Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Issue 10100 (16th September 2017)

• Record Type: Journal Article
• Authors: Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abdulkader, Rizwan Suliankatchi; Abdulle, Abdishakur M; Abebo, Teshome Abuka; Abera, Semaw Ferede; Aboyans, Victor; Abu-Raddad, Laith J; Ackerman, Ilana N; Adamu, Abdu Abdullahi; Adetokunboh, Olatunji; Afarideh, Mohsen; Afshin, Ashkan; Agarwal, Sanjay Kumar; Aggarwal, Rakesh; Agrawal, Anurag; Agrawal, Sutapa; Ahmadieh, Hamid; Ahmed, Muktar Beshir; Aichour, Miloud Taki Eddine; Aichour, Amani Nidhal; Aichour, Ibtihel; Aiyar, Sneha; Akinyemi, Rufus Olusola; Akseer, Nadia; Al Lami, Faris Hasan; Alahdab, Fares; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore; Alam, Tahiya; Alasfoor, Deena; Alene, Kefyalew Addis; Ali, Raghib; Alizadeh-Navaei, Reza; Alkerwi, Ala'a; Alla, François; Allebeck, Peter; Allen, Christine; Al-Maskari, Fatma; Al-Raddadi, Rajaa; Alsharif, Ubai; Alsowaidi, Shirina; Altirkawi, Khalid A; Amare, Azmeraw T; Amini, Erfan; Ammar, Walid; Amoako, Yaw Ampem; Andersen, Hjalte H; Antonio, Carl Abelardo T; Anwari, Palwasha; Ärnlöv, Johan; Artaman, Al; Aryal, Krishna Kumar; Asayesh, Hamid; Asgedom, Solomon W; Assadi, Reza; Atey, Tesfay Mehari; Atnafu, Niguse Tadele; Atre, Sachin R; Avila-Burgos, Leticia; Avokphako, Euripide Frinel G Arthur; Awasthi, Ashish; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Banerjee, Amitava; Bannick, Marlena S; Barac, Aleksandra; Barber, Ryan M; Barker-Collo, Suzanne L; Bärnighausen, Till; Barquera, Simon; Barregard, Lars; Barrero, Lope H; Basu, Sanjay; Battista, Bob; Battle, Katherine E; Baune, Bernhard T; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Béjot, Yannick; Bekele, Bayu Begashaw; Bell, Michelle L; Bennett, Derrick A; Bensenor, Isabela M; Benson, Jennifer; Berhane, Adugnaw; Berhe, Derbew Fikadu; Bernabé, Eduardo; Betsu, Balem Demtsu; Beuran, Mircea; Beyene, Addisu Shunu; Bhala, Neeraj; Bhansali, Anil; Bhatt, Samir; Bhutta, Zulfiqar A; Biadgilign, Sibhatu; Bicer, Burcu Kucuk; Bienhoff, Kelly; Bikbov, Boris; Birungi, Charles; Biryukov, Stan; Bisanzio, Donal; Bizuayehu, Habtamu Mellie; Boneya, Dube Jara; Boufous, Soufiane; Bourne, Rupert R A; Brazinova, Alexandra; Brugha, Traolach S; Buchbinder, Rachelle; Bulto, Lemma Negesa Bulto; Bumgarner, Blair R; Butt, Zahid A; Cahuana-Hurtado, Lucero; Cameron, Ewan; Car, Mate; Carabin, Hélène; Carapetis, Jonathan R; Cárdenas, Rosario; Carpenter, David O; Carrero, Juan Jesus; Carter, Austin; Carvalho, Felix; Casey, Daniel C; Caso, Valeria; Castañeda-Orjuela, Carlos A; Castle, Chris D; Catalá-López, Ferrán; Chang, Hsing-Yi; Chang, Jung-Chen; Charlson, Fiona J; Chen, Honglei; Chibalabala, Mirriam; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Chitheer, Abdulaal A; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Cirillo, Massimo; Colombara, Danny; Cooper, Cyrus; Cortesi, Paolo Angelo; Criqui, Michael H; Crump, John A; Dadi, Abel Fekadu; Dalal, Koustuv; Dandona, Lalit; Dandona, Rakhi; das Neves, José; Davitoiu, Dragos V; de Courten, Barbora; De Leo, Diego De; Defo, Barthelemy Kuate; Degenhardt, Louisa; Deiparine, Selina; Dellavalle, Robert P; Deribe, Kebede; Des Jarlais, Don C; Dey, Subhojit; Dharmaratne, Samath D; Dhillon, Preet Kaur; Dicker, Daniel; Ding, Eric L; Djalalinia, Shirin; Do, Huyen Phuc; Dorsey, E Ray; dos Santos, Kadine Priscila Bender; Douwes-Schultz, Dirk; Doyle, Kerrie E; Driscoll, Tim R; Dubey, Manisha; Duncan, Bruce Bartholow; El-Khatib, Ziad Ziad; Ellerstrand, Jerisha; Enayati, Ahmadali; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Erskine, Holly