National disability-adjusted life years (DALYs) for 257 diseases and injuries in Ethiopia, 1990–2015: findings from the global burden of disease study 2015

Population Health Metrics

Research

Tilahun N. Haregu¹  Muluken Dessalegn²  Kebede Deribe³  Solomon Abrha Damtew⁴  Tolesa Bekele⁵  Yihunie Lakew⁶  Mesoud Mohammed⁷  Mahlet Kifle⁷  Molla Gedefaw⁷  Mohsen Naghavi⁸  Tom Achoki⁸  Jed Blore⁸  Awoke Misganaw⁸  Kristopher J. Krohn⁸  Amare Deribew⁹  Semaw Ferede Abera^1,10  Gizachew Assefa Tessema^1,11  Azmeraw T. Amare^1,12  Yohannes Adama Melaku^1,13  Yibeltal Assefa^1,14  Biruck Desalegn Yirsaw^1,15 

[1] Africa Population and Health Research Center, Nairobi, Kenya;Amref Health Africa in Ethiopia, Addis Ababa, Ethiopia;Brighton and Sussex Medical School, Brighton, UK;School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia;College of Health Sciences and Medicine, Wolayta Sodo University, Addis Ababa, Ethiopia;Department of Public Health, College of Medicine and Health Sciences, Madda Walabu University, Bale Robe, Ethiopia;Ethiopian Public Health Association, Addis Ababa, Ethiopia;Federal Ministry of Health, Addis Ababa, Ethiopia;Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA;KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya;Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK;St. Paul Millennium Medical College, Addis Ababa, Ethiopia;School of Public Health, College of Health Sciences, Mekelle University, Mek’ele, Ethiopia;Institute for Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany;School of Public Health, University of Adelaide, Adelaide, Australia;Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia;School of Public Health, University of Adelaide, Adelaide, Australia;Federal Ministry of Health, Addis Ababa, Ethiopia;College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia;School of Public Health, University of Adelaide, Adelaide, Australia;School of Public Health, College of Health Sciences, Mekelle University, Mek’ele, Ethiopia;School of Public Health, University of Queensland, St Lucia, Australia;University of South Australia, Adelaide, Australia;

关键词: Disability-adjusted life years;    Communicable disease;    Maternal and neonatal disease;    Nutritional deficiency disorders;    Non-communicable diseases;    Injuries;    Ethiopia;   

DOI  :  10.1186/s12963-017-0146-0

 received in 2016-07-11, accepted in 2017-07-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDisability-adjusted life years (DALYs) provide a summary measure of health and can be a critical input to guide health systems, investments, and priority-setting in Ethiopia. We aimed to determine the leading causes of premature mortality and disability using DALYs and describe the relative burden of disease and injuries in Ethiopia.MethodsWe used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for non-fatal disease burden, cause-specific mortality, and all-cause mortality to derive age-standardized DALYs by sex for Ethiopia for each year. We calculated DALYs by summing years of life lost due to premature mortality (YLLs) and years lived with disability (YLDs) for each age group and sex. Causes of death by age, sex, and year were measured mainly using Causes of Death Ensemble modeling. To estimate YLDs, a Bayesian meta-regression method was used. We reported DALY rates per 100,000 for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases, and injuries, with 95% uncertainty intervals (UI) for Ethiopia.ResultsNon-communicable diseases caused 23,118.1 (95% UI, 17,124.4–30,579.6), CMNN disorders resulted in 20,200.7 (95% UI, 16,532.2–24,917.9), and injuries caused 3781 (95% UI, 2642.9–5500.6) age-standardized DALYs per 100,000 in Ethiopia in 2015. Lower respiratory infections, diarrheal diseases, and tuberculosis were the top three leading causes of DALYs in 2015, accounting for 2998 (95% UI, 2173.7–4029), 2592.5 (95% UI, 1850.7–3495.1), and 2562.9 (95% UI, 1466.1–4220.7) DALYs per 100,000, respectively. Ischemic heart disease and cerebrovascular disease were the fourth and fifth leading causes of age-standardized DALYs, with rates of 2535.7 (95% UI, 1603.7–3843.2) and 2159.9 (95% UI, 1369.7–3216.3) per 100,000, respectively. The following causes showed a reduction of 60% or more over the last 25 years: lower respiratory infections, diarrheal diseases, tuberculosis, neonatal encephalopathy, preterm birth complications, meningitis, malaria, protein-energy malnutrition, iron-deficiency anemia, measles, war and legal intervention, and maternal hemorrhage.ConclusionsEthiopia has been successful in reducing age-standardized DALYs related to most communicable, maternal, neonatal, and nutritional deficiency diseases in the last 25 years, causing a major ranking shift to types of non-communicable disease. Lower respiratory infections, diarrheal disease, and tuberculosis continue to be leading causes of premature death, despite major declines in burden. Non-communicable diseases also showed reductions as premature mortality declined; however, disability outcomes for these causes did not show declines. Recently developed non-communicable disease strategies may need to be amended to focus on cardiovascular diseases, cancer, diabetes, and major depressive disorders. Increasing trends of disabilities due to neonatal encephalopathy, preterm birth complications, and neonatal disorders should be emphasized in the national newborn survival strategy. Generating quality data should be a priority through the development of new initiatives such as vital events registration, surveillance programs, and surveys to address gaps in data. Measuring disease burden at subnational regional state levels and identifying variations with urban and rural population health should be conducted to support health policy in Ethiopia.

【 授权许可】

CC BY   
© The Author(s). 2017