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

Theo Vos, Ryan M. Barber, Brad Bell, Amelia Bertozzi-Villa, Stan Biryukov, Ian Bolliger, Fiona Charlson, Adrian Davis, Louisa Degenhardt, Daniel Dicker, Leilei Duan, Holly Erskine, Valery L. Feigin, Alize J. Ferrari, Christina Fitzmaurice, Thomas Fleming, Nicholas Graetz, Caterina Guinovart, Juanita Haagsma, Gillian M. HansenSarah Wulf Hanson, Kyle R. Heuton, Hideki Higashi, Nicholas Kassebaum, Hmwe Kyu, Evan Laurie, Xiofeng Liang, Katherine Lofgren, Rafael Lozano, Michael F. MacIntyre, Maziar Moradi-Lakeh, Mohsen Naghavi, Grant Nguyen, Shaun Odell, Katrina Ortblad, David Allen Roberts, Gregory A. Roth, Logan Sandar, Peter T. Serina, Jeffrey D. Stanaway, Caitlyn Steiner, Bernadette Thomas, Stein Emil Vollset, Harvey Whiteford, Timothy M. Wolock, Pengpeng Ye, Maigeng Zhou, Marco A. Ãvila, Gunn Marit Aasvang, Cristiana Abbafati, Ayse Abbasoglu Ozgoren, Foad Abd-Allah, Muna I.Abdel Aziz, Semaw F. Abera, Victor Aboyans, Jerry P. Abraham, Biju Abraham, Ibrahim Abubakar, Laith J. Abu-Raddad, Niveen M.E. Abu-Rmeileh, Tania C. Aburto, Tom Achoki, Ilana N. Ackerman, Ademola Adelekan, Zanfina Ademi, Arsène K. Adou, Josef C. Adsuar, Johan Arnlov, Emilie E. Agardh, Mazin J. Al Khabouri, Sayed Saidul Alam, Deena Alasfoor, Mohammed I. Albittar, Miguel A. Alegretti, Alicia V. Aleman, Zewdie A. Alemu, Rafael Alfonso-Cristancho, Samia Alhabib, Raghib Ali, Francois Alla, Peter Allebeck, Peter J. Allen, Mohammad Abdulaziz AlMazroa, Ubai Alsharif, Elena Alvarez, Nelson Alvis-Guzman, Omid Ameli, Heresh Amini, Walid Ammar, Benjamin O. Anderson, H. Ross Anderson, Carl Abelardo T. Antonio, Palwasha Anwari, Henry Apfel, Valentain S.Arsic Arsenijevic, Al Artaman, Rana J. Asghar, Reza Assadi, Lydia S. Atkins, Charles Atkinson, Alaa Badawi, Maria C. Bahit, Talal Bakfalouni, Kalpana Balakrishnan, Shivanthi Balalla, Amitava Banerjee, Suzanne L. Barker-Collo, Simon Barquera, Lars Barregard, Lope H. Barrero, Sanjay Basu, Arindam Basu, Amanda Baxter, Justin Beardsley, Neeraj Bedi, Ettore Beghi, Tolesa Bekele, Michelle L. Bell, Corina Benjet, Derrick A. Bennett, Isabela M. Bensenor, Habib Benzian, Eduardo Bernabe, Tariku J. Beyene, Neeraj Bhala, Ashish Bhalla, Zulfiqar Bhutta, Kelly Bienhoff, Boris Bikbov, Aref Bin Abdulhak, Jed D. Blore, Fiona M. Blyth, Megan A. Bohensky, Berrak Bora Basara, Guilherme Borges, Natan M. Bornstein, Dipan Bose, Soufiane Boufous, Rupert R. Bourne, Lindsay N. Boyers, Michael Brainin, Michael Brauer, Carol E.G. Brayne, Alexandra Brazinova, Nicholas J.K. Breitborde, Hermann Brenner, Adam D.M. Briggs, Peter M. Brooks, Jonathan Brown, Traolach S. Brugha, Rachelle Buchbinder, Geoffrey C. Buckle, Gene Bukhman, Andrew G. Bulloch, Michael Burch, Richard Burnett, Rosario Cardenas, Norberto L. Cabral, Ismael R. Campos-Nonato, Julio C. Campuzano, Jonathan R. Carapetis, David O. Carpenter, Valeria Caso, Carlos A. Castaneda-Orjuela, Ferran Catala-Lopez, Vineet K. Chadha, Jung Chen Chang, Honglei Chen, Wanqing Chen, Peggy P. Chiang, Odgerel Chimed-Ochir, Rajiv Chowdhury, Hanne Christensen, Costas A. Christophi, Sumeet S. Chugh, Massimo Cirillo, Megan