Table 2.
Joinpoint regression analysis of age-standardized mortality rates, and mortality rates from HIV in MENA countries, 1990–2019.
| Country | Trend 1 | Trend 2 | Trend 3 | Trend 4 | Trend 5 | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Years | APC (95% CI) | Years | APC (95% CI) | Years | APC (95% CI) | Years | APC (95% CI) | Years | APC (95% CI) | |
| Age-standardized mortality rates (GBD database) | ||||||||||
| Algeria | 1990–1996 | 10.1* (9.7, 10.4) | 1997–1999 | 3.8* (1.3, 6.3) | 2000–2007 | 9.5* (9.1, 9.9) | 2008–2013 | −0.1 (−0.7, 0.4) | 2014–2019 | −8* (−8.4, −7.5) |
| Bahrain | 1990–1998 | 8.2* (7.3, 9.1) | 1999–2002 | −10.3* (−14.4, −6.1) | 2003–2007 | −1.2 (−4.1, 1.7) | 2008–2016 | −6.6* (−7.6, −5.7) | 2017–2019 | −15.7* (−23.2, −7.5) |
| Djibouti | 1990–1991 | 243.9* (215.9, 274.3) | 1992–1995 | 99.8* (91.5, 108.5) | 1996–2000 | 33.7* (30.2, 37.3) | 2001–2008 | 1.8* (0.6, 2.9) | 2009–2019 | −5.4* (−0.6, −4.8) |
| Egypt | 1990–1994 | 9.3* (6.5, 12.2) | 1995–2004 | −0.3 (−1.4, 0.7) | 2005–2007 | −11.6* (−21.3, −0.8) | 2008–2012 | 0.3 (−3.3, 4) | 2013–2019 | −13* (−14.7, −11.3) |
| Iran | 1990–1997 | 10.7* (10.2, 11.1) | 1998–2004 | 14.8* (14.1, 15.5) | 2005–2008 | 5.1* (3.1, 7.2) | 2009–2011 | 9.4* (5.3, 13.7) | 2012–2019 | 5.1* (4.6, 5.7) |
| Iraq | 1990–1995 | 12.5* (12.1, 13) | 1996–2002 | 10.4* (10, 10.9) | 2003–2005 | 5.3* (2.8, 7.8) | 2006–2019 | 1.7* (1.5, 1.8) | – | – |
| Jordan | 1990–1994 | 14.8* (13.5, 16.1) | 1995–2003 | 9.8* (9.2, 10.4) | 2004–2006 | −14.5* (−18.8, −10) | 2007–2012 | 10.8* (9.5, 10) | 2013–2019 | −3.3* (−4.1, −2.4) |
| Kuwait | – | – | – | – | – | – | – | – | – | – |
| Lebanon | 1990–1993 | 6.9* (4.7, 9.2) | 1994–1999 | 0.7 (−0.8, 2.3) | 2000–2005 | −5.8* (−7.3, −4.4) | 2006–2019 | −2.5* (−2.8, −2.1) | – | – |
| Libya | 1990–1991 | 14.1* (11.8, 16.4) | 1992–2003 | 10.2* (10.1, 10.4) | 2004–2011 | 3.3* (3.1, 3.6) | 2012–2015 | −1.3* (−2.3, −0.3) | 2016–2019 | 1.8* (0.8, 2.8) |
| Morocco | 1990–1993 | 19.2* (18.2, 20.3) | 1994–1998 | 13.8* (12.8, 14.9) | 1999–2002 | 10.5* (9, 12.1) | 2003–2011 | 1.2* (0.9, 1.5) | 2012–2019 | −9.6* (−9.9, −9.2) |
| Oman | 1990–1999 | 16.7* (16.3, 17) | 2000–2002 | −6.3* (−10.1, −2.3) | 2003–2008 | 20* (18.9, 21.1) | 2009–2019 | −3.1* (−3.4, −2.8) | – | – |
| Palestine | 1990–1992 | 17.5* (16.3, 18.6) | 1993–1996 | 12.5* (11.4,13.6) | 1997–2004 | 9.3* (9, 9.6) | 2005–2007 | 4.4* (2.3, 6.5) | 2008–2019 | 0.2* (0, 0.3) |
| Qatar | 1990–1994 | 9.9* (9, 10.9) | 1995–1998 | −1.8 (−3.7, 0.1) | 1999–2001 | −30.1* (−32.7, −27.4) | 2002–2008 | 1.8* (1.2, 2.5) | 2009–2019 | −5.6* (−5.9, −5.3) |
| Saudi Arabia | 1990–1992 | 11.6* (11.1, 12.1) | 1993–2002 | 8.8* (8.7, 8.9) | 2003–2005 | 4.1* (3.1, 5.1) | 2006–2011 | 0 (− 0.2, 0.2) | 2012–2019 | −1.6* (−1.7, −1.5) |
| Somalia | 1990–1991 | 153.6* (135.8, 172.6) | 1992–1995 | 55.7* (50.2, 61.5) | 1996–1999 | 26.8* (22.3, 31.4) | 2000–2005 | 4.5* (2.8, 6.2) | 2006–2019 | −5.8* (−6.1, −5.4) |
| Sudan | 1990–1991 | 49.9* (39.8, 60.8) | 1992–1995 | 27.1* (22.7, 31.6) | 1996–1999 | 14.5* (10.5, 18.6) | 2000–2004 | 6.8* (4.4, 9.2) | 2005–2019 | 0.4* (0, 0.7) |
