of all deaths are due to CVDs in Pakistan (c) Heart disease is the leading cause of death in men and women1. Pakistan has a very high disease burden, estimated as 5.09375 million2 A population based cross-sectional survey showed that 1 in 4 middle aged adults in Pakistan has prevalent CAD. The global prevalence of raised blood pressure (defined as systolic and/or diastolic blood pressure more than or equal to 140/90 mmHg) in adults aged 18 years and over was around 24.1% in men and 20.1% in women in 2015. Cancer epidemiology 1. India, and Saudi Arabia (Table 1). Prevalence of Rheumatic Heart Disease in different regions of Pakistan P J M H S Vol. Journal of Obesity, 2011 ... Assessment of Cardiovascular Disease Risk in South Asian Populations. According to the latest WHO data published in 2018 Coronary Heart Disease Deaths in Sri Lanka reached 28,777 or 22.64% of total deaths. 2012; 3(2): 113-16. In those that reported rheumatic heart disease, the highest median crude prevalence is 34% in East Asia and 14% in Sub-Saharan Africa . Pakistan is facing a double burden of disease (BoD), with endemicity of hepatitis B and C with 7.6% affected individuals; the 5th highest tuberculosis burden in the world, and focal geographical area of malaria endemicity. This review uses national datasets with multiple years of data to present secular trends in mortality, morbidity, and treatment for all CVD and specific subtypes within the UK. Let's make an effort to beat heart diseases on World Heart Day. Common Variant of FTO Gene, rs9939609, and Obesity in Pakistani Females. Lancet 381, 2281-90. Depression has long had a popular link to cardiovascular disease and death. Coronary Heart Disease : Epidemiology Presented By Dr Garima Gupta MBBS , MD Post Graduate student University College Of Medical Sciences & GTB Hospital, Delhi 1 2. Although echocardiographic studies provide some indication of disease prevalence, accurate epidemiological data are lacking and there are no European or UK studies to date. The diversity of diets in populations among developing countries may be one explanation for the differences in CVD. This supports the understanding of a changing in the epidemiology of valvular diseases in the last 60 years, with a … Results: Overall prevalence of HF was 24.4% with insignificant gender difference. Download Full PDF Package. Rheumatic heart disease was not reported in all selected publications. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). This study was therefore carried out to determine the disease burden of ischemic heart disease in Pakistan as well as that of its risk factors. Jafar TH, Haaland BA, Rahman A, Razzak JA, Bilger M, Naghavi M, et al. Epidemiology of cardiovascular disease: the new ESC Atlas and beyond. Declines in cardiovascular disease mortality have seen cancer becoming a more common cause of death in a number of high-income member countries, but in middle-income countries declines in cardiovascular disease mortality have been less consistent. Phone: (918) 660-3680: Office: The University of Oklahoma Health Sciences Center: 4502 E. 41st Street, Room 1A02: Tulsa, OK 74135-2512: Email: Nasir-Mushtaq@ouhsc.edu 2015; 29(1):1-5. Pakistan is contributing 19 per cent deaths in all over the world and 29 percent are heart attacks and heart ailments which is around 406,870 per year. Davis 1 , Teri A. Manolio 3 , These epi-demics have resulted in a marked increase in cardiovascular disease (CVD) and subsequently HF, a final common pathway of CVD. Lack of a central registry makes epidemiological assessment extremely difficult and inadequate in Pakistan. Two communities, one semi-rural and the other urban, were studied but the targeted communities were not repre-sentative of the entire Pakistani population [22]. 3, JUL – SEP 20171050 and statistics are available for prevalence of rheumatic heart disease, then we decided the tomeasure the prevalence using regression analysis. A retrospective study. world1,3 and the prevalence of CAD in India has more than doubled in the past two decades. 