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

Published Online: 07 June 2015
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
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
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.
The results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.

An Extract by G Mohan.