Global burden of sickle cell anaemia in children under five, 2010-2050: modelling based on demographics, excess mortality, and interventions
The global burden of sickle cell anaemia (SCA) is set to rise as a consequence of improved survival in high-prevalence low- and middle-income countries and population migration to higher-income countries. The host of quantitative evidence documenting these changes has not been assembled at the globa...
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| description | The global burden of sickle cell anaemia (SCA) is set to rise as a consequence of improved survival in high-prevalence low- and middle-income countries and population migration to higher-income countries. The host of quantitative evidence documenting these changes has not been assembled at the global level. The purpose of this study is to estimate trends in the future number of newborns with SCA and the number of lives that could be saved in under-five children with SCA by the implementation of different levels of health interventions.
First, we calculated projected numbers of newborns with SCA for each 5-y interval between 2010 and 2050 by combining estimates of national SCA frequencies with projected demographic data. We then accounted for under-five mortality (U5m) projections and tested different levels of excess mortality for children with SCA, reflecting the benefits of implementing specific health interventions for under-five patients in 2015, to assess the number of lives that could be saved with appropriate health care services. The estimated number of newborns with SCA globally will increase from 305,800 (confidence interval [CI]: 238,400-398,800) in 2010 to 404,200 (CI: 242,500-657,600) in 2050. It is likely that Nigeria (2010: 91,000 newborns with SCA [CI: 77,900-106,100]; 2050: 140,800 [CI: 95,500-200,600]) and the Democratic Republic of the Congo (2010: 39,700 [CI: 32,600-48,800]; 2050: 44,700 [CI: 27,100-70,500]) will remain the countries most in need of policies for the prevention and management of SCA. We predict a decrease in the annual number of newborns with SCA in India (2010: 44,400 [CI: 33,700-59,100]; 2050: 33,900 [CI: 15,900-64,700]). The implementation of basic health interventions (e.g., prenatal diagnosis, penicillin prophylaxis, and vaccination) for SCA in 2015, leading to significant reductions in excess mortality among under-five children with SCA, could, by 2050, prolong the lives of 5,302,900 [CI: 3,174,800-6,699,100] newborns with SCA. Similarly, large-scale universal screening could save the lives of up to 9,806,000 (CI: 6,745,800-14,232,700) newborns with SCA globally, 85% (CI: 81%-88%) of whom will be born in sub-Saharan Africa. The study findings are limited by the uncertainty in the estimates and the assumptions around mortality reductions associated with interventions.
Our quantitative approach confirms that the global burden of SCA is increasing, and highlights the need to develop specific national policies for appr |
| doi_str_mv | 10.1371/journal.pmed.1001484 |
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First, we calculated projected numbers of newborns with SCA for each 5-y interval between 2010 and 2050 by combining estimates of national SCA frequencies with projected demographic data. We then accounted for under-five mortality (U5m) projections and tested different levels of excess mortality for children with SCA, reflecting the benefits of implementing specific health interventions for under-five patients in 2015, to assess the number of lives that could be saved with appropriate health care services. The estimated number of newborns with SCA globally will increase from 305,800 (confidence interval [CI]: 238,400-398,800) in 2010 to 404,200 (CI: 242,500-657,600) in 2050. It is likely that Nigeria (2010: 91,000 newborns with SCA [CI: 77,900-106,100]; 2050: 140,800 [CI: 95,500-200,600]) and the Democratic Republic of the Congo (2010: 39,700 [CI: 32,600-48,800]; 2050: 44,700 [CI: 27,100-70,500]) will remain the countries most in need of policies for the prevention and management of SCA. We predict a decrease in the annual number of newborns with SCA in India (2010: 44,400 [CI: 33,700-59,100]; 2050: 33,900 [CI: 15,900-64,700]). The implementation of basic health interventions (e.g., prenatal diagnosis, penicillin prophylaxis, and vaccination) for SCA in 2015, leading to significant reductions in excess mortality among under-five children with SCA, could, by 2050, prolong the lives of 5,302,900 [CI: 3,174,800-6,699,100] newborns with SCA. Similarly, large-scale universal screening could save the lives of up to 9,806,000 (CI: 6,745,800-14,232,700) newborns with SCA globally, 85% (CI: 81%-88%) of whom will be born in sub-Saharan Africa. The study findings are limited by the uncertainty in the estimates and the assumptions around mortality reductions associated with interventions.
