5321. Saving lives through road safety risk factor interventions: global and national estimates.
作者: Andres I Vecino-Ortiz.;Madhuram Nagarajan.;Sarah Elaraby.;Deivis Nicolas Guzman-Tordecilla.;Nino Paichadze.;Adnan A Hyder.
来源: Lancet. 2022年400卷10347期237-250页
Global road mortality is a leading cause of death in many low-income and middle-income countries. Data to support priority setting under current resource constraints are urgently needed to achieve Sustainable Development Goal (SDG) 3.6. This Series paper estimates the potential number of lives saved if each country implemented interventions to address risk factors for road injuries. We did a systematic review of all available evidence-based, preventive interventions for mortality reduction that targeted the four main risk factors for road injuries (ie, speeding, drink driving, helmet use, and use of seatbelt or child restraint). We used literature review variables and considered three key country-level variables (gross domestic product per capita, population density, and government effectiveness) to generate country-specific estimates on the potential annual attributable number of lives that would be saved by interventions focusing on these four risk factors in 185 countries. Our results suggest that the implementation of evidence-based road safety interventions that target the four main road safety risk factors could prevent between 25% and 40% of all fatal road injuries worldwide. Interventions addressing speed could save about 347 258 lives globally per year, and at least 16 304 lives would be saved through drink driving interventions. The implementation of seatbelt interventions could save about 121 083 lives, and 51 698 lives could be saved by helmet interventions. We identify country-specific estimates of the potential number of lives saved that would be attributable to these interventions. Our results show the potential effectiveness of the implementation and scaling of these interventions. This paper presents key evidence for priority setting on road safety interventions and shows a path for reaching SDG 3.6.
5322. Improvement in trauma care for road traffic injuries: an assessment of the effect on mortality in low-income and middle-income countries.
作者: Junaid A Razzak.;Junaid Bhatti.;Kate Wright.;Mulinda Nyirenda.;Muhammad Ramzan Tahir.;Adnan A Hyder.
来源: Lancet. 2022年400卷10348期329-336页
Over 90% of the annual 1·35 million worldwide deaths due to road traffic injuries (RTIs) occur in low-income and middle-income countries (LMICs). For this Series paper, our aim was two-fold. Firstly, to review evidence on effective interventions for victims of RTIs; and secondly, to estimate the potential number of lives saved by effective trauma care systems and clinical interventions in LMICs. We reviewed all the literature on trauma-related health systems and clinical interventions published during the past 20 years using MEDLINE, Embase, and Web of Science. We included studies in which mortality was the primary outcome and excluded studies in which trauma other than RTIs was the predominant injury. We used data from the Global Status Report on Road Safety 2018 and a Monte Carlo simulation technique to estimate the potential annual attributable number of lives saved in LMICs. Of the 1921 studies identified for our review of the literature, 62 (3·2%) met the inclusion criteria. Only 28 (1·5%) had data to calculate relative risk. We found that more than 200 000 lives per year can be saved globally with the implementation of a complete trauma system with 100% coverage in LMICs. Partial system improvements such as establishing trauma centres (>145 000 lives saved) and instituting and improving trauma teams (>115 000) were also effective. Emergency medical services had a wide range of effects on mortality, from increasing mortality to saving lives (>200 000 excess deaths to >200 000 lives saved per year). For clinical interventions, damage control resuscitation (>60 000 lives saved per year) and institution of interventional radiology (>50 000 lives saved per year) were the most effective interventions. On the basis of the scarce evidence available, a few key interventions have been identified to provide guidance to policy makers and clinicians on evidence-based interventions that can reduce deaths due to RTIs in LMICs. We also highlight important gaps in knowledge on the effects of other interventions.
5325. Early food intervention and skin emollients to prevent food allergy in young children (PreventADALL): a factorial, multicentre, cluster-randomised trial.
作者: Håvard Ove Skjerven.;Anine Lie.;Riyas Vettukattil.;Eva Maria Rehbinder.;Marissa LeBlanc.;Anna Asarnoj.;Kai-Håkon Carlsen.;Åshild Wik Despriee.;Martin Färdig.;Sabina Wärnberg Gerdin.;Berit Granum.;Hrefna Katrín Gudmundsdóttir.;Guttorm Haugen.;Gunilla Hedlin.;Geir Håland.;Christine Monceyron Jonassen.;Linn Landrø.;Caroline-Aleksi Olsson Mägi.;Inge Christoffer Olsen.;Knut Rudi.;Carina Madelen Saunders.;Marius Kurås Skram.;Anne Cathrine Staff.;Cilla Söderhäll.;Sandra G Tedner.;Sigve Aadalen.;Hilde Aaneland.;Björn Nordlund.;Karin C Lødrup Carlsen.
来源: Lancet. 2022年399卷10344期2398-2411页
Primary prevention of food allergy by early introduction of allergenic foods seems promising. We aimed to determine whether early food introduction or the application of regular skin emollients in infants from a general population reduced the risk of food allergy.
5326. Global burden of antimicrobial resistance: essential pieces of a global puzzle - Authors' reply.
作者: Mohsen Naghavi.;Christopher J L Murray.;Kevin S Ikuta.;Tomislav Mestrovic.;Lucien Swetschinski.;Benn Sartorius.
来源: Lancet. 2022年399卷10344期2349-2350页 |