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2. Contributors

Author

Azagury, Dan E., primary, Behrns, Kevin E., additional, Blevins, Katherine S., additional, Boden, Mark, additional, Chadwick, David E., additional, Chandra, Venita, additional, Cohen, Mark S., additional, Cole, Elizabeth, additional, David, Frank S., additional, Denend, Lyn, additional, Egeland, Ryan D., additional, Eisenach, James C., additional, Filarski, Thomas J., additional, Frye, C. Corbin, additional, Goldstein, Johnathan, additional, Hayden, Andy, additional, Heise, Theodore W., additional, Hobday, Thomas, additional, Hood, James, additional, Klapman, Seth, additional, Krummel, Thomas M., additional, Kumthekar, Priya, additional, Leuthardt, Eric, additional, Mackie, Thomas R., additional, Makower, Josh, additional, Matthews, Dennis, additional, Mazzocchi, Rudy A., additional, Miller, Kyle, additional, Myers, Barry S., additional, Narayanan, Deepa, additional, Paul-Robinson, Jenell, additional, Rapp, Zachary, additional, Robert Hallford, Charles, additional, Sanström, Lee L., additional, Sarr, Michael G., additional, Schrankler, Jay, additional, Stossel, Thomas P., additional, Swaroop, Mamta, additional, Voorhees, William D., additional, Wall, James K., additional, Walsh, Tom, additional, Weingarten, Michael, additional, Wynne, Elisabeth K., additional, and Zema, Carla L., additional

Published
2018
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3. 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