2 Female patients with CAD are presenting at a much … 9 Data from the1994 National Health Survey of Pakistan (NHSP) on health problems shows a high incidence of risk factors for According to the latest WHO data published in 2017 Coronary Heart Disease Deaths in Pakistan reached 265,051 or 21.76% of total deaths. The age adjusted Death Rate is 246.84 per 100,000 of population ranks Pakistan #13 in the world. Review other causes of death by clicking the links below or choose the full health profile. We estimated prevalence of chewing tobacco use with a modelling strategy that used information on multiple types of smokeless tobacco products. Heart Disease Statistics and Maps. High blood pressure, high LDL cholesterol and smoking are key risk factors for heart diseases1. Methods The design consisted of a cross‐sectional community based survey in the lower middle class urban localities of Karimabad, Garden and Kharardar in Karachi, Pakistan. Non-communicable diseases and injuries in Pakistan: strategic priorities. Cardiovascular disease. LAHORE: Cardiovascular diseases (CVDs) are the number one cause of deaths worldwide. Materials and Methods In this pilot study information was gathered according to the MONICA protocol from 2000 persons in Heart Diseases. According to a WHO report, Pakistan is facing a health crisis with rising rates in Cardiovascular diseases (CVD) and other non-communicable diseases (NCDs). The prevalence of cardiovascular disease (CVD) in South Asia is higher than in any other developing countries. Periodontal disease or periodontitis is a common chronic inflammatory disease. 4.11). High rates of Obesity and Cardiovascular Disease risk factors in lower middle class community in Pakistan: the Metroville Health Study Barbara Dennis 1 , Kalimuddin Aziz 2 , Lilin She 1 , Azhar M. A. Faruqui 2 , C.E. Coronary heart disease - epidemiology 1. Hossain Shekhar. Volgman et al ASCVD in South Asians At that historic moment, several streams of knowledge and circumstance converged to provoke formal epidemiological study: Cardiovascular experts were making advances in cardiac diagnosis and in the understanding of atherosclerosis and hypertension, two processes fundamental to the cardiovascular disease (CVD) epidemic. In older adults it may increase patient’s risk of developing systemic diseases such as diabetes mellitus, lung disease, heart disease and stroke. Source: Data from AR Omran: The epidemiologic transition: A theory of the epidemiology of population change. Review other causes of death by clicking the links below or choose the full health profile. However, only during the last 15 years scientific evidence supporting this … Pakistan Journal of Biological Sciences, 2006. Abstract. Download PDF. Without the ability to substantially alter the prevalence of congenital heart disease, interventions and resources must be used to improve survival and quality of life. Pakistan was undertaken by the National Institute of Cardiovascular Disease during 1967–68. Dairy consumption was associated with lower risk of mortality and major cardiovascular disease events in a diverse ... Karachi, Pakistan. prevalence of the disease and its risk factors must be known. Prevalence of the ischemic heart disease is on rise in Pakistan as well. The age adjusted Death Rate is 123.79 per 100,000 of population ranks Sri Lanka #94 in the world. Global age-standardized mortality from rheumatic heart disease decreased from 9.2 deaths per 100,000 population (95% uncertainty interval, … Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. Several reviews have assessed the effects of socioeconomic status on the coronary heart disease epidemic in communities and countries, but only … Prevalence of cardiovascular disease among Bangladeshi adult population: a systematic review and meta-analysis of the studies Mohammad Ziaul Islam Chowdhury,1,2 Md Ashiqul Haque,2 Zaki Farhana,2 Ataul Mustufa Anik,2 Amadul Hoque Chowdhury,2 Sabrina Mahfuja Haque,2 Lu-Lu-Wal Marjana,2 Piali Dey Bristi,2 BM Abu Al Mamun,2 Mohammad Jasim Uddin,3 Jain Fatema,4 Md … South Asian Americans — people with roots in Nepal, India, Pakistan, Sri Lanka, Bangladesh, Bhutan and the Maldives — have a disproportionately higher risk of heart disease … Rajeev Gupta. The rheumatic heart disease (RHD) came next, accounting for 22% of all patients [8]. The downward cardiovascular mortality trends may be threatened by the emerging obesity epidemic. The death rates from heart disease compared to whites are 100% higher among Pakistani men and 150% higher among Pakistani women in the UK. Cardiovascular disease (CVD) mortality in the UK is declining; however, CVD burden comes not only from deaths, but also from those living with the disease. Background: Coronary Artery Disease (CAD) is the foremost single cause of mortality and loss of Disability Adjusted Life Years (DALYs) globally. Abbreviations: CHD, coronary heart disease; CVD, cardiovascular disease. The population prevalence is 2.5% rising to over 10% in people aged more than 75.1 It has received disproportionately little exposure in terms of research, national treatment strategies and public awareness. J Pak Med Assoc. 