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Global, Regional, and National Incidence, Prevalence, and Years Lived With Disability for 328 Diseases and Injuries for 195 Countries, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016 Publisher Pubmed



Vos T1 ; Abajobir AA4 ; Abbafati C8 ; Abbas KM9 ; Abdallah F10 ; Abdulle AM11 ; Abebo TA12 ; Abera SF13, 18 ; Aboyans V19 ; Aburaddad LJ20 ; Ackerman IN21 ; Adamu AA24 ; Adetokunboh O26 ; Afarideh M90 Show All Authors
Authors
  1. Vos T1
  2. Abajobir AA4
  3. Abbafati C8
  4. Abbas KM9
  5. Abdallah F10
  6. Abdulle AM11
  7. Abebo TA12
  8. Abera SF13, 18
  9. Aboyans V19
  10. Aburaddad LJ20
  11. Ackerman IN21
  12. Adamu AA24
  13. Adetokunboh O26
  14. Afarideh M90
  15. Afshin A1
  16. Agarwal SK27
  17. Aggarwal R28
  18. Agrawal A29, 30
  19. Agrawal S33
  20. Ahmad Kiadaliri A34
  21. Ahmadieh H36, 39
  22. Ahmed MB40
  23. Aichour AN42
  24. Aichour I43
  25. Aichour MTE44
  26. Aiyar S1
  27. Akinyemi RO45, 46
  28. Akseer N47, 48
  29. Al Lami FH51
  30. Alahdab F52, 53
  31. Alaly Z54
  32. Alam K55, 59, 61
  33. Alam N62
  34. Alam T1
  35. Alasfoor D63
  36. Alene KA64, 67
  37. Ali R75
  38. Alizadehnavaei R76
  39. Alkerwi A77
  40. Alla F78
  41. Allebeck P112
  42. Allen C1
  43. Almaskari F79
  44. Alraddadi R80
  45. Alsharif U82
  46. Alsowaidi S79
  47. Altirkawi KA83
  48. Amare AT84, 86
  49. Amini E88, 89
  50. Ammar W104
  51. Amoako YA105
  52. Andersen HH106
  53. Antonio CAT108
  54. Anwari P109
  55. Arnlov J110, 114
  56. Artaman A115
  57. Aryal KK116, 117
  58. Asayesh H118
  59. Asgedom SW17
  60. Assadi R119
  61. Atey TM17
  62. Atnafu NT120
  63. Atre SR121, 123
  64. Avilaburgos L124
  65. Avokpaho EFGA125, 126
  66. Awasthi A127
  67. Ayala Quintanilla BP128, 129
  68. Ba Saleem HO130
  69. Bacha U131
  70. Badawi A49, 132
  71. Balakrishnan K133
  72. Banerjee A134
  73. Bannick MS1
  74. Barac A137
  75. Barber RM1
  76. Barkercollo SL139
  77. Barnighausen T140, 142, 143
  78. Barquera S124
  79. Barregard L144
  80. Barrero LH145
  81. Basu S146
  82. Battista B147
  83. Battle KE69
  84. Baune BT84
  85. Bazarganhejazi S148, 149
  86. Beardsley J150
  87. Bedi N151
  88. Beghi E152
  89. Bejot Y153
  90. Bekele BB65, 154
  91. Bell ML155
  92. Bennett DA71
  93. Bensenor IM158
  94. Benson J1
  95. Berhane A159
  96. Berhe DF14, 161
  97. Bernabe E165
  98. Betsu BD17
  99. Beuran M166, 167
  100. Beyene AS168
  101. Bhala N170, 171
  102. Bhansali A172
  103. Bhatt S173
  104. Bhutta ZA47, 177
  105. Biadgilign S178
  106. Bienhoff K1
  107. Bikbov B179
  108. Birungi C136
  109. Biryukov S1
  110. Bisanzio D72
  111. Bizuayehu HM181
  112. Boneya DJ180
  113. Boufous S182
  114. Bourne RRA186
  115. Brazinova A187
  116. Brugha TS188
  117. Buchbinder R21, 189
  118. Bulto LNB169
  119. Bumgarner BR1
  120. Butt ZA190
  121. Cahuanahurtado L124
  122. Cameron E70
  123. Car M176, 191
  124. Carabin H192
  125. Carapetis JR193
  126. Cardenas R194
  127. Carpenter DO195
  128. Carrero JJ111
  129. Carter A1
  130. Carvalho F196
  131. Casey DC1
  132. Caso V200
  133. Castanedaorjuela CA201, 202
  134. Castle CD1
  135. Catalalopez F203, 204
  136. Chang HY205, 206
  137. Chang JC207
  138. Charlson FJ1, 4, 208
  139. Chen H209
  140. Chibalabala M210
  141. Chibueze CE211
  142. Chisumpa VH212, 213
  143. Chitheer AA214
  144. Christopher DJ215
  145. Ciobanu LG84
  146. Cirillo M216
  147. Colombara D1
  148. Cooper C73, 217, 218
  149. Cortesi PA219
  150. Criqui MH221
  151. Crump JA222
  152. Dadi AF66, 224
  153. Dalal K225
  154. Dandona L1, 33
  155. Dandona R1, 33
  156. Das Neves J197
  157. Davitoiu DV166
  158. De Courten B23
  159. De Leo D226
  160. Degenhardt L1, 183
  161. Deiparine S1
  162. Dellavalle RP227
  163. Deribe K228, 229
  164. Des Jarlais DC231, 232
  165. Dey S31
  166. Dharmaratne SD233
  167. Dhillon PK33
  168. Dicker D1
  169. Ding EL140
  170. Djalalinia S234
  171. Do HP235
  172. Dorsey ER236
  173. Dos Santos KPB237
  174. Douwesschultz D1
  175. Doyle KE68, 238
  176. Driscoll TR60
  177. Dubey M239
  178. Duncan BB240, 241
  179. Elkhatib ZZ112, 242
  180. Ellerstrand J4
  181. Enayati A243
  182. Endries AY244
  183. Ermakov SP245, 246
  184. Erskine HE1, 4, 208
  185. Eshrati B247, 248
  186. Eskandarieh S249
  187. Esteghamati A90
  188. Estep K1
  189. Fanuel FBB250, 251
  190. Farinha CSES252, 253
  191. Faro A254
  192. Farzadfar F89
  193. Fazeli MS147
  194. Feigin VL255
  195. Fereshtehnejad SM110
  196. Fernandes JC256
  197. Ferrari AJ1, 4, 208
  198. Feyissa TR257
  199. Filip I258
  200. Fischer F259
  201. Fitzmaurice C1, 2, 260
  202. Flaxman AD1
  203. Flor LS261, 262
  204. Foigt N263
  205. Foreman KJ1
  206. Franklin RC264
  207. Fullman N1
  208. Furst T173, 265, 267
  209. Furtado JM268
  210. Futran ND3
  211. Gakidou E1
  212. Ganji M103
  213. Garciabasteiro AL269, 270
  214. Gebre T271
  215. Gebrehiwot TT41
  216. Geleto A169, 272
  217. Gemechu BL273
  218. Gesesew HA41, 224
  219. Gething PW74
  220. Ghajar A91
  221. Gibney KB274
  222. Gill PS275
  223. Gillum RF276
  224. Ginawi IAM277
  225. Giref AZ230
  226. Gishu MD169, 278
  227. Giussani G152
  228. