Samuel B. Albertson Dina Abushanab Sawsan Abuhammad David Adedia Kamoru Ademola Adedokun Percival Delali Delali Agordoh A. Bhoomadevi Catherine Bisignano Qorinah Estiningtyas Sakilah Adnani Oluwawemimo Oluseun Adebowale Ebenezer Afrifa-Yamoah Hasan Aalruz Avina Vongpradith Samuel M. Ostroff Richard Gyan Aboagye Molalign Aligaz Aligaz Adisu Melese Shenkut Abebe Navidha Aggarwal Rizwan Suliankatchi Abdulkader Arman Abdous Nagah M. Abourashed Toufik Abdul-Rahman Belete Muluadam Admassie Regina Mae Villanueva Dominguez Hana J. Abukhadijah Abdullahi Tunde Aborode Abdulrakib Abdulrahim Abdelmuhsin Abdelgadir Hassan Abolhassani Adedeji Adenusi Saheed Ayodeji Adekola Yirgalem Abere Shairyar Afzal Oluwatobi E. Adegbile None Abdullah Sadik Abdulwehab Belayneh Jejaw Abate Aishah Fadila Adamu Syed Hani Abidi Tajudeen Adesanmi Adebisi Kulmira Abdykerimova Wakgari Mosisa Abdisa Alqassem H. Abuarqoub Ahmed Abdelrahman Abdelgalil Amanda Movo Rofiat Adewumi Adewumi Aderinoye-Rabiu Hasan Aalruz Krishna Prasad Acharya Meklit Girma Abebe Abdulbasit Sherfa Abduljelil Bhoomadevi A Ahmed AH Abdellatif Nermeen Abu-Elala Adekola George Adepoju Zirak Ahmed Abdulrahman Kalkidan Yibeltal Admassu Yau Adamu Nagah M. Abourashed Daniel Adeyemi Adepoju Olumide Abiodun Saira Afzal

Publication Name: Lancet Infectious Diseases

Publication Date: 2026-01-01

Volume: Unknown

Issue: Unknown

Page Range: Unknown

Description:

Background: Enteric infectious diseases claim more than 1 million lives annually and are among the top ten causes of death in children younger than 5 years. Remarkable global investment has been dedicated to enteric infectious disease prevention and control; however, the shifting global health landscape is testing the continuance of progress. To evaluate the current status and guide future interventions, we present the latest epidemiological estimates of enteric infectious diseases from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 and assess progress towards the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) mortality target of fewer than 20 deaths per 100 000 children younger than 5 years by 2025. Methods: We quantified the incidence, mortality, and disability-adjusted life-years (DALYs) of enteric infectious diseases by age, sex, and year across 204 countries and territories from 1990 to 2023. In GBD 2023, the following were considered under the category of enteric infectious diseases: diarrhoeal diseases, enteric fever (typhoid and paratyphoid), invasive non-typhoidal Salmonella spp (iNTS) infections, and other intestinal infectious diseases. We also examined 15 aetiologies contributing to diarrhoeal diseases. Incidence and prevalence were estimated with DisMod-MR (version 2.1), a Bayesian meta-regression tool, drawing on data from systematic reviews, population-based surveys, claims data, and hospital sources. Cause-specific mortality was modelled with Cause of Death Ensemble Modelling based on data from sources including vital registration, mortality surveillance, verbal autopsy, and minimally invasive tissue sampling. Years of life lost and years lived with disability were computed and combined to derive DALYs. For aetiology-specific estimation, population-attributable fractions (PAFs) for 15 pathogens were derived with a counterfactual framework. Point estimates and 95% uncertainty intervals (UIs) were generated from 250 draws from the posterior distribution. Findings: In 2023, enteric infectious diseases resulted in an estimated 1·27 million (95% UI 0·963–1·68) deaths globally, declining from 3·69 million (3·04–4·56) in 1990. The global age-standardised mortality rate (ASMR) decreased from 74·1 (62·0–92·9) per 100 000 population to 16·4 (12·6–21·3) per 100 000 population during the same period. Diarrhoeal diseases accounted for most deaths in 2023 (1·11 million [0·811–1·54]), followed by enteric fever and iNTS. South Asia and sub-Saharan Africa remained the most affected regions in 2023, with 599 000 (441 000–882 000) and 501 000 (373 000–648 000) deaths due to enteric infectious diseases, respectively, predominantly from diarrhoeal disease. Rotavirus was the leading cause of all-age diarrhoeal disease deaths (PAF 16·3% [12·0–21·5]), followed by norovirus (10·2% [2·4–17·0]) and Shigella spp (9·3% [5·4–15·2]). Among children younger than 5 years, PAFs of deaths due to diarrhoeal diseases were 40·2% (32·5–48·5) for rotavirus, 24·0% (15·1–36·7) for Shigella spp, and 23·4% (13·7–34·3) for adenovirus. Across 204 countries and territories, 141 met the GAPPD mortality target in 2023. The driving aetiologies among countries that did not meet the target in 2023 varied slightly by GBD super-region, but the highest or second-highest number of deaths in children younger than 5 years were consistently attributed to rotavirus. Astrovirus and sapovirus, newly included in GBD 2023, were responsible for 24 600 (6290–49 000) and 18 800 (4650–44 400) deaths, respectively, in 2023, mainly in children younger than 5 years. Interpretation: Our findings show that mortality and ASMRs of enteric infectious diseases declined substantially between 1990 and 2023. This decline is consistent with the expansion of public health measures and broader socioeconomic development. However, the burden in 2023 remains considerably high, with the highest mortality concentrated in sub-Saharan Africa and south Asia. Considering that more than a quarter of all countries had yet to meet the GAPPD mortality target in 2023, sustained efforts are needed to address the persistent burden in affected countries and to adapt to the changing global health landscape. Funding: Gates Foundation.

