TY - JOUR
T1 - The burden of neurological conditions in north Africa and the Middle East, 1990–2019
T2 - a systematic analysis of the Global Burden of Disease Study 2019
AU - GBD 2019 North Africa and the Middle East Neurology Collaborators
AU - Avan, Abolfazl
AU - Feigin, Valery L.
AU - Bennett, Derrick A.
AU - Steinmetz, Jaimie D.
AU - Hachinski, Vladimir
AU - Stranges, Saverio
AU - Owolabi, Mayowa O.
AU - Aali, Amirali
AU - Abbasi-Kangevari, Mohsen
AU - Abbasi-Kangevari, Zeinab
AU - Abd-Allah, Foad
AU - Abdollahzade, Sina
AU - Abidi, Hassan
AU - Abolhassani, Hassan
AU - Abualhasan, Ahmed
AU - Abu-Gharbieh, Eman
AU - Abu-Rmeileh, Niveen ME
AU - Abu-Zaid, Ahmed
AU - Ahmad, Aqeel
AU - Ahmadi, Sepideh
AU - Ahmed, Luai A.
AU - Ajami, Marjan
AU - Al Hamad, Hanadi
AU - Alanezi, Fahad Mashhour
AU - Alanzi, Turki M.
AU - Alimohamadi, Yousef
AU - Aljunid, Syed Mohamed
AU - Al-Raddadi, Rajaa M.
AU - Amiri, Sohrab
AU - Arabloo, Jalal
AU - Arulappan, Judie
AU - Arumugam, Ashokan
AU - Asadi-Pooya, Ali A.
AU - Athar, Mohammad
AU - Athari, Seyyed Shamsadin
AU - Atout, Maha Moh d.Wahbi
AU - Azadnajafabad, Sina
AU - Azangou-Khyavy, Mohammadreza
AU - Azari Jafari, Amirhossein
AU - Azzam, Ahmed Y.
AU - Baghcheghi, Nayereh
AU - Bagherieh, Sara
AU - Baltatu, Ovidiu Constantin
AU - Bazmandegan, Gholamreza
AU - Bhojaraja, Vijayalakshmi S.
AU - Bijani, Ali
AU - Bitaraf, Saeid
AU - Calina, Daniela
AU - Darwish, Amira Hamed
AU - Djalalinia, Shirin
AU - Doheim, Mohamed Fahmy
AU - Dorostkar, Fariba
AU - Eini, Ebrahim
AU - El Nahas, Nevine
AU - El Sayed, Iman
AU - Elhadi, Muhammed
AU - Elmonem, Mohamed A.
AU - Eskandarieh, Sharareh
AU - Faghani, Shahriar
AU - Fallahzadeh, Aida
AU - Farahmand, Mohammad
AU - Ghafourifard, Mansour
AU - Ghamari, Seyyed Hadi
AU - Gholami, Ali
AU - Ghozy, Sherief
AU - Goleij, Pouya
AU - Hadei, Mostafa
AU - Hafezi-Nejad, Nima
AU - Haj-Mirzaian, Arvin
AU - Halwani, Rabih
AU - Hamidi, Samer
AU - Hasaballah, Ahmed I.
AU - Hassan, Amr
AU - Hedna, Khedidja
AU - Hegazy, Mohamed I.
AU - Heidari-Soureshjani, Reza
AU - Hosseini, Mohammad Salar
AU - Hoveidamanesh, Soodabeh
AU - Jahrami, Haitham
AU - Jamshidi, Elham
AU - Javaheri, Tahereh
AU - Jayapal, Sathish Kumar
AU - Kalankesh, Laleh R.
AU - Kalhor, Rohollah
AU - Kamiab, Zahra
AU - Keykhaei, Mohammad
AU - Khader, Yousef Saleh
AU - Khan, Maseer
AU - Khan, Moien AB
AU - Khatatbeh,
AU - Khayat Kashani, Hamid Reza
AU - Khosravi, Ahmad
AU - Kompani, Farzad
AU - Koohestani, Hamid Reza
AU - Larijani, Bagher
AU - Lasrado, Savita
AU - Magdy Abd El Razek, Mohammed
AU - Malekpour, Mohammad Reza
AU - Malik, Ahmad Azam
AU - Mansournia, Mohammad Ali
AU - Mardi, Parham
AU - Maroufi, Seyed Farzad
AU - Masoudi, Sahar
AU - Mayeli, Mahsa
AU - Mehrabi Nasab, Entezar
AU - Menezes, Ritesh G.
AU - Mirmoeeni, Seyyedmohammadsadeq
AU - Mirza-Aghazadeh-Attari, Mohammad
AU - Mobarakabadi, Maryam
AU - Mohammadi, Esmaeil
AU - Mohammadi, Soheil
AU - Mohan, Syam
AU - Mokdad, Ali H.