Coggeshall, Aaron Cohen, Valentina Colistro, Samantha M. Colquhoun, Alejandra G. Contreras, Leslie T. Cooper, Cyrus Cooper, Kimberly Cooperrider, Josef Coresh, Monica Cortinovis, Michael H. Criqui, John A. Crump, Lucia Cuevas-Nasu, Rakhi Dandona, Lalit Dandona, Emily Dansereau, Hector G. Dantes, Paul I. Dargan, Gail Davey, Dragos V. Davitoiu, Anand Dayama, Vanessa De La Cruz-Gongora, Shelley F. De La Vega, Diego De Leo, Borja Del Pozo-Cruz, Robert P. Dellavalle, Kebede Deribe, Sarah Derrett, Don C. Des Jarlais, Muluken Dessalegn, Gabrielle A. DeVeber, Samath D. Dharmaratne, Cesar Diaz-Torne, Eric L. Ding, Klara Dokova, E. R. Dorsey, Tim R. Driscoll, Herbert Duber, Adnan M. Durrani, Karen M. Edmond, Richard G. Ellenbogen, Matthias Endres, Sergey P. Ermakov, Babak Eshrati, Alireza Esteghamati, Kara Estep, Saman Fahimi, Farshad Farzadfar, Derek F.J. Fay, David T. Felson, Seyed Mohammad Fereshtehnejad, Jefferson G. Fernandes, Cluesa P. Ferri, Abraham Flaxman, Nataliya Foigt, Kyle J. Foreman, F. Gerry R. Fowkes, Richard C. Franklin, Thomas Furst, Neal D. Futran, Belinda J. Gabbe, Fortune G. Gankpe, Francisco A. Garcia-Guerra, Johanna M. Geleijnse, Bradford D. Gessner, Katherine B. Gibney, Richard F. Gillum, Ibrahim A. Ginawi, Maurice Giroud, Giorgia Giussani, Shifalika Goenka, Ketevan Goginashvili, Philimon Gona, Teresita Gonzalez De Cosio, Richard A. Gosselin, Carolyn C. Gotay, Atsushi Goto, Hebe N. Gouda, Richard L. Guerrant, Harish C. Gugnani, David Gunnell, Rajeev Gupta, Rahul Gupta, Reyna A. Gutierrez, Nima Hafezi-Nejad, Holly Hagan, Yara Halasa, Randah R. Hamadeh, Hannah Hamavid, Mouhanad Hammami, Graeme J. Hankey, Yuantao Hao, Hilda L. Harb, Josep Maria Haro, Rasmus Havmoeller, Roderick J. Hay, Simon Hay, Mohammad T. Hedayati, Ileana B.Heredia Pi, Pouria Heydarpour, Martha Hijar, Hans W. Hoek, Howard J. Hoffman, John C. Hornberger, H. Dean Hosgood, Mazeda Hossain, Peter J. Hotez, Damian G. Hoy, Mohamed Hsairi, Howard Hu, Guoqing Hu, John J. Huang, Cheng Huang, Laetitia Huiart, Abdullatif Husseini, Marissa Iannarone, Kim M. Iburg, Kaire Innos, Manami Inoue, Kathryn H. Jacobsen, Simerjot K. Jassal, Panniyammakal Jeemon, Paul N. Jensen, Vivekanand Jha, Guohong Jiang, Ying Jiang, Jost B. Jonas, Jonathan Joseph, Knud Juel, Haidong Kan, Andre Karch, Chante Karimkhani, Ganesan Karthikeyan, Ronit Katz, Anil Kaul, Norito Kawakami, Dhruv S. Kazi, Andrew H. Kemp, Andre P. Kengne, Yousef S. Khader, Shams Eldin A.H. Khalifa, Ejaz A. Khan, Gulfaraz Khan, Young Ho Khang, Irma Khonelidze, Christian Kieling, Daniel Kim, Sungroul Kim, Ruth W. Kimokoti, Yohannes Kinfu, Jonas M. Kinge, Brett M. Kissela, Miia Kivipelto, Luke Knibbs, Ann Kristin Knudsen, Yoshihiro Kokubo, Soewarta Kosen, Alexander Kramer, Michael Kravchenko, Rita V. Krishnamurthi, Sanjay Krishnaswami, Barthelemy Kuate Defo, Burcu Kucuk Bicer, Ernst J. Kuipers, Veena S. Kulkarni, Kaushalendra Kumar, G. Anil Kumar, Gene F. Kwan, Taavi Lai, Ratilal Lalloo, Hilton Lam, Qing Lan, Van C. Lansingh, Heidi Larson, Anders Larsson, Alicia E.B. Lawrynowicz, Janet L. Leasher, Jong Tae Lee, James Leigh, Ricky Leung, Miriam Levi, Bin Li, Yichong Li, Yongmei