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The Global, Regional, and National Burden of Gastro-Oesophageal Reflux Disease in 195 Countries and Territories, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017 Publisher Pubmed



Dirac MA1, 4 ; Safiri S5, 6 ; Tsoi D1 ; Adedoyin RA8 ; Afshin A1, 2 ; Akhlaghi N10 ; Alahdab F11 ; Almulhim AM12 ; Amini S14 ; Ausloos F15 ; Bacha U16 ; Banach M17, 18 ; Bhagavathula AS19, 20 ; Bijani A21 Show All Authors
Authors
  1. Dirac MA1, 4
  2. Safiri S5, 6
  3. Tsoi D1
  4. Adedoyin RA8
  5. Afshin A1, 2
  6. Akhlaghi N10
  7. Alahdab F11
  8. Almulhim AM12
  9. Amini S14
  10. Ausloos F15
  11. Bacha U16
  12. Banach M17, 18
  13. Bhagavathula AS19, 20
  14. Bijani A21
  15. Biondi A24
  16. Borzi AM23
  17. Colombara D1, 66
  18. Dagnew B25
  19. Daryani A28
  20. Davitoiu DV29, 30
  21. Demeke FM31
  22. Demoz GT32, 35
  23. Do HP36
  24. Etemadi A37, 40
  25. Farzadfar F39
  26. Fischer F41
  27. Gebre AK45
  28. Gebremariam H42
  29. Gebremichael B46
  30. Ghashghaee A48
  31. Ghoshal UC51
  32. Hamidi S52
  33. Hasankhani M7
  34. Hassan S53
  35. Hay SI1, 2
  36. Hoang CL36
  37. Hole MK54
  38. Ikuta KS1, 3
  39. Ilesanmi OS55
  40. Irvani SSN57
  41. James SL1
  42. Joukar F58
  43. Kabir A49
  44. Kassaye HG59
  45. Kavetskyy T61, 62
  46. Kengne AP63, 64
  47. Khalilov R65
  48. Khan MU66
  49. Khan EA67
  50. Khan M68
  51. Khater A69
  52. Kimokoti RW70
  53. Koyanagi A71, 72
  54. Manda AL73
  55. Mehta D74
  56. Mehta V75
  57. Meretoja TJ76, 77
  58. Mestrovic T78, 79
  59. Mirrakhimov EM80, 81
  60. Mithra P82
  61. Mohammadianhafshejani A83
  62. Mohammadookhorasani M84
  63. Mokdad AH1, 2
  64. Moossavi M85
  65. Moradi G86, 87
  66. Mustafa G88, 89
  67. Naimzada MD90, 91
  68. Nasserimoghaddam S38
  69. Nazari J13, 92
  70. Negoi I29, 93
  71. Nguyen CT94
  72. Nguyen HLT94
  73. Nixon MR1
  74. Olum S95, 96
  75. Pourshams A38
  76. Poustchi H38
  77. Rabiee M97, 98
  78. Rabiee N97, 98
  79. Rafiei A26, 27
  80. Rawaf S99, 101
  81. Rawaf DL100, 102
  82. Roberts NLS1
  83. Roshandel G38, 103
  84. Safari S56
  85. Salimzadeh H38
  86. Sartorius B2, 104
  87. Sarveazad A47
  88. Sepanlou SG38, 105
  89. Sharifi A103
  90. Soheili A106, 107
  91. Suleria HAR108
  92. Tadesse DB33, 109
  93. Tela FGG44
  94. Tesfay BE60
  95. Thakur B110, 111
  96. Tran BX112
  97. Vacante M24
  98. Vahedi P113
  99. Veisani Y114
  100. Vos T1, 2
  101. Vosoughi K9, 50
  102. Werdecker A115, 116
  103. Wondmieneh AB34, 117
  104. Yeshitila YG118
  105. Zamani M22
  106. Zewdie KA43
  107. Zhang ZJ119
  108. Malekzadeh R38, 105
  109. Naghavi M1, 2
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
  2. 2. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
  3. 3. Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, United States
  4. 4. Swedish Family Medicine, First Hill, Seattle, WA, United States
  5. 5. Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  6. 6. Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  7. 7. School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
  8. 8. Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
  9. 9. Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, United States
  10. 10. School of Medicine, Johns Hopkins University, Baltimore, MD, United States
  11. 11. Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, United States
  12. 12. College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
  13. 13. Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
  14. 14. Department of Health Services Management, Arak University of Medical Sciences, Arak, Iran
  15. 15. Gastroenterology Department, University of Liege, Liege, Belgium
  16. 16. School of Health Sciences, University of Management and Technology, Lahore, Pakistan
  17. 17. Department of Hypertension, Medical University of Lodz, Lodz, Poland
  18. 18. Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
  19. 19. Internal Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
  20. 20. Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
  21. 21. Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
  22. 22. Student Research Committee, Babol University of Medical Sciences, Babol, Iran
  23. 23. Department of Clinical and Experimental Medicine (A M Borzi MD), University of Catania, Catania, Italy
  24. 24. Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
  25. 25. Department of Human Physiology, University of Gondar, Gondar, Ethiopia
  26. 26. Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
  27. 27. Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  28. 28. Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  29. 29. Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  30. 30. Department of Surgery, Clinical Emergency Hospital Sf Pantelimon, Bucharest, Romania
  31. 31. Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
  32. 32. School of Pharmacy, Aksum University, Aksum, Ethiopia
  33. 33. School of Nursing, Aksum University, Aksum, Ethiopia