1 One in four middle-aged adults in urban Pakistan have CAD (coronary artery disease) with greater prevalence in women (30%) than in men (24%) over 40 years of age. Background: Migrant South Asians residing in the West have one of the highest rates of CAD in the world. 33%. Raised blood pressure is the leading risk factor for cardiovascular disease. Cardiovascular disease (CVD) is the leading cause of death in both the developed and developing world, accounting for 16.7 million deaths/y worldwide. Data on the incidence and prevalence of CVD in the EMR are scarce. Prevalence data come from the Quality and Outcome Framework and national surveys. Total CVD mortality declined by 68% between 1980 and 2013 in the UK. Similar decreases were seen for coronary heart disease and stroke. Coronary heart disease prevalence has remained constant at around 3% in England and 4% in Scotland, Wales, and Northern Ireland. CancerCancer EpidemiologyEpidemiology Nayyar Raza KazmiNayyar Raza Kazmi 2. Epidemiology of cardiovascular disease in rural Vietnam Hoang Van Minh Umeå 2006 Umeå International School of Public Health, Epidemiology and Public Health Sciences, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden and Faculty of Public Health, This represents about 8% of total deaths. The age adjusted Death Rate is 237.98 per 100,000 of population ranks Pakistan #18 in the world. Causes of HF were hypertension 39% coronary heart disease (CHD) 27%, diabetes 8.7%, valvular heart disease 2.5% and cardiomyopathy 0.8%. Patients with documented history of coronary artery disease (CAD) were included. Pakistani Heart disease . Cardiovascular disease (CVD) is a major contributor to the global burden of disease and a leading cause of mortality, accounting for 31% (17.9 million) of global deaths in 2016. 2013. Bowry, MBChB, MSc,b Jennifer Lewey, MD,a,c Sagar B. Dugani, MD, PhD,a and Niteesh K. Choudhry, MD, PhDa aDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Six reviews reported the prevalence of anxiety in the context of cardiovascular disease (CVD). According to the latest WHO data published in 2018 Coronary Heart Disease Deaths in Pakistan reached 251,220 or 20.28% of total deaths. Coronary Heart Disease. Prevalence of IHD in Pakistan varies from 11.2% in rural areas to 26% in urban areas [2, 3]. Congenital heart disease is a large, rapidly emerging global problem in child health. Milbank Mem Fund Q 49:509, 1971; and SJ Olshansky, AB Ault: The fourth stage of the epidemiologic transition: The age of delayed degenerative diseases. In Pakistan, chronic diseases are projected to account for 42% of all deaths (see below). We produced all-ages and premature age-standardised … Presentation Summary : Cardiovascular disease (CVD), including stroke and coronary heart disease (CHD), is a leading cause of mortality in the East Asia and Pacific region, according Review The Burden of Cardiovascular Disease in Low- and Middle-Income Countries: Epidemiology and Management Ashna D.K. Coronary heart disease has become a major health concern over the past several decades. Prof Rajeev Gupta, MD . Heart disease, a leading cause of death in the United States, creates an enormous burden for people, communities, and healthcare providers and systems. In Pakistan, population data for heart disease is limited; two population studies were conducted in 1965 and 1973 that showed that the prevalence of heart disease is between 0%and 3.7% in rural and urban areas. Crude And Sex Specific Prevalence Of Cardiovascular Disease Risk Chronic Non Communicable Diseases Ministry Of Health Wellness Ophthalmological Society Of Jamaica Burden Of Heart Failure In Latin America A Systematic Review And Nhp Cardiovascular … Sizing Up a Public Health Crisis Estimates of disease in nonmigrant populations are conflicting. This article describes the epidemiologic distribution of NCDs in Pakistan, with a special emphasis on the 4 main afflictions (Cardiovascular diseases, Cancers, Chronic Respiratory Diseases, and Diabetes) which together account for 36% of total deaths, a disconcerting figure considering that the approach to these conditions is largely preventive. High Levels of Cardiovascular Risk Factors among Pakistanis in Norway Compared to Pakistanis in Pakistan. Incidence and prevalence. The rate of substance abuse (opioids, cocaine, electronic cigarettes, and anabolic steroi … A total of 835 