Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems
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01.12.2021 |
Cork M.A.
Henry N.J.
Watson S.
Croneberger A.J.
Baumann M.
Letourneau I.D.
Yang M.
Serfes A.L.
Abbas J.
Abbasi N.
Abbastabar H.
Abreu L.G.
Abu-Gharbieh E.
Achappa B.
Adabi M.
Adal T.G.
Adegbosin A.E.
Adekanmbi V.
Adetokunboh O.O.
Agudelo-Botero M.
Ahinkorah B.O.
Ahmadi K.
Ahmed M.B.
Alhassan R.K.
Alipour V.
Almasi-Hashiani A.
Alvis-Guzman N.
Ancuceanu R.
Andrei T.
Anvari D.
Aqeel M.
Arabloo J.
Aremu O.
Asaad M.
Atnafu D.D.
Atreya A.
Paulina Ayala Quintanilla B.
Azari S.
B B D.
Baig A.A.
Banach M.
Bante S.A.
Barboza M.A.
Basu S.
Bedi N.
F Bejarano Ramirez D.
Bensenor I.M.
Beyene F.Y.
Bezabih Y.M.
Bhagavathula A.S.
Bhardwaj N.
Bhardwaj P.
Bhattacharyya K.
Bhutta Z.A.
Bijani A.
Birlik S.M.
Bitew Z.W.
Bohlouli S.
Boloor A.
Brunoni A.R.
Butt Z.A.
Cárdenas R.
Carvalho F.
Mauricio Castaldelli-Maia J.
A Castañeda-Orjuela C.
Charan J.
Chatterjee S.
Chattu V.K.
Chattu S.K.
Ahsanul Kabir Chowdhury M.
Christopher D.J.
Chu D.T.
Cook A.J.
Cormier N.M.
M A Dahlawi S.
Daoud F.
A Dávila-Cervantes C.
Weaver N.D.
P De la Hoz F.
Demeke F.M.
Denova-Gutiérrez E.
Deribe K.
Deuba K.
Dharmaratne S.D.
Dhungana G.P.
Diaz D.
Djalalinia S.
Duraes A.R.
Eagan A.W.
Earl L.
Effiong A.
El Sayed Zaki M.
Tantawi M.E.
Elayedath R.
I El-Jaafary S.
Jose A Faraon E.
Faro A.
Fattahi N.
Fauk N.K.
Fernandes E.
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BMC Medicine |
10.1186/s12916-020-01876-4 |
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© 2021, The Author(s). Background: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods: We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results: All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions: Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.
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Myocardial micro-alternation index: Influence of age, gender and prevalence of normal values in screening of the population
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01.01.2018 |
Ivanov G.
Bulanova N.
Nikolaeva M.
Schelykalina S.
Nikolaev D.
Halabi G.
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Medical News of North Caucasus |
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0 |
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© 2018 Stavropol State Medical University. All Rights Reserved. Myocardial micro-alternation index (IMM) is one of the characteristics of the ECG dispersion mapping (DM) which is widely used for screening of the population. We studied the relationship between IMM, age and gender. We also investigated the prevalence of different IMM ranges: normal (<15 %, 15-21 % - boundary, >21 % - pathological) in visitors of the health centers (HC). Data of 537 820 visitors of the HC from 25 regions of Russia were analyzed. The visitors underwent ECG DM recording, anthropometry, measurement of blood pressure, glucose and cholesterol in capillary blood. The results have shown that IMM dependence on age and sex is very weak, so the special criteria are not required. The prevalence of IMM ranges («normal», «borderline values» and «pathology») is found to be age-dependent: the prevalence of pathological and borderline IMM values increased from 55 years and 35 years respectively. From the same age there is a decrease in the proportion of visitors with normal IMM values. The share of visitors with risk factors for non-communicable diseases is maximal among those whose values are in the IMM range considered as «pathology» and minimal in the range of «normal».
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