Ashok Pandey
@nhrc.gov.np
Researcher, Research
Public Health Research Society Nepal
EDUCATION
MPH/BPH
Scopus Publications
Scopus Publications
Austin Carter, Meixin Zhang, Khai Hoan Tram, Magdalene K Walters, Deepa Jahagirdar, Edmond D Brewer, Amanda Novotney, Dylan Lasher, Emmanuel A Mpolya, Avina Vongpradith,et al.
Elsevier BV
Valery L Feigin, Melsew Dagne Abate, Yohannes Habtegiorgis Abate, Samar Abd ElHafeez, Foad Abd-Allah, Ahmed Abdelalim, Atef Abdelkader, Michael Abdelmasseh, Sherief Abd-Elsalam, Parsa Abdi,et al.
Elsevier BV
Hannah Han, Ian D Letourneau, Yohannes Habtegiorgis Abate, Michael Abdelmasseh, Eman Abu-Gharbieh, Tigist Demssew Adane, Bright Opoku Ahinkorah, Aqeel Ahmad, Ali Ahmadi, Ayman Ahmed,et al.
Elsevier BV
Konrad Pesudovs, Van Charles Lansingh, John H. Kempen, Ian Tapply, Arthur G. Fernandes, Maria V. Cicinelli, Alessandro Arrigo, Nicolas Leveziel, Paul Svitil Briant, Theo Vos,et al.
Springer Science and Business Media LLC
Abstract Background To estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by cataract and their proportion of the total number of vision-impaired individuals. Methods A systematic review and meta-analysis of published population studies and gray literature from 2000 to 2020 was carried out to estimate global and regional trends. We developed prevalence estimates based on modeled distance visual impairment and blindness due to cataract, producing location-, year-, age-, and sex-specific estimates of moderate to severe vision impairment (MSVI presenting visual acuity <6/18, ≥3/60) and blindness (presenting visual acuity <3/60). Estimates are age-standardized using the GBD standard population. Results In 2020, among overall (all ages) 43.3 million blind and 295 million with MSVI, 17.0 million (39.6%) people were blind and 83.5 million (28.3%) had MSVI due to cataract blind 60% female, MSVI 59% female. From 1990 to 2020, the count of persons blind (MSVI) due to cataract increased by 29.7%(93.1%) whereas the age-standardized global prevalence of cataract-related blindness improved by −27.5% and MSVI increased by 7.2%. The contribution of cataract to the age-standardized prevalence of blindness exceeded the global figure only in South Asia (62.9%) and Southeast Asia and Oceania (47.9%). Conclusions The number of people blind and with MSVI due to cataract has risen over the past 30 years, despite a decrease in the age-standardized prevalence of cataract. This indicates that cataract treatment programs have been beneficial, but population growth and aging have outpaced their impact. Growing numbers of cataract blind indicate that more, better-directed, resources are needed to increase global capacity for cataract surgery.
, João M. Furtado, Jost B. Jonas, Ian Tapply, Arthur G. Fernandes, Maria Vittoria Cicinelli, Alessandro Arrigo, Nicolas Leveziel, Serge Resnikoff, Hugh R. Taylor,et al.
Springer Science and Business Media LLC
Abstract Background We aimed to update estimates of global vision loss due to age-related macular degeneration (AMD). Methods We did a systematic review and meta-analysis of population-based surveys of eye diseases from January, 1980, to October, 2018. We fitted hierarchical models to estimate the prevalence of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness ( < 3/60) caused by AMD, stratified by age, region, and year. Results In 2020, 1.85 million (95%UI: 1.35 to 2.43 million) people were estimated to be blind due to AMD, and another 6.23 million (95%UI: 5.04 to 7.58) with MSVI globally. High-income countries had the highest number of individuals with AMD-related blindness (0.60 million people; 0.46 to 0.77). The crude prevalence of AMD-related blindness in 2020 (among those aged ≥ 50 years) was 0.10% (0.07 to 0.12) globally, and the region with the highest prevalence of AMD-related blindness was North Africa/Middle East (0.22%; 0.16 to 0.30). Age-standardized prevalence (using the GBD 2019 data) of AMD-related MSVI in people aged ≥ 50 years in 2020 was 0.34% (0.27 to 0.41) globally, and the region with the highest prevalence of AMD-related MSVI was also North Africa/Middle East (0.55%; 0.44 to 0.68). From 2000 to 2020, the estimated crude prevalence of AMD-related blindness decreased globally by 19.29%, while the prevalence of MSVI increased by 10.08%. Conclusions The estimated increase in the number of individuals with AMD-related blindness and MSVI globally urges the creation of novel treatment modalities and the expansion of rehabilitation services.
