Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.
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Murray Christopher J L, Vos Theo, Lozano Rafael, Naghavi Mohsen, Flaxman Abraham D, Michaud Catherine, Ezzati Majid, Shibuya Kenji, Salomon Joshua A, Abdalla Safa, Aboyans Victor, Abraham Jerry, Ackerman Ilana, Aggarwal Rakesh, Ahn Stephanie Y, Ali Mohammed K, Alvarado Miriam, Anderson H Ross, Anderson Laurie M, Andrews Kathryn G, Atkinson Charles, Baddour Larry M, Bahalim Adil N, Barker-Collo Suzanne, Barrero Lope H, Bartels David H, Basáñez Maria-Gloria, Baxter Amanda, Bell Michelle L, Benjamin Emelia J, Bennett Derrick, Bernabé Eduardo, Bhalla Kavi, Bhandari Bishal, Bikbov Boris, Bin Abdulhak Aref, Birbeck Gretchen, Black James A, Blencowe Hannah, Blore Jed D, Blyth Fiona, Bolliger Ian, Bonaventure Audrey, Boufous Soufiane, Bourne Rupert, Boussinesq Michel, Braithwaite Tasanee, Brayne Carol, Bridgett Lisa, Brooker Simon, Brooks Peter, Brugha Traolach S, Bryan-Hancock Claire, Bucello Chiara, Buchbinder Rachelle, Buckle Geoffrey, Budke Christine M, Burch Michael, Burney Peter, Burstein Roy, Calabria Bianca, Campbell Benjamin, Canter Charles E, Carabin Hélène, Carapetis Jonathan, Carmona Loreto, Cella Claudia, Charlson Fiona, Chen Honglei, Cheng Andrew Tai-Ann, Chou David, Chugh Sumeet S, Coffeng Luc E, Colan Steven D, Colquhoun Samantha, Colson K Ellicott, Condon John, Connor Myles D, Cooper Leslie T, Corriere Matthew, Cortinovis Monica, de Vaccaro Karen Courville, Couser William, Cowie Benjamin C, Criqui Michael H, Cross Marita, Dabhadkar Kaustubh C, Dahiya Manu, Dahodwala Nabila, Damsere-Derry James, Danaei Goodarz, Davis Adrian, De Leo Diego, Degenhardt Louisa, Dellavalle Robert, Delossantos Allyne, Denenberg Julie, Derrett Sarah, Des Jarlais Don C, Dharmaratne Samath D, Dherani Mukesh, Diaz-Torne Cesar, Dolk Helen, Dorsey E Ray, Driscoll Tim, Duber Herbert, Ebel Beth, Edmond Karen, Elbaz Alexis, Ali Suad Eltahir, Erskine Holly, Erwin Patricia J, Espindola Patricia, Ewoigbokhan Stalin E, Farzadfar Farshad, Feigin Valery, Felson David T, Ferrari Alize, Ferri Cleusa P, Fèvre Eric M, Finucane Mariel M, Flaxman Seth, Flood Louise, Foreman Kyle, Forouzanfar Mohammad H, Fowkes Francis Gerry R, Fransen Marlene, Freeman Michael K, Gabbe Belinda J, Gabriel Sherine E, Gakidou Emmanuela, Ganatra Hammad A, Garcia Bianca, Gaspari Flavio, Gillum Richard F, Gmel Gerhard, Gonzalez-Medina Diego, Gosselin Richard, Grainger Rebecca, Grant Bridget, Groeger Justina, Guillemin Francis, Gunnell David, Gupta Ramyani, Haagsma Juanita, Hagan Holly, Halasa Yara A, Hall Wayne, Haring Diana, Haro Josep Maria, Harrison James E, Havmoeller Rasmus, Hay Roderick J, Higashi Hideki, Hill Catherine, Hoen Bruno, Hoffman Howard, Hotez Peter J, Hoy Damian, Huang John J, Ibeanusi Sydney E, Jacobsen Kathryn H, James Spencer L, Jarvis Deborah, Jasrasaria Rashmi, Jayaraman Sudha, Johns Nicole, Jonas Jost B, Karthikeyan Ganesan, Kassebaum Nicholas, Kawakami Norito, Keren Andre, Khoo Jon-Paul, King Charles H, Knowlton Lisa Marie, Kobusingye Olive, Koranteng Adofo, Krishnamurthi Rita, Laden Francine, Lalloo Ratilal, Laslett Laura L, Lathlean Tim, Leasher Janet L, Lee Yong Yi, Leigh James, Levinson Daphna, Lim Stephen S, Limb Elizabeth, Lin