E; Eshrati, Babak; Eskandarieh, Sharareh; Esteghamati, Alireza; Estep, Kara; Fanuel, Fanuel Belayneh Bekele; Farinha, Carla Sofia E Sa; Faro, André; Farzadfar, Farshad; Fazeli, Mir Sohail; Feigin, Valery L; Fereshtehnejad, Seyed-Mohammad; Fernandes, João C; Ferrari, Alize J; Feyissa, Tesfaye Regassa; Filip, Irina; Fischer, Florian; Fitzmaurice, Christina; Flaxman, Abraham D; Flor, Luisa Sorio; Foigt, Nataliya; Foreman, Kyle J; Franklin, Richard C; Fullman, Nancy; Fürst, Thomas; Furtado, Joao M; Futran, Neal D; Gakidou, Emmanuela; Ganji, Morsaleh; Garcia-Basteiro, Alberto L; Gebre, Teshome; Gebrehiwot, Tsegaye Tewelde; Geleto, Ayele; Gemechu, Bikila Lencha; Gesesew, Hailay Abrha; Gething, Peter W; Ghajar, Alireza; Gibney, Katherine B; Gill, Paramjit Singh; Gillum, Richard F; Ginawi, Ibrahim Abdelmageem Mohamed; Giref, Ababi Zergaw; Gishu, Melkamu Dedefo; Giussani, Giorgia; Godwin, William W; Gold, Audra L; Goldberg, Ellen M; Gona, Philimon N; Goodridge, Amador; Gopalani, Sameer Vali; Goto, Atsushi; Goulart, Alessandra Carvalho; Griswold, Max; Gugnani, Harish Chander; Gupta, Rahul; Gupta, Rajeev; Gupta, Tanush; Gupta, Vipin; Hafezi-Nejad, Nima; Hailu, Gessessew Bugssa; Hailu, Alemayehu Desalegne; Hamadeh, Randah Ribhi; Hamidi, Samer; Handal, Alexis J; Hankey, Graeme J; Hanson, Sarah Wulf; Hao, Yuantao; Harb, Hilda L; Hareri, Habtamu Abera; Haro, Josep Maria; Harvey, James; Hassanvand, Mohammad Sadegh; Havmoeller, Rasmus; Hawley, Caitlin; Hay, Simon I; Hay, Roderick J; Henry, Nathaniel J; Heredia-Pi, Ileana Beatriz; Hernandez, Julio Montañez; Heydarpour, Pouria; Hoek, Hans W; Hoffman, Howard J; Horita, Nobuyuki; Hosgood, H Dean; Hostiuc, Sorin; Hotez, Peter J; Hoy, Damian G; Htet, Aung Soe; Hu, Guoqing; Huang, Hsiang; Huynh, Chantal; Iburg, Kim Moesgaard; Igumbor, Ehimario Uche; Ikeda, Chad; Irvine, Caleb Mackay Salpeter; Jacobsen, Kathryn H; Jahanmehr, Nader; Jakovljevic, Mihajlo B; Jassal, Simerjot K; Javanbakht, Mehdi; Jayaraman, Sudha P; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Guohong; John, Denny; Johnson, Sarah Charlotte; Johnson, Catherine O; Jonas, Jost B; Jürisson, Mikk; Kabir, Zubair; Kadel, Rajendra; Kahsay, Amaha; Kamal, Ritul; Kan, Haidong; Karam, Nadim E; Karch, André; Karema, Corine Kakizi; Kasaeian, Amir; Kassa, Getachew Mullu; Kassaw, Nigussie Assefa; Kassebaum, Nicholas J; Kastor, Anshul; Katikireddi, Srinivasa Vittal; Kaul, Anil; Kawakami, Norito; Keiyoro, Peter Njenga; Kengne, Andre Pascal; Keren, Andre; Khader, Yousef Saleh; Khalil, Ibrahim A; Khan, Ejaz Ahmad; Khang, Young-Ho; Khosravi, Ardeshir; Khubchandani, Jagdish; Kiadaliri, Aliasghar Ahmad; Kieling, Christian; Kim, Yun Jin; Kim, Daniel; Kim, Pauline; Kimokoti, Ruth W; Kinfu, Yohannes; Kisa, Adnan; Kissimova-Skarbek, Katarzyna A; Kivimaki, Mika; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Kravchenko, Michael; Krishnaswami, Sanjay; Krohn, Kristopher J; Kumar, G Anil; Kumar, Pushpendra; Kumar, Sanjiv; Kyu, Hmwe H; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lambert, Nkurunziza; Lan, Qing; Larsson, Anders; Lavados, Pablo M; Leasher, Janet L; Lee, Paul H; Lee, Jong-Tae; Leigh, James; Leshargie, Cheru Tesema; Leung, Janni; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Li Kappe, Darya; Liang, Xiaofeng; Liben, Misgan Legesse; Lim, Stephen S; Linn, Shai; Liu, Patrick Y; Liu, Angela; Liu, Shiwei; Liu, Yang; Lodha, Rakesh; Logroscino, Giancarlo; London, Stephanie J; Looker, Katharine J; Lopez, Alan D; Lorkowski, Stefan; Lotufo, Paulo A; Low, Nicola; Lozano, Rafael; Lucas, Timothy C D; Macarayan, Erlyn Rachelle King; Magdy Abd El Razek, Hassan; Magdy Abd El Razek, Mohammed; Mahdavi, Mahdi; Majdan, Marek; Majdzadeh, Reza; Majeed, Azeem; Malekzadeh, Reza; Malhotra, Rajesh; Malta, Deborah