, Konrad Pesudovs, Van Charles Lansingh, John H. Kempen, Ian Tapply, Arthur G. Fernandes, Maria Vittoria Cicinelli, Alessandro Arrigo, Nicolas Leveziel, Serge Resnikoff,et al.
Springer Science and Business Media LLC
Michael Brauer, Gregory A Roth, Aleksandr Y Aravkin, Peng Zheng, Kalkidan Hassen Abate, Yohannes Habtegiorgis Abate, Cristiana Abbafati, Rouzbeh Abbasgholizadeh, Madineh Akram Abbasi, Mohammadreza Abbasian,et al.
Elsevier BV
Austin E Schumacher, Hmwe Hmwe Kyu, Amirali Aali, Cristiana Abbafati, Jaffar Abbas, Rouzbeh Abbasgholizadeh, Madineh Akram Abbasi, Mohammadreza Abbasian, Samar Abd ElHafeez, Michael Abdelmasseh,et al.
Elsevier BV
Jaimie D Steinmetz, Katrin Maria Seeher, Nicoline Schiess, Emma Nichols, Bochen Cao, Chiara Servili, Vanessa Cavallera, Ewerton Cousin, Hailey Hagins, Madeline E Moberg,et al.
Elsevier BV
Rajesh Sharma, Hedayat Abbastabar, Deldar Morad Abdulah, Hassan Abidi, Hassan Abolhassani, Zahra Abrehdari-Tafreshi, Abdorrahim Absalan, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Juan Manuel Acuna,et al.
Elsevier BV
Sarah Brooke Sirota, Matthew C Doxey, Regina-Mae Villanueva Dominguez, Rose Grace Bender, Avina Vongpradith, Samuel B Albertson, Amanda Novotney, Katrin Burkart, Austin Carter, Parsa Abdi,et al.
Elsevier BV
Madeline E Moberg, Erin B Hamilton, Scott M Zeng, Dana Bryazka, Jeff T Zhao, Rachel Feldman, Yohannes Habtegiorgis Abate, Mohsen Abbasi-Kangevari, Ame Mehadi Abdurehman, Aidin Abedi,et al.
Elsevier BV
Sashi Silwal, Kristina Parajuli, Astha Acharya, Ajnish Ghimire, Savita Pandey, Ashok Pandey, Anil Poudyal, Bihungum Bista, Pradip Gyanwali, and Meghnath Dhimal
Public Library of Science (PLoS)
Background Nepal has been devastated by an unprecedented COVID-19 outbreak, affecting people emotionally, physically, and socially, resulting in significant morbidity and mortality. Approximately 10% of COVID-19 affected people have symptoms that last more than 3–4 weeks and experience numerous symptoms causing an impact on everyday functioning, social, and cognitive function. Thus, it is vital to know about the recovered patient’s health status and undertake rigorous examinations to detect and treat infections. Hence, this study aims to assess the health status of COVID-19 post-recovery patients in Nepal. Method A descriptive cross-sectional mixed-method study was conducted in all seven provinces of Nepal. A total of 552 interviews were conducted for the quantitative study, and 25 in-depth interviews were conducted for the qualitative study among above 18 years COVID-19-recovered patients. The data was gathered over the phone through the purposive sampling method The results of a descriptive and thematic analysis were interpreted. Finding The majority (more than 80%) of the recovered patients could routinely perform household duties, activities outside the home, and financial job accounting. However, a few of them required assistance in carrying out all of those tasks. Prior and then after COVID-19 infection, smoking habits reduced by about one-tenth and alcohol intake decreased by a twelve percent. A qualitative finding revealed that the majority of COVID-19 symptomatic patients experienced a variety of physical symptoms such as fever, headache, body pain, fatigue, tiredness, sore throat, cough, loss of taste, loss of smell, sneezing, loss of appetite, and difficulty breathing, while others felt completely fine after being recovered. Furthermore, there was no variation in the daily functional activities of the majority of the recovered patients, while a few were found conducting fewer activities than usual because they were concerned about their health. For social health, quantitative data indicated that more than half of the participants’ social health was severely impacted. According to the IDI, the majority of the interviewees perceived society’s ignorance and misbehavior. Family members were the most often solicited sources of support. Some participants got care and assistance, but the majority did not get affection or love from their relatives. Moreover, regarding mental health, 15 percent of participants had repeated disturbing and unwanted thoughts about COVID-19 after being recovered, 16 percent tried to avoid information on COVID-19 and 7 .7 percent of people had unfavorable ideas or sentiments about themselves. More than 16 percent of participants reported feeling some level of stress related to the workplace and home. While in-depth interviews participants revealed that COVID-infected patients who were asymptomatic didn’t experience any emotional change in them but recovered patients who are symptomatic symptoms had anxiety and still being conscious of COVID-19 in fear of getting infected again Additionally, it was discovered that participants’ mental health is influenced by ignorance of society, as well as by fake news posted to social media. Conclusion COVID-19 infection has had an impact on physical, mental, and social well-being. Hence, to aid in the early recovery of COVID-19 patients, provision of evaluating and reporting the clinical features, early detection and management of long COVID case is needed from the local and provincial and central government of Nepal.