Our quantitative approach confirms that the global burden of SCA is increasing, and highlights the need to develop specific national policies for appropriate public health planning, particularly in low- and middle-income countries. Further empirical collaborative epidemiological studies are vital to assess current and future health care needs, especially in Nigeria, the Democratic Republic of the Congo, and India.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1001484</identifier><identifier>PMID: 23874164</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Antibiotics ; Bayes Theorem ; Biology ; Birth Rate ; Child, Preschool ; Children ; Confidence intervals ; Cost of Illness ; Demographics ; Demography ; Earth Sciences ; Estimates ; Global Health - trends ; Health aspects ; Humans ; Immunization ; Infant ; Infant, Newborn ; Low income groups ; Medicine ; Models, Theoretical ; Mortality ; Population ; Population Density ; Prevalence studies (Epidemiology) ; Public health ; Risk Factors ; Sickle cell anemia ; Sickle Cell Trait - economics ; Sickle Cell Trait - epidemiology ; Social aspects ; Social medicine ; Time Factors</subject><ispartof>PLoS medicine, 2013-07, Vol.10 (7), p.e1001484-e1001484</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Piel et al 2013 Piel et al</rights><rights>2013 Piel et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Piel FB, Hay SI, Gupta S, Weatherall DJ, Williams TN (2013) Global Burden of Sickle Cell Anaemia in Children under Five, 2010-2050: Modelling Based on Demographics, Excess Mortality, and Interventions. PLoS Med 10(7): e1001484. doi:10.1371/journal.pmed.1001484</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c769t-184d2ac433b58d6630599abdf6bd9fa34937d771d57a0fcace153ade785a19de3</citedby><cites>FETCH-LOGICAL-c769t-184d2ac433b58d6630599abdf6bd9fa34937d771d57a0fcace153ade785a19de3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712914/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712914/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23874164$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Piel, Frédéric B</creatorcontrib><creatorcontrib>Hay, Simon I</creatorcontrib><creatorcontrib>Gupta, Sunetra</creatorcontrib><creatorcontrib>Weatherall, David J</creatorcontrib><creatorcontrib>Williams, Thomas N</creatorcontrib><title>Global burden of sickle cell anaemia in children under five, 2010-2050: modelling based on demographics, excess mortality, and interventions</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>The global burden of sickle cell anaemia (SCA) is set to rise as a consequence of improved survival in high-prevalence low- and middle-income countries and population migration to higher-income countries. The host of quantitative evidence documenting these changes has not been assembled at the global level. The purpose of this study is to estimate trends in the future number of newborns with SCA and the number of lives that could be saved in under-five children with SCA by the implementation of different levels of health interventions.
First, we calculated projected numbers of newborns with SCA for each 5-y interval between 2010 and 2050 by combining estimates of national SCA frequencies with projected demographic data. We then accounted for under-five mortality (U5m) projections and tested different levels of excess mortality for children with SCA, reflecting the benefits of implementing specific health interventions for under-five patients in 2015, to assess the number of lives that could be saved with appropriate health care services. The estimated number of newborns with SCA globally will increase from 305,800 (confidence interval [CI]: 238,400-398,800) in 2010 to 404,200 (CI: 242,500-657,600) in 2050. It is likely that Nigeria (2010: 91,000 newborns with SCA [CI: 77,900-106,100]; 2050: 140,800 [CI: 95,500-200,600]) and the Democratic Republic of the Congo (2010: 39,700 [CI: 32,600-48,800]; 2050: 44,700 [CI: 27,100-70,500]) will remain the countries most in need of policies for the prevention and management of SCA. We predict a decrease in the annual number of newborns with SCA in India (2010: 44,400 [CI: 33,700-59,100]; 2050: 33,900 [CI: 15,900-64,700]). The implementation of basic health interventions (e.g., prenatal diagnosis, penicillin prophylaxis, and vaccination) for SCA in 2015, leading to significant reductions in excess mortality among under-five children with SCA, could, by 2050, prolong the lives of 5,302,900 [CI: 3,174,800-6,699,100] newborns with SCA. Similarly, large-scale universal screening could save the lives of up to 9,806,000 (CI: 6,745,800-14,232,700) newborns with SCA globally, 85% (CI: 81%-88%) of whom will be born in sub-Saharan Africa. The study findings are limited by the uncertainty in the estimates and the assumptions around mortality reductions associated with interventions.