Author

Vos, T, Barber, Rm, Bell, B, Bertozzi Villa, A, Biryukov, S, Bolliger, I, Charlson, F, Davis, A, Degenhardt, L, Dicker, D, Duan, L, Erskine, H, Feigin, Vl, Ferrari, Aj, Fitzmaurice, C, Fleming, T, Graetz, N, Guinovart, C, Haagsma, J, Hansen, Gm, Hanson, Sw, Heuton, Kr, Higashi, H, Kassebaum, N, Kyu, H, Laurie, E, Liang, X, Lofgren, K, Lozano, R, Macintyre, Mf, Moradi Lakeh, M, Naghavi, M, Nguyen, G, Odell, S, Ortblad, K, Roberts, Da, Roth, Ga, Sandar, L, Serina, Pt, Stanaway, Jd, Steiner, C, Thomas, B, Vollset, Se, Whiteford, H, Wolock, Tm, Ye, P, Zhou, M, Ãvila, Ma, Aasvang, Gm, Abbafati, C, Abbasoglu, Ozgoren, A, Abd Allah, F, Abdel, Aziz, Abera, Sf, Aboyans, V, Abraham, Jp, Abraham, B, Abubakar, I, Abu Raddad, Lj, Abu Rmeileh, Nm, Aburto, Tc, Achoki, T, Ackerman, In, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Arnlov, J, Agardh, Ee, Khabouri, Al, Alam, Ss, Alasfoor, D, Albittar, Mi, Alegretti, Ma, Aleman, Av, Alemu, Za, Alfonso Cristancho, R, Alhabib, S, Ali, R, Alla, F, Allebeck, P, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis, Guzman, Ameli, N, O, Amini, H, Ammar, W, Anderson, Bo, Anderson, Hr, Antonio, Ca, Anwari, P, Apfel, H, Arsenijevic, Vs, Artaman, A, Asghar, Rj, Assadi, R, Atkins, Ls, Atkinson, C, Badawi, A, Bahit, Mc, Bakfalouni, T, Balakrishnan, K, Balalla, S, Banerjee, A, Barker Collo, Sl, Barquera, S, Barregard, L, Barrero, Lh, Basu, S, Basu, A, Baxter, A, Beardsley, J, Bedi, N, Beghi, E, Bekele, T, Bell, Ml, Benjet, C, Bennett, Da, Bensenor, Im, Benzian, H, Bernabe, E, Beyene, Tj, Bhala, N, Bhalla, A, Bhutta, Z, Bienhoff, K, Bikbov, B, Bin, Abdulhak, Blore, Jd, Blyth, Fm, Bohensky, Ma, Bora, Basara, B, Borges, G, Bornstein, Nm, Bose, D, Boufous, S, Bourne, Rr, Boyers, Ln, Brainin, M, Brauer, M, Brayne, Ce, Brazinova, A, Breitborde, Nj, Brenner, H, Briggs, Ad, Brooks, Pm, Brown, J, Brugha, Ts, Buchbinder, R, Buckle, Gc, Bukhman, G, Bulloch, Ag, Burch, M, Burnett, R, Cardenas, R, Cabral, Nl, Campos, Nonato, Campuzano, Ir, Carapetis, Jc, Carpenter, Do, Caso, V, Castaneda Orjuela, Ca, Catala Lopez, F, Chadha, Vk, Chang, Jc, Chen, H, Chen, W, Chiang, Pp, Chimed Ochir, O, Chowdhury, R, Christensen, H, Christophi, Ca, Chugh, Ss, Cirillo, Massimo, Coggeshall, M, Cohen, A, Colistro, V, Colquhoun, Sm, Contreras, Ag, Cooper, Lt, Cooper, C, Cooperrider, K, Coresh, J, Cortinovis, M, Criqui, Mh, Crump, Ja, Cuevas Nasu, L, Dandona, R, Dandona, L, Dansereau, E, Dantes, Hg, Dargan, Pi, Davey, G, Davitoiu, Dv, Dayama, A, La, De, Cruz, Gongora, De, V, Vega, La, De, Sf, Leo, D, Del, Pozo, Cruz, Dellavalle, Rp, Deribe, K, Derrett, S, Des, Jarlais, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Diaz Torne, C, Ding, El, Dokova, K, Dorsey, Er, Driscoll, Tr, Duber, H, Durrani, Am, Edmond, Km, Ellenbogen, Rg, Endres, M, Ermakov, Sp, Eshrati, B, Esteghamati, A, Estep, K, Fahimi, S, Farzadfar, F, Fay, Df, Felson, Dt, Fereshtehnejad, Sm, Fernandes, Jg, Ferri, Cp, Flaxman, A, Foigt, N, Foreman, Kj, Fowkes, Fg, Franklin, Rc, Furst, T, Futran, Nd, Gabbe, Bj, Gankpe, Fg, Garcia, Guerra, Geleijnse, Fa, Gessner, Bd, Gibney, Kb, Gillum, Rf, Ginawi, Ia, Giroud, M, Giussani, G, Goenka, S, Goginashvili, K, Gona, P, Gonzalez, De, Cosio, T, Gosselin, Ra, Gotay, Cc, Goto, A, Gouda, Hn, Guerrant, Rl, Gugnani, Hc, Gunnell, D, Gupta, R, Gutierrez, Ra, Hafezi Nejad, N, Hagan, H, Halasa, Y, Hamadeh, Rr, Hamavid, H, Hammami, M, Hankey, Gj, Hao, Y, Harb, Hl, Haro, Jm, Havmoeller, R, Hay, Rj, Hay, S, Hedayati, Mt, Heredia, Pi, Heydarpour, P, Hijar, M, Hoek, Hw, Hoffman, Hj, Hornberger, Jc, Hosgood, Hd, Hossain, M, Hotez, Pj, Hoy, Dg, Hsairi, M, Hu, H, Hu, G, Huang, Jj, Huang, C, Huiart, L, Husseini, A, Iannarone, M, Iburg, Km, Innos, K, Inoue, M, Jacobsen, Kh, Jassal, Sk, Jeemon, P, Jensen, Pn, Jha, V, Jiang, G, Jiang, Y, Jonas, Jb, Joseph, J, Juel, K, Kan, H, Karch, A, Karimkhani, C, Karthikeyan, G, Katz, R, Kaul, A, Kawakami, N, Kazi, Ds, Kemp, Ah, Kengne, Ap, Khader, Ys, Khalifa, Se, Khan, Ea, Khan, G, Khang, Yh, Khonelidze, I, Kieling, C, Kim, D, Kim, S, Kimokoti, Rw, Kinfu, Y, Kinge, Jm, Kissela, Bm, Kivipelto, M, Knibbs, L, Knudsen, Ak, Kokubo, Y, Kosen, S, Kramer, A, Kravchenko, M, Krishnamurthi, Rv, Krishnaswami, S, Kuate, Defo, Kucuk, B, Bicer, B, Kuipers, Ej, Kulkarni, Vs, Kumar, K, Kumar, Ga, Kwan, Gf, Lai, T, Lalloo, R, Lam, H, Lan, Q, Lansingh, Vc, Larson, H, Larsson, A, Lawrynowicz, Ae, Leasher, Jl, Lee, Jt, Leigh, J, Leung, R, Levi, M, Li, B, Li, Y, Liang, J, Lim, S, Lin, Hh, Lind, M, Lindsay, Mp, Lipshultz, Se, Liu, S, Lloyd, Bk, Lockett, Ohno, S, Logroscino, G, Looker, Kj, Lopez, Ad, Lopez Olmedo, N, Lortet Tieulent, J, Lotufo, Pa, Low, N, Lucas, Rm, Lunevicius, R, Lyons, Ra, Ma, J, Ma, S, Mackay, Mt, Majdan, M, Malekzadeh, R, Mapoma, Cc, Marcenes, W, March, Lm, Margono, C, Marks, Gb, Marzan, Mb, Masci, Jr, Mason Jones, Aj, Matzopoulos, Rg, Mayosi, Bm, Mazorodze, Tt, Mcgill, Nw, Mcgrath, Jj, Mckee, M, Mclain, A, Mcmahon, Bj, Meaney, Pa, Mehndiratta, Mm, Mejia Rodriguez, F, Mekonnen, W, Melaku, Ya, Meltzer, M, Memish, Za, Mensah, G, Meretoja, A, Mhimbira, Fa, Micha, R, Miller, Tr, Mills, Ej, Mitchell, Pb, Mock, Cn, Moffitt, Te, Mohamed, Ibrahim, N, Mohammad, Ka, Mokdad, Ah, Mola, Gl, Monasta, L, Montico, M, Montine, Tj, Moore, Ar, Moran, Ae, Morawska, L, Mori, R, Moschandreas, J, Moturi, Wn, Moyer, M, Mozaffarian, D, Mueller, Uo, Mukaigawara, M, Murdoch, Me, Murray, J, Murthy, Ks, Naghavi, P, Nahas, Z, Naheed, A, Naidoo, Ks, Naldi, L, Nand, D, Nangia, V, Narayan, Km, Nash, D, Nejjari, C, Neupane, Sp, Newman, Lm, Newton, Cr, Ng, M, Ngalesoni, Fn, Nhung, Nt, Nisar, Mi, Nolte, S, Norheim, Of, Norman, Re, Norrving, B, Nyakarahuka, L, Ih, Oh, Ohkubo, T, Omer, Sb, Opio, Jn, Ortiz, A, Pandian, Jd, Panelo, Ci, Papachristou, C, Park, Ek, Parry, Cd, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pedraza, Ls, Pellegrini, Ca, Pereira, Dm, Perez Ruiz, Fp, Perico, N, Pervaiz, A, Pesudovs, K, Peterson, Cb, Petzold, M, Phillips, Mr, Phillips, D, Phillips, B, Piel, Fb, Plass, D, Poenaru, D, Polanczyk, Gv, Polinder, S, Pope, Ca, Popova, S, Poulton, Rg, Pourmalek, F, Prabhakaran, D, Prasad, Nm, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi Movaghar, V, Rahman, Su, Raju, M, Rakovac, I, Rana, Sm, Razavi, H, Refaat, A, Rehm, J, Remuzzi, G, Resnikoff, S, Ribeiro, Al, Riccio, Pm, Richardson, L, Richardus, Jh, Riederer, Am, Robinson, M, Roca, A, Rodriguez, A, Rojas Rueda, D, Ronfani, L, Rothenbacher, D, Roy, N, Ruhago, Gm, Sabin, N, Sacco, Rl, Ksoreide, K, Saha, S, Sahathevan, R, Sahraian, Ma, Sampson, U, Sanabria, Jr, Sanchez Riera, L, Santos, Is, Satpathy, M, Saunders, Je, Sawhney, M, Saylan, Mi, Scarborough, P, Schoettker, B, Schneider, Ij, Schwebel, Dc, Scott, Jg, Seedat, S, Sepanlou, Sg, Serdar, B, Servan Mori, Ee, Shackelford, K, Shaheen, A, Shahraz, S, Shamah, Levy, T, Shangguan, S, She, J, Sheikhbahaei, S, Shepard, Ds, Shi, P, Shibuya, K, Shinohara, Y, Shiri, R, Shishani, K, Shiue, I, Shrime, Mg, Sigfusdottir, Id, Silberberg, Dh, Simard, Ep, Sindi, S, Singh, Ja, Singh, L, Skirbekk, V, Sliwa, K, Soljak, M, Soneji, S, Soshnikov, Ss, Speyer, P, Sposato, La, Sreeramareddy, Ct, Stoeckl, H, Stathopoulou, Vk, Steckling, N, Stein, Mb, Stein, Dj, Steiner, Tj, Stewart, A, Stork, E, Stovner, Lj, Stroumpoulis, K, Sturua, L, Sunguya, Bf, Swaroop, M, Sykes, Bl, Tabb, Km, Takahashi, K, Tan, F, Tandon, N, Tanne, D, Tanner, M, Tavakkoli, M, Taylor, Hr, Ao, Te, Temesgen, Am, Ten, Have, M, Tenkorang, Ey, Terkawi, As, Theadom, Am, Thomas, E, Thorne Lyman, Al, Thrift, Ag, Tleyjeh, Im, Tonelli, M, Topouzis, F, Towbin, Ja, Toyoshima, H, Traebert, J, Tran, Bx, Trasande, L, Trillini, M, Truelsen, T, Trujillo, U, Tsilimbaris, M, Tuzcu, Em, Ukwaja, Kn, Undurraga, Ea, Uzun, Sb, Van, Brakel, Van, Wh, Vijver, De, Van, S, Dingenen, R, Van, Gool, Varakin, Yy, Vasankari, Tj, Vavilala, Ms, Veerman, Lj, Velasquez, Melendez, G, Venketasubramanian, N, Vijayakumar, L, Villalpando, S, Violante, Fs, Vlassov, Vv, Waller, S, Wallin, Mt, Wan, X, Wang, L, Wang, J, Wang, Y, Warouw, Ts, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Werdecker, A, Wessells, Kr, Westerman, R, Wilkinson, Jd, Williams, Hc, Williams, Tn, Woldeyohannes, Sm, Wolfe, Cd, Wong, Jq, Wong, H, Woolf, Ad, Wright, Jl, Wurtz, B, Xu, G, Yang, G, Yano, Y, Yenesew, Ma, Yentur, Gk, Yip, P, Yonemoto, N, Yoon, Sj, Younis, M, Yu, C, Kim, Ky, Zaki, Mel, Zhang, Y, Zhao, Z, Zhao, Y, Zhu, J, Zonies, D, Zunt, Jr, Salomon, Ja, Murray, C. J., Vos, T, Barber, Rm, Bell, B, Bertozzi-Villa, A, Biryukov, S, Bolliger, I, Charlson, F, Davis, A, Degenhardt, L, Dicker, D, Duan, L, Erskine, H, Feigin, Vl, Ferrari, Aj, Fitzmaurice, C, Fleming, T, Graetz, N, Guinovart, C, Haagsma, J, Hansen, Gm, Hanson, Sw, Heuton, Kr, Higashi, H, Kassebaum, N, Kyu, H, Laurie ELiang, X, Lofgren, K, Lozano, R, Macintyre, Mf, Moradi-Lakeh, M, Naghavi, M, Nguyen, G, Odell, S, Ortblad, K, Roberts, Da, Roth, Ga, Sandar, L, Serina, Pt, Stanaway, Jd, Steiner, C, Thomas, B, Vollset, Se, Whiteford, H, Wolock, Tm, Ye, P, Zhou, M, Ãvila, Ma, Aasvang, Gm, Abbafati, C, Abbasoglu Ozgoren, A, Abd-Allah, F, Abdel Aziz MI, Abera, Sf, Aboyans, V, Abraham, Jp, Abraham, B, Abubakar, I, Abu-Raddad, Lj, Abu-Rmeileh, Nm, Aburto, Tc, Achoki TAckerman IN, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Arnlov, J, Agardh, Ee, Al Khabouri MJ, Alam, S, Alasfoor, D, Albittar, Mi, Alegretti MAAleman