METHODS: Data from 45 LMICs were obtained from the Global School-based Student Health Survey (GSHS) between 2009 and 2019. Lifestyle behavior factors were collected through a structured questionnaire. Suicidal ideation, plan, and attempt were ascertained by three single-item questions. Lifestyle risk scores were calculated via a sufficient dimension reduction technique, and lifestyle risk clusters were constructed using a latent class analysis. Generalized linear mixed models with odds ratio (OR) and 95% confidence interval (CI) were used to estimate the lifestyle-STB associations.

RESULTS: A total of 229,041 adolescents were included in the final analysis. The weighted prevalence of suicidal ideation, plan, and attempt was 7.37%, 5.81%, and 4.59%, respectively. Compared with the favorable lifestyle group, the unfavorable group had 1.48-, 1.53-, and 3.11-fold greater odds of suicidal ideation (OR = 1.48, 95%CI: 1.30-1.69), plan (OR = 1.53, 95%CI 1.34-1.75), and attempt (OR = 3.11, 95%CI 2.64-3.65). Four clusters of lifestyle risk behaviors were identified, namely healthy lifestyles (H-L), insufficient intake of vegetables and fruit (V-F), frequent consumption of soft drinks and fast food (D-F), and tobacco smoking and alcohol drinking (S-A) clusters. Compared with H-L cluster, V-F cluster was associated with 43% and 42% higher odds of suicidal ideation and plan, followed by S-A cluster (26% for ideation and 20% for plan), but not significant in D-F cluster (P > 0.05). D-F cluster was associated with 2.85-fold increased odds of suicidal attempt, followed by V-F cluster (2.43-fold) and S-A cluster (1.18-fold).

METHODS: An epidemiological-economic model was used to describe current prevalence and direct medical costs of ten obesity-related comorbidities, including type 2 diabetes and hypertension, in adults aged 20-69 years living with obesity, and estimate incidence and costs over 10 years. Incidence reduction and the associated savings by 2032 were then estimated for a 10% weight-loss scenario.

RESULTS: The total estimated medical costs for the ten obesity-related comorbidities in 2022 were 2.9, 7.5, 10.2, and 23.3 billion USD in Australia, South Korea, Thailand, and India, respectively. Costs increase to 6.9, 18.4, 23.5, and 44.3 billion USD in 2032, if insufficient action is taken. A 10% weight reduction would result in estimated savings of 0.3, 1.2, 2.2, and 3.0 billion USD in Australia, South Korea, Thailand, and India, respectively, in 2032, with cumulative savings over the 10-year period of 1.8, 7.0, 13.0, and 17.4 billion USD. Incidence of comorbidities were estimated to rise less in the weight-loss scenario.

METHODS: Using a societal perspective, the economic burden was calculated at the country level and presented by World Health Organization (WHO) regions and World-Bank income levels. The disease burden was obtained from previously published global disease burden studies in 2016 and disaggregated for 194 countries. Estimates of healthcare resource utilisation were sourced from a literature review, and online interviews were conducted with 20 experts from all 6 WHO regions. Relevant costs were obtained from the literature and estimated in 2016 international dollars (I$).

RESULTS: Both genital HSV-2 (I$31·2 billion) and HSV-1 (I$4·0 billion) infections and their consequences were estimated to cost I$35·3 billion globally in 2016. The major economic burden was from the Americas and Western Pacific regions combined, accounting for almost two-thirds of the global burden (I$20·8 billion). High- and upper-middle-income countries bore a large proportion of the economic burden (76·6% or I$27·0 billion). Costs were driven by the large number of HSV-2 recurrences; however, even assuming conservatively that people with symptomatic herpes have on average only one episode a year, global costs were estimated at I$16·5 billion.