Showing 2 results for Mortality
Behzad Karami Matin, Moslem Soofi, Ali Kazemi Karyani, Shahin Soltani, Bita Shokri, Shiva Amani, Zahra Shahbazi,
Volume 21, Issue 3 (9-2020)
Abstract
Objective: Congenital anomalies are functional or structural anomalies that can occur as a single or a group of anomalies. Studies have shown that socioeconomic factors can affect congenital anomalies such that the middle- and low-income countries suffer more from the congenital anomalies. This study aimed to determine the essential socioeconomic determinants of the disability-adjusted life year (DALY) for congenital anomalies in children aged <5 years.
Materials & Methods: This is a cross-sectional study using the latest available data in 2017, which were extracted from the international databases of the World Bank, the Institute for Health Metrics and Evaluation, and the United Nations Educational, Scientific, and Cultural Organization. In the study, we analyzed data from 196 countries divided into 6 geographical regions of African Region (AFRO), European Region (EURO), Pan American Health Organization (PAHO), Eastern Mediterranean Region (EMRO), Western Pacific Region (WPRO), and South-East Asia Region (SEARO). To identify the main determinants of the DALY, gross domestic products (GDP) per capita, poverty rate, government, private and external health expenditures per capita, mean years of schooling, and literacy rate were used. Data analysis was performed in STATA v.15 using the one-way ANOVA and the linear regression analysis.
Results: The lowest and highest rates of DALY was reported in Luxembourg (856.29 per 100000 population) and Sudan (21714.7 per 100000 population), respectively. The AFRO and EURO regions had the highest (9392.78±4250.56), and the lowest (2969.11±1961.64) mean of DALY. In Iran, the DALY rate was reported 7721.48 per 100000 population, which was higher than those in the EURO and PAHO regions and lower than those in the AFRO and EMRO regions. The results of linear regression analysis showed that mean years of schooling was the strongest predictor of DALY (β=-0.44, P=0.001) followed by the poverty rate (β=0.36, P=0.002). The results of one-way ANOVA indicated that the rate of DALY was significantly different between different social and economic groups, and it was higher in the lower socioeconomic groups.
Conclusion: Mean years of schooling and poverty rate are the strongest predictors of DALY for congenital anomalies in children under 5 years of age. Low-income countries, especially those in the AFRO and EMRO regions, are the most prone to the disability and premature death caused by congenital anomalies in children under 5 years of age compared to the high-income countries. Therefore, the equitable distribution of screening and health care services and educational infrastructures for deprived and lower socioeconomic countries should be taken into account by national and international health organizations.
Behzad Karami Matin, Ali Kazemi Karyani, Shahin Soltani, Sharam Akbari, Shiva Toloui Rakhshan, Marzieh Mohammadi Moghadam,
Volume 23, Issue 2 (7-2022)
Abstract
Objective: Down syndrome or trisomy 21 is one of the most common human chromosomal disorders that affect cognitive functions, communication and behavioral skills. At the macro level, various factors can contribute to the Down syndrome prevalence and mortality. This study aimed to investigate the association of health system functions with Down syndrome prevalence and mortality worldwide.
Materials & Methods: The study was a cross-sectional study conducted based on the secondary analysis of existing data in 2019. Data from 202 countries in six different regions (African Region [AFRO], Eastern Mediterranean Region [EMRO], European Region [EURO], South-East Asia Region [SEARO], Western Pacific Region [WPRO], and Pan American Health Organization [PAHO]) were included in the study. Data were extracted from the World Health Organization (WHO), the World Bank and the Institute for Health Metrics and Evaluation databases. The adjusted linear regression analysis was used to examine the association between health system-related factors with prevalence of, and death due to Down syndrome as the outcome variables. In the present study, two functions of health financing (domestic general government health expenditure [GGHE-D] per capita in PPP [purchasing power parity] int$, domestic private health expenditure [PHE-D] per capita in PPP int$, external health expenditure [EXT] per capita in PPP int$) and health system resources (nurse and midwifery personnel, generalist medical practitioners [GMP], specialist medical practitioners [SMP], pharmacists, dentists, physiotherapists) were included in the study as independent variables. We used the Stata software version 14 to analyze
Results: Africa and low-income countries had the highest deaths due to Down syndrome. On the other side, Europe and high-income countries had the highest prevalence of Down syndrome worldwide. According to the available data, Iran had a lower prevalence (29.31 vs 38.44 per 100,000 population) and higher deaths (0.34 vs 0.32 per 100,000 population) compared to high- income countries. The 20-year trend of prevalence of, and deaths due to Down syndrome in Iran has always been lower and higher than high-income countries, respectively. Linear regression analysis showed that GGHE-D per capita (β=0.385, P<0.001) and PHE-D per capita (β=0.354, P=0.02) could predict the prevalence of Down syndrome significantly in the study countries. On the other hand, nurse and midwifery personnel (β=-0.607, P=0.014) and number of SMP (β=0.420, P=0.025) were associated with increased deaths from Down syndrome in the included countries.
Conclusion: Our findings showed GGHE-D and PHE-D are associated with a higher prevalence of Down syndrome in health systems. On the other hand, health system resources (nurses and SMP) were the main predictors of death due to Down syndrome in the included countries. International organizations and governments need to monitor and improve the equitable access of vulnerable groups to health services in low-income countries. Improving health insurance coverage and equitable distribution of health resources is suggested to reduce deaths due to Down syndrome in Iran.