# name
Estimates of the global, regional, and national morbidity,
                mortality, and aetiologies of lower respiratory infections in
                195 countries, 1990-2016: a systematic analysis for the Global
                Burden of Disease Study 2016

# metadata.dc.contributor.author[].value
GBD 2016 Lower Respiratory Infections Collaborators

# metadata.dc.description.abstract[].value
Background: Lower respiratory infections are a leading cause of morbidity and mortality around the world. The Global
Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, provides an up-to-date analysis of the burden of
lower respiratory infections in 195 countries. This study assesses cases, deaths, and aetiologies spanning the past
26 years and shows how the burden of lower respiratory infection has changed in people of all ages.
Methods: We used three separate modelling strategies for lower respiratory infections in GBD 2016: a Bayesian
hierarchical ensemble modelling platform (Cause of Death Ensemble model), which uses vital registration, verbal
autopsy data, and surveillance system data to predict mortality due to lower respiratory infections; a compartmental
meta-regression tool (DisMod-MR), which uses scientific literature, population representative surveys, and healthcare data to predict incidence, prevalence, and mortality; and modelling of counterfactual estimates of the population
attributable fraction of lower respiratory infection episodes due to Streptococcus pneumoniae, Haemophilus influenzae
type b, influenza, and respiratory syncytial virus. We calculated each modelled estimate for each age, sex, year, and
location. We modelled the exposure level in a population for a given risk factor using DisMod-MR and a spatiotemporal Gaussian process regression, and assessed the effectiveness of targeted interventions for each risk factor in
children younger than 5 years. We also did a decomposition analysis of the change in LRI deaths from 2000–16 using
the risk factors associated with LRI in GBD 2016.
Findings: In 2016, lower respiratory infections caused 652 572 deaths (95% uncertainty interval [UI] 586475–720 612)
in children younger than 5 years (under-5s), 1 080958 deaths (943 749–1 170638) in adults older than 70 years, and
2 377697 deaths (2145584–2512809) in people of all ages, worldwide. Streptococcus pneumoniae was the leading cause
of lower respiratory infection morbidity and mortality globally, contributing to more deaths than all other aetiologies
combined in 2016 (1 189937 deaths, 95% UI 690 445–1770 660). Childhood wasting remains the leading risk factor for
lower respiratory infection mortality among children younger than 5 years, responsible for 61·4% of lower respiratory
infection deaths in 2016 (95% UI 45·7–69·6). Interventions to improve wasting, household air pollution, ambient
particulate matter pollution, and expanded antibiotic use could avert one under-5 death due to lower respiratory
infection for every 4000 children treated in the countries with the highest lower respiratory infection burden.
Interpretation: Our findings show substantial progress in the reduction of lower respiratory infection burden, but this
progress has not been equal across locations, has been driven by decreases in several primary risk factors, and might
require more effort among elderly adults. By highlighting regions and populations with the highest burden, and the
risk factors that could have the greatest effect, funders, policy makers, and programme implementers can more
effectively reduce lower respiratory infections among the world’s most susceptible populations.

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Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Estimates of the global, regional, and national morbidity,
                mortality, and aetiologies of lower respiratory infections in
                195 countries, 1990-2016: a systematic analysis for the Global
                Burden of Disease Study 2016