Our quantitative approach confirms that the global burden of SCA is increasing, and highlights the need to develop specific national policies for appropriate public health planning, particularly in low- and middle-income countries. Further empirical collaborative epidemiological studies are vital to assess current and future health care needs, especially in Nigeria, the Democratic Republic of the Congo, and India.</description><subject>Antibiotics</subject><subject>Bayes Theorem</subject><subject>Biology</subject><subject>Birth Rate</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Confidence intervals</subject><subject>Cost of Illness</subject><subject>Demographics</subject><subject>Demography</subject><subject>Earth Sciences</subject><subject>Estimates</subject><subject>Global Health - trends</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Immunization</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Low income groups</subject><subject>Medicine</subject><subject>Models, Theoretical</subject><subject>Mortality</subject><subject>Population</subject><subject>Population Density</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Public health</subject><subject>Risk Factors</subject><subject>Sickle cell anemia</subject><subject>Sickle Cell Trait - economics</subject><subject>Sickle Cell Trait - epidemiology</subject><subject>Social aspects</subject><subject>Social medicine</subject><subject>Time Factors</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNqVk2trFDEUhgdRbK3-A9FAQRS6azLJ3PwglKK1UCx4-xrOJGdmU7PJmsyU9j_4o810t6ULBZX5MEPmed9zci5Z9pzROeMVe3vux-DAzldL1HNGKRO1eJDtskI0M1ZW5cM73zvZkxjPKc0b2tDH2U7O60qwUuxmv4-tb8GSdgwaHfEdiUb9tEgUWkvAAS4NEOOIWhirQ0JGpzGQzlzgAckpo7OcFvQdWXqdFMb1pIWImnhHNC59H2C1MCoeELxUGGPiwgDWDFcHyV0n5wHDBbrBeBefZo86sBGfbd572fePH74dfZqdnh2fHB2ezlRVNsOM1ULnoATnbVHrsuS0aBpodVe2uumAi4ZXuqqYLiqgnQKFrOCgsaoLYI1Gvpe9XPuurI9yU8gomeC0qvNSiEScrAnt4VyugllCuJIejLw-8KGXEAajLMqmRFpXXSp1myK3eQOoOaMcOqZLjix5vd9EG9vUK5UuG8BumW7_cWYhe38hU5fzhk3JvN4YBP9rxDjIpYlTf8ChH1PeRU55lVcN_zsqGCs5Y3xKa3-N9pBuYVznU3A14fKQCyaKVInJcHYP1aPDlKl32Jl0vMXP7-HTk4bBqHsFb7YEiRnwcuhhjFGefP3yH-znf2fPfmyzr-6wCwQ7LKK34_VQboNiDargYwzY3XaRUTlt5c0wyWkr5WYrk-zF3Qm4Fd2sIf8DFOcwog</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Piel, Frédéric B</creator><creator>Hay, Simon I</creator><creator>Gupta, Sunetra</creator><creator>Weatherall, David J</creator><creator>Williams, Thomas N</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISN</scope><scope>ISR</scope><scope>7X8</scope><scope>C1K</scope><scope>F1W</scope><scope>H95</scope><scope>H97</scope><scope>L.G</scope><scope>5PM</scope><scope>DOA</scope><scope>CZK</scope></search><sort><creationdate>20130701</creationdate><title>Global burden of sickle cell anaemia in children under five, 2010-2050: modelling based on demographics, excess mortality, and interventions</title><author>Piel, Frédéric B ; Hay, Simon I ; Gupta, Sunetra ; Weatherall, David J ; Williams, Thomas N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c769t-184d2ac433b58d6630599abdf6bd9fa34937d771d57a0fcace153ade785a19de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Antibiotics</topic><topic>Bayes Theorem</topic><topic>Biology</topic><topic>Birth Rate</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Confidence intervals</topic><topic>Cost of Illness</topic><topic>Demographics</topic><topic>Demography</topic><topic>Earth Sciences</topic><topic>Estimates</topic><topic>Global Health - trends</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Immunization</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Low income groups</topic><topic>Medicine</topic><topic>Models, Theoretical</topic><topic>Mortality</topic><topic>Population</topic><topic>Population Density</topic><topic>Prevalence studies (Epidemiology)</topic><topic>Public health</topic><topic>Risk Factors</topic><topic>Sickle cell anemia</topic><topic>Sickle Cell Trait - economics</topic><topic>Sickle Cell Trait - epidemiology</topic><topic>Social aspects</topic><topic>Social medicine</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Piel, Frédéric B</creatorcontrib><creatorcontrib>Hay, Simon I</creatorcontrib><creatorcontrib>Gupta, Sunetra</creatorcontrib><creatorcontrib>Weatherall, David J</creatorcontrib><creatorcontrib>Williams, Thomas