Journal
LANCET
Volume 386, Issue 9995, Pages 743-800Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(15)60692-4
Keywords
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Categories
Funding
- Lundbeck and Auckland University of Technology University
- Bill AMP
- Melinda Gates Foundation
- Ministry of Health, Labour and Welfare of Japan
- Australian National health and Medical Research Council (NHMRC) [1041742]
- Japan Society of Clinical Pharmacology and Therapeutics
- National Heart Foundation, Australia
- Wellcome Trust [091758, 095066, 089963/Z/09/Z, 099876]
- Health Protection Scotland
- National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Evaluation of Interventions, and Sexual Health 24
- WHO
- University of Illinois, Lemann Institute for Brazilian Studies Faculty Research Grant
- NIHR Oxford BRC
- NIHR
- CIBERSAM
- Instituto de Salud Carlos III
- Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- Qatar National Research Fund [NPRP 04-924-3-251]
- joint US National Institutes of Health-National Science Foundation Ecology and Evolution of Infectious Disease program [R01 TW009237]
- UK Biotechnology and Biological Sciences Research Council (BBSRC) [BB/J010367/1]
- UK BBSRC Zoonoses in Emerging Livestock Systems awards [BB/L017679, BB/L018926, BB/L018845]
- Queensland Department of Health
- VIROPHARMA
- EISAI
- UCB-Pharma
- GlaxoSmithKline
- Italian Drug Agency
- Italian Ministry of Health
- Sanofi-Aventis
- American ALS Association
- Wellcome Trust
- NIHR Biomedical Research Centre at Guy's and St Thomas' National Health Service Foundation Trust and King's College London - NIHR
- Abbott
- ABMRF
- Astrazeneca
- Biocodex
- Eli-Lilly
- Jazz Pharmaceuticals
- Johnson Johnson
- Lundbeck
- National Responsible Gambling Foundation
- Novartis
- Orion
- Pfizer
- Pharmacia
- Roche
- Servier
- Solvay
- Sumitomo
- Sun
- Takeda
- Tikvah
- Wyeth
- Medical Research Council of South Africa
- Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health [5T32HD057822]
- Public Health Foundation of India
- consortium of UK universities
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)
- Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)
- Fundacao de Amparo a Pesquisa do Estado do Rio Grande do Sul (FAPERGS)
- Farr Institute at CIPHER
- Arthritis Research UK
- British Heart Foundation
- Cancer Research UK
- Economic and Social Research Council
- Engineering and Physical Sciences Research Council
- Medical Research Council
- National Institute of Health Research
- National Institute for Social Care and Health Research (Welsh Assembly Government)
- Chief Scientist Office (Scottish Government Health Directorates)
- MRC [MR/K006525/1]
- Savient
- Regeneron
- Allergan
- American College of Rheumatology's Guidelines Subcommittee of the Quality of Care Committee
- Veterans Affairs Rheumatology Field Advisory Committee
- National Health and Medical Research of Australia
- NIH, the National Institute of Environmental Health Sciences
- Brien Holden Vision Institute
- Victorian Articles 56 Government
- Korean Health Technology research and development project, Ministry of Health and Welfare, North Korea [HI13C0729]
- NIH
- Commonwealth Government of Australia
- Institute of Bone and Joint Research
- Crucell
- Merck
- Sanofi Pasteur
- NIH [R01 DA 003574]
- Oklahoma Center for the Advancement of Science and Technology
- NIHR Career Development Fellowship
- Wellcome Trust Training Fellowship [099876]
- South African Medical Research Council
- BBSRC [BB/J010367/1, BB/L018926/1, BB/L018845/1] Funding Source: UKRI
- MRC [MR/K006525/1, MR/L003120/1] Funding Source: UKRI
- Biotechnology and Biological Sciences Research Council [BB/L018926/1, BB/L018845/1, BB/J010367/1] Funding Source: researchfish
- British Heart Foundation [RG/08/014/24067] Funding Source: researchfish
- Medical Research Council [MR/K006525/1, G9817803B, MR/L003120/1] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10165, ACF-2011-13-012, CDF-2013-06-012, NF-SI-0510-10060, RP-PG-0407-10184] Funding Source: researchfish
- Grants-in-Aid for Scientific Research [25253051] Funding Source: KAKEN
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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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