William M Gardner, Christian Razo, Theresa A McHugh, Hailey Hagins, Victor M Vilchis-Tella, Conor Hennessy, Heather Jean Taylor, Nandita Perumal, Kia Fuller, Kelly M Cercy,et al.
Elsevier BV
Kanyin Liane Ong, Lauryn K Stafford, Susan A McLaughlin, Edward J Boyko, Stein Emil Vollset, Amanda E Smith, Bronte E Dalton, Joe Duprey, Jessica A Cruz, Hailey Hagins,et al.
Elsevier BV
K. Parajuli, Sashi Silwal, Astha Acharya, Anil Poudyal, Neelam Dhakal, Ashok Pandey, Tamanna Neupane, Bihungum Bista, Meghnath Dhimal and Pradip Gyanwali
BACKGROUND
The worldwide containment strategy for COVID-19 outbreak includes laboratory-confirmed cases, and their isolation and management in health care institutions or at home. The spread of the COVID-19 virus has mandated home isolation for mild cases, as recommended by the Government of Nepal. Isolation is a situation that can have a substantial influence on physical and mental health of isolated people. This study is aimed to assess physical and mental well-being of COVID-19 home isolated patients, and their home management practices.
METHODS
A descriptive cross-sectional research using quantitative methods was carried out. Purposive sampling was used to select COVID-19 patients. Total 536 COVID-19 home isolated patients were included in this study. Telephonic interview was conducted to obtain the data. Descriptive analysis was done and interpreted.
RESULTS
About 34 % of the participants were symptomatic. The most common symptoms experienced were fever (22.6%), followed by cough (19.4%) and cold (16.1%). About 20 % indicated having difficulties isolating at home due to lack of separate room. Furthermore, 4 percent of the participants didn't have anyone to take care of them at home. Also almost 2 percent of participants didn't get family support when infected. Moreover, majorities of individuals had normal stress, depression and anxiety level.
CONCLUSIONS
Most of the participants' physical and mental health was found to be normal though some of them experienced difficulties for management during home isolation. Hence, Interventions should focus resilience building by improving communication to address fears and concerns, encouraging routines and physical activities, and taking measures to reduce loneliness.
Emily Haeuser, Audrey L. Serfes, Michael A. Cork, Mingyou Yang, Hedayat Abbastabar, E. S. Abhilash, Maryam Adabi, Oladimeji M. Adebayo, Victor Adekanmbi, Daniel Adedayo Adeyinka,et al.
Springer Science and Business Media LLC
Abstract Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.
Khanh Bao Tran, Justin J Lang, Kelly Compton, Rixing Xu, Alistair R Acheson, Hannah Jacqueline Henrikson, Jonathan M Kocarnik, Louise Penberthy, Amirali Aali, Qamar Abbas,et al.
Elsevier BV
Dana Bryazka, Marissa B Reitsma, Max G Griswold, Kalkidan Hassen Abate, Cristiana Abbafati, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Amir Abdoli, Mohammad Abdollahi, Abu Yousuf Md Abdullah,et al.