Open Access: Yes

DOI: 10.1016/S1473-3099(26)00194-5

Global, regional, and national burden of tuberculosis and multidrug-resistant tuberculosis by HIV status, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Usha Adiga Emad M. Abdallah Meriem Abdoun Eman Abu-Gharbieh Amr Selim Abu Lila Siddig Ibrahim Abdelwahab Rashad Abdul-Ghani Anirudh Balakrishna Acharya Mohd Adnan Victor Adekanmbi Dhiraj Motilal Agarwal Asrat Agalu Abejew Samar Abd Elhafeez Jeza Muhamad Abdul Aziz Ripon Kumar Adhikary Muhammad Sohail Afzal Auwal Abdullahi Ukachukwu O. Abaraogu Rana Kamal Abu Farha Isaac Yeboah Addo Bilyaminu Abubakar Ahmad Y. Abuhelwa Olatunji O. Adetokunboh Ali Abuhaliema Obed Adonteng-Kissi Lawan Hassan Adamu Sherief Abd-Elsalam Swetha Acharya Williams Agyemang-Duah Mei Fong Liew Charles Oluwaseun Adetunji Juliana Bunmi Adetunji Aseel Aburub Deldar Morad Abdulah Abiola Victor Adepoju Jiawei He Makinde Adebayo Adeniyi Abdu A. Adamu Rezheen Fatah Abdulrahman Olumide Thomas Adeleke Feleke Doyore Agide Jorge R. Ledesma Babatope Oluwadamilare Adebiyi Olifan Zewdie Abil Sawsan Abuhammad Kamoru Ademola Adedokun Percival Delali Delali Agordoh Oluwawemimo Oluseun Adebowale Arailym Abilbayeva Ebenezer Afrifa-Yamoah Yasir M. Abdulateef Abdul Momin Rizwan Ahmad Mai Abdel Haleem Abusalah Aanuoluwapo Adeyimika Afolabi Samuel M. Ostroff Richard Gyan Aboagye Molalign Aligaz Aligaz Adisu Shimaa M. Aboelnaga Huong Thi Chu Navidha Aggarwal Wondimnew Desalegn Addis Ridwan Olamilekan Adesola Ali Abdolizadeh Arman Abdous Nagah M. Abourashed Prince Owusu Adoma Gizachew Beykaso Agafari Belete Muluadam Admassie Regina Mae Villanueva Dominguez Hana J. Abukhadijah Abdullahi Tunde Aborode Meixin Zhang Jianing Ma Abdulrakib Abdulrahim Hassan Abolhassani Saheed Ayodeji Adekola Sophie Mei Lin Whikehart Oluwatobi E. Adegbile Habtamu Abebe Getahun Nuhu Lawan Adamu None Abdullah Sadik Abdulwehab Belayneh Jejaw Abate Megan Verma Syed Hani Abidi Tajudeen Adesanmi Adebisi Wakgari Mosisa Abdisa Amanda Movo Mahdi Aghaalikhani Yasir M. Abdulateef Krishna Prasad Acharya Adamu Adamu Ahmad Hassan A. Abdou Zirak Ahmed Abdulrahman Nagah M. Abourashed Hatem A Eltaly Mazhar Abbas Vijay K. Aggarwal Adnan Ahmad Nermeen Abu-Elala Olumide Abiodun Saira Afzal