John Kent, Lipnick Michael, Lipshultz Steven E, Liu Wei, Loane Maria, Ohno Summer Lockett, Lyons Ronan, Mabweijano Jacqueline, MacIntyre Michael F, Malekzadeh Reza, Mallinger Leslie, Manivannan Sivabalan, Marcenes Wagner, March Lyn, Margolis David J, Marks Guy B, Marks Robin, Matsumori Akira, Matzopoulos Richard, Mayosi Bongani M, McAnulty John H, McDermott Mary M, McGill Neil, McGrath John, Medina-Mora Maria Elena, Meltzer Michele, Mensah George A, Merriman Tony R, Meyer Ana-Claire, Miglioli Valeria, Miller Matthew, Miller Ted R, Mitchell Philip B, Mock Charles, Mocumbi Ana Olga, Moffitt Terrie E, Mokdad Ali A, Monasta Lorenzo, Montico Marcella, Moradi-Lakeh Maziar, Moran Andrew, Morawska Lidia, Mori Rintaro, Murdoch Michele E, Mwaniki Michael K, Naidoo Kovin, Nair M Nathan, Naldi Luigi, Narayan K M Venkat, Nelson Paul K, Nelson Robert G, Nevitt Michael C, Newton Charles R, Nolte Sandra, Norman Paul, Norman Rosana, O'Donnell Martin, O'Hanlon Simon, Olives Casey, Omer Saad B, Ortblad Katrina, Osborne Richard, Ozgediz Doruk, Page Andrew, Pahari Bishnu, Pandian Jeyaraj Durai, Rivero Andrea Panozo, Patten Scott B, Pearce Neil, Padilla Rogelio Perez, Perez-Ruiz Fernando, Perico Norberto, Pesudovs Konrad, Phillips David, Phillips Michael R, Pierce Kelsey, Pion Sébastien, Polanczyk Guilherme V, Polinder Suzanne, Pope C Arden, Popova Svetlana, Porrini Esteban, Pourmalek Farshad, Prince Martin, Pullan Rachel L, Ramaiah Kapa D, Ranganathan Dharani, Razavi Homie, Regan Mathilda, Rehm Jürgen T, Rein David B, Remuzzi Guiseppe, Richardson Kathryn, Rivara Frederick P, Roberts Thomas, Robinson Carolyn, De Leòn Felipe Rodriguez, Ronfani Luca, Room Robin, Rosenfeld Lisa C, Rushton Lesley, Sacco Ralph L, Saha Sukanta, Sampson Uchechukwu, Sanchez-Riera Lidia, Sanman Ella, Schwebel David C, Scott James Graham, Segui-Gomez Maria, Shahraz Saeid, Shepard Donald S, Shin Hwashin, Shivakoti Rupak, Singh David, Singh Gitanjali M, Singh Jasvinder A, Singleton Jessica, Sleet David A, Sliwa Karen, Smith Emma, Smith Jennifer L, Stapelberg Nicolas J C, Steer Andrew, Steiner Timothy, Stolk Wilma A, Stovner Lars Jacob, Sudfeld Christopher, Syed Sana, Tamburlini Giorgio, Tavakkoli Mohammad, Taylor Hugh R, Taylor Jennifer A, Taylor William J, Thomas Bernadette, Thomson W Murray, Thurston George D, Tleyjeh Imad M, Tonelli Marcello, Towbin Jeffrey A, Truelsen Thomas, Tsilimbaris Miltiadis K, Ubeda Clotilde, Undurraga Eduardo A, van der Werf Marieke J, van Os Jim, Vavilala Monica S, Venketasubramanian N, Wang Mengru, Wang Wenzhi, Watt Kerrianne, Weatherall David J, Weinstock Martin A, Weintraub Robert, Weisskopf Marc G, Weissman Myrna M, White Richard A, Whiteford Harvey, Wiebe Natasha, Wiersma Steven T, Wilkinson James D, Williams Hywel C, Williams Sean R M, Witt Emma, Wolfe Frederick, Woolf Anthony D, Wulf Sarah, Yeh Pon-Hsiu, Zaidi Anita K M, Zheng Zhi-Jie, Zonies David, Lopez Alan D, AlMazroa Mohammad A, Memish Ziad A
Аннотация
METHODS: We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights.
FINDINGS: Global DALYs remained stable from 1990 (2·503 billion) to 2010 (2·490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions.
INTERPRETATION: Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.
FUNDING: Bill & Melinda Gates Foundation.