AU - Momtazmanesh, Sara
AU - Montazeri, Fateme
AU - Moradi Sarabi, Mostafa
AU - Moraga, Paula
AU - Morovatdar, Negar
AU - Motaghinejad, Majid
AU - Naghavi, Mohsen
AU - Natto, Zuhair S.
AU - Nejadghaderi, Seyed Aria
AU - Noroozi, Nafise
AU - Okati-Aliabad, Hassan
AU - Pazoki Toroudi, Hamidreza
AU - Perna, Simone
AU - Piradov, Michael A.
AU - Pourahmadi, Mohammadreza
AU - Rafiei, Alireza
AU - Rahimi-Movaghar, Vafa
AU - Rahmani, Amir Masoud
AU - Rahmani, Shayan
AU - Rahmanian, Vahid
AU - Rajabpour-Sanati, Ali
AU - Rao, Chythra R.
AU - Rashidi, Mohammad Mahdi
AU - Rawassizadeh, Reza
AU - Razeghian-Jahromi, Iman
AU - Redwan, Elrashdy Moustafa Mohamed
AU - Rezaee, Malihe
AU - Rezaei, Nazila
AU - Rezaei, Negar
AU - Rezaei, Nima
AU - Rezaeian, Mohsen
AU - Rikhtegar, Reza
AU - Saad, Aly M.A.
AU - Saddik, Basema
AU - Sadeghi, Masoumeh
AU - Sadeghian, Saeid
AU - Saeedi Moghaddam, Sahar
AU - Sahebkar, Amirhossein
AU - Salahi, Saina
AU - Salahi, Sarvenaz
AU - Samy, Abdallah M.
AU - Sanadgol, Nima
AU - Sarveazad, Arash
AU - Sathian, Brijesh
AU - Saylan, Mete
AU - Shahbandi, Ataollah
AU - Shahrokhi, Shayan
AU - Shams-Beyranvand, Mehran
AU - Shanawaz, Mohd
AU - Sharifi-Rad, Javad
AU - Sheikhi, Rahim Ali
AU - Shetty, Jeevan K.
AU - Shobeiri, Parnian
AU - Shorofi, Seyed Afshin
AU - Siabani, Soraya
AU - Tabatabaei, Seyyed Mohammad
AU - Taheri Abkenar, Yasaman
AU - Taheri Soodejani, Moslem
AU - Temsah, Mohamad Hani
AU - Vakilian, Alireza
AU - Valadan Tahbaz, Sahel
AU - Valizadeh, Rohollah
AU - Vaziri, Siavash
AU - Vo, Bay
AU - Yahyazadeh Jabbari, Seyed Hossein
AU - Yesiltepe, Metin
AU - Zaki, Nazar
AU - Zare, Iman
AU - Zare Dehnavi, Ali
AU - Zoladl, Mohammad
PY - 2024/6
Y1 - 2024/6
N2 - Background: The burden of neurological conditions in north Africa and the Middle East is increasing. We aimed to assess the changes in the burden of neurological conditions in this super-region to aid with future decision making. Methods: In this analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 data, we examined temporal trends of disability-adjusted life-years (DALYs; deaths and disabilities combined), deaths, incident cases, and prevalent cases of 14 major neurological conditions and eight subtypes in 21 countries in the north Africa and the Middle East super-region. Additionally, we assessed neurological DALYs due to 22 potentially modifiable risk factors, within four levels of classification, during the period 1990–2019. We used a Bayesian modelling estimation approach, and generated 95% uncertainty intervals (UIs) for final estimates on the basis of the 2·5th and 97·5th percentiles of 1000 draws from the posterior distribution. Findings: In 2019, there were 441·1 thousand (95% UI 347·2–598·4) deaths and 17·6 million (12·5–24·7) neurological DALYs in north Africa and the Middle East. The leading causes of neurological DALYs were stroke, migraine, and Alzheimer's disease and other dementias (hereafter dementias). In north Africa and the Middle East in 2019, 85·8% (82·6–89·1) of stroke and 39·9% (26·4–54·7) of dementia age-standardised DALYs were attributable to modifiable risk factors. North Africa and the Middle East had the highest age-standardised DALY rates per 100 000 population due to dementia (387·0 [172·0–848·5]), Parkinson's disease (84·4 [74·7–103·2]), and migraine (601·4 [107·0–1371·8]) among the global super-regions. Between 1990 and 2019, there was a decrease in the age-standardised DALY rates related to meningitis (–75·8% [–81·1 to –69·5]), tetanus (–88·2% [–93·9 to –76·1]), stroke (–32·0% [–39·1 to –23·3]), intracerebral haemorrhage (–51·7% [–58·2 to –43·8]), idiopathic epilepsy (–26·2% [–43·6 to –1·1]), and subarachnoid haemorrhage (–62·8% [–71·6 to –41·0]), but for all other neurological conditions there was no change. During 1990–2019, the number of DALYs due to dementias, Parkinson's disease, multiple sclerosis, ischaemic stroke, and headache disorder (ie, migraine and tension-type headache) more than doubled in the super-region, and the burden of years lived with disability (YLDs), incidence, and prevalence of multiple sclerosis, motor neuron disease, Parkinson's disease, and ischaemic stroke increased both in age-standardised rate and count. During this period, the absolute burden of YLDs due to head and spinal injuries almost doubled. Interpretation: The increasing burden of neurological conditions in north Africa and the Middle East accompanies the increasing ageing population. Stroke and dementia are the primary causes of neurological disability and death, primarily attributable to common modifiable risk factors. Synergistic, systematic, lifetime, and multi-sectoral interventions aimed at preventing or mitigating the burden are needed.Funding: Bill & Melinda Gates Foundation. Translations: For the Persian, Arabic and Turkish translations of the abstract see Supplementary Materials section.
