

@article {3111,
	title = {Disability-adjusted life years ({DALYs}) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the {Global} {Burden} of {Disease} {Study} 2010},
	journal = {Lancet (London, England)},
	volume = {380},
	number = {9859},
	year = {2012},
	month = {dec},
	pages = {2197{\textendash}2223},
	abstract = {BACKGROUND: Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time. METHODS: We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights. FINDINGS: Global DALYs remained stable from 1990 (2{\textperiodcentered}503 billion) to 2010 (2{\textperiodcentered}490 billion). Crude DALYs per 1000 decreased by 23\% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41\% of global DALYs in 1990 to 25\% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80\% of DALYs in sub-Saharan Africa. In 1990, 47\% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43\% from non-communicable diseases, and 10\% from injuries. By 2010, this had shifted to 35\%, 54\%, and 11\%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29\%), followed by lower respiratory infections (top rank in 1990; 44\% decline in DALYs), stroke (fifth in 1990; 19\% increase), diarrhoeal diseases (second in 1990; 51\% decrease), and HIV/AIDS (33rd in 1990; 351\% increase). Major depressive disorder increased from 15th to 11th rank (37\% increase) and road injury from 12th to 10th rank (34\% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. INTERPRETATION: Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results. FUNDING: Bill \& Melinda Gates Foundation.},
	keywords = {80 and over, Adolescent, Adult, Age Factors, Aged, Child, Female, Global Health, Health Status, Humans, Infant, Male, Middle Aged, Newborn, Preschool, prevalence, Quality-Adjusted Life Years, Sex Factors, Wounds and Injuries, Young Adult},
	issn = {1474-547X},
	doi = {10.1016/S0140-6736(12)61689-4},
	author = {Murray, Christopher J. L. and Vos, Theo and Lozano, Rafael and Naghavi, Mohsen and Flaxman, Abraham D. and Michaud, Catherine and Ezzati, Majid and Shibuya, Kenji and Salomon, Joshua A. and Abdalla, Safa and Aboyans, Victor and Abraham, Jerry and Ackerman, Ilana and Aggarwal, Rakesh and Ahn, Stephanie Y. and Ali, Mohammed K. and Alvarado, Miriam and Anderson, H. Ross and Anderson, Laurie M. and Andrews, Kathryn G. and Atkinson, Charles and Baddour, Larry M. and Bahalim, Adil N. and Barker-Collo, Suzanne and Barrero, Lope H. and Bartels, David H. and Bas{\'a}{\~n}ez, Mar{\'\i}a-Gloria and Baxter, Amanda and Bell, Michelle L. and Benjamin, Emelia J. and Bennett, Derrick and Bernab{\'e}, Eduardo and Bhalla, Kavi and Bhandari, Bishal and Bikbov, Boris and Bin Abdulhak, Aref and Birbeck, Gretchen and Black, James A. and Blencowe, Hannah and Blore, Jed D. and Blyth, Fiona and Bolliger, Ian and Bonaventure, Audrey and Boufous, Soufiane and Bourne, Rupert and Boussinesq, Michel and Braithwaite, Tasanee and Brayne, Carol and Bridgett, Lisa and Brooker, Simon and Brooks, Peter and Brugha, Traolach S. and Bryan-Hancock, Claire and Bucello, Chiara and Buchbinder, Rachelle and Buckle, Geoffrey and Budke, Christine M. and Burch, Michael and Burney, Peter and Burstein, Roy and Calabria, Bianca and Campbell, Benjamin