AV, Alemu, Za, Alfonso-Cristancho, R, Alhabib, S, Ali, R, Alla, F, Allebeck, P, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis-Guzman NAmeli, O, Amini, H, Ammar, W, Anderson, Bo, Anderson, Hr, Antonio, Ca, Anwari, P, Apfel, H, Arsenijevic, V, Artaman, A, Asghar, Rj, Assadi, R, Atkins, L, Atkinson, C, Badawi, A, Bahit, Mc, Bakfalouni, T, Balakrishnan, K, Balalla, S, Banerjee, A, Barker-Collo, Sl, Barquera, S, Barregard, L, Barrero LHBasu, S, Basu, A, Baxter, A, Beardsley, J, Bedi, N, Beghi, E, Bekele, T, Bell, Ml, Benjet, C, Bennett, Da, Bensenor, Im, Benzian, H, Bernabe, E, Beyene TJBhala, N, Bhalla, A, Bhutta, Z, Bienhoff, K, Bikbov, B, Bin Abdulhak, A, Blore, Jd, Blyth, Fm, Bohensky, Ma, Bora Basara, B, Borges, G, Bornstein, Nm, Bose, D, Boufous, S, Bourne, Rr, Boyers, Ln, Brainin, M, Brauer, M, Brayne, Ce, Brazinova, A, Breitborde, Nj, Brenner, H, Briggs, Ad, Brooks, Pm, Brown JBrugha TS, Buchbinder, R, Buckle, Gc, Bukhman, G, Bulloch, Ag, Burch, M, Burnett, R, Cardenas, R, Cabral, Nl, Campos Nonato IR, Campuzano JCCarapetis JR, Carpenter, Do, Caso, V, Castaneda-Orjuela, Ca, Catala-Lopez, F, Chadha, Vk, Chang, Jc, Chen, H, Chen, W, Chiang, Pp, Chimed-Ochir, O, Chowdhury, R, Christensen, H, Christophi, Ca, Chugh, S, Cirillo, M, Coggeshall, M, Cohen, A, Colistro, V, Colquhoun, Sm, Contreras, Ag, Cooper LTCooper, C, Cooperrider, K, Coresh, J, Cortinovis, M, Criqui, Mh, Crump, Ja, Cuevas-Nasu, L, Dandona, R, Dandona, L, Dansereau, E, Dantes, Hg, Dargan, Pi, Davey, G, Davitoiu, Dv, Dayama, A, De la Cruz-Gongora, V, de la Vega SF, De Leo, D, del Pozo-Cruz, B, Dellavalle, Rp, Deribe, K, Derrett, S, Des Jarlais DC, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Diaz-Torne, C, Ding, El, Dokova, K, Dorsey, Er, Driscoll, Tr, Duber, H, Durrani, Am, Edmond, Km, Ellenbogen, Rg, Endres, M, Ermakov, Sp, Eshrati, B, Esteghamati, A, Estep, K, Fahimi, S, Farzadfar, F, Fay, Df, Felson, Dt, Fereshtehnejad SMFernandes JG, Ferri, Cp, Flaxman, A, Foigt, N, Foreman, Kj, Fowkes, Fg, Franklin, Rc, Furst, T, Futran, Nd, Gabbe, Bj, Gankpe, Fg, Garcia-Guerra FAGeleijnse JM, Gessner, Bd, Gibney, Kb, Gillum, Rf, Ginawi, Ia, Giroud, M, Giussani, G, Goenka, S, Goginashvili, K, Gona, P, Gonzalez de Cosio TGosselin RA, Gotay, Cc, Goto, A, Gouda, Hn, Guerrant, Rl, Gugnani, Hc, Gunnell, D, Gupta, R, Gutierrez, Ra, Hafezi-Nejad, N, Hagan HHalasa, Y, Hamadeh, Rr, Hamavid, H, Hammami, M, Hankey, Gj, Hao, Y, Harb, Hl, Haro, Jm, Havmoeller, R, Hay, Rj, Hay, S, Hedayati, Mt, Heredia Pi IB, Heydarpour, P, Hijar, M, Hoek, Hw, Hoffman, Hj, Hornberger, Jc, Hosgood, Hd, Hossain, M, Hotez, Pj, Hoy, Dg, Hsairi, M, Hu, H, Hu, G, Huang JJHuang, C, Huiart, L, Husseini, A, Iannarone, M, Iburg, Km, Innos, K, Inoue, M, Jacobsen, Kh, Jassal, Sk, Jeemon, P, Jensen, Pn, Jha, V, Jiang, G, Jiang YJonas JB, Joseph, J, Juel, K, Kan, H, Karch, A, Karimkhani, C, Karthikeyan, G, Katz, R, Kaul, A, Kawakami, N, Kazi, D, Kemp, Ah, Kengne, Ap, Khader, Y, Khalifa, Se, Khan, Ea, Khan, G, Khang, Yh, Khonelidze, I, Kieling, C, Kim, D, Kim, S, Kimokoti, Rw, Kinfu, Y, Kinge, Jm, Kissela, Bm, Kivipelto MKnibbs, L, Knudsen, Ak, Kokubo, Y, Kosen, S, Kramer, A, Kravchenko, M, Krishnamurthi, Rv, Krishnaswami, S, Kuate Defo, B, Kucuk Bicer, B, Kuipers EJKulkarni VS, Kumar, K, Kumar, Ga, Kwan, Gf, Lai, T, Lalloo, R, Lam, H, Lan, Q, Lansingh, Vc, Larson, H, Larsson, A, Lawrynowicz, Ae, Leasher, Jl, Lee, Jt, Leigh, J, Leung, R, Levi, M, Li, B, Li, Y, Liang, J, Lim, S, Lin, Hh, Lind, M, Lindsay, Mp, Lipshultz, Se, Liu, S, Lloyd, Bk, Lockett Ohno, S, Logroscino, G, Looker, Kj, Lopez, Ad, Lopez-Olmedo, N, Lortet-Tieulent, J, Lotufo, Pa, Low, N, Lucas, Rm, Lunevicius, R, Lyons, Ra, Ma, J, Ma, S, Mackay MTMajdan, M, Malekzadeh, R, Mapoma, Cc, Marcenes, W, March, Lm, Margono, C, Marks, Gb, Marzan, Mb, Masci, Jr, Mason-Jones, Aj, Matzopoulos RGMayosi BM, Mazorodze, Tt, Mcgill, Nw, Mcgrath, Jj, Mckee, M, Mclain, A, Mcmahon, Bj, Meaney, Pa, Mehndiratta, Mm, Mejia-Rodriguez, F, Mekonnen, W, Melaku, Ya, Meltzer, M, Memish, Za, Mensah, G, Meretoja, A, Mhimbira, Fa, Micha, R, Miller, Tr, Mills, Ej, Mitchell, Pb, Mock, Cn, Moffitt TEMohamed Ibrahim, N, Mohammad, Ka, Mokdad, Ah, Mola, Gl, Monasta, L, Montico, M, Montine, Tj, Moore, Ar, Moran, Ae, Morawska, L, Mori RMoschandreas, J, Moturi, Wn, Moyer, M, Mozaffarian, D, Mueller, Uo, Mukaigawara, M, Murdoch, Me, Murray, J, Murthy, K, Naghavi, P, Nahas ZNaheed, A, Naidoo, K, Naldi, L, Nand, D, Nangia, V, Narayan, Km, Nash, D, Nejjari, C, Neupane, Sp, Newman, Lm, Newton, Cr, Ng, M, Ngalesoni FNNhung NT, Nisar, Mi, Nolte, S, Norheim, Of, Norman, Re, Norrving, B, Nyakarahuka, L, Oh, Ih, Ohkubo, T, Omer, Sb, Opio, Jn, Ortiz, A, Pandian JDPanelo CI, Papachristou, C, Park, Ek, Parry, Cd, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pedraza, L, Pellegrini, Ca, Pereira, Dm, Perez-Ruiz, Fp, Perico, N, Pervaiz, A, Pesudovs, K, Peterson, Cb, Petzold, M, Phillips, Mr, Phillips, D, Phillips, B, Piel, Fb, Plass, D, Poenaru, D, Polanczyk GVPolinder, S, Pope, Ca, Popova, S, Poulton, Rg, Pourmalek, F, Prabhakaran, D, Prasad, Nm, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, Su, Raju, M, Rakovac, I, Rana, Sm, Razavi, H, Refaat, A, Rehm, J, Remuzzi, G, Resnikoff, S, Ribeiro, Al, Riccio, Pm, Richardson, L, Richardus, Jh, Riederer, Am, Robinson, M, Roca, A, Rodriguez, A, Rojas-Rueda, D, Ronfani, L, Rothenbacher, D, Roy, N, Ruhago, Gm, Sabin, N, Sacco, Rl, Ksoreide, K, Saha, S, Sahathevan, R, Sahraian, Ma, Sampson, U, Sanabria, Jr, Sanchez-Riera, L, Santos, I, Satpathy, M, Saunders, Je, Sawhney, M, Saylan MIScarborough, P, Schoettker, B, Schneider, Ij, Schwebel, Dc, Scott, Jg, Seedat, S, Sepanlou, Sg, Serdar, B, Servan-Mori, Ee, Shackelford, K, Shaheen AShahraz, S, Shamah Levy, T, Shangguan, S, She, J, Sheikhbahaei, S, Shepard, D, Shi, P, Shibuya, K, Shinohara, Y, Shiri, R, Shishani, K, Shiue, I, Shrime, Mg, Sigfusdottir, Id, Silberberg, Dh, Simard, Ep, Sindi, S, Singh, Ja, Singh, L, Skirbekk, V, Sliwa, K, Soljak, M, Soneji, S, Soshnikov, S, Speyer PSposato LA, Sreeramareddy, Ct, Stoeckl, H, Stathopoulou, Vk, Steckling, N, Stein, Mb, Stein, Dj, Steiner, Tj, Stewart, A, Stork, E, Stovner LJStroumpoulis, K, Sturua, L, Sunguya, Bf, Swaroop, M, Sykes, Bl, Tabb, Km, Takahashi, K, Tan, F, Tandon, N, Tanne, D, Tanner, M, Tavakkoli, M, Taylor, Hr, Te Ao BJ, Temesgen, Am, Ten Have, M, Tenkorang, Ey, Terkawi, A, Theadom, Am, Thomas, E, Thorne-Lyman, Al, Thrift, Ag, Tleyjeh, Im, Tonelli, M, Topouzis, F, Towbin, Ja, Toyoshima, H, Traebert, J, Tran, Bx, Trasande, L, Trillini, M, Truelsen, T, Trujillo, U, Tsilimbaris, M, Tuzcu, Em, Ukwaja KNUndurraga EA, Uzun, Sb, van Brakel WH, van de Vijver, S, Van Dingenen, R, van Gool CH, Varakin, Yy, Vasankari, Tj, Vavilala, M, Veerman LJVelasquez-Melendez, G, Venketasubramanian, N, Vijayakumar, L, Villalpando, S, Violante, F, Vlassov, Vv, Waller, S, Wallin, Mt, Wan, X, Wang, L, Wang, J, Wang, Y, Warouw, T, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Werdecker, A, Wessells, Kr, Westerman, R, Wilkinson, Jd, Williams HCWilliams TN, Woldeyohannes, Sm, Wolfe, Cd, Wong, Jq, Wong, H, Woolf, Ad, Wright, Jl, Wurtz, B, Xu, G, Yang, G, Yano, Y, Yenesew, Ma, Yentur GKYip, P, Yonemoto, N, Yoon, Sj, Younis, M, Yu, C, Kim, Ky, Zaki Mel, S, Zhang, Y, Zhao, Z, Zhao, Y, Zhu, J, Zonies, D, Zunt, Jr, Salomon, Ja, Murray, Cj., Vos, Theo, Barber, Ryan M., Bell, Brad, Bertozzi-Villa, Amelia, Biryukov, Stan, Bolliger, Ian, Charlson, Fiona, Davis, Adrian, Degenhardt, Louisa, Dicker, Daniel, Duan, Leilei, Erskine, Holly, Feigin, Valery L., Ferrari, Alize J., Fitzmaurice, Christina, Fleming, Thoma, Graetz, Nichola, Guinovart, Caterina, Haagsma, Juanita, Hansen, Gillian M., Hanson, Sarah Wulf, Heuton, Kyle R., Higashi, Hideki, Kassebaum, Nichola, Kyu, Hmwe, Laurie, Evan, Liang, Xiofeng, Lofgren, Katherine, Lozano, Rafael, Macintyre, Michael F., Moradi-Lakeh, Maziar, Naghavi, Mohsen, Nguyen, Grant, Odell, Shaun, Ortblad, Katrina, Roberts, David Allen, Roth, Gregory A., Sandar, Logan, Serina, Peter T., Stanaway, Jeffrey D., 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Heredia, Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W., Hoffman, Howard J., Hornberger, John C., Hosgood, H. 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Venkat, Nash, Deni, Nejjari, Chakib, Neupane, Sudan P., Newman, Lori M., Newton, Charles R., Ng, Marie, Ngalesoni, Frida N., Nhung, Nguyen T., Nisar, Muhammad I., Nolte, Sandra, Norheim, Ole F., Norman, Rosana E., Norrving, Bo, Nyakarahuka, Luke, Oh, In Hwan, Ohkubo, Takayoshi, Omer, Saad B., Opio, John Nelson, Ortiz, Alberto, Pandian, Jeyaraj D., Panelo, Carlo Irwin A., Papachristou, Christina, Park, Eun-Kee, Parry, Charles D., Caicedo, Angel J. 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Ryan, Westerman, Ronny, Wilkinson, James D., Williams, Hywel C., Williams, Thomas N., Woldeyohannes, Solomon M., Wolfe, Charles D.A., Wong, John Q., Wong, Haidong, Woolf, Anthony D., Wright, Jonathan L., Wurtz, Brittany, Xu, Gelin, Yang, Gonghuan, Yano, Yuichiro, Yenesew, Muluken A., Yentur, Gokalp K., Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa, Yu, Chuanhua, Kim, Kim Yun, Zaki, Maysaa El Sayed, Zhang, Yong, Zhao, Zheng, Zhao, Yong, Zhu, Jun, Zonies, David, Zunt, Joseph R., Salomon, Joshua A., Murray, Christopher J.L., Cell biology, Gastroenterology & Hepatology, Epidemiology, Health Technology Assessment (HTA), and Public Health