Publication Name: Lancet Infectious Diseases

Publication Date: 2026-01-01

Volume: Unknown

Issue: Unknown

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Description:

Background: Tuberculosis (TB) is the leading global cause of death from a single infectious agent. Recent reductions in global health funding have threatened TB control, making comprehensive assessment of TB, HIV-related TB, and drug-resistant TB burdens before these disruptions essential for shaping effective responses. The WHO End TB Strategy sets targets of a 95% reduction in TB deaths and a 90% reduction in TB incidence between 2015 and 2035. Using results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, this study aims to assess the burden of TB and multidrug-resistant TB (MDR-TB) across 204 countries and territories, and to evaluate progress towards the WHO End TB incidence and mortality targets. Methods: We quantified TB mortality using the Cause of Death Ensemble modelling platform with global vital registration, surveillance, verbal autopsy, and minimally invasive tissue sampling data. For TB morbidity estimation, we simultaneously modelled incidence, prevalence, and mortality by age and sex using DisMod-MR 2.1. A population attributable fraction (PAF) approach was applied to stratify morbidity and mortality estimates by HIV and drug-resistance status. We also calculated disability-adjusted life-years (DALYs) as the sum of years of life lost and years lived with disability. For the risk factor analysis, a comparative risk assessment framework was used and PAFs were derived for alcohol use, smoking, and high fasting plasma glucose to determine the proportion of TB burden associated with these risk factors. Findings: In 2023, there were an estimated 9·11 million (95% uncertainty interval 8·04–10·3) incident cases of all-form TB, 1·22 million (0·98–1·49) deaths, and 54·6 million (43·8–65·5) DALYs globally. HIV-related TB comprised 781 000 (690 000–879 000) incident cases and 210 000 (142 000–279 000) deaths, contributing 11·0 million (7·56–14·3) DALYs. MDR-TB accounted for 466 000 (198 000–1 080 000) incident cases, 102 000 (31 700–238 000) deaths, and 3·96 million (1·31–9·01) DALYs. From 2015 to 2023, global all-form TB incidence rates declined by 19·2% (17·8–20·5) and deaths declined by 22·6% (4·7–35·7); declines were larger for drug-susceptible TB than for MDR-TB. Sub-Saharan Africa and south Asia had the highest mortality burdens in 2023; reductions in all-form TB incidence and mortality were uneven between 2000 and 2023, with limited progress in both measures in Latin America and the Caribbean. Removing smoking, alcohol use, and high fasting plasma glucose would reduce global TB deaths to 768 000 (592 000–970 000) and DALYs to 34·9 million (27·8–43·8) in 2023; MDR-TB deaths would decrease to 77 200 (23 400–183 000) and DALYs to 3·12 million (1·03–7·29). Interpretation: Global progress towards WHO End TB targets is disparate and fragile. Although many regions achieved meaningful gains, others have stagnated in recent years. The complexity of TB prevention is amplified by divergent MDR-TB trends, the persistent burden of HIV, and growing exposure to modifiable risk factors. Recent volatility in global health financing threatens to further destabilise this vulnerable epidemiological landscape; concerted action is urgently needed to temper disruptions and preserve progress. Funding: Gates Foundation.

Open Access: Yes

DOI: 10.1016/S1473-3099(26)00295-1