Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
Artikel i vetenskaplig tidskrift, 2018

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury.


Spencer L. James

University of Washington

Degu Abate

Haramaya University

Kalkidan Hassen Abate

Jimma Universitetet

Solomon M. Abay

Addis Ababa University

Cristiana Abbafati

Sapienza, Università di Roma

Nooshin Abbasi

Montreal Neuroimaging Center

Non-Communicable Diseases Research Center

Hedayat Abbastabar

Imam Khomeini International University

Foad Abd-Allah

Cairo University

Jemal Abdela

School of Pharmacy

Ahmed Abdelalim

Cairo University

Ibrahim Abdollahpour

Arak University of Medical Sciences

Multiple Sclerosis Research Center

Rizwan Suliankatchi Abdulkader

Manonmaniam Sundaranar University

Zegeye Abebe

Human Nutrition Department

Semaw F. Abera

Universität Hohenheim

School of Public Health

Olifan Zewdie Abil

University of Medical Sciences

Haftom Niguse Abraha

Clinical Pharmacy Unit

Laith J. Abu-Raddad

Weill Cornell Medicine-Qatar

Niveen M.E. Abu-Rmeileh

Birzeit University

Manfred Mario Kokou Accrombessi

Bénin Clinical Research Institute

Dilaram Acharya

Kathmandu University

Dongguk University

Pawan Acharya

Nepal Development Society

Ilana N. Ackerman

School of Public Health and Preventive Medicine

Abdu A Adamu

Cochrane South Africa

Oladimeji M. Adebayo

University College Hospital

Victor Adekanmbi

Cardiff University

Olatunji Adetokunboh

Cochrane South Africa

Mina G. Adib

Saint Mark Hospital

Jose C. Adsuar

Sport Science Department

Kossivi Agbelenko Afanvi

University of Lomé

Ministry of Health and Social Protection

Mohsen Afarideh

Tehran University of Medical Sciences

Ashkan Afshin

University of Washington

Gina Agarwal

McMaster University

Kareha M. Agesa

University of Washington

Rakesh Aggarwal

McMaster University

Sargis Aghasi Aghayan

Yerevan State University

Scientific Center of Zoology and Hydroecology

Sutapa Agrawal

Vital Strategies

Public Health Foundation of India

Alireza Ahmadi

Kermanshah University of Medical Sciences

Mehdi Ahmadi

Environmental Technologies Research Center

Hamid Ahmadieh

Shahid Beheshti University of Medical Sciences

Muktar Beshir Ahmed

Jimma Universitetet

Amani Nidhal Aichour

University Ferhat Abbas of Setif

Ibtihel Aichour

University Ferhat Abbas of Setif

Miloud Taki Eddine Aichour

High National School of Veterinary Medicine

Tomi F. Akinyemiju

University of Kentucky

Nadia Akseer

Hospital for Sick Children University of Toronto

Ziyad Al-Aly

Washington University in St. Louis

VA St Louis Health Care System

Ayman Al-Eyadhy

Pediatric Intensive Care Unit

Hesham M. Al-Mekhlafi

Sana'a University

Medical Research Center

Rajaa Al-Raddadi

King Abdulaziz University

Fares Alahdab

Mayo Clinic

Khurshid Alam

School of Population Health

Tahiya Alam

University of Washington

Alaa Alashi

Cleveland Clinic Foundation

Seyed Moayed Alavian

Baqiyatallah University of Medical Sciences

Kefyalew Addis Alene

Institute of Public Health

Research School of Population Health

Mehran Alijanzadeh

Qazvin University of Medical Sciences

Reza Alizadeh-Navaei

Gastrointestinal Cancer Research Center

Syed M. Aljunid

University of Kuwait

Universiti Kebangsaan Malaysia

Ala'A Alkerwi

Luxembourg Institute of Health

François Alla

Université de Bordeaux

Peter Allebeck


Mohamed M.L. Alouani

University Ferhat Abbas of Setif

Khalid Altirkawi

King Saud University

Nelson Alvis-Guzman

University of the Coast

Universidad de Cartagena

Azmeraw T. Amare

Bahar Dar University

Sansom Institute

Leopold N. Aminde

School of Public Health

Walid Ammar

Federal Ministry of Health

American University of Beirut

Yaw Ampem Amoako

Komfo Anokye Teaching Hospital

Nahla Anber

Mansoura Faculty of Medicine

Mansoura University

Catalina Liliana Andrei

Carol Davila University of Medicine and Pharmacy

Sofia Androudi

University of Thessaly

Megbaru Debalkie Animut

Arba Minch University

Mina Anjomshoa

Rafsanjan University of Medical Sciences

Mustafa Geleto Ansha

Debre Berhan University

Carl Abelardo T. Antonio

Department of Health Manila

Palwasha Anwari

Independent Consultant

Jalal Arabloo

Health Management and Economics Research Center

Antonio Arauz

Instituto Nacional de Neurología y Neurocirugía

Olatunde Aremu

Birmingham City University

Filippo Ariani


Bahram Armoon

Saveh University of Medical Sciences

Johan Ärnlöv

Högskolan i Dalarna

Amit Arora

Oral Health Services

Faculty of Medicine and Health Sciences

Al Artaman

University of Manitoba

Krishna Kumar Aryal

Abt Associates Nepal

Hamid Asayesh

School of Paramedical

Rana Jawad Asghar

South Asian Public Health Forum

Zerihun Ataro

Haramaya University

Sachin R. Atre

Dr. D. Y. Patil Medical College, Hospital & Research Centre

Centre for Clinical Global Health Education

Marcel Ausloos

University of Newcastle Business School

Leticia Avila-Burgos

Center for Health Systems Research

Euripide Frinel G. Arthur Avokpaho

Bénin Clinical Research Institute

Contrôle Des Maladies Infectieuses

Ashish Awasthi

Public Health Foundation of India

Indian Institute of Public Health

Beatriz Paulina Ayala Quintanilla

Judith Lumley Centre

National Institutes of Health, Bethesda

Rakesh Ayer

University of Tokyo

Peter S. Azzopardi

Burnet Institute

Australia Bahir Dar University

Arefeh Babazadeh

Center for Infectious Diseases Research

Hamid Badali

Mazandaran University of Medical Sciences

Alaa Badawi

Public Health Agency of Canada

Ayele Geleto Bali

School of Public Health

Mohsen Mazidi

Chalmers, Biologi och bioteknik, Livsmedelsvetenskap

The Lancet

0140-6736 (ISSN) 1474-547X (eISSN)

Vol. 392 10159 1789-1858



Miljömedicin och yrkesmedicin

Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi





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