Global Burden of Disease 1-22-09

Global Burden of Disease 1-22-09 - Articles Global and...

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Articles www.thelancet.com Vol 367 May 27, 2006 1747 Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data Alan D Lopez, Colin D Mathers, Majid Ezzati, Dean T Jamison, Christopher J L Murray Summary Background Our aim was to calculate the global burden of disease and risk factors for 2001, to examine regional trends from 1990 to 2001, and to provide a starting point for the analysis of the Disease Control Priorities Project (DCPP). Methods We calculated mortality, incidence, prevalence, and disability adjusted life years (DALYs) for 136 diseases and injuries, for seven income/geographic country groups. To assess trends, we re-estimated all-cause mortality for 1990 with the same methods as for 2001. We estimated mortality and disease burden attributable to 19 risk factors. Findings About 56 million people died in 2001. Of these, 10·6 million were children, 99% of whom lived in low-and- middle-income countries. More than half of child deaths in 2001 were attributable to acute respiratory infections, measles, diarrhoea, malaria, and HIV/AIDS. The ten leading diseases for global disease burden were perinatal conditions, lower respiratory infections, ischaemic heart disease, cerebrovascular disease, HIV/AIDS, diarrhoeal diseases, unipolar major depression, malaria, chronic obstructive pulmonary disease, and tuberculosis. There was a 20% reduction in global disease burden per head due to communicable, maternal, perinatal, and nutritional conditions between 1990 and 2001. Almost half the disease burden in low-and-middle-income countries is now from non- communicable diseases (disease burden per head in Sub-Saharan Africa and the low-and-middle-income countries of Europe and Central Asia increased between 1990 and 2001). Undernutrition remains the leading risk factor for health loss. An estimated 45% of global mortality and 36% of global disease burden are attributable to the joint hazardous eF ects of the 19 risk factors studied. Uncertainty in all-cause mortality estimates ranged from around 1% in high- income countries to 15–20% in Sub-Saharan Africa. Uncertainty was larger for mortality from speci± c diseases, and for incidence and prevalence of non-fatal outcomes. Interpretation Despite uncertainties about mortality and burden of disease estimates, our ± ndings suggest that substan- tial gains in health have been achieved in most populations, countered by the HIV/AIDS epidemic in Sub-Saharan Africa and setbacks in adult mortality in countries of the former Soviet Union. Our results on major disease, injury, and risk factor causes of loss of health, together with information on the cost-eF ectiveness of interventions, can assist in accelerating progress towards better health and reducing the persistent diF erentials in health between poor and rich countries.
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Global Burden of Disease 1-22-09 - Articles Global and...

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