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

Spencer L. James, Degu Abate, Kalkidan Hassen Abate, Solomon M. Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Zegeye Abebe, Semaw F. Abera, Olifan Zewdie Abil, Haftom Niguse Abraha, Laith Jamal Abu-Raddad, Niveen M.E. Abu-Rmeileh, Manfred Mario Kokou Accrombessi, Dilaram AcharyaPawan Acharya, Ilana N. Ackerman, Abdu A. Adamu, Oladimeji M. Adebayo, Victor Adekanmbi, Olatunji O. Adetokunboh, Mina G. Adib, Jose C. Adsuar, Kossivi Agbelenko Afanvi, Mohsen Afarideh, Ashkan Afshin, Gina Agarwal, Kareha M. Agesa, Rakesh Aggarwal, Sargis Aghasi Aghayan, Sutapa Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Hamid Ahmadieh, Muktar Beshir Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Tomi Akinyemiju, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Hesham M. Al-Mekhlafi, Rajaa M. Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Alaa Alashi, Seyed Moayed Alavian, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Mohamed M.L. Alouani, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T. Amare, Leopold N. Aminde, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Mustafa Geleto Ansha, Carl Abelardo T. Antonio, Palwasha Anwari, Jalal Arabloo, Antonio Arauz, Olatunde Aremu, Filippo Ariani, Bahram Armoon, Johan Ärnlöv, Amit Arora, Al Artaman, Krishna K. Aryal, Hamid Asayesh, Rana Jawad Asghar, Zerihun Ataro, Sachin R. Atre, Marcel Ausloos, Leticia Avila-Burgos, Euripide F.G.A. Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Rakesh Ayer, Peter S. Azzopardi, Arefeh Babazadeh, Hamid Badali, Alaa Badawi, Ayele Geleto Bali, Katherine E. Ballesteros, Shoshana H. Ballew, Maciej Banach, Joseph Adel Mattar Banoub, Amrit Banstola, Aleksandra Barac, Miguel A. Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Lope H. Barrero, Bernhard T. Baune, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Béjot, Abate Bekele Belachew, Yihalem Abebe Belay, Michelle L. Bell, Aminu K. Bello, Isabela M. Bensenor, Eduardo Bernabe, Robert S. Bernstein, Mircea Beuran, Tina Beyranvand, Neeraj Bhala, Suraj Bhattarai, Soumyadeep Bhaumik, Zulfiqar A. Bhutta, Belete Biadgo, Ali Bijani, Boris Bikbov, Ver Bilano, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Donal Bisanzio, Brigette F. Blacker, Fiona M. Blyth, Ibrahim R. Bou-Orm, Soufiane Boufous, Rupert Bourne, Oliver J. Brady, Michael Brainin, Luisa C. Brant, Alexandra Brazinova, Nicholas J.K. Breitborde, Hermann Brenner, Paul Svitil Briant, Andrew M. Briggs, Andrey Nikolaevich Briko, Gabrielle Britton, Traolach Brugha, Rachelle Buchbinder, Reinhard Busse, Zahid A. Butt, Lucero Cahuana-Hurtado, Jorge Cano, Rosario Cárdenas, Juan J. Carrero, Austin Carter, Félix Carvalho, Carlos A. Castañeda-Orjuela, Jacqueline Castillo Rivas, Franz Castro, Ferrán Catalá-López, Kelly M. Cercy, Ester Cerin, Yazan Chaiah, Alex R. Chang, Hsing Yi Chang, Jung Chen Chang, Fiona J. Charlson, Aparajita Chattopadhyay, Vijay Kumar Chattu, Pankaj