Carvalho; Mamun, Abdullah A; Manguerra, Helena; Manhertz, Treh; Mantilla, Ana; Mantovani, Lorenzo G; Mapoma, Chabila C; Marczak, Laurie B; Martinez-Raga, Jose; Martins-Melo, Francisco Rogerlândio; Martopullo, Ira; März, Winfried; Mathur, Manu Raj; Mazidi, Mohsen; McAlinden, Colm; McGaughey, Madeline; McGrath, John J; McKee, Martin; McNellan, Claire; Mehata, Suresh; Mehndiratta, Man Mohan; Mekonnen, Tefera Chane; Memiah, Peter; Memish, Ziad A; Mendoza, Walter; Mengistie, Mubarek Abera; Mengistu, Desalegn Tadese; Mensah, George A; Meretoja, Tuomo J; Meretoja, Atte; Mezgebe, Haftay Berhane; Micha, Renata; Millear, Anoushka; Miller, Ted R; Mills, Edward J; Mirarefin, Mojde; Mirrakhimov, Erkin M; Misganaw, Awoke; Mishra, Shiva Raj; Mitchell, Philip B; Mohammad, Karzan Abdulmuhsin; Mohammadi, Alireza; Mohammed, Kedir Endris; Mohammed, Shafiu; Mohanty, Sanjay K; Mokdad, Ali H; Mollenkopf, Sarah K; Monasta, Lorenzo; Montico, Marcella; Moradi-Lakeh, Maziar; Moraga, Paula; Mori, Rintaro; Morozoff, Chloe; Morrison, Shane D; Moses, Mark; Mountjoy-Venning, Cliff; Mruts, Kalayu Birhane; Mueller, Ulrich O; Muller, Kate; Murdoch, Michele E; Murray, Christopher J L; Murthy, Gudlavalleti Venkata Satyanarayana; Musa, Kamarul Imran; Nachega, Jean B; Nagel, Gabriele; Naghavi, Mohsen; Naheed, Aliya; Naidoo, Kovin S; Naldi, Luigi; Nangia, Vinay; Natarajan, Gopalakrishnan; Negasa, Dumessa Edessa; Negoi, Ruxandra Irina; Negoi, Ionut; Newton, Charles R; Ngunjiri, Josephine Wanjiku; Nguyen, Trang Huyen; Nguyen, Quyen Le; Nguyen, Cuong Tat; Nguyen, Grant; Nguyen, Minh; Nichols, Emma; Ningrum, Dina Nur Anggraini; Nolte, Sandra; Nong, Vuong Minh; Norrving, Bo; Noubiap, Jean Jacques N; O'Donnell, Martin J; Ogbo, Felix Akpojene; Oh, In-Hwan; Okoro, Anselm; Oladimeji, Olanrewaju; Olagunju, Tinuke Oluwasefunmi; Olagunju, Andrew Toyin; Olsen, Helen E; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Ong, Kanyin; Opio, John Nelson; Oren, Eyal; Ortiz, Alberto; Osgood-Zimmerman, Aaron; Osman, Majdi; Owolabi, Mayowa O; PA, Mahesh; Pacella, Rosana E; Pana, Adrian; Panda, Basant Kumar; Papachristou, Christina; Park, Eun-Kee; Parry, Charles D; Parsaeian, Mahboubeh; Patten, Scott B; Patton, George C; Paulson, Katherine; Pearce, Neil; Pereira, David M; Perico, Norberto; Pesudovs, Konrad; Peterson, Carrie Beth; Petzold, Max; Phillips, Michael Robert; Pigott, David M; Pillay, Julian David; Pinho, Christine; Plass, Dietrich; Pletcher, Martin A; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prabhakaran, Dorairaj; Prasad, Noela M; Prasad, Narayan; Purcell, Carrie; Qorbani, Mostafa; Quansah, Reginald; Quintanilla, Beatriz Paulina Ayala; Rabiee, Rynaz H S; Radfar, Amir; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Afarin; Rahimi-Movaghar, Vafa; Rahman, Mohammad Hifz Ur; Rahman, Mahfuzar; Rai, Rajesh Kumar; Rajsic, Sasa; Ram, Usha; Ranabhat, Chhabi Lal; Rankin, Zane; Rao, Puja C; Rao, Paturi Vishnupriya; Rawaf, Salman; Ray, Sarah E; Reiner, Robert C; Reinig, Nikolas; Reitsma, Marissa B; Remuzzi, Giuseppe; Renzaho, Andre M N; Resnikoff, Serge; Rezaei, Satar; Ribeiro, Antonio L; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A; Roy, Ambuj; Rubagotti, Enrico; Ruhago, George Mugambage; Saadat, Soheil; Sadat, Nafis; Safdarian, Mahdi; Safi, Sare; Safiri, Saeid; Sagar, Rajesh; Sahathevan, Ramesh; Salama, Joseph; Saleem, Huda Omer Ba; Salomon, Joshua A; Salvi, Sundeep Santosh; Samy, Abdallah M; Sanabria, Juan R; Santomauro, Damian; Santos, Itamar S; Santos, João Vasco; Santric Milicevic, Milena M; Sartorius, Benn; Satpathy, Maheswar; Sawhney, Monika; Saxena, Sonia; Schmidt, Maria