Li, Juan Liang, Stephen Lim, Hsien Ho Lin, Margaret Lind, M. Patrice Lindsay, Steven E. Lipshultz, Shiwei Liu, Belinda K. Lloyd, Summer Lockett Ohno, Giancarlo Logroscino, Katharine J. Looker, Alan D. Lopez, Nancy Lopez-Olmedo, Joannie Lortet-Tieulent, Paulo A. Lotufo, Nicola Low, Robyn M. Lucas, Raimundas Lunevicius, Ronan A. Lyons, Jixiang Ma, Stefan Ma, Mark T. MacKay, Marek Majdan, Reza Malekzadeh, Christopher C. Mapoma, Wagner Marcenes, Lyn M. March, Chris Margono, Guy B. Marks, Melvin B. Marzan, Joseph R. Masci, Amanda J. Mason-Jones, Richard G. Matzopoulos, Bongani M. Mayosi, Tasara T. Mazorodze, Neil W. McGill, John J. McGrath, Martin McKee, Abby McLain, Brian J. McMahon, Peter A. Meaney, Man Mohan Mehndiratta, Fabiola Mejia-Rodriguez, Wubegzier Mekonnen, Yohannes A. Melaku, Michele Meltzer, Ziad A. Memish, George Mensah, Atte Meretoja, Francis A. Mhimbira, Renata Micha, Ted R. Miller, Edward J. Mills, Philip B. Mitchell, Charles N. Mock, Terrie E. Moffitt, Norlinah Mohamed Ibrahim, Karzan A. Mohammad, Ali H. Mokdad, Glen L. Mola, Lorenzo Monasta, Marcella Montico, Thomas J. Montine, Ami R. Moore, Andrew E. Moran, Lidia Morawska, Rintaro Mori, Joanna Moschandreas, Wilkister N. Moturi, Madeline Moyer, Dariush Mozaffarian, Ulrich O. Mueller, Mitsuru Mukaigawara, Michele E. Murdoch, Joseph Murray, Kinnari S. Murthy, Paria Naghavi, Ziad Nahas, Aliya Naheed, Kovin S. Naidoo, Luigi Naldi, Devina Nand, Vinay Nangia, K. M.Venkat Narayan, Denis Nash, Chakib Nejjari, Sudan P. Neupane, Lori M. Newman, Charles R. Newton, Marie Ng, Frida N. Ngalesoni, Nguyen T. Nhung, Muhammad I. Nisar, Sandra Nolte, Ole F. Norheim, Rosana E. Norman, Bo Norrving, Luke Nyakarahuka, In Hwan Oh, Takayoshi Ohkubo, Saad B. Omer, John Nelson Opio, Alberto Ortiz, Jeyaraj D. Pandian, Carlo Irwin A. Panelo, Christina Papachristou, Eun Kee Park, Charles D. Parry, Angel J.Paternina Caicedo, Scott B. Patten, Vinod K. Paul, Boris I. Pavlin, Neil Pearce, Lilia S. Pedraza, Carlos A. Pellegrini, David M. Pereira, Fernando P. Perez-Ruiz, Norberto Perico, Aslam Pervaiz, Konrad Pesudovs, Carrie B. Peterson, Max Petzold, Michael R. Phillips, David Phillips, Bryan Phillips, Frederic B. Piel, Dietrich Plass, Dan Poenaru, Guilherme V. Polanczyk, Suzanne Polinder, C. A. Pope, Svetlana Popova, Richie G. Poulton, Farshad Pourmalek, Dorairaj Prabhakaran, Noela M. Prasad, Dima Qato, D. A. Quistberg, Anwar Rafay, Kazem Rahimi, Vafa Rahimi-Movaghar, Sajjad Ur Rahman, Murugesan Raju, Ivo Rakovac, Saleem M. Rana, Homie Razavi, Amany Refaat, Jurgen Rehm, Giuseppe Remuzzi, Serge Resnikoff, Antonio L. Ribeiro, Patricia M. Riccio, Lee Richardson, Jan Hendrik Richardus, Anne M. Riederer, Margot Robinson, Anna Roca, Alina Rodriguez, David Rojas-Rueda, Luca Ronfani, Dietrich Rothenbacher, Nobhojit Roy, George M. Ruhago, Nsanzimana Sabin, Ralph L. Sacco, Kjetil Ksoreide, Sukanta Saha, Ramesh Sahathevan, Mohammad Ali Sahraian, Uchechukwu Sampson, Juan R. Sanabria, Lidia Sanchez-Riera, Itamar S. Santos, Maheswar Satpathy, James E. Saunders, Monika Sawhney, Mete I. Saylan, Peter Scarborough, Ben Schoettker, Ione J.C. Schneider, David C. Schwebel, James