Chaturvedi, Peggy Pei Chia Chiang, Ken Lee Chin, Abdulaal Chitheer, Jee Young J. Choi, Rajiv Chowdhury, Hanne Christensen, Devasahayam J. Christopher, Flavia M. Cicuttini, Liliana G. Ciobanu, Massimo Cirillo, Rafael M. Claro, Daniel Collado-Mateo, Cyrus Cooper, Josef Coresh, Paolo Angelo Cortesi, Monica Cortinovis, Megan Costa, Ewerton Cousin, Michael H. Criqui, Elizabeth A. Cromwell, Marita Cross, John A. Crump, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Paul I. Dargan, Ahmad Daryani, Rajat Das Gupta, José Das Neves, Tamirat Tesfaye Dasa, Gail Davey, Adrian C. Davis, Dragos Virgil Davitoiu, Barbora De Courten, Fernando Pio De La Hoz, Diego De Leo, Jan Walter De Neve, Meaza Girma Degefa, Louisa Degenhardt, Selina Deiparine, Robert P. Dellavalle, Gebre Teklemariam Demoz, Kebede Deribe, Nikolaos Dervenis, Don C. Des Jarlais, Getenet Ayalew Dessie, Subhojit Dey, Samath Dhamminda Dharmaratne, Mesfin Tadese Dinberu, M. Ashworth Dirac, Shirin Djalalinia, Linh Doan, Klara Dokova, David Teye Doku, E. Ray Dorsey, Kerrie E. Doyle, Tim Robert Driscoll, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B. Duncan, Andre R. Duraes, Hedyeh Ebrahimi, Soheil Ebrahimpour, Michelle Marie Echko, David Edvardsson, Andem Effiong, Joshua R. Ehrlich, Charbel El Bcheraoui, Maysaa El Sayed Zaki, Ziad El-Khatib, Hajer Elkout, Iqbal R.F. Elyazar, Ahmadali Enayati, Aman Yesuf Endries, Benjamin Er, Holly E. Erskine, Babak Eshrati, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Hamed Fakhim, Vahid Fallah Omrani, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Talha A. Farid, Carla Sofia Esá Farinha, Andrea Farioli, Andre Faro, Maryam S. Farvid, Farshad Farzadfar, Valery L. Feigin, Netsanet Fentahun, Seyed Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C. Fernandes, Alize J. Ferrari, Garumma Tolu Feyissa, Irina Filip, Florian Fischer, Christina Fitzmaurice, Nataliya A. Foigt, Kyle J. Foreman, Jack Fox, Tahvi D. Frank, Takeshi Fukumoto, Nancy Fullman, Thomas Fürst, João M. Furtado, Neal D. Futran, Seana Gall, Morsaleh Ganji, Fortune Gbetoho Gankpe, Alberto L. Garcia-Basteiro, William M. Gardner, Abadi Kahsu Gebre, Amanuel Tesfay Gebremedhin, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M. Geleijnse, Ricard Genova-Maleras, Yilma Chisha Dea Geramo, Peter W. Gething, Kebede Embaye Gezae, Keyghobad Ghadiri, Khalil Ghasemi Falavarjani, Maryam Ghasemi-Kasman, Mamata Ghimire, Rakesh Ghosh, Aloke Gopal Ghoshal, Simona Giampaoli, Paramjit Singh Gill, Tiffany K. Gill, Ibrahim Abdelmageed Ginawi, Giorgia Giussani, Elena V. Gnedovskaya, Ellen M. Goldberg, Srinivas Goli, Hector Gómez-Dantés, Philimon N. Gona, Sameer Vali Gopalani, Taren M. Gorman, Alessandra C. Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Morgan E. Grams, Giuseppe Grosso, Harish Chander Gugnani, Yuming Guo, Prakash C. Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Bishal Gyawali, Juanita A. Haagsma, Vladimir Hachinski, Nima Hafezi-Nejad, Hassan Haghparast Bidgoli, Tekleberhan B. Hagos, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R. Hamadeh, Samer Hamidi, Alexis J. Handal, Graeme J. Hankey, Yuantao Hao, Hilda L. Harb, Sivadasanpillai Harikrishnan, Josep Maria Haro, Mehedi Hasan, Hadi Hassankhani, Hamid Yimam Hassen, Rasmus Havmoeller, Caitlin N. Hawley, Roderick J. Hay, Simon I. Hay, Akbar Hedayatizadeh-Omran, Behzad Heibati, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Sousan Heydarpour, Desalegn Tsegaw Hibstu, Huong Thanh Hoang, Hans W. Hoek, Howard J. Hoffman, Michael K. Hole, Enayatollah Homaie Rad, Praveen Hoogar, H. Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Peter J. Hotez, Damian G. Hoy, Mohamed Hsairi, Aung Soe Htet, Guoqing Hu, John J. Huang, Chantal K. Huynh, Kim Moesgaard Iburg, Chad Thomas Ikeda, Bogdan Ileanu, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Sheikh Mohammed, Shariful Islam, Farhad Islami, Kathryn H. Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Ravi Prakash Jha, Vivekanand Jha, John S. Ji, Catherine O. Johnson, Jost B. Jonas, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Tanuj Kanchan, Manoochehr Karami, Behzad Karami Matin, André Karch, Corine Karema, Narges Karimi, Seyed M. Karimi, Amir Kasaeian, Dessalegn H. Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J. Kassebaum, Srinivasa Vittal Katikireddi, Norito Kawakami, Ali Kazemi Karyani, Masoud Masoud Keighobadi, Peter Njenga Keiyoro, Laura Kemmer, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Ibrahim A. Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young Ho Khang, Mohammad Khazaei, Abdullah T. Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Aliasghar A. Kiadaliri, Daniel N. Kiirithio, Cho Il Kim, Daniel Kim, Pauline Kim, Young Eun Kim, Yun Jin Kim, Ruth W. Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimäki, Ann Kristin Skrindo Knudsen, Jonathan M. Kocarnik, Sonali Kochhar, Yoshihiro Kokubo, Tufa Kolola, Jacek A. Kopec, Soewarta Kosen, Georgios A. Kotsakis, Parvaiz A. Koul, Ai Koyanagi, Michael A. Kravchenko, Kewal Krishan, Kristopher J. Krohn, Barthelemy Kuate Defo, Burcu Kucuk Bicer, G. Anil Kumar, Manasi Kumar, Hmwe Hmwe Kyu, Deepesh P. Lad, Sheetal D. Lad, Alessandra Lafranconi, Ratilal Lalloo, Tea Lallukka, Faris Hasan Lami, Van C. Lansingh, Arman Latifi, Kathryn Mei Ming Lau, Jeffrey V. Lazarus, Janet L. Leasher, Jorge R. Ledesma, Paul H. Lee, James Leigh, Janni Leung, Miriam Levi, Sonia Lewycka, Shanshan Li, Yichong Li, Yu Liao, Misgan Legesse Liben, Lee Ling Lim, Stephen S. Lim, Shiwei Liu, Rakesh Lodha, Katharine J. Looker, Alan D. Lopez, Stefan Lorkowski, Paulo A. Lotufo, Nicola Low, Rafael Lozano, Tim C.D. Lucas, Lydia R. Lucchesi, Raimundas Lunevicius, Ronan A. Lyons, Stefan Ma, Erlyn Rachelle King Macarayan, Mark T. Mackay, Fabiana Madotto, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Dhaval P. Maghavani, Narayan Bahadur Mahotra, Hue Thi Mai, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A. Mamun, Ana