AB - Background: The burden of neurological conditions in north Africa and the Middle East is increasing. We aimed to assess the changes in the burden of neurological conditions in this super-region to aid with future decision making. Methods: In this analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 data, we examined temporal trends of disability-adjusted life-years (DALYs; deaths and disabilities combined), deaths, incident cases, and prevalent cases of 14 major neurological conditions and eight subtypes in 21 countries in the north Africa and the Middle East super-region. Additionally, we assessed neurological DALYs due to 22 potentially modifiable risk factors, within four levels of classification, during the period 1990–2019. We used a Bayesian modelling estimation approach, and generated 95% uncertainty intervals (UIs) for final estimates on the basis of the 2·5th and 97·5th percentiles of 1000 draws from the posterior distribution. Findings: In 2019, there were 441·1 thousand (95% UI 347·2–598·4) deaths and 17·6 million (12·5–24·7) neurological DALYs in north Africa and the Middle East. The leading causes of neurological DALYs were stroke, migraine, and Alzheimer's disease and other dementias (hereafter dementias). In north Africa and the Middle East in 2019, 85·8% (82·6–89·1) of stroke and 39·9% (26·4–54·7) of dementia age-standardised DALYs were attributable to modifiable risk factors. North Africa and the Middle East had the highest age-standardised DALY rates per 100 000 population due to dementia (387·0 [172·0–848·5]), Parkinson's disease (84·4 [74·7–103·2]), and migraine (601·4 [107·0–1371·8]) among the global super-regions. Between 1990 and 2019, there was a decrease in the age-standardised DALY rates related to meningitis (–75·8% [–81·1 to –69·5]), tetanus (–88·2% [–93·9 to –76·1]), stroke (–32·0% [–39·1 to –23·3]), intracerebral haemorrhage (–51·7% [–58·2 to –43·8]), idiopathic epilepsy (–26·2% [–43·6 to –1·1]), and subarachnoid haemorrhage (–62·8% [–71·6 to –41·0]), but for all other neurological conditions there was no change. During 1990–2019, the number of DALYs due to dementias, Parkinson's disease, multiple sclerosis, ischaemic stroke, and headache disorder (ie, migraine and tension-type headache) more than doubled in the super-region, and the burden of years lived with disability (YLDs), incidence, and prevalence of multiple sclerosis, motor neuron disease, Parkinson's disease, and ischaemic stroke increased both in age-standardised rate and count. During this period, the absolute burden of YLDs due to head and spinal injuries almost doubled. Interpretation: The increasing burden of neurological conditions in north Africa and the Middle East accompanies the increasing ageing population. Stroke and dementia are the primary causes of neurological disability and death, primarily attributable to common modifiable risk factors. Synergistic, systematic, lifetime, and multi-sectoral interventions aimed at preventing or mitigating the burden are needed.Funding: Bill & Melinda Gates Foundation. Translations: For the Persian, Arabic and Turkish translations of the abstract see Supplementary Materials section.
KW - Global Burden of Disease
KW - Neurological conditions
KW - North Africa
KW - Middle East
UR - http://www.scopus.com/inward/record.url?scp=85193773695&partnerID=8YFLogxK
U2 - 10.1016/S2214-109X(24)00093-7
DO - 10.1016/S2214-109X(24)00093-7
M3 - Article
C2 - 38604203
AN - SCOPUS:85193773695
SN - 2214-109X
VL - 12
SP - e960-e982
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 6
ER -
