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

Global Burden of Disease Study 2013 Collaborators

Research output: Contribution to journalArticleResearchpeer-review

2554 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)743 - 800
Number of pages58
JournalThe Lancet
Volume386
Issue number9995
DOIs
Publication statusPublished - 2015

Cite this

@article{314666f85eb4492db2be43249490e0a1,
title = "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",
abstract = "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.",
author = "Murray, {Christopher J L} and Ryan Barber and Kyle Foreman and Ozgoren, {Ayse Abbasoglu} and Foad Abd-Allah and Abera, {Semaw Ferede} and Victor Aboyans and Abraham, {Jerry P} and Ibrahim Abubakar and Abu-Raddad, {Laith J} and Abu-Rmeileh, {Niveen Me E} and Achoki, {Tom N} and Ackerman, {Ilana Naomi} and Zanfina Ademi and Adou, {Arsene Kouablan} and Adsuar, {Jose C} and Ashkan Afshin and Agardh, {Emilie Elisabet} and Alam, {Sayed Saidul} and Deena Alasfoor and Albittar, {Mohammed I} and Alegretti, {Miguel Angel} and Alemu, {Zewdie Aderaw} and Rafael Alfonso-Cristancho and Samia Alhabib and Raghib Ali and Francois Alla and Peter Allebeck and Mohammad Almazroa and Ubai Alsharif and Elena Alvarez and Nelson Alvis-Guzman and Amare, {Azmeraw T} and Ameh, {Emmanuel A} and Heresh Amini and Walid Ammar and Anderson, {Hugh Ross} and Anderson, {Benjamin O} and Antonio, {Carl Abelardo T} and Palwasha Anwari and Johan Arnlov and Arsenijevic, {Valentina S Arsic} and Ali Artaman and Asghar, {Rana Jawad} and Reza Assadi and Atkins, {Lydia S} and Avila, {Marco A} and Baffour Awuah and Bachman, {Victoria F} and Alaa Badawi and Rachelle Buchbinder and Gabbe, {Belinda Jane} and Katherine Gibney and Belinda Lloyd and Thrift, {Amanda Gay} and {Global Burden of Disease Study 2013 Collaborators}",
year = "2015",
doi = "10.1016/S0140-6736(15)60692-4",
language = "English",
volume = "386",
pages = "743 -- 800",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier",
number = "9995",

}

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. / Global Burden of Disease Study 2013 Collaborators.

In: The Lancet, Vol. 386, No. 9995, 2015, p. 743 - 800.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013

T2 - A systematic analysis for the Global Burden of Disease Study 2013

AU - Murray, Christopher J L

AU - Barber, Ryan

AU - Foreman, Kyle

AU - Ozgoren, Ayse Abbasoglu

AU - Abd-Allah, Foad

AU - Abera, Semaw Ferede

AU - Aboyans, Victor

AU - Abraham, Jerry P

AU - Abubakar, Ibrahim

AU - Abu-Raddad, Laith J

AU - Abu-Rmeileh, Niveen Me E

AU - Achoki, Tom N

AU - Ackerman, Ilana Naomi

AU - Ademi, Zanfina

AU - Adou, Arsene Kouablan

AU - Adsuar, Jose C

AU - Afshin, Ashkan

AU - Agardh, Emilie Elisabet

AU - Alam, Sayed Saidul

AU - Alasfoor, Deena

AU - Albittar, Mohammed I

AU - Alegretti, Miguel Angel

AU - Alemu, Zewdie Aderaw

AU - Alfonso-Cristancho, Rafael

AU - Alhabib, Samia

AU - Ali, Raghib

AU - Alla, Francois

AU - Allebeck, Peter

AU - Almazroa, Mohammad

AU - Alsharif, Ubai

AU - Alvarez, Elena

AU - Alvis-Guzman, Nelson

AU - Amare, Azmeraw T

AU - Ameh, Emmanuel A

AU - Amini, Heresh

AU - Ammar, Walid

AU - Anderson, Hugh Ross

AU - Anderson, Benjamin O

AU - Antonio, Carl Abelardo T

AU - Anwari, Palwasha

AU - Arnlov, Johan

AU - Arsenijevic, Valentina S Arsic

AU - Artaman, Ali

AU - Asghar, Rana Jawad

AU - Assadi, Reza

AU - Atkins, Lydia S

AU - Avila, Marco A

AU - Awuah, Baffour

AU - Bachman, Victoria F

AU - Badawi, Alaa

AU - Buchbinder, Rachelle

AU - Gabbe, Belinda Jane

AU - Gibney, Katherine

AU - Lloyd, Belinda

AU - Thrift, Amanda Gay

AU - Global Burden of Disease Study 2013 Collaborators

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

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U2 - 10.1016/S0140-6736(15)60692-4

DO - 10.1016/S0140-6736(15)60692-4

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VL - 386

SP - 743

EP - 800

JO - The Lancet

JF - The Lancet

SN - 0140-6736

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