Laura Manda, Helena Manguerra, Treh Manhertz, Mohammad Ali Mansournia, Lorenzo Giovanni Mantovani, Chabila Christopher Mapoma, Joemer C. Maravilla, Wagner Marcenes, Ashley Marks, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Winfried März, Melvin B. Marzan, Tivani Phosa Mashamba-Thompson, Benjamin Ballard Massenburg, Manu Raj Mathur, Kunihiro Matsushita, Pallab K. Maulik, Mohsen Mazidi, Colm McAlinden, John J. McGrath, Martin McKee, Man Mohan Mehndiratta, Ravi Mehrotra, Kala M. Mehta, Varshil Mehta, Fabiola Mejia-Rodriguez, Tesfa Mekonen, Addisu Melese, Mulugeta Melku, Michele Meltzer, Peter T.N. Memiah, Ziad A. Memish, Walter Mendoza, Desalegn Tadese Mengistu, Getnet Mengistu, George A. Mensah, Seid Tiku Mereta, Atte Meretoja, Tuomo J. Meretoja, Tomislav Mestrovic, Naser Mohammad Gholi Mezerji, Bartosz Miazgowski, Tomasz Miazgowski, Anoushka I. Millear, Ted R. Miller, Benjamin Miltz, G. K. Mini, Mojde Mirarefin, Erkin M. Mirrakhimov, Awoke Temesgen Misganaw, Philip B. Mitchell, Habtamu Mitiku, Babak Moazen, Bahram Mohajer, Karzan Abdulmuhsin Mohammad, Noushin Mohammadifard, Mousa Mohammadnia-Afrouzi, Mohammed A. Mohammed, Shafiu Mohammed, Farnam Mohebi, Modhurima Moitra, Ali H. Mokdad, Mariam Molokhia, Lorenzo Monasta, Yoshan Moodley, Mahmood Moosazadeh, Ghobad Moradi, Maziar Moradi-Lakeh, Mehdi Moradinazar, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Joana Morgado-Da-Costa, Shane Douglas Morrison, Marilita M. Moschos, Seyyed Meysam Mousavi, Kalayu Brhane Mruts, Achenef Asmamaw Muche, Kindie Fentahun Muchie, Ulrich Otto Mueller, Oumer Sada Muhammed, Satinath Mukhopadhyay, Kate Muller, John Everett Mumford, Manoj Murhekar, Jonah Musa, Kamarul Imran Musa, Ghulam Mustafa, Ashraf F. Nabhan, Chie Nagata, Mohsen Naghavi, Aliya Naheed, Azin Nahvijou, Gurudatta Naik, Nitish Naik, Farid Najafi, Luigi Naldi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Bruno Ramos Nascimento, Gopalakrishnan Natarajan, Nahid Neamati, Ionut Negoi, Ruxandra Irina Negoi, Subas Neupane, Charles Richard James Newton, Josephine W. Ngunjiri, Anh Quynh Nguyen, Ha Thu Nguyen, Huong Lan Thi Nguyen, Huong Thanh Nguyen, Long Hoang Nguyen, Minh Nguyen, Nam Ba Nguyen, Son Hoang Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Molly R. Nixon, Nomonde Nolutshungu, Shuhei Nomura, Ole F. Norheim, Mehdi Noroozi, Bo Norrving, Jean Jacques Noubiap, Hamid Reza Nouri, Malihe Nourollahpour Shiadeh, Mohammad Reza Nowroozi, Elaine O. Nsoesie, Peter S. Nyasulu, Christopher M. Odell, Richard Ofori-Asenso, Felix Akpojene Ogbo, In Hwan Oh, Olanrewaju Oladimeji, Andrew T. Olagunju, Tinuke O. Olagunju, Pedro R. Olivares, Helen Elizabeth Olsen, Bolajoko Olubukunola Olusanya, Kanyin L. Ong, Sok King Ong, Eyal Oren, Alberto Ortiz, Erika Ota, Stanislav S. Otstavnov, Simon øverland, Mayowa Ojo Owolabi, P. A. Mahesh, Rosana Pacella, Amir H. Pakpour, Adrian Pana, Songhomitra Panda-Jonas, Andrea Parisi, Eun Kee Park, Charles D.H. Parry, Shanti Patel, Sanghamitra