Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data
Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data
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DOI：
10.1016/s0140-6736(06)68770-9
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发表时间：
2006-05-27
期刊：
影响因子：
168.9
通讯作者：
Murray, Christopher J. L.
中科院分区：
文献类型：
--
作者：
Lopez, Alan D.;Mathers, Colin D.;Murray, Christopher J. L.
背景我们的目标是计算2001年全球疾病负担和风险因素，检查1990年至2001年的区域趋势，并为疾病控制优先项目（DCPP）的分析提供起点。方法我们计算了136种疾病和伤害的死亡率、发病率、患病率和残疾调整生命年（DALYs），七个收入/地理国家组。为了评估趋势，我们用与2001年相同的方法重新估计了1990年的全因死亡率。我们估计死亡率和疾病负担归因于19个风险factors.Findings约56万人在2001年死亡。其中，1060万人是儿童，其中99%生活在中低收入国家。2001年半数以上的儿童死亡是由于急性呼吸道感染、麻疹、腹泻、疟疾和艾滋病毒/艾滋病。全球疾病负担的十大疾病是围产期疾病、下呼吸道感染、缺血性心脏病、脑血管疾病、艾滋病毒/艾滋病、糖尿病、单相严重抑郁症、疟疾、慢性阻塞性肺病和结核病。1990年至2001年期间，由于传染病、孕产妇、围产期和营养状况，全球人均疾病负担减少了20%。中低收入国家的疾病负担现在几乎有一半来自非传染性疾病（1990年至2001年期间，撒哈拉以南非洲以及欧洲和中亚中低收入国家的人均疾病负担有所增加）。营养不良仍然是健康损失的主要风险因素。据估计，45%的全球死亡率和36%的全球疾病负担可归因于所研究的19个风险因素的联合危险效应。全因死亡率估计的不确定性从高收入国家的1%左右到撒哈拉以南非洲的15-20%不等。不确定性较大的死亡率从特定的疾病，发病率和患病率的非致命性outcome.Interpretation尽管死亡率和疾病负担的估计不确定性，我们的研究结果表明，在健康方面取得了很大的进步，在大多数人群中，由艾滋病毒/艾滋病的流行在撒哈拉以南非洲和挫折在前苏联国家的成人死亡率。我们关于主要疾病、伤害和健康损失风险因素原因的结果，加上关于干预措施成本效益的信息，可以帮助加快改善健康的进展，减少穷国和富国之间长期存在的健康差距。
Background Our aim was to calculate the global burden of disease and risk factors for 2001, to examine regional trends from 1990 to 2001, and to provide a starting point for the analysis of the Disease Control Priorities Project (DCPP).Methods We calculated mortality, incidence, prevalence, and disability adjusted life years (DALYs) for 136 diseases and injuries, for seven income/geographic country groups. To assess trends, we re-estimated all-cause mortality for 1990 with the same methods as for 2001. We estimated mortality and disease burden attributable to 19 risk factors.Findings About 56 million people died in 2001. Of these, 10.6 million were children, 99% of whom lived in low-and-middle-income countries. More than half of child deaths in 2001 were attributable to acute respiratory infections, measles, diarrhoea, malaria, and HIV/AIDS. The ten leading diseases for global disease burden were perinatal conditions, lower respiratory infections, ischaemic heart disease, cerebrovascular disease, HIV/AIDS, diarrhoeal diseases, unipolar major depression, malaria, chronic obstructive pulmonary disease, and tuberculosis. There was a 20% reduction in global disease burden per head due to communicable, maternal, perinatal, and nutritional conditions between 1990 and 2001. Almost half the disease burden in low-and-middle-income countries is now from non-communicable diseases (disease burden per head in Sub-Saharan Africa and the low-and-middle-income countries of Europe and Central Asia increased between 1990 and 2001). Undernutrition remains the leading risk factor for health loss. An estimated 45% of global mortality and 36% of global disease burden are attributable to the joint hazardous effects of the 19 risk factors studied. Uncertainty in all-cause mortality estimates ranged from around 1% in high-income countries to 15-20% in Sub-Saharan Africa. Uncertainty was larger for mortality from specific diseases, and for incidence and prevalence of non-fatal outcomes.Interpretation Despite uncertainties about mortality and burden of disease estimates, our findings suggest that substantial gains in health have been achieved in most populations, countered by the HIV/AIDS epidemic in Sub-Saharan Africa and setbacks in adult mortality in countries of the former Soviet Union. our results on major disease, injury, and risk factor causes of loss of health, together with information on the cost-effectiveness of interventions, can assist in accelerating progress towards better health and reducing the persistent differentials in health between poor and rich countries.