and Canter, Charles E. and Carabin, H{\'e}l{\`e}ne and Carapetis, Jonathan and Carmona, Loreto and Cella, Claudia and Charlson, Fiona and Chen, Honglei and Cheng, Andrew Tai-Ann and Chou, David and Chugh, Sumeet S. and Coffeng, Luc E. and Colan, Steven D. and Colquhoun, Samantha and Colson, K. Ellicott and Condon, John and Connor, Myles D. and Cooper, Leslie T. and Corriere, Matthew and Cortinovis, Monica and de Vaccaro, Karen Courville and Couser, William and Cowie, Benjamin C. and Criqui, Michael H. and Cross, Marita and Dabhadkar, Kaustubh C. and Dahiya, Manu and Dahodwala, Nabila and Damsere-Derry, James and Danaei, Goodarz and Davis, Adrian and De Leo, Diego and Degenhardt, Louisa and Dellavalle, Robert and Delossantos, Allyne and Denenberg, Julie and Derrett, Sarah and Des Jarlais, Don C. and Dharmaratne, Samath D. and Dherani, Mukesh and Diaz-Torn{\'e}, Cesar and Dolk, Helen and Dorsey, E. Ray and Driscoll, Tim and Duber, Herbert and Ebel, Beth and Edmond, Karen and Elbaz, Alexis and Ali, Suad Eltahir and Erskine, Holly and Erwin, Patricia J. and Espindola, Patricia and Ewoigbokhan, Stalin E. and Farzadfar, Farshad and Feigin, Valery and Felson, David T. and Ferrari, Alize and Ferri, Cleusa P. and F{\`e}vre, Eric M. and Finucane, Mariel M. and Flaxman, Seth and Flood, Louise and Foreman, Kyle and Forouzanfar, Mohammad H. and Fowkes, Francis Gerry R. and Fransen, Marlene and Freeman, Michael K. and Gabbe, Belinda J. and Gabriel, Sherine E. and Gakidou, Emmanuela and Ganatra, Hammad A. and Garcia, Bianca and Gaspari, Flavio and Gillum, Richard F. and Gmel, Gerhard and Gonz{\'a}lez-Medina, Diego and Gosselin, Richard and Grainger, Rebecca and Grant, Bridget and Groeger, Justina and Guillemin, Francis and Gunnell, David and Gupta, Ramyani and Haagsma, Juanita and Hagan, Holly and Halasa, Yara A. and Hall, Wayne and Haring, Diana and Haro, Josep Maria and Harrison, James E. and Havmoeller, Rasmus and Hay, Roderick J. and Higashi, Hideki and Hill, Catherine and Hoen, Bruno and Hoffman, Howard and Hotez, Peter J. and Hoy, Damian and Huang, John J. and Ibeanusi, Sydney E. and Jacobsen, Kathryn H. and James, Spencer L. and Jarvis, Deborah and Jasrasaria, Rashmi and Jayaraman, Sudha and Johns, Nicole and Jonas, Jost B. and Karthikeyan, Ganesan and Kassebaum, Nicholas and Kawakami, Norito and Keren, Andre and Khoo, Jon-Paul and King, Charles H. and Knowlton, Lisa Marie and Kobusingye, Olive and Koranteng, Adofo and Krishnamurthi, Rita and Laden, Francine and Lalloo, Ratilal and Laslett, Laura L. and Lathlean, Tim and Leasher, Janet L. and Lee, Yong Yi and Leigh, James and Levinson, Daphna and Lim, Stephen S. and Limb, Elizabeth and Lin, John Kent and Lipnick, Michael and Lipshultz, Steven E. and Liu, Wei and Loane, Maria and Ohno, Summer Lockett and Lyons, Ronan and Mabweijano, Jacqueline and Macintyre, Michael F. and Malekzadeh, Reza and Mallinger, Leslie and Manivannan, Sivabalan and Marcenes, Wagner and March, Lyn and Margolis, David J. and Marks, Guy B. and Marks, Robin and Matsumori, Akira and Matzopoulos, Richard and Mayosi, Bongani M. and McAnulty, John H. and McDermott, Mary M. and McGill, Neil and McGrath, John and Medina-Mora, Maria Elena and