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Int. J. Environ. Res. Public Health 2018, 15(1), 170; https://doi.org/10.3390/ijerph15010170

Global Mortality Burden of Cirrhosis and Liver Cancer Attributable to Injection Drug Use, 1990–2016: An Age-Period-Cohort and Spatial Autocorrelation Analysis

1
Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China
2
Global Health Institute, Wuhan University, 8 Donghunan Road, Wuhan 430072, China
*
Author to whom correspondence should be addressed.
Received: 5 January 2018 / Revised: 19 January 2018 / Accepted: 20 January 2018 / Published: 22 January 2018
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Abstract

We analyzed the temporal and spatial variations in mortality burden of cirrhosis and liver cancer attributable to injection drug use (IDU) from 1990 to 2016. Mortality data of IDU-attributable cirrhosis and IDU-attributable liver cancer on the global and national scales from 1990 to 2016 were collected from the Global Burden of Disease (GBD) studies. Age-period-cohort (APC) model analysis was used to analyze the global mortality trends of target disease, and spatial autocorrelation analysis based on Geographic Information System was applied to illustrate the clusters of the most epidemic countries. Globally, from 1990 to 2015, mortality rates (age-standardized, per 100,000) of IDU-attributable cirrhosis increased continually from 1.5 to 1.9, while from 0.4 to 0.9 for IDU-attributable liver cancer. The APC model analysis indicated that the increases of mortality were mainly driven by period effects, with the mortality risk increasing by 6.82-fold for IDU-attributable cirrhosis and 3.08-fold for IDU-attributable liver cancer. The spatial analysis suggested that IDU-attributable cirrhosis mortality were geographically clustered from 1990 to 2016, and hot spots were mainly located in less well developed countries of Latin America, East and Central Europe and Central Asia. Our study provides epidemiological evidence for global interventions against advanced liver disease among injection drug users (IDUs). View Full-Text
Keywords: injection drug use; cirrhosis; liver cancer; mortality burden; age-period-cohort model analysis; spatial autocorrelation analysis injection drug use; cirrhosis; liver cancer; mortality burden; age-period-cohort model analysis; spatial autocorrelation analysis
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Yang, J.; Zhang, Y.; Luo, L.; Meng, R.; Yu, C. Global Mortality Burden of Cirrhosis and Liver Cancer Attributable to Injection Drug Use, 1990–2016: An Age-Period-Cohort and Spatial Autocorrelation Analysis. Int. J. Environ. Res. Public Health 2018, 15, 170.

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