Journal article 2764 views
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
The Lancet, Volume: 380, Issue: 9859, Pages: 2163 - 2196
Full text not available from this repository: check for access using links below.
Background Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion andmonitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and2000 have been the only studies to quantify non-fatal health outcomes across an e...
|Published in:||The Lancet|
Check full text
No Tags, Be the first to tag this record!
Background Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion andmonitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at theglobal and regional level. Neither eff ort quantifi ed uncertainty in prevalence or years lived with disability (YLDs).Methods Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, andexcess mortality. Sources included published studies, case notifi cation, population-based cancer registries, otherdisease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys,other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, andlarge methodological variation between data sources. For some disorders, we used natural history models, geospatialmodels, back-calculation models (models calculating incidence from population mortality rates and case fatality), orregistration completeness models (models adjusting for incomplete registration with health-system access and othercovariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs bycause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We includeduncertainty estimates at all stages of the analysis.Findings Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per1 million people to 350 000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated(correlation coeffi cient –0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. Themain contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes orendocrine diseases. The leading specifi c causes of YLDs were much the same in 2010 as they were in 1990: low backpain, major depressive disorder, iron-defi ciency anaemia, neck pain, chronic obstructive pulmonary disease, anxietydisorders, migraine, diabetes, and falls. Age-specifi c prevalence of YLDs increased with age in all regions and hasdecreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar comparedwith years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, andanaemia were important causes of YLDs in sub-Saharan Africa.Interpretation Rates of YLDs per 100 000 people have remained largely constant over time but rise steadily with age.Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalencesof the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, havenot decreased. Health systems will need to address the needs of the rising numbers of individuals with a range ofdisorders that largely cause disability but not mortality. Quantifi cation of the burden of non-fatal health outcomes willbe crucial to understand how well health systems are responding to these challenges. Effective and affordablestrategies to deal with this rising burden are an urgent priority for health systems in most parts of the world.
Faculty of Medicine, Health and Life Sciences