Subjects
Male, Gerontology, Nutrition and Disease, Epidemiology, years lived with disability, Global burden of disease, acute and chronic diseases, countries, Prevalence, Disease, Global Health, Medical and Health Sciences, Conduct disorder, Otitis-media, Cost of Illness, Residence Characteristics, Voeding en Ziekte, 80 and over, Global health, 2.2 Factors relating to the physical environment, 2.1 Biological and endogenous factors, countries, Aetiology, Child, Aged, 80 and over, Medicine(all), education.field_of_study, ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, Incidence, Mortality rate, Incidence (epidemiology), Pain Research, Neglected Diseases, Alcohol dependence, General Medicine, Middle Aged, Global burden of disease, Global Burden of Disease Study 2013 Collaborators, Mental Health, Infectious Diseases, Attention deficit/Hyperactivity disorder, Burden of Illness, Child, Preschool, Acute Disease, Female, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, Adolescent, GBD 2013, Population, acute and chronic diseases, Young Adult, Mental-disorders, Age Distribution, Medicine, General & Internal, Weights, General & Internal Medicine, medicine, Humans, Life Science, Disabled Persons, Sex Distribution, Preschool, education, Developing Countries, VLAG, Aged, Science & Technology, business.industry, Developed Countries, Cutaneous Leishmaniasis, Infant, Newborn, Infant, Health outcomes, Newborn, medicine.disease, Comorbidity, Brain Disorders, years lived with disability, Good Health and Well Being, Disease, injury, incidence, prevalence, YLDs, GBD 2010, Chronic Disease, Wounds and Injuries, business, 2.4 Surveillance and distribution, Iron-deficiency, Demography
Abstract

Summary 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. Funding Bill & Melinda Gates Foundation. 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. Funding Bill & Melinda Gates Foundation.

