@article{27398, keywords = {Young Adult, Wounds and Injuries, Sex Factors, Quality-Adjusted Life Years, Prevalence, Middle Aged, Male, Infant, Newborn, Infant, Humans, Health Status, Global health, Female, Child, Preschool, Child, Aged, 80 and over, Aged, Age Factors, Adult, Adolescent}, author = {Murray C and Vos T and Lozano R and Naghavi M and Flaxman A and Michaud C and Ezzati M and Shibuya K and Salomon JA and Abdalla S and Aboyans V and Abraham J and Ackerman I and Aggarwal R and Ahn SY and Ali M and Alvarado M and Anderson R and Anderson L and Andrews K and Atkinson C and Baddour LM and Bahalim AN and Barker-Collo S and Barrero LH and Bartels D and Basáñez M and Baxter A and Bell M and Benjamin E and Bennett D and Bernabé E and Bhalla K and Bhandari B and Bikbov B and Bin Abdulhak A and Birbeck G and Black J and Blencowe H and Blore J and Blyth FM and Bolliger I and Bonaventure A and Boufous S and Bourne R and Boussinesq M and Braithwaite T and Brayne C and Bridgett L and Brooker S and Brooks P and Brugha TS and Bryan-Hancock C and Bucello C and Buchbinder R and Buckle G and Budke C and Burch M and Burney P and Burstein R and Calabria B and Campbell B and Canter CE and Carabin H and Carapetis J and Carmona L and Cella C and Charlson FJ and Chen H and Cheng AT and Chou D and Chugh S and Coffeng L and Colan SD and Colquhoun S and Colson E and Condon J and Connor MD and Cooper LT and Corriere M and Cortinovis M and Vaccaro KC and Couser W and Cowie BC and Criqui M and Cross M and Dabhadkar K and Dahiya M and Dahodwala N and Damsere-Derry J and Danaei G and Davis A and De Leo D and Degenhardt L and Dellavalle R and Delossantos A and Denenberg J and Derrett S and Des Jarlais DC and Dharmaratne SD and Dherani MK and Diaz-Torné C and Dolk H and Dorsey R and Driscoll T and Duber HC and Ebel B and Edmond KM and Elbaz A and Ali SE and Erskine H and Erwin PJ and Espindola P and Ewoigbokhan SE and Farzadfar F and Feigin VL and Felson DT and Ferrari A and Ferri CP and Fèvre EM and Finucane MM and Flaxman S and Flood L and Foreman K and Forouzanfar M and Fowkes FG and Fransen M and Freeman M and Gabbe BJ and Gabriel SE and Gakidou E and Ganatra HA and Garcia B and Gaspari F and Gillum RF and Gmel G and González-Medina D and Gosselin R and Grainger R and Grant B and Groeger J and Guillemin F and Gunnell D and Gupta R and Haagsma J and Hagan H and Halasa YA and Hall W and Haring D and Haro JM and Harrison J and Havmoeller R and Hay R and Higashi H and Hill C and Hoen B and Hoffman H and Hotez P and Hoy DG and Huang J and Ibeanusi S and Jacobsen K and James S and Jarvis D and Jasrasaria R and Jayaraman S and Johns N and Jonas J and Karthikeyan G and Kassebaum N and Kawakami N and Keren A and Khoo J and King C and Knowlton LM and Kobusingye O and Koranteng A and Krishnamurthi R and Laden F and Lalloo R and Laslett L and Lathlean T and Leasher JL and Lee YY and Leigh J and Levinson D and Lim S and Limb E and Lin JK and Lipnick M and Lipshultz S and Liu W and Loane M and Ohno SL and Lyons RA and Mabweijano J and Macintyre M and Malekzadeh R and Mallinger L and Manivannan S and Marcenes W and March L and Margolis D and Marks GB and Marks R and Matsumori A and Matzopoulos R and Mayosi BM and McAnulty JH and McDermott M and Mcgill NW and McGrath J and Medina-Mora ME and Meltzer M and Mensah G and Merriman T and Meyer A and Miglioli V and Miller M and Miller T and Mitchell PB and Mock C and Mocumbi AO and Moffitt T and Mokdad A and Monasta L and Montico M and Moradi-Lakeh M and Moran A and Morawska L and Mori R and Murdoch M and Mwaniki MK and Naidoo K and Nair N and Naldi L and Narayan VK M and Nelson P and Nelson R and Nevitt M and Newton CR and Nolte S and Norman P and Norman R and O'Donnell M and O'Hanlon S and Olives C and Omer SB and Ortblad K and Osborne R and Ozgediz D and Page A and Pahari B and Pandian JD and Rivero AP and Patten S and Pearce N and Padilla RP and Perez-Ruiz F and Perico N and Pesudovs K and Phillips D and Phillips M and Pierce K and Pion S and Polanczyk GV and Polinder S and Pope AC and Popova S and Porrini E and Pourmalek F and Prince M and Pullan R and Ramaiah K and Ranganathan D and Razavi H and Regan M and Rehm JT and Rein DB and Remuzzi G and Richardson K and Rivara F and Roberts T and Robinson C and De Leòn FR and Ronfani L and Room R and Rosenfeld LC and Rushton L and Sacco RL and Saha S and Sampson U and Sanchez-Riera L and Sanman E and Schwebel D and Scott JG and Segui-Gomez M and Shahraz S and Shepard DS and Shin H and Shivakoti R and Singh D and Singh GM and Singh JA and Singleton J and Sleet DA and Sliwa K and Smith E and Smith JL and Stapelberg N and Steer AC and Steiner TJ and Stolk W and Stovner LJ and Sudfeld C and Syed S and Tamburlini G and Tavakkoli M and Taylor H and Taylor JA and Taylor W and Thomas B and Thomson M and Thurston GD and Tleyjeh IM and Tonelli M and Towbin J and Truelsen T and Tsilimbaris MK and Ubeda C and Undurraga E and Werf MJ and Van Os J and Vavilala M and Venketasubramanian N and Wang M and Wang W and Watt K and Weatherall D and Weinstock MA and Weintraub R and Weisskopf MG and Weissman MM and White R and Whiteford HA and Wiebe N and Wiersma S and Wilkinson JD and Williams HC and Williams S and Witt E and Wolfe F and Woolf AD and Wulf SK and Yeh P and Zaidi A and Zheng Z and Zonies D and Lopez AD and Almazroa M and Memish Z}, title = {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.}, abstract = {

BACKGROUND: Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time.

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.

}, year = {2012}, journal = {Lancet (London, England)}, volume = {380}, pages = {2197-223}, issn = {1474-547X}, url = {http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)61689-4.pdf}, doi = {10.1016/S0140-6736(12)61689-4}, language = {eng}, }