Pati, Snehal T. Patil, Ajay Patle, George C. Patton, Vishnupriya Rao Paturi, Katherine R. Paulson, Neil Pearce, David M. Pereira, Norberto Perico, Konrad Pesudovs, Hai Quang Pham, Michael R. Phillips, David M. Pigott, Julian David Pillay, Michael A. Piradov, Meghdad Pirsaheb, Farhad Pishgar, Oleguer Plana-Ripoll, Dietrich Plass, Suzanne Polinder, Svetlana Popova, Maarten J. Postma, Akram Pourshams, Hossein Poustchi, Dorairaj Prabhakaran, Swayam Prakash, V. Prakash, Caroline A. Purcell, Manorama B. Purwar, Mostafa Qorbani, D. Alex Quistberg, Amir Radfar, Anwar Rafay, Alireza Rafiei, Fakher Rahim, Kazem Rahimi, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Sajjad Ur Rahman, Rajesh Kumar Rai, Fatemeh Rajati, Usha Ram, Prabhat Ranjan, Anna Ranta, Puja C. Rao, David Laith Rawaf, Salman Rawaf, K. Srinath Reddy, Robert C. Reiner, Nickolas Reinig, Marissa Bettay Reitsma, Giuseppe Remuzzi, Andre M.N. Renzaho, Serge Resnikoff, Satar Rezaei, Mohammad Sadegh Rezai, Antonio Luiz P. Ribeiro, Stephen R. Robinson, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Gregory A. Roth, Ambuj Roy, Enrico Rubagotti, Perminder S. Sachdev, Nafis Sadat, Basema Saddik, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Hosein Safari, Yahya Safari, Roya Safari-Faramani, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Haniye Sadat Sajadi, Nasir Salam, Joseph S. Salama, Payman Salamati, Komal Saleem, Zikria Saleem, Yahya Salimi, Joshua A. Salomon, Sundeep Santosh Salvi, Inbal Salz, Abdallah M. Samy, Juan Sanabria, Yingying Sang, Damian Francesco Santomauro, Itamar S. Santos, João Vasco Santos, Milena M. Santric Milicevic, Bruno Piassi Sao Jose, Mayank Sardana, Abdur Razzaque Sarker, Nizal Sarrafzadegan, Benn Sartorius, Shahabeddin Sarvi, Brijesh Sathian, Maheswar Satpathy, Arundhati R. Sawant, Monika Sawhney, Sonia Saxena, Mete Saylan, Elke Schaeffner, Maria Inês Schmidt, Ione J.C. Schneider, Ben Schöttker, David C. Schwebel, Falk Schwendicke, James G. Scott, Mario Sekerija, Sadaf G. Sepanlou, Edson Serván-Mori, Seyedmojtaba Seyedmousavi, Hosein Shabaninejad, Azadeh Shafieesabet, Mehdi Shahbazi, Amira A. Shaheen, Masood Ali Shaikh, Mehran Shams-Beyranvand, Mohammadbagher Shamsi, Morteza Shamsizadeh, Heidar Sharafi, Kiomars Sharafi, Mehdi Sharif, Mahdi Sharif-Alhoseini, Meenakshi Sharma, Rajesh Sharma, Jun She, Aziz Sheikh, Peilin Shi, Kenji Shibuya, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, Kawkab Shishani, Ivy Shiue, Farhad Shokraneh, Haitham Shoman, Mark G. Shrime, Si Si, Soraya Siabani, Tariq J. Siddiqi, Inga Dora Sigfusdottir, Rannveig Sigurvinsdottir, João Pedro Silva, Dayane Gabriele Alves Silveira, Narayana Sarma Venkata Singam, Jasvinder A. Singh, Narinder Pal Singh, Virendra Singh, Dhirendra Narain Sinha, Eirini Skiadaresi, Erica Leigh N. Slepak, Karen Sliwa, David L. Smith, Mari Smith, Adauto Martins Soares Filho, Badr Hasan Sobaih, Soheila Sobhani, Eugène Sobngwi, Samir S. Soneji, Moslem Soofi, Masoud Soosaraei, Reed