Published
2015
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4. The Bolivian trauma patient's experience: A qualitative needs assessment.

Author

Rook JM, Wood E, Boeck MA, Blair KJ, Monroy A, Ludi E, Keller EJ, Victorson D, Foíanini E, and Swaroop M

Subjects
Bolivia epidemiology, First Aid, Hospitals, Humans, Needs Assessment, Emergency Medical Services
Abstract

Background: Despite a significant burden of injury-related deaths, the Plurinational State of Bolivia (Bolivia), a lower- middle-income country in South America, lacks a formalized trauma system. This study sought to examine Bolivian trauma care from the patient perspective in order to determine barriers to care and targets for improvement., Methods: Investigators conducted 15 semi-structured interviews with trauma patients admitted at four hospitals in Santa Cruz de la Sierra, Bolivia in June and July of 2016. Interviews were transcribed, translated, and analyzed through content and discourse analysis to identify key themes and perceptions of trauma care., Results: Participants primarily presented with orthopedic injuries due to road traffic incidents and falls. Only one participant reported receiving first aid from a layperson at the scene of injury. Of the 15 participants, 12 did not know any number to contact emergency medical services (EMS). Participants expressed negative views of EMS as well as concerns for slow response times and inadequate personnel and training. Two thirds of participants were initially brought to a hospital without adequate resources to care for their injuries. Participants generally expressed positive views regarding healthcare workers involved in their hospital-based medical care., Conclusions: This region of Bolivia has a disorganized, underutilized, and distrusted trauma system. In order to increase survival, interventions should focus on improving prehospital trauma care. Potential interventions include the implementation of layperson trauma first responder courses, the establishment of a medical emergency hotline, the unification of EMS, the implementation of basic training requirements for EMS personnel, and public education campaigns to increase trust in EMS., Competing Interests: Declaration of Competing Interest We have no conflicts of interest to disclose., (Copyright © 2020. Published by Elsevier Ltd.)

Published
2021
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5. The development and implementation of a layperson trauma first responder course in La Paz, Bolivia: A pilot study.

Author

Boeck MA, Callese TE, Nelson SK, Schuetz SJ, Fuentes Bazan C, Saavedra Laguna JMP, Shapiro MB, Issa NM, and Swaroop M

Subjects
Adult, Bolivia, Curriculum, Educational Status, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Needs Assessment, Occupations, Pilot Projects, Program Development, Program Evaluation, First Aid methods, Wounds and Injuries therapy
Abstract

Background: Ninety percent of nearly five million annual global injury deaths occur in low- and middle-income countries (LMICs), where prehospital care systems are frequently rudimentary or nonexistent. The World Health Organization considers layperson first-responders as essential for emergency medical services in low-resource settings lacking more formalized systems. This study sought to develop and implement a layperson trauma first responder course (TFRC) in Bolivia., Materials and Methods: In March and April 2013 nine sessions of the eight-hour TFRC were held in La Paz, Bolivia. The course charged a nominal fee, and was led by an American surgeon and medical student. The TFRC built upon existing models with local stakeholder input, and included both didactic and practical components. Participants completed a baseline survey, and pre and posttests. The primary outcome was test performance, with secondary outcomes including demographic sub-group test score analyses and exam question validation. Data were assessed using nonparametric and psychometric methods RESULTS: One hundred fifty-nine individuals met study inclusion criteria. Participant median age was 28 (IQR 24, 36), 49.1% were male, 59.1% worked in a medical field, most had secondary (35.2%) or university (56.0%) level educations, and 67.3% had prior first aid training. Median test scores improved after course completion (48% vs. 76%, p <0.001), along with skill confidence (4 vs. 4.5, p <0.001). Most questions had appropriate item difficulty indices, point bi-serial correlation coefficients, and positive Pretest Posttest Difference Indices. Cronbach alpha coefficients for pre and posttest scores were 0.72 and 0.78, respectively., Conclusions: This study presents data from the first offering of an original TFRC for laypeople in Bolivia. Increased participant knowledge and skill confidence after course completion, and acceptable overall psychometric test properties, indicate this model is valid and effective. Future aims include TFRC revision, and enrollment of more layperson first responders to increase population-level impacts., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Published
2018
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6. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Author

Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, Burnett R, Casey D, Coates MM, Cohen A, Delwiche K, Estep K, Frostad JJ, Astha KC, Kyu HH, Moradi-Lakeh M, Ng M, Slepak EL, Thomas BA, Wagner J, Aasvang GM, Abbafati C, Abbasoglu Ozgoren A, Abd-Allah F, Abera SF, Aboyans V, Abraham B, Abraham JP, Abubakar I, Abu-Rmeileh NM, Aburto TC, Achoki T, Adelekan A, Adofo K, Adou AK, Adsuar JC, Afshin A, Agardh EE, Al Khabouri MJ, Al Lami FH, Alam SS, Alasfoor D, Albittar MI, Alegretti MA, Aleman AV, Alemu ZA, Alfonso-Cristancho R, Alhabib S, Ali R, Ali MK, Alla F, Allebeck P, Allen PJ, Alsharif U, Alvarez E, Alvis-Guzman N, Amankwaa AA, Amare AT, Ameh EA, Ameli O, Amini H, Ammar W, Anderson BO, Antonio CA, Anwari P, Argeseanu Cunningham S, Arnlöv J, Arsenijevic VS, Artaman A, Asghar RJ, Assadi R, Atkins LS, Atkinson C, Avila MA, Awuah B, Badawi A, Bahit MC, Bakfalouni T, Balakrishnan K, Balalla S, Balu RK, Banerjee A, Barber RM, Barker-Collo SL, Barquera S, Barregard L, Barrero LH, Barrientos-Gutierrez T, Basto-Abreu AC, Basu A, Basu S, Basulaiman MO, Batis Ruvalcaba C, Beardsley J, Bedi N, Bekele T, Bell ML, Benjet C, Bennett DA, Benzian H, Bernabé E, Beyene TJ, Bhala N, Bhalla A, Bhutta ZA, Bikbov B, Bin Abdulhak AA, Blore JD, Blyth FM, Bohensky MA, Bora Başara B, Borges G, Bornstein NM, Bose D, Boufous S, Bourne RR, Brainin M, Brazinova A, Breitborde NJ, Brenner H, Briggs AD, Broday DM, Brooks PM, Bruce NG, Brugha TS, Brunekreef B, Buchbinder R, Bui LN, Bukhman G, Bulloch AG, Burch M, Burney PG, Campos-Nonato IR, Campuzano JC, Cantoral AJ, Caravanos J, Cárdenas R, Cardis E, Carpenter DO, Caso V, Castañeda-Orjuela CA, Castro RE, Catalá-López F, Cavalleri F, Çavlin A, Chadha VK, Chang JC, Charlson FJ, Chen H, Chen W, Chen Z, Chiang PP, Chimed-Ochir O, Chowdhury R, Christophi CA, Chuang TW, Chugh SS, Cirillo M, Claßen TK, Colistro V, Colomar M, Colquhoun SM, Contreras AG, Cooper C, Cooperrider K, Cooper LT, Coresh J, Courville KJ, Criqui MH, Cuevas-Nasu L, Damsere-Derry J, Danawi H, Dandona L, Dandona R, Dargan PI, Davis A, Davitoiu DV, Dayama A, de Castro EF, De la Cruz-Góngora V, De Leo D, de Lima G, Degenhardt L, del Pozo-Cruz B, Dellavalle RP, Deribe K, Derrett S, Des Jarlais DC, Dessalegn M, deVeber GA, Devries KM, Dharmaratne SD, Dherani MK, Dicker D, Ding EL, Dokova K, Dorsey ER, Driscoll TR, Duan L, Durrani AM, Ebel BE, Ellenbogen RG, Elshrek YM, Endres M, Ermakov SP, Erskine HE, Eshrati B, Esteghamati A, Fahimi S, Faraon EJ, Farzadfar F, Fay DF, Feigin VL, Feigl AB, Fereshtehnejad SM, Ferrari AJ, Ferri CP, Flaxman AD, Fleming TD, Foigt N, Foreman KJ, Paleo UF, Franklin RC, Gabbe B, Gaffikin L, Gakidou E, Gamkrelidze A, Gankpé FG, Gansevoort RT, García-Guerra FA, Gasana E, Geleijnse JM, Gessner BD, Gething P, Gibney KB, Gillum RF, Ginawi IA, Giroud M, Giussani G, Goenka S, Goginashvili K, Gomez Dantes H, Gona P, Gonzalez de Cosio T, González-Castell D, Gotay CC, Goto A, Gouda HN, Guerrant RL, Gugnani HC, Guillemin F, Gunnell D, Gupta R, Gupta R, Gutiérrez RA, Hafezi-Nejad N, Hagan H, Hagstromer M, Halasa YA, Hamadeh RR, Hammami M, Hankey GJ, Hao Y, Harb HL, Haregu TN, Haro JM, Havmoeller R, Hay SI, Hedayati MT, Heredia-Pi IB, Hernandez L, Heuton KR, Heydarpour P, Hijar M, Hoek HW, Hoffman HJ, Hornberger JC, Hosgood HD, Hoy DG, Hsairi M, Hu G, Hu H, Huang C, Huang JJ, Hubbell BJ, Huiart L, Husseini A, Iannarone ML, Iburg KM, Idrisov BT, Ikeda N, Innos K, Inoue M, Islami F, Ismayilova S, Jacobsen KH, Jansen HA, Jarvis DL, Jassal SK, Jauregui A, Jayaraman S, Jeemon P, Jensen PN, Jha V, Jiang F, Jiang G, Jiang Y, Jonas JB, Juel K, Kan H, Kany Roseline SS, Karam NE, Karch A, Karema CK, Karthikeyan G, Kaul A, Kawakami N, Kazi DS, Kemp AH, Kengne AP, Keren A, Khader YS, Khalifa SE, Khan EA, Khang YH, Khatibzadeh S, Khonelidze I, Kieling C, Kim D, Kim S, Kim Y, Kimokoti RW, Kinfu Y, Kinge JM, Kissela BM, Kivipelto M, Knibbs LD, Knudsen AK, Kokubo Y, Kose MR, Kosen S, Kraemer A, Kravchenko M, Krishnaswami S, Kromhout H, Ku T, Kuate Defo B, Kucuk Bicer B, Kuipers EJ, Kulkarni C, Kulkarni VS, Kumar GA, Kwan GF, Lai T, Lakshmana Balaji A, Lalloo R, Lallukka T, Lam H, Lan Q, Lansingh VC, Larson HJ, Larsson A, Laryea DO, Lavados PM, Lawrynowicz AE, Leasher JL, Lee JT, Leigh J, Leung R, Levi M, Li Y, Li Y, Liang J, Liang X, Lim SS, Lindsay MP, Lipshultz SE, Liu S, Liu Y, Lloyd BK, Logroscino G, London SJ, Lopez N, Lortet-Tieulent J, Lotufo PA, Lozano R, Lunevicius R, Ma J, Ma S, Machado VM, MacIntyre MF, Magis-Rodriguez C, Mahdi AA, Majdan M, Malekzadeh R, Mangalam S, Mapoma CC, Marape M, Marcenes W, Margolis DJ, Margono C, Marks GB, Martin RV, Marzan MB, Mashal MT, Masiye F, Mason-Jones AJ, Matsushita K, Matzopoulos R, Mayosi BM, Mazorodze TT, McKay AC, McKee M, McLain A, Meaney PA, Medina C, Mehndiratta MM, Mejia-Rodriguez F, Mekonnen W, Melaku YA, Meltzer M, Memish ZA, Mendoza W, Mensah GA, Meretoja A, Mhimbira FA, Micha R, Miller TR, Mills EJ, Misganaw A, Mishra S, Mohamed Ibrahim N, Mohammad KA, Mokdad AH, Mola GL, Monasta L, Montañez Hernandez JC, Montico M, Moore AR, Morawska L, Mori R, Moschandreas J, Moturi WN, Mozaffarian D, Mueller UO, Mukaigawara M, Mullany EC, Murthy KS, Naghavi M, Nahas Z, Naheed A, Naidoo KS, Naldi L, Nand D, Nangia V, Narayan KM, Nash D, Neal B, Nejjari C, Neupane SP, Newton CR, Ngalesoni FN, Ngirabega Jde D, Nguyen G, Nguyen NT, Nieuwenhuijsen MJ, Nisar MI, Nogueira JR, Nolla JM, Nolte S, Norheim OF, Norman RE, Norrving B, Nyakarahuka L, Oh IH, Ohkubo T, Olusanya BO, Omer SB, Opio JN, Orozco R, Pagcatipunan RS Jr, Pain AW, Pandian JD, Panelo CI, Papachristou C, Park EK, Parry CD, Paternina Caicedo AJ, Patten SB, Paul VK, Pavlin BI, Pearce N, Pedraza LS, Pedroza A, Pejin Stokic L, Pekericli A, Pereira DM, Perez-Padilla R, Perez-Ruiz F, Perico N, Perry SA, Pervaiz A, Pesudovs K, Peterson CB, Petzold M, Phillips MR, Phua HP, Plass D, Poenaru D, Polanczyk GV, Polinder S, Pond CD, Pope CA, Pope D, Popova S, Pourmalek F, Powles J, Prabhakaran D, Prasad NM, Qato DM, Quezada AD, Quistberg DA, Racapé L, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman SU, Raju M, Rakovac I, Rana SM, Rao M, Razavi H, Reddy KS, Refaat AH, Rehm J, Remuzzi G, Ribeiro AL, Riccio PM, Richardson L, Riederer A, Robinson M, Roca A, Rodriguez A, Rojas-Rueda D, Romieu I, Ronfani L, Room R, Roy N, Ruhago GM, Rushton L, Sabin N, Sacco RL, Saha S, Sahathevan R, Sahraian MA, Salomon JA, Salvo D, Sampson UK, Sanabria JR, Sanchez LM, Sánchez-Pimienta TG, Sanchez-Riera L, Sandar L, Santos IS, Sapkota A, Satpathy M, Saunders JE, Sawhney M, Saylan MI, Scarborough P, Schmidt JC, Schneider IJ, Schöttker B, Schwebel DC, Scott JG, Seedat S, Sepanlou SG, Serdar B, Servan-Mori EE, Shaddick G, Shahraz S, Levy TS, Shangguan S, She J, Sheikhbahaei S, Shibuya K, Shin HH, Shinohara Y, Shiri R, Shishani K, Shiue I, Sigfusdottir ID, Silberberg DH, Simard EP, Sindi S, Singh A, Singh GM, Singh JA, Skirbekk V, Sliwa K, Soljak M, Soneji S, Søreide K, Soshnikov S, Sposato LA, Sreeramareddy CT, Stapelberg NJ, Stathopoulou V, Steckling N, Stein DJ, Stein MB, Stephens N, Stöckl H, Straif K, Stroumpoulis K, Sturua L, Sunguya BF, Swaminathan S, Swaroop M, Sykes BL, Tabb KM, Takahashi K, Talongwa RT, Tandon N, Tanne D, Tanner M, Tavakkoli M, Te Ao BJ, Teixeira CM, Téllez Rojo MM, Terkawi AS, Texcalac-Sangrador JL, Thackway SV, Thomson B, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tobollik M, Tonelli M, Topouzis F, Towbin JA, Toyoshima H, Traebert J, Tran BX, Trasande L, Trillini M, Trujillo U, Dimbuene ZT, Tsilimbaris M, Tuzcu EM, Uchendu US, Ukwaja KN, Uzun SB, van de Vijver S, Van Dingenen R, van Gool CH, van Os J, Varakin YY, Vasankari TJ, Vasconcelos AM, Vavilala MS, Veerman LJ, Velasquez-Melendez G, Venketasubramanian N, Vijayakumar L, Villalpando S, Violante FS, Vlassov VV, Vollset SE, Wagner GR, Waller SG, Wallin MT, Wan X, Wang H, Wang J, Wang L, Wang W, Wang Y, Warouw TS, Watts CH, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Wessells KR, Westerman R, Whiteford HA, Wilkinson JD, Williams HC, Williams TN, Woldeyohannes SM, Wolfe CD, Wong JQ, Woolf AD, Wright JL, Wurtz B, Xu G, Yan LL, Yang G, Yano Y, Ye P, Yenesew M, Yentür GK, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Younoussi Z, Yu C, Zaki ME, Zhao Y, Zheng Y, Zhou M, Zhu J, Zhu S, Zou X, Zunt JR, Lopez AD, Vos T, and Murray CJ