Inês; Schneider, Ione J C; Schöttker, Ben; Schwebel, David C; Schwendicke, Falk; 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Vidavalur, Ramesh; Violante, Francesco S; Vladimirov, Sergey K; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Vos, Theo; Wadilo, Fiseha; Wakayo, Tolassa; Wang, Yuan-Pang; Weaver, Marcia; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Westerman, Ronny; Whiteford, Harvey A; Wijeratne, Tissa; Wiysonge, Charles Shey; Wolfe, Charles D A; Woodbrook, Rachel; Woolf, Anthony D; Workicho, Abdulhalik; Xavier, Denis; Xu, Gelin; Yadgir, Simon; Yaghoubi, Mohsen; Yakob, Bereket; Yan, Lijing L; Yano, Yuichiro; Ye, Pengpeng; Yimam, Hassen Hamid; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Yotebieng, Marcel; Younis, Mustafa Z; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zegeye, Elias Asfaw; Zenebe, Zerihun Menlkalew; Zhang, Xueying; Zhou, Maigeng; Zipkin, Ben; Zodpey, Sanjay; Zuhlke, Liesl Joanna;
• Is Part Of: Lancet. Volume 390:Issue 10100(2017)
• Page Start: 1211
• Page End: 1259
• Publication Date: 2017-09-16
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(17)32154-2
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: Background: As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. Methods: We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings: Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8–75·9 million [7·2%, 6·0–8·3]), 45·1 million (29·0–62·8 million [5·6%, 4·0–7·2]), 36·3 million (25·3–50·9 million [4·5%, 3·8–5·3]), 34·7 million (23·0–49·6 million [4·3%, 3·5–5·2]), and 34·1 million (23·5–46·0 million [4·2%, 3·2–5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3–3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-communicable diseases has been growing rapidly across all SDI quintiles, partly because of population growth, but also the ageing of populations. The largest absolute increases in total numbers of YLDs globally were between the ages of 40 and 69 years. Age-standardised YLD rates for all conditions combined were 10·4% (95% UI 9·0–11·8) higher in women than in men. Iron-deficiency anaemia, migraine, Alzheimer's disease and other dementias, major depressive disorder, anxiety, and all musculoskeletal disorders apart from gout were the main conditions contributing to higher YLD rates in women. Men had higher age-standardised rates of substance use disorders, diabetes, cardiovascular diseases, cancers, and all injuries apart from sexual violence. Globally, we noted much less geographical variation in disability than has been documented for premature mortality. In 2016, there was a less than two times difference in age-standardised YLD rates for all causes between the location with the lowest rate (China, 9201 YLDs per 100 000, 95% UI 6862–11943) and highest rate (Yemen, 14 774 YLDs per 100 000, 11 018–19 228). Interpretation: The decrease in death rates since 1990 for most causes has not been matched by a similar decline in age-standardised YLD rates. For many large causes, YLD rates have either been stagnant or have increased for some causes, such as diabetes. As populations are ageing, and the prevalence of disabling disease generally increases steeply with age, health systems will face increasing demand for services that are generally costlier than the interventions that have led to declines in mortality in childhood or for the major causes of mortality in adults. Up-to-date information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response. Funding: Bill & Melinda Gates Foundation, and the National Institute on Aging and the National Institute of Mental Health of the National Institutes of Health.