Elsevier BV
A. Poudyal, M. Dhimal, Ram Prasad Rimal, Laxman Prasad Rimal, N. Dhakal, Ashok Pandey and P. Gyanwali
BACKGROUND
Body Temperature is one of the most common and an important sign of health and disease. Considering the need of keeping physical distance, newer methods have evolved such as; thermal imaging systems which have been used by several countries during epidemics. Therefore, the present study was conducted to compare body temperatures obtained with thermo graphic camera and commercially available thermal gun with reference to standard digital clinical thermometer.
METHODS
The study was comparative analytical in nature and quantitative method was used to collect data. Temperatures in degrees Fahrenheit were taken simultaneously using the three different thermometers in 101 patients at the outpatient fever screening clinic at Tribhuvan University Teaching Hospital, Kathmandu. The Bland Altman statistical test was used to assess the concordance by the 95% limits of agreement.
RESULTS
The thermo-graphic camera gave concordance (limits of agreement-0.0360 to 0.0440 °F) with standard digital clinical thermometer. Similarly, commercially available thermal gun gave the concordance (limits of agreement 0.0042 to 0.1293 °F) with standard digital clinical thermometer.
CONCLUSIONS
The results of the present study show that both thermo-graphic camera and thermal gun were found to be concordant compared to digital clinical thermometer. Therefore, it could be a preferable option for the screening of fever in mass number of individuals as part of an initial check at entry points.
P. Belbase, A. Basnet, A. Parajuli, Sudip Paudel and A. Pandey
Violence against health workers has been considered a common issue throughout the world. The protection of health workers in low and middle-income countries such as Nepal has not been considered a serious issue by the government. But due to the surge of COVID-19 pandemic and increasing violence against health workers, commendable steps have been taken by the Government of Nepal to protect the safety and security of health workers and health institutions in Nepal. However, the question mark on effective implementation of the ordinance exits suggesting for the appropriate action from concerned authorities and strong collaboration among these sectors. Keywords: Health worker; Nepal; ordinance; safety.
Katherine R Paulson, Aruna M Kamath, Tahiya Alam, Kelly Bienhoff, Gdiom Gebreheat Abady, Jaffar Abbas, Mohsen Abbasi-Kangevari, Hedayat Abbastabar, Foad Abd-Allah, Sherief M Abd-Elsalam,et al.
Elsevier BV
Summary Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3–74·0) in 2000 to 37·1 (33·2–41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8–29·5) in 2000 to 17·9 (16·3–19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05–10·30) in 2000 and 5·05 million (4·27–6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53–4·02]) in 2000 to 48% (2·42 million; 2·06–2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71–0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27–1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35–2·58; 37% [95% UI 32–43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Funding Bill & Melinda Gates Foundation.
Parkes J Kendrick, Marissa B Reitsma, Mohsen Abbasi-Kangevari, Amir Abdoli, Mohammad Abdollahi, Aidin Abedi, E S Abhilash, Victor Aboyans, Oladimeji M Adebayo, Shailesh M Advani,et al.
The Lancet Public Health Elsevier BV
Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15–19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: –1·21% [–1·26 to –1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (−0·94% [–1·72 to –0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Funding Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
Marissa B Reitsma, Parkes J Kendrick, Emad Ababneh, Cristiana Abbafati, Mohsen Abbasi-Kangevari, Amir Abdoli, Aidin Abedi, E S Abhilash, Derrick Bary Abila, Victor Aboyans,et al.
The Lancet Elsevier BV
Summary Background Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings Globally in 2019, 1·14 billion (95% uncertainty interval 1·13–1·16) individuals were current smokers, who consumed 7·41 trillion (7·11–7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5–28·5] reduction) and females (37·7% [35·4–39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98–1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16–8·20) deaths and 200 million (185–214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3–21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Funding Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
A. Pandey, Pradeep Belbase and Ayuska Parajuli
In the race for a safe and effective vaccine against Coronavirus disease-19 manufacturer plays a critical role throughout the development, clinical trial, manufacturing, supply, and vaccination phases. For the efficacy of Coronavirus disease-19 vaccine, proper transport, storage, vaccine carrier, adjuvant, dosage form and route of vaccine administration plays a crucial role for immune response. In the context of no more people were willing to pay for a Coronavirus disease-19 vaccine the logistics of manufacturing, storing and distributing the vaccine, and mass vaccination are essential. It is urgent to improve health promotion and reduce the barriers to Coronavirus disease-19 vaccination. Keywords: COVID-19; vaccine development; vaccination.