Subjects
Female, Global Health statistics & numerical data, Health Behavior, Humans, Male, Nutritional Status, Occupational Exposure adverse effects, Risk Assessment methods, Risk Factors, Sanitation trends, Environmental Exposure adverse effects, Global Health trends, Metabolic Diseases epidemiology, Occupational Diseases epidemiology
Abstract

Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution., Methods: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol., Findings: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa., Interpretation: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks., Funding: Bill & Melinda Gates Foundation., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Published
2015
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7. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition.

Author

Murray CJ, Barber RM, Foreman KJ, Abbasoglu Ozgoren A, Abd-Allah F, Abera SF, Aboyans V, Abraham JP, Abubakar I, Abu-Raddad LJ, Abu-Rmeileh NM, Achoki T, Ackerman IN, Ademi Z, Adou AK, Adsuar JC, Afshin A, Agardh EE, Alam SS, Alasfoor D, Albittar MI, Alegretti MA, Alemu ZA, Alfonso-Cristancho R, Alhabib S, Ali R, Alla F, Allebeck P, Almazroa MA, Alsharif U, Alvarez E, Alvis-Guzman N, Amare AT, Ameh EA, Amini H, Ammar W, Anderson HR, Anderson BO, Antonio CA, Anwari P, Arnlöv J, Arsic Arsenijevic VS, Artaman A, Asghar RJ, Assadi R, Atkins LS, Avila MA, Awuah B, Bachman VF, Badawi A, Bahit MC, Balakrishnan K, Banerjee A, Barker-Collo SL, Barquera S, Barregard L, Barrero LH, Basu A, Basu S, Basulaiman MO, Beardsley J, Bedi N, Beghi E, Bekele T, Bell ML, Benjet C, Bennett DA, Bensenor IM, Benzian H, Bernabé E, Bertozzi-Villa A, Beyene TJ, Bhala N, Bhalla A, Bhutta ZA, Bienhoff K, Bikbov B, Biryukov S, Blore JD, Blosser CD, Blyth FM, Bohensky MA, Bolliger IW, Bora Başara B, Bornstein NM, Bose D, Boufous S, Bourne RR, Boyers LN, Brainin M, Brayne CE, Brazinova A, Breitborde NJ, Brenner H, Briggs AD, Brooks PM, Brown JC, Brugha TS, Buchbinder R, Buckle GC, Budke CM, Bulchis A, Bulloch AG, Campos-Nonato IR, Carabin H, Carapetis JR, Cárdenas R, Carpenter DO, Caso V, Castañeda-Orjuela CA, Castro RE, Catalá-López F, Cavalleri F, Çavlin A, Chadha VK, Chang JC, Charlson FJ, Chen H, Chen W, Chiang PP, Chimed-Ochir O, Chowdhury R, Christensen H, Christophi CA, Cirillo M, Coates MM, Coffeng LE, Coggeshall MS, Colistro V, Colquhoun SM, Cooke GS, Cooper C, Cooper LT, Coppola LM, Cortinovis M, Criqui MH, Crump JA, Cuevas-Nasu L, Danawi H, Dandona L, Dandona R, Dansereau E, Dargan PI, Davey G, Davis A, Davitoiu DV, Dayama A, De Leo D, Degenhardt L, Del Pozo-Cruz B, Dellavalle RP, Deribe K, Derrett S, Des Jarlais DC, Dessalegn M, Dharmaratne SD, Dherani MK, Diaz-Torné C, Dicker D, Ding EL, Dokova K, Dorsey ER, Driscoll TR, Duan L, Duber HC, Ebel BE, Edmond KM, Elshrek YM, Endres M, Ermakov SP, Erskine HE, Eshrati B, Esteghamati A, Estep K, Faraon EJ, Farzadfar F, Fay DF, Feigin VL, Felson DT, Fereshtehnejad SM, Fernandes JG, Ferrari AJ, Fitzmaurice C, Flaxman AD, Fleming TD, Foigt N, Forouzanfar MH, Fowkes FG, Paleo UF, Franklin RC, Fürst T, Gabbe B, Gaffikin L, Gankpé FG, Geleijnse JM, Gessner BD, Gething P, Gibney KB, Giroud M, Giussani G, Gomez Dantes H, Gona P, González-Medina D, Gosselin RA, Gotay CC, Goto A, Gouda HN, Graetz N, Gugnani HC, Gupta R, Gupta R, Gutiérrez RA, Haagsma J, Hafezi-Nejad N, Hagan H, Halasa YA, Hamadeh RR, Hamavid H, Hammami M, Hancock J, Hankey GJ, Hansen GM, Hao Y, Harb HL, Haro JM, Havmoeller R, Hay SI, Hay RJ, Heredia-Pi IB, Heuton KR, Heydarpour P, Higashi H, Hijar M, Hoek HW, Hoffman HJ, Hosgood HD, Hossain M, Hotez PJ, Hoy DG, Hsairi M, Hu G, Huang C, Huang JJ, Husseini A, Huynh C, Iannarone ML, Iburg KM, Innos K, Inoue M, Islami F, Jacobsen KH, Jarvis DL, Jassal SK, Jee SH, Jeemon P, Jensen PN, Jha V, Jiang G, Jiang Y, Jonas JB, Juel K, Kan H, Karch A, Karema CK, Karimkhani C, Karthikeyan G, Kassebaum NJ, Kaul A, Kawakami N, Kazanjan K, Kemp AH, Kengne AP, Keren A, Khader YS, Khalifa SE, Khan EA, Khan G, Khang YH, Kieling C, Kim D, Kim S, Kim Y, Kinfu Y, Kinge JM, Kivipelto M, Knibbs LD, Knudsen AK, Kokubo Y, Kosen S, Krishnaswami S, Kuate Defo B, Kucuk Bicer B, Kuipers EJ, Kulkarni C, Kulkarni VS, Kumar GA, Kyu HH, Lai T, Lalloo R, Lallukka T, Lam H, Lan Q, Lansingh VC, Larsson A, Lawrynowicz AE, Leasher JL, Leigh J, Leung R, Levitz CE, Li B, Li Y, Li Y, Lim SS, Lind M, Lipshultz SE, Liu S, Liu Y, Lloyd BK, Lofgren KT, Logroscino G, Looker KJ, Lortet-Tieulent J, Lotufo PA, Lozano R, Lucas RM, Lunevicius R, Lyons RA, Ma S, Macintyre MF, Mackay MT, Majdan M, Malekzadeh R, Marcenes W, Margolis DJ, Margono C, Marzan MB, Masci JR, Mashal MT, Matzopoulos R, Mayosi BM, Mazorodze TT, Mcgill NW, Mcgrath JJ, Mckee M, Mclain A, Meaney PA, Medina C, Mehndiratta MM, Mekonnen W, Melaku YA, Meltzer M, Memish ZA, Mensah GA, Meretoja A, Mhimbira FA, Micha R, Miller TR, Mills EJ, Mitchell PB, Mock CN, Mohamed Ibrahim N, Mohammad KA, Mokdad AH, Mola GL, Monasta L, Montañez Hernandez JC, Montico M, Montine TJ, Mooney MD, Moore AR, Moradi-Lakeh M, Moran AE, Mori R, Moschandreas J, Moturi WN, Moyer ML, Mozaffarian D, Msemburi WT, Mueller UO, Mukaigawara M, Mullany EC, Murdoch ME, Murray J, Murthy KS, Naghavi M, Naheed A, Naidoo KS, Naldi L, Nand D, Nangia V, Narayan KM, Nejjari C, Neupane SP, Newton CR, Ng M, Ngalesoni FN, Nguyen G, Nisar MI, Nolte S, Norheim OF, Norman RE, Norrving B, Nyakarahuka L, Oh IH, Ohkubo T, Ohno SL, Olusanya BO, Opio JN, Ortblad K, Ortiz A, Pain AW, Pandian JD, Panelo CI, Papachristou C, Park EK, Park JH, Patten SB, Patton GC, Paul VK, Pavlin BI, Pearce N, Pereira DM, Perez-Padilla R, Perez-Ruiz F, Perico N, Pervaiz A, Pesudovs K, Peterson CB, Petzold M, Phillips MR, Phillips BK, Phillips DE, Piel FB, Plass D, Poenaru D, Polinder S, Pope D, Popova S, Poulton RG, Pourmalek F, Prabhakaran D, Prasad NM, Pullan RL, Qato DM, Quistberg DA, Rafay A, Rahimi K, Rahman SU, Raju M, Rana SM, Razavi H, Reddy KS, Refaat A, Remuzzi G, Resnikoff S, Ribeiro AL, Richardson L, Richardus JH, Roberts DA, Rojas-Rueda D, Ronfani L, Roth GA, Rothenbacher D, Rothstein DH, Rowley JT, Roy N, Ruhago GM, Saeedi MY, Saha S, Sahraian MA, Sampson UK, Sanabria JR, Sandar L, Santos IS, Satpathy M, Sawhney M, Scarborough P, Schneider IJ, Schöttker B, Schumacher AE, Schwebel DC, Scott JG, Seedat S, Sepanlou SG, Serina PT, Servan-Mori EE, Shackelford KA, Shaheen A, Shahraz S, Shamah Levy T, Shangguan S, She J, Sheikhbahaei S, Shi P, Shibuya K, Shinohara Y, Shiri R, Shishani K, Shiue I, Shrime MG, Sigfusdottir ID, Silberberg DH, Simard EP, Sindi S, Singh A, Singh JA, Singh L, Skirbekk V, Slepak EL, Sliwa K, Soneji S, Søreide K, Soshnikov S, Sposato LA, Sreeramareddy CT, Stanaway JD, Stathopoulou V, Stein DJ, Stein MB, Steiner C, Steiner TJ, Stevens A, Stewart A, Stovner LJ, Stroumpoulis K, Sunguya BF, Swaminathan S, Swaroop M, Sykes BL, Tabb KM, Takahashi K, Tandon N, Tanne D, Tanner M, Tavakkoli M, Taylor HR, Te Ao BJ, Tediosi F, Temesgen AM, Templin T, Ten Have M, Tenkorang EY, Terkawi AS, Thomson B, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tonelli M, Topouzis F, Toyoshima H, Traebert J, Tran BX, Trillini M, Truelsen T, Tsilimbaris M, Tuzcu EM, Uchendu US, Ukwaja KN, Undurraga EA, Uzun SB, Van Brakel WH, Van De Vijver S, van Gool CH, Van Os J, Vasankari TJ, Venketasubramanian N, Violante FS, Vlassov VV, Vollset SE, Wagner GR, Wagner J, Waller SG, Wan X, Wang H, Wang J, Wang L, Warouw TS, Weichenthal S, Weiderpass E, Weintraub RG, Wenzhi W, Werdecker A, Westerman R, Whiteford HA, Wilkinson JD, Williams TN, Wolfe CD, Wolock TM, Woolf AD, Wulf S, Wurtz B, Xu G, Yan LL, Yano Y, Ye P, Yentür GK, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Zaki ME, Zhao Y, Zheng Y, Zonies D, Zou X, Salomon JA, Lopez AD, and Vos T