| Syria | 1990–2001 | 6* (5.5, 6.5) | 2002–2009 | −3.1* (−4.1, −2.1) | 2010–2013 | 4.3* (0.2, 8.5) | 2014–2016 | −9.1* (−16.1, −1.6) | 2017–2019 | 4.3* (−3.7, 12.9) |
| Tunisia | 1990–1992 | 15.3* (13.7, 16.9) | 1993–2000 | 12.3* (11.9, 12.8) | 2001–2011 | 7.8* (7.6, 8.1) | 2012–2016 | 1.5* (0.6, 2.4) | 2017–2019 | −3.7* (−6.3, −1) |
| UAE | 1990–2000 | 11.5* (11, 12) | 2001–2008 | 8.6* (7.6, 9.6) | 2009–2013 | 24.1* (21.5, 26.7) | 2014–2016 | 17.3* (9.9, 25.3) | 2017–2019 | −7.3* (−13.2, −0.9) |
| Yemen | 1990–1994 | 8.3* (7.6, 9) | 1995–2006 | 2.7* (2.5, 2.9) | 2007–2010 | −3.5* (−4.9, −2.1) | 2011–2015 | −0.9* (−1.8, 0) | 2016–2019 | 2.2* (0.7, 3.7) |
| Total | 1990–1997 | 39.5* (38.7, 40.3) | 1998–2000 | 20.1* (14.1, 26.5) | 2001–2004 | 5.1* (2.4, 7.8) | 2005–2010 | −1.4* (−2.5, −0.2) | 2011–2019 | −4.7* (−5.3, −4.2) |
| Mortality rates (UNAIDS database) | ||||||||||
| Djibouti | 1990–1994 | 78.4* (74.3, 82.5) | 1995–1999 | 32.6* (28.3, 36.9) | 2000–2005 | 6.6* (4.2, 9.1) | 2006–2012 | −5* (−6.7, −3.4) | 2013–2019 | −14* (−15.5, −12.5) |
| Egypt | 1990–1994 | 35.5* (32.9, 38.1) | 1995–2003 | 21.1* (20, 22.2) | 2004–2006 | −1.2 (−9.4, 7.6) | 2007–2013 | 12.4* (10.8, 14.1) | 2014–2019 | 1.8 (−0.2, 3.7) |
| Iran | 1990–1994 | 19.2* (18.1, 20.3) | 1995–2004 | 33.4* (32.9, 33.9) | 2005–2008 | 18.9* (16.6, 21.3) | 2009–2013 | 5.1* (3.8, 6.4) | 2014–2019 | −6.8* (−7.6, −5.9) |
| Jordan | 1990–1998 | 7.6* (6.1, 9.2) | 1999–2001 | −16.2* (_28.3, −2.1) | 2002–2014 | 6.2* (5.2, 7.2) | 2015–2019 | −1.8 (−6.6, 3.1) | – | – |
| Lebanon | 1990–1992 | 25.2* (20.7, 29.9) | 1993–1996 | 14.3* (10.2, 18.5) | 1997–1999 | 6 (−1.5, 14.1) | 2000–2002 | −10.5* (−16.8, −3.7) | 2003–2019 | 0.8* (0.5, 1) |
| Libya | 1990–1998 | 31.6* (30.5, 32.8) | 1999–2001 | −0.4 (−9.4, 9.6) | 2002–2006 | 21.3* (17.7, 25) | 2007–2013 | 2.8* (1.1, 4.4) | 2014–2019 | −3.8* (−5.8, −1.8) |
| Morocco | 1990–1994 | 18.8* (16.2, 21.4) | 1995–2000 | 12.9* (10.5, 15.4) | 2001–2010 | 1* (0.1, 1.9) | 2011–2019 | −8.5* (−9.4, −7.5) | – | – |
| Qatar | 1990–1993 | 11.3* (8.7, 13.9) | 1994–2003 | −5.9* (−6.5, −5.3) | 2004–2013 | 9.6* (8.9, 10.3) | 2014–2016 | −39.6* (−43.9, −34.9) | 2017–2019 | −15.8* (−21.9, −9.3) |
| Saudi Arabia | 1990–1993 | 28.1* (23.8, 32.6) | 1994–1996 | −13.1* (−22, −3.1) | 1997–2004 | 11.1* (9.5, 12.7) | 2005–2013 | −1 (−2.1, 0.2) | 2014–2019 | 10.5* (7.8, 13.2) |
| Somalia | 1990–1994 | 29.2* (27.7, 30.6) | 1995–1999 | 18.3* (16.5, 20.2) | 2000–2005 | 8.1* (6.9, 9.3) | 2006–2012 | −5.1* (−5.9, −4.3) | 2013–2019 | −12.2* (−12.9, −11.4) |
| Sudan | 1990–1995 | 45.9* (42.4, 49.4) | 1996–1999 | 27.1* (18.3, 36.4) | 2000–2004 | 11.8* (6.9, 17) | 2005–2015 | −1.6* (−2.7, −0.6) | 2016–2019 | −9.2* (−15.4, −2.5) |
| Syria | 1990–2000 | 8.8* (7.7, 9.8) | 2001–2012 | 5.1* (4.1, 6.1) | 2013–2016 | 12.2* (4.4, 20.5) | 2017–2019 | − 7.7 (− 20, 6.6) | – | – |
| Tunisia | 1990–1999 | 17.6* (16.9, 18.3) | 2000–2002 | 3.1 (−4.4, 11.2) | 2003–2005 | 15.4* (7, 24.5) | 2006–2014 | 6.7* (5.8, 7.6) | 2015–2019 | −0.5 (−2.8, 1.9) |
| Yemen | 1990–1994 | 9.5* (7.9, 11) | 1995–2006 | 4.1* (3.6, 4.5) | 2007–2009 | −9.4* (−15, −3.4) | 2010–2019 | 2.5* (1.9, 3.1) | – | – |
APC annual percentage change, UAE United Arab Emirates.
*P <0.05 versus 0 (output from joinpoint regression analysis).