Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013 Article
Author(s): Kaul A.,Li Y.,Barber R.M.,De Leo D.,Moran A.E.,Dingenen R.V.,Shahraz S.,Miller T.R.,Poenaru D.,Rahman S.U.,Alam S.S.,Krishnamurthi R.V.,Assadi R.,Stein M.B.,Gabbe B.J.,Sahraian M.A.,Sykes B.L.,Chen W.,Campos-Nonato I.R.,Ortiz A.,Gankpe F.G.,Popova S.,Brayne C.E.G.,Lloyd B.K.,Zhao Y.,Gessner B.D.,Murthy K.S.,Serdar B.,Tavakkoli M.,Guerrant More ...
The Lancet Volume 386, Issue 9995, 2015 , Pages 743-800
DOI:10.1016/S0140-6736(15)60692-4
Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries. © 2015 Elsevier Ltd.
Keywords
newborn ovary polycystic disease newborn disease Chagas disease Humans Africa south of the Sahara chlamydiasis ischemic heart disease Age Distribution substance abuse Disabled Persons anemia chronic disease hemolytic anemia malaria Infant, Newborn disabled person low back pain communicable disease periodontal disease burn disability urinary tract infection age distribution genital herpes acute hepatitis A priority journal incidence thalassemia glucose 6 phosphate dehydrogenase deficiency comorbidity intellectual impairment uterus myoma diabetes mellitus premenstrual syndrome typhoid fever Developing Countries very elderly male trichomoniasis human Child injury cataract Acute Disease congenital disorder puerperal infection simulation Prevalence dengue health Aged, 80 and over cost of illness acute hepatitis B Infant young adult rheumatoid arthritis digestive system disease population growth gonorrhea Sex Distribution child musculoskeletal disease prevalence maternal hypertension hepatitis C female adolescent Residence Characteristics developing country chronic obstructive lung disease aged tension headache tropical disease Aged refraction error demography malignant neoplastic disease developed country Human immunodeficiency virus infection Cost of Illness Article statistics and numerical data Female Middle Aged diarrhea Male systematic review (topic) iron deficiency anemia visual impairment infant neurologic disease sickle cell trait preschool child chronic respiratory tract disease heart disease pelvic organ prolapse major depression biliary tract disease Global Health tooth pain Young Adult Adult bacterial skin disease Developed Countries hypertension traffic accident lower respiratory tract infection adult sex ratio otitis media chronic kidney disease acute otitis media middle aged Incidence acute disease Adolescent interstitial nephritis non communicable disease mortality Chronic Disease upper respiratory tract infection hepatitis E osteoarthritis Neglected Diseases Wounds and Injuries schistosomiasis chickenpox Child, Preschool dental caries

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