G. Scott, Soraya Seedat, Sadaf G. Sepanlou, Berrin Serdar, Edson E. Servan-Mori, Katya Shackelford, Amira Shaheen, Saeid Shahraz, Teresa Shamah Levy, Siyi Shangguan, Jun She, Sara Sheikhbahaei, Donald S. Shepard, Peilin Shi, Kenji Shibuya, Yukito Shinohara, Rahman Shiri, Kawkab Shishani, Ivy Shiue, Mark G. Shrime, Inga D. Sigfusdottir, Donald H. Silberberg, Edgar P. Simard, Shireen Sindi, Jasvinder A. Singh, Lavanya Singh, Vegard Skirbekk, Karen Sliwa, Michael Soljak, Samir Soneji, Sergey S. Soshnikov, Peter Speyer, Luciano A. Sposato, Chandrashekhar T. Sreeramareddy, Heidi Stoeckl, Vasiliki Kalliopi Stathopoulou, Nadine Steckling, Murray B. Stein, Dan J. Stein, Timothy J. Steiner, Andrea Stewart, Eden Stork, Lars J. Stovner, Konstantinos Stroumpoulis, Lela Sturua, Bruno F. Sunguya, Mamta Swaroop, Bryan L. Sykes, Karen M. Tabb, Ken Takahashi, Feng Tan, Nikhil Tandon, David Tanne, Marcel Tanner, Mohammad Tavakkoli, Hugh R. Taylor, Braden J. Te Ao, Awoke Misganaw Temesgen, Margreet Ten Have, Eric Yeboah Tenkorang, Abdullah Sulieman Terkawi, Alice M. Theadom, Elissa Thomas, Andrew L. Thorne-Lyman, Amanda G. Thrift, Imad M. Tleyjeh, Marcello Tonelli, Fotis Topouzis, Jeffrey A. Towbin, Hideaki Toyoshima, Jefferson Traebert, Bach X. Tran, Leonardo Trasande, Matias Trillini, Thomas Truelsen, Ulises Trujillo, Miltiadis Tsilimbaris, Emin M. Tuzcu, Kingsley N. Ukwaja, Eduardo A. Undurraga, Selen B. Uzun, Wim H. Van Brakel, Steven Van De Vijver, Rita Van Dingenen, Coen H. Van Gool, Yuri Y. Varakin, Tommi J. Vasankari, Monica S. Vavilala, Lennert J. Veerman, Gustavo Velasquez-Melendez, Narayanaswamy Venketasubramanian, Lakshmi Vijayakumar, Salvador Villalpando, Francesco S. Violante, Vasiliy V. Vlassov, Stephen Waller, Mitchell T. Wallin, Xia Wan, Linhong Wang, Jianli Wang, Yanping Wang, Tati S. Warouw, Scott Weichenthal, Elisabete Weiderpass, Robert G. Weintraub, Andrea Werdecker, K. Ryan Wessells, Ronny Westerman, James D. Wilkinson, Hywel C. Williams, Thomas N. Williams, Solomon M. Woldeyohannes, Charles D.A. Wolfe, John Q. Wong, Haidong Wong, Anthony D. Woolf, Jonathan L. Wright, Brittany Wurtz, Gelin Xu, Gonghuan Yang, Yuichiro Yano, Muluken A. Yenesew, Gokalp K. Yentur, Paul Yip, Naohiro Yonemoto, Seok Jun Yoon, Mustafa Younis, Chuanhua Yu, Kim Yun Kim, Maysaa El Sayed Zaki, Yong Zhang, Zheng Zhao, Yong Zhao, Jun Zhu, David Zonies, Joseph R. Zunt, Joshua A. Salomon, Christopher J.L. Murray

Research output: Contribution to journalArticle

3085 Scopus citations

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 (US)
Pages (from-to)743-800
Number of pages58
JournalThe Lancet
Volume386
Issue number9995
DOIs
StatePublished - Aug 22 2015

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    Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Bolliger, I., Charlson, F., Davis, A., Degenhardt, L., Dicker, D., Duan, L., Erskine, H., Feigin, V. L., Ferrari, A. J., Fitzmaurice, C., Fleming, T., Graetz, N., Guinovart, C., Haagsma, J., ... Murray, C. J. L. (2015). 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. The Lancet, 386(9995), 743-800. https://doi.org/10.1016/S0140-6736(15)60692-4