N</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>MEDLINE - Academic</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Piel, Frédéric B</au><au>Hay, Simon I</au><au>Gupta, Sunetra</au><au>Weatherall, David J</au><au>Williams, Thomas N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Global burden of sickle cell anaemia in children under five, 2010-2050: modelling based on demographics, excess mortality, and interventions</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>10</volume><issue>7</issue><spage>e1001484</spage><epage>e1001484</epage><pages>e1001484-e1001484</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>The global burden of sickle cell anaemia (SCA) is set to rise as a consequence of improved survival in high-prevalence low- and middle-income countries and population migration to higher-income countries. The host of quantitative evidence documenting these changes has not been assembled at the global level. The purpose of this study is to estimate trends in the future number of newborns with SCA and the number of lives that could be saved in under-five children with SCA by the implementation of different levels of health interventions.
First, we calculated projected numbers of newborns with SCA for each 5-y interval between 2010 and 2050 by combining estimates of national SCA frequencies with projected demographic data. We then accounted for under-five mortality (U5m) projections and tested different levels of excess mortality for children with SCA, reflecting the benefits of implementing specific health interventions for under-five patients in 2015, to assess the number of lives that could be saved with appropriate health care services. The estimated number of newborns with SCA globally will increase from 305,800 (confidence interval [CI]: 238,400-398,800) in 2010 to 404,200 (CI: 242,500-657,600) in 2050. It is likely that Nigeria (2010: 91,000 newborns with SCA [CI: 77,900-106,100]; 2050: 140,800 [CI: 95,500-200,600]) and the Democratic Republic of the Congo (2010: 39,700 [CI: 32,600-48,800]; 2050: 44,700 [CI: 27,100-70,500]) will remain the countries most in need of policies for the prevention and management of SCA. We predict a decrease in the annual number of newborns with SCA in India (2010: 44,400 [CI: 33,700-59,100]; 2050: 33,900 [CI: 15,900-64,700]). The implementation of basic health interventions (e.g., prenatal diagnosis, penicillin prophylaxis, and vaccination) for SCA in 2015, leading to significant reductions in excess mortality among under-five children with SCA, could, by 2050, prolong the lives of 5,302,900 [CI: 3,174,800-6,699,100] newborns with SCA. Similarly, large-scale universal screening could save the lives of up to 9,806,000 (CI: 6,745,800-14,232,700) newborns with SCA globally, 85% (CI: 81%-88%) of whom will be born in sub-Saharan Africa. The study findings are limited by the uncertainty in the estimates and the assumptions around mortality reductions associated with interventions.
Our quantitative approach confirms that the global burden of SCA is increasing, and highlights the need to develop specific national policies for appropriate public health planning, particularly in low- and middle-income countries. Further empirical collaborative epidemiological studies are vital to assess current and future health care needs, especially in Nigeria, the Democratic Republic of the Congo, and India.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23874164</pmid><doi>10.1371/journal.pmed.1001484</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Antibiotics Bayes Theorem Biology Birth Rate Child, Preschool Children Confidence intervals Cost of Illness Demographics Demography Earth Sciences Estimates Global Health - trends Health aspects Humans Immunization Infant Infant, Newborn Low income groups Medicine Models, Theoretical Mortality Population Population Density Prevalence studies (Epidemiology) Public health Risk Factors Sickle cell anemia Sickle Cell Trait - economics Sickle Cell Trait - epidemiology Social aspects Social medicine Time Factors |
| title | Global burden of sickle cell anaemia in children under five, 2010-2050: modelling based on demographics, excess mortality, and interventions |
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