J.D. Sorensen, Joan B. Soriano, Ireneous N. Soyiri, Luciano A. Sposato, Chandrashekhar T. Sreeramareddy, Vinay Srinivasan, Jeffrey D. Stanaway, Dan J. Stein, Caitlyn Steiner, Timothy J. Steiner, Mark A. Stokes, Lars Jacob Stovner, Michelle L. Subart, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Bruno F. Sunguya, Patrick John Sur, Ipsita Sutradhar, Bryan L. Sykes, Dillon O. Sylte, Rafael Tabarés-Seisdedos, Santosh Kumar Tadakamadla, Birkneh Tilahun Tadesse, Nikhil Tandon, Segen Gebremeskel Tassew, Mohammad Tavakkoli, Nuno Taveira, Hugh R. Taylor, Arash Tehrani-Banihashemi, Tigist Gashaw Tekalign, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Habtamu Temesgen, Mohamad Hani Temsah, Omar Temsah, Abdullah Sulieman Terkawi, Mebrahtu Teweldemedhin, Kavumpurathu Raman Thankappan, Nihal Thomas, Binyam Tilahun, Quyen G. To, Marcello Tonelli, Roman Topor-Madry, Fotis Topouzis, Anna E. Torre, Miguel Tortajada-Girbés, Mathilde Touvier, Marcos Roberto Tovani-Palone, Jeffrey A. Towbin, Bach Xuan Tran, Khanh Bao Tran, Christopher E. Troeger, Thomas Clement Truelsen, Miltiadis K. Tsilimbaris, Derrick Tsoi, Lorainne Tudor Car, E. Murat Tuzcu, Kingsley N. Ukwaja, Irfan Ullah, Eduardo A. Undurraga, Jurgen Unutzer, Rachel L. Updike, Muhammad Shariq Usman, Olalekan A. Uthman, Muthiah Vaduganathan, Afsane Vaezi, Pascual R. Valdez, Santosh Varughese, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Santos Villafaina, Francesco S. Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Stein Emil Vollset, Kia Vosoughi, Isidora S. Vujcic, Fasil Shiferaw Wagnew, Yasir Waheed, Stephen G. Waller, Yafeng Wang, Yuan Pang Wang, Elisabete Weiderpass, Robert G. Weintraub, Daniel J. Weiss, Fitsum Weldegebreal, Kidu Gidey Weldegwergs, Andrea Werdecker, T. Eoin West, Harvey A. Whiteford, Justyna Widecka, Tissa Wijeratne, Lauren B. Wilner, Shadrach Wilson, Andrea Sylvia Winkler, Alison B. Wiyeh, Charles Shey Wiysonge, Charles D.A. Wolfe, Anthony D. Woolf, Shouling Wu, Yun Chun Wu, Grant M.A. Wyper, Denis Xavier, Gelin Xu, Simon Yadgir, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Lijing L. Yan, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Alex Yeshaneh, Ebrahim M. Yimer, Paul Yip, Engida Yisma, Naohiro Yonemoto, Seok Jun Yoon, Marcel Yotebieng, Mustafa Z. Younis, Mahmoud Yousefifard, Chuanhua Yu, Vesna Zadnik, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Zohreh Zare, Ayalew Jejaw Zeleke, Zerihun Menlkalew Zenebe, Kai Zhang, Zheng Zhao, Maigeng Zhou, Sanjay Zodpey, Inbar Zucker, Theo Vos, Christopher J.L. Murray

Research output: Contribution to journalArticlepeer-review

2557 Scopus citations

Abstract

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.
Original languageEnglish (US)
Pages (from-to)1789-1858
Number of pages70
JournalThe Lancet
Volume392
Issue number10159
DOIs
StatePublished - Nov 10 2018
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint

Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this