patients (555 males and 280 females) and 794 control subjects (486 males and 308 females) were recruited in this study. Affiliations. Introduction Heart valve disease is as common as heart failure. The highest prevalence and mortality rates of cardiovascular disease are seen in low- income countries, including India. Objective: We conducted this study to determine the prevalence of coronary artery disease (CAD) and its risk factors in Karachi, Pakistan. The 2004 Global Burden of Disease Study reported an incidence of 0.4 million for heart … Declines in cardiovascular disease mortality have seen cancer becoming a more common cause of death in a number of high-income member countries, but in middle-income countries declines in cardiovascular disease mortality have been less consistent. Most of the data regarding disease burden estimates are mostly centerbased. The low-income countries included Bangladesh, India, Pakistan, Tanzania, and Zimbabwe. Pakistanis above 45 years have hypertension (a) 1 in 10. people aged 30-70 die from CVD (b) 30% to 40%. Significantly higher prevalence observed with increasing age (p. value 0.001). “Therefore, it is urgent to carry out broader cardiovascular disease monitoring and intervention treatment in Pakistan.” To combine advanced medical technology with local conditions in Pakistan, Dr Wahid Abdul had got some inspiration from a special action in China. Associations of unprocessed and processed meat intake with mortality and cardiovascular disease in 21 countries [Prospective Urban Rural Epidemiology (PURE) Study]: a prospective cohort study ... and high-income countries. Cardiovascular diseases possess a major cause for fatality and disability the world over. The CDC-Pakistan FELTP, located in the Pakistan NIH, has worked closely with the GoP since 2006. Risk factors of cardiovascular disease and its recommendations in Pakistani context. A large percentage of this burden is found in low and middle income countries. Cardiomyopathy was a major risk factor in Sub-Saharan Africa, Latin America, the Caribbean, and Asia Pacific region (Fig. The prevalence of cardiovascular diseases in China is on a continuous rise. 1,2 South Asians have relatively high risk of CVD compared to other regions and its prevalence is higher in young age groups and women. 3,4 Prevention requires major action to reduce the adverse consequences of risk factors for cardiovascular disease. Objectives To estimate the prevalence and awareness of risk factors and risk behaviours of coronary heart disease (CHD) in the lower middle class residing in urban localities of Karachi, a mega city of Pakistan. Fig.1: Organogram of data selection. We carried out a case control study to determine the prevalence of various cardiovascular risk factors in a Pakistani population. 1 Priodontal infections have also been implicated as one of several factors in the development of coronary heart disease. The Pakistani population is at risk of cardiovascular diseases due to unhealthy diets, lack of exercise and smoking. The data released in august 2014 has been analysed from the australian bureau of statistics australian health survey 201112 and is based on australians aged 18 years of age and over. disease epidemiology. diseases were the most common etiology, representing 63% of all cases of native heart valve disease. Burden of CVD in Pakistan Population surveys • Pitfalls in sampling design, sample size standardization and measurement errors, but still remain the most important source of information today National health Survey of Pakistan (NHSP) • Ischemic Heart Disease (IHD) was reported as 12% of the adult mortality in Pakistan. According to the report, ‘Capitalizing on the Demographic Transition: Tackling Non – Communicable Diseases in … Prevalence of Dyslipidemic Phenotypes Including Hyper-apoB and Evaluation of Cardiovascular Disease Risk in Normocholesterolemic Type 2 Diabetic Patients. Author information: (1)Aga Khan University School of Nursing and Midwifery Karachi, Pakistan. A review of the epidemiology of chronic kidney disease in Pakistan: A global and regional perspective Salman Imtiaz , Beena Salman , Ruqaya Qureshi , Murtaza F Drohlia , Aasim Ahmad Department of Nephrology, Dorab Patel Postgraduate Training and Research Center, The Kidney Center Postgraduate Training Institute, Karachi, Pakistan J Cardiovasc Dis Res. The high incidence of cardiovascular disease (CVD) in the Middle East relates to the high prevalence of well-known risk factors such as: hypertension, smoking, dyslipidaemia (high cholesterol), diabetes, obesity and unhealthy lfestyle. 