Meltzer, Michele and Mensah, George A. and Merriman, Tony R. and Meyer, Ana-Claire and Miglioli, Valeria and Miller, Matthew and Miller, Ted R. and Mitchell, Philip B. and Mock, Charles and Mocumbi, Ana Olga and Moffitt, Terrie E. and Mokdad, Ali A. and Monasta, Lorenzo and Montico, Marcella and Moradi-Lakeh, Maziar and Moran, Andrew and Morawska, Lidia and Mori, Rintaro and Murdoch, Michele E. and Mwaniki, Michael K. and Naidoo, Kovin and Nair, M. Nathan and Naldi, Luigi and Narayan, K. M. Venkat and Nelson, Paul K. and Nelson, Robert G. and Nevitt, Michael C. and Newton, Charles R. and Nolte, Sandra and Norman, Paul and Norman, Rosana and O{\textquoteright}Donnell, Martin and O{\textquoteright}Hanlon, Simon and Olives, Casey and Omer, Saad B. and Ortblad, Katrina and Osborne, Richard and Ozgediz, Doruk and Page, Andrew and Pahari, Bishnu and Pandian, Jeyaraj Durai and Rivero, Andrea Panozo and Patten, Scott B. and Pearce, Neil and Padilla, Rogelio Perez and Perez-Ruiz, Fernando and Perico, Norberto and Pesudovs, Konrad and Phillips, David and Phillips, Michael R. and Pierce, Kelsey and Pion, S{\'e}bastien and Polanczyk, Guilherme V. and Polinder, Suzanne and Pope, C. Arden and Popova, Svetlana and Porrini, Esteban and Pourmalek, Farshad and Prince, Martin and Pullan, Rachel L. and Ramaiah, Kapa D. and Ranganathan, Dharani and Razavi, Homie and Regan, Mathilda and Rehm, J{\"u}rgen T. and Rein, David B. and Remuzzi, Guiseppe and Richardson, Kathryn and Rivara, Frederick P. and Roberts, Thomas and Robinson, Carolyn and De Le{\`o}n, Felipe Rodriguez and Ronfani, Luca and Room, Robin and Rosenfeld, Lisa C. and Rushton, Lesley and Sacco, Ralph L. and Saha, Sukanta and Sampson, Uchechukwu and Sanchez-Riera, Lidia and Sanman, Ella and Schwebel, David C. and Scott, James Graham and Segui-Gomez, Maria and Shahraz, Saeid and Shepard, Donald S. and Shin, Hwashin and Shivakoti, Rupak and Singh, David and Singh, Gitanjali M. and Singh, Jasvinder A. and Singleton, Jessica and Sleet, David A. and Sliwa, Karen and Smith, Emma and Smith, Jennifer L. and Stapelberg, Nicolas J. C. and Steer, Andrew and Steiner, Timothy and Stolk, Wilma A. and Stovner, Lars Jacob and Sudfeld, Christopher and Syed, Sana and Tamburlini, Giorgio and Tavakkoli, Mohammad and Taylor, Hugh R. and Taylor, Jennifer A. and Taylor, William J. and Thomas, Bernadette and Thomson, W. Murray and Thurston, George D. and Tleyjeh, Imad M. and Tonelli, Marcello and Towbin, Jeffrey A. and Truelsen, Thomas and Tsilimbaris, Miltiadis K. and Ubeda, Clotilde and Undurraga, Eduardo A. and van der Werf, Marieke J. and Van Os, Jim and Vavilala, Monica S. and Venketasubramanian, N. and Wang, Mengru and Wang, Wenzhi and Watt, Kerrianne and Weatherall, David J. and Weinstock, Martin A. and Weintraub, Robert and Weisskopf, Marc G. and Weissman, Myrna M. and White, Richard A. and Whiteford, Harvey and Wiebe, Natasha and Wiersma, Steven T. and Wilkinson, James D. and Williams, Hywel C. and Williams, Sean R. M. and Witt, Emma and Wolfe, Frederick and Woolf, Anthony D. and Wulf, Sarah and Yeh, Pon-Hsiu and Zaidi, Anita K. M. and Zheng, Zhi-Jie and Zonies, David and Lopez, Alan D. and Almazroa, Mohammad A. and Memish, Ziad A.}
}