Subjects
Aged, Female, Humans, Male, Middle Aged, Mortality, Premature, Quality-Adjusted Life Years, Socioeconomic Factors, Chronic Disease epidemiology, Communicable Diseases epidemiology, Global Health statistics & numerical data, Health Transition, Life Expectancy, Wounds and Injuries epidemiology
Abstract

Background: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development., Methods: We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time., Findings: Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6-6·6), from 65·3 years (65·0-65·6) in 1990 to 71·5 years (71·0-71·9) in 2013, HALE at birth rose by 5·4 years (4·9-5·8), from 56·9 years (54·5-59·1) to 62·3 years (59·7-64·8), total DALYs fell by 3·6% (0·3-7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6-29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non-communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries., Interpretation: Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition--in which increasing sociodemographic status brings structured change in disease burden--is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions., Funding: Bill & Melinda Gates Foundation., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Published
2015
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9. Burden of road traffic injuries in Nepal: results of a countrywide population-based survey.

Author

Nepal S, Gupta S, Wong EG, Gurung S, Swaroop M, Kushner AL, and Nwomeh BC

Abstract

Background: Road traffic injury has emerged as a leading cause of mortality, contributing to 2·1% of deaths globally and is predicted to be the third highest contributor to the global burden of mortality by 2020. This major public health problem disproportionately affects low-income and middle-income countries, where such incidents are too often underreported. Our study aims to explore the epidemiology of road traffic injurys in Nepal at a population level via a countrywide study., Methods: The Surgeons OverSeas Assessment of Surgical Need (SOSAS) tool, a cluster randomised, cross-sectional nationwide survey, was conducted in Nepal between May 25, and June 12, 2014. Two-stage cluster sampling was performed: 15 of 75 districts were chosen randomly proportional to population; within each district, after stratification for urban and rural, and three clusters were randomly chosen. Questions were structured anatomically and designed around a representative spectrum of surgical conditions. Road traffic injury-related results were reported., Findings: 1350 households and 2695 individuals were surveyed with a response rate of 97%. 75 road traffic injuries were reported in 72 individuals (2·67% [95% CI 2·10-3·35] of the study population), with a mean age of 33·2 years (SD 1·85). The most commonly affected age group was 30-44 years, with females showing significantly lower odds of sustaining a road traffic injury than men (crude odds ratio 0·29 [95% CI 0·16-0·52]). Road traffic injuries composed 19·8% of the injuries reported. Motorcycle crashes were the most common road traffic injuries (48·0%), followed by car, truck, or bus crashes (26·7%), and pedestrian or bicycle crashes (25·3%). The extremity was the most common anatomic site injured (74·7%). Of the 80 deaths reported in the previous year, 7·5% (n=6) were due to road traffic injuries., Interpretation: This study provides the epidemiology of road traffic injuries at a population-based level in the first countrywide surgical needs assessment in Nepal. WHO reported that mortality due to road traffic injuries in Nepal in 2011 was 1·7%, whereas our study reported 7·5%, consistent with the concept of underreporting of deaths in police and hospital level data noted in previous literature. Road traffic injuries continue to be a significant problem in Nepal, probably greater than previously reported; future efforts should focus on addressing this growing epidemic through preventive and mitigating strategies., Funding: The Association for Academic Surgery and Surgeons OverSeas., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Published
2015
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