2019 Mar;69(3):306-312. Abstract. 1. The death rates from heart disease compared to whites are 100% higher among Pakistani men and 150% higher among Pakistani women in the UK. 2 Yousuf M, Ling NH, Jawad S, Omair S, Yaping P. Periodontal status of Pakistani orthodontic patients. In Pakistan, population data for heart disease is limited; two population studies were conducted in 1965 and 1973 that showed that the prevalence of heart disease is between 0%and 3.7% in rural and urban areas. It is important to noted that vegetables and fruits are the important foods of maintaining a healthy and prosperous because at the absence of hearty foods, people are suffering from such diseases. In addition, CDC plans to intensively train 18 FELTP residents to support immunization and polio eradication activities. Pakistan continues to have transmission of all forms of viral hepatitis. With 4-5% of the population infected, the country has one of the highest rates of hepatitis C virus infection in the world. Find facts, statistics, maps, and other data related to heart disease. KARACHI, Sept 28: At least 12 Pakistanis die every hour due to heart attack while more than one third (34 per cent) of all deaths in Pakistan are caused by cardiovascular diseases … By Prof Adeela Shahid. It is important to noted that vegetables and fruits are the important foods of maintaining a healthy and prosperous because at the absence of hearty foods, people are suffering from such diseases. Moreover, they develop heart disease up to a decade earlier (often before the fifth decade of life). world1,3 and the prevalence of CAD in India has more than doubled in the past two decades. Barolia R(1), Sayani AH(1). Methods: The cross-sectional study was carried out from June to December 2012 by arranging health camps for asymptomatic population in Karachi at busy shopping areas frequented by people of all socioeconomic classes. FELTP has served as a key technical arm during several public health events, including the Human Avian Influenza outbreak in 2007, an HIV outbreak in 2008, the flood response in … People of South Asian descent, including those from India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan and the Maldives, have a higher risk of ASCVD – fourfold higher than the general population. The overall HIV prevalence of 21.0%, although 77.0% Cardiovascular Disease (cvd), Including Stroke And Coronary Heart Disease (chd), Is PPT. Valvular heart Disease (VHD) is the source of significant morbidity and mortality with increasing prevalence but is poorly researched in comparison with other areas of cardiac disease. Prevalence rate of 31.69% was found among positive samples size of diabetes patients for CVD risk while Asthma and Anemia patients shows 2.92% and 12.95% prevalence of CVD. By Andrew Tonkin. Bowry, MBChB, MSc,b Jennifer Lewey, MD,a,c Sagar B. Dugani, MD, PhD,a and Niteesh K. Choudhry, MD, PhDa aDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, A group of diseases characterized by anA group of diseases characterized by an Abnormal growth of cellsAbnormal growth of cells Ability to invade adjacent tissues and evenAbility to invade adjacent tissues and even distant organsdistant organs Cardiovascular disease risk factors in Pakistani population with newly diagnosed Type 2 diabetes mellitus: A cross-sectional study of selected family practitioner clinics in four provinces of Pakistan (CardiP Study). OBJECTIVE: To determine the frequency of new coronary artery disease (CAD) cases during the years 2015, 2016 and 2017 in patients presenting to a cardiology clinic and to look for its current trends in Khyber Pakhtunkhwa (KP), Pakistan. Cardiovascular disease (CVD) is one of the major causes of death across the world. The overall prevalence of ischemic heart diseases in men was 2.3% in the rural METHODS: This descriptive study was conducted in a private clinic of interventional cardiologist, based in Lady Reading Hospital, Peshawar, Pakistan … Introduction. Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Objective: To study the prevalence and the pattern of distribution of congenital heart disease.Study Design: Descriptive cross-sectional study.Place and Duration of Study: The study was conducted at outpatient department (OPD) of CMH Chhor and DHQ Umerkot, Sindh (Pakistan), from Dec 2019 to Mar 2020.Methodology: All the children (<12 years age) presenting to Paediatric OPD of the … This study was designed, to determine the prevalence of congenital heart disease in rural Pakistan. This effort covers the prevalence and comparison of NDs including hypertension, stroke, epilepsy, depression, Parkinson's disease (PD) and Alzheimer's disease (AD) in the above mentioned countries. There is a paucity of reliable data concerning the incidence of heart disease among children in Pakistan. Cardiovascular Disease and Stroke in Women and Special Popula-tions Committee of ... Nepal, Pakistan, and Sri Lanka) make up one quarter of the world’s ... cardiovascular diseases genetics prevalence risk factors sociological factors. Ischemic heart disease, also known as coronary artery disease, is the main cause of death in Pakistan. 11, NO. 1 One in four middle-aged adults in urban Pakistan have CAD (coronary artery disease) with greater prevalence in women (30%) than in men (24%) over 40 years of age. The term prevalence of cardiovascular disease usually refers to the estimated population of people who are managing cardiovascular disease at any given time. Cardiovascular disease 22% Cancer 6% Diabetes 1% 8% and perinatal, nutritional deficiencies 50% 8% Chronic respiratory disease FACING THE FACTS: THE IMPACT OF CHRONIC DISEASE IN PAKISTAN Chronic diseases are the major cause of death and disability worldwide. heart disease (IHD) and infection-related heart disease (ie, rheumatic heart disease [RHD]) has improved with the recent progress in medical and public health programs. Pakistan is contributing 19 per cent deaths in all over the world and 29 percent are heart attacks and heart ailments which is around 406,870 per year. In the past 2 decades, a high prevalence of risk factors for cardiovascular disease, such as obesity, physical inactivity, and poor diet, has been observed among young individuals living in developed countries. Review The Burden of Cardiovascular Disease in Low- and Middle-Income Countries: Epidemiology and Management Ashna D.K. This accounts for nearly 7 million deaths and 129 million DALYs annually and is a huge global economic burden. “Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2.” Indian heart journal 54(1), 59-66. Search for articles by this author. In Pakistan, chronic diseases are projected to account for 42% of all deaths (see below). This is an attempt to evaluate the burden of NDs in Pakistan and a comparison with the neighboring counties. Objectives: To estimate the prevalence of Chronic Kidney Disease in an urban city and to assess the risk factors associated with the condition. 2 Female patients with CAD are presenting at a much … Cardio-Vascular Disease • Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. METHODS: During a cross-sectional survey of rural population belonging to major ethnic groups living in three provinces of Pakistan to determine the prevalence of rheumatic heart disease (RHD), CHD rates were calculated as a sub study. Pakistani Heart disease . CVDs are the number one cause of death globally: more people die annually from CVDs than from any other cause.. 1 Bhateja S. High prevalence of cardiovascular diseases among other medically compromised conditions in dental patients. Pakistan has a very high disease burden, estimated as 5.09375 million2 A population based cross-sectional survey showed that 1 in 4 middle aged adults in Pakistan has prevalent CAD. A few reports of selected school-age children from Karachi [1] and Islamabad [2] show an incidence of 1.8, and 1.5 per 1,000 children for heart disease. The epidemiology of cardiovascular diseases in sub-Saharan Africa: the Global Burden of Diseases, Injuries and Risk Factors 2010 Study. This study was carried out to explore the association between dietary patterns and the presence of cardiovascular risk factors among Pakistani low income urban … Cardiovascular disease 22% Cancer 6% Diabetes 1% 8% and perinatal, nutritional deficiencies 50% 8% Chronic respiratory disease FACING THE FACTS: THE IMPACT OF CHRONIC DISEASE IN PAKISTAN Chronic diseases are the major cause of death and disability worldwide. Percentage of this burden is found in low and middle income countries ( p. value 0.001 ) the. S Vol common pathway of CVD in the world CVD mortality declined by 68 % 1980. And disability the world data from AR Omran: the global burden of diseases, Injuries and risk must... Decade earlier ( often before the fifth decade of life ) or the. A decade earlier ( often before the fifth decade of life ) children!, Razzak JA, Bilger M, Naghavi M, et al in Sub-Saharan Africa Latin! 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