  34. 34. Department of Nursing and Midwifery, Addis Ababa, Ethiopia
  35. 35. Addis Ababa University, Addis Ababa, Ethiopia
  36. 36. Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
  37. 37. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
  38. 38. Digestive Diseases Research Institute, Tehran, Iran
  39. 39. Non-communicable Diseases Research Center, Tehran, Iran
  40. 40. Tehran University of Medical Sciences, Tehran, Iran
  41. 41. Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
  42. 42. Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
  43. 43. Department of Pharmacy, Mekelle University, Mekelle, Ethiopia
  44. 44. Department of Public health, Mekelle University, Mekelle, Ethiopia
  45. 45. School of Pharmacy, Mekelle University, Mekelle, Ethiopia
  46. 46. School of Public Health, Haramaya University, Harar, Ethiopia
  47. 47. Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
  48. 48. Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran
  49. 49. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
  50. 50. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
  51. 51. Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
  52. 52. School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  53. 53. Centre for International Health and Section for Ethics and Health Economics, University of Bergen, Bergen, Norway
  54. 54. Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, TX, United States
  55. 55. Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
  56. 56. Emergency Department, Tehran, Iran
  57. 57. Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  58. 58. Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
  59. 59. Department of Pharmacy, Adigrat University, Adigrat, Ethiopia
  60. 60. Department of Public Health, Adigrat University, Adigrat, Ethiopia
  61. 61. Department of Applied Physics, The John Paul II Catholic University of Lublin, Lublin Voivodeship, Poland
  62. 62. Department of Biology and Chemistry, Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
  63. 63. Non-Communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town, South Africa
  64. 64. Department of Medicine, University of Cape Town, Cape Town, South Africa
  65. 65. Department of Physiology, Baku State University, Baku, Azerbaijan
  66. 66. Health Policy Department, George Washington University, Washington, DC, United States
  67. 67. Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
  68. 68. Department of Epidemiology, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
  69. 69. Internal Medicine and Gastroenterology Department, National Hepatology and Tropical Research Institute, Cairo, Egypt
  70. 70. Department of Nutrition, Simmons University, Boston, MA, United States
  71. 71. CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
  72. 72. Catalan Institution for Research and Advanced Studies, Barcelona, Spain
  73. 73. Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
  74. 74. Division of Gastroenterology and Hepatobiliary Disease, New York Medical College, Valhalla, NY, United States
  75. 75. Department of Internal Medicine, SevenHills Hospital, Mumbai, India
  76. 76. Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
  77. 77. University of Helsinki, Helsinki, Finland
  78. 78. Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia
  79. 79. University Centre Varazdin, University North, Varazdin, Croatia
  80. 80. Faculty of Internal Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
  81. 81. Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
  82. 82. Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
  83. 83. Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
  84. 84. Department of Clinical Biochemistry, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
  85. 85. Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran
  86. 86. Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
  87. 87. Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
  88. 88. Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan
  89. 89. Department of Pediatrics & Pediatric Pulmonology, Institute of Mother & Child Care, Multan, Pakistan
  90. 90. Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russian Federation
  91. 91. Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russian Federation
  92. 92. Iranian Ministry of Health and Medical Education, Tehran, Iran
  93. 93. Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
  94. 94. Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam
  95. 95. Department of Food Science and Postharvest Technology, Gulu University, Gulu, Uganda
  96. 96. Ghent University, Ghent, Belgium
  97. 97. Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
  98. 98. Department of Chemistry, Sharif University of Technology, Tehran, Iran
  99. 99. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
  100. 100. WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
  101. 101. Academic Public Health Department, Public Health England, London, United Kingdom
  102. 102. University College London Hospitals, London, United Kingdom
  103. 103. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  104. 104. Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
  105. 105. Non-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  106. 106. Medical Surgical Nursing Department, Urmia University of Medical Science, Urmia, Iran
  107. 107. Emergency Nursing Department, Semnan University of Medical Sciences, Iran
  108. 108. Department of Agriculture and Food Systems, University of Melbourne, Melbourne, VIC, Australia
  109. 109. Axum College of Health Science, Mekelle, Ethiopia
  110. 110. Molecular and Translational Medicine, Texas Tech University, El Paso, TX, United States
  111. 111. Massachusetts Veterans Epidemiology Research and Information Center, CSP Coordinating Center, Harvard University, Boston, MA, United States
  112. 112. Department of Health Economics, Hanoi Medical University, Hanoi, Viet Nam
  113. 113. Department of Anatomical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
  114. 114. Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
  115. 115. Demographic Change and Ageing Research Area, Federal Institute for Population Research, Wiesbaden, Germany
  116. 116. Center of Population and Health, Wiesbaden, Germany
  117. 117. Department of Nursing, Wollo University, Dessie, Ethiopia
  118. 118. Department of Nursing, Arba Minch University, Arba Minch, Ethiopia
  119. 119. Department of Preventive Medicine, Wuhan University, Wuhan, China

Source: The Lancet Gastroenterology and Hepatology Published:2020


Abstract

Background: Gastro-oesophageal reflux disease is a common chronic ailment that causes uncomfortable symptoms and increases the risk of oesophageal adenocarcinoma. We aimed to report the burden of gastro-oesophageal reflux disease in 195 countries and territories between 1990 and 2017, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. Methods: We did a systematic review to identify measurements of the prevalence of gastro-oesophageal reflux disease in geographically defined populations worldwide between 1990 and 2017. These estimates were analysed with DisMod-MR, a Bayesian mixed-effects meta-regression tool that incorporates predictive covariates and adjustments for differences in study design in a geographical cascade of models. Fitted values for broader geographical units inform prior distributions for finer geographical units. Prevalence was estimated for 195 countries and territories. Reports of the frequency and severity of symptoms among individuals with gastro-oesophageal reflux disease were used to estimate the prevalence of cases with no, mild to moderate, or severe to very severe symptoms at a given time; these estimates were multiplied by disability weights to estimate years lived with disability (YLD). Findings: Data to estimate gastro-oesophageal reflux disease burden were scant, totalling 144 location-years (unique measurements from a year and location, regardless of whether a study reported them alongside measurements for other locations or years) of prevalence data. These came from six (86%) of seven GBD super-regions, 11 (52%) of 21 GBD regions, and 39 (20%) of 195 countries and territories. Mean estimates of age-standardised prevalence for all locations in 2017 ranged from 4408 cases per 100 000 population to 14 035 cases per 100 000 population. Age-standardised prevalence was highest (>11 000 cases per 100 000 population) in the USA, Italy, Greece, New Zealand, and several countries in Latin America and the Caribbean, north Africa and the Middle East, and eastern Europe; it was lowest (<7000 cases per 100 000 population) in the high-income Asia Pacific, east Asia, Iceland, France, Denmark, and Switzerland. Global prevalence peaked at ages 75–79 years, at 18 820 (95% uncertainty interval [95% UI] 13 770–24 000) cases per 100 000 population. Global age-standardised prevalence was stable between 1990 and 2017 (8791 [95% UI 7772–9834] cases per 100 000 population in 1990 and 8819 [7781–9863] cases per 100 000 population in 2017, percentage change 0·3% [–0·3 to 0·9]), but all-age prevalence increased by 18·1% (15·6–20·4) between 1990 and 2017, from 7859 (6905–8851) cases per 100 000 population in 1990 to 9283 (8189–10 400) cases per 100 000 population in 2017. YLDs increased by 67·1% (95% UI 63·5–70·3) between 1990 and 2017, from 3·60 million (1·93–6·12) in 1990 to 6·01 million (3·22–10·19) in 2017. Interpretation: Gastro-oesophageal reflux disease is common worldwide, although less so in much of eastern Asia. The stability of our global age-standardised prevalence estimates over time suggests that the epidemiology of the disease has not changed, but the estimates of all-age prevalence and YLDs, which increased between 1990 and 2017, suggest that the burden of gastro-oesophageal reflux disease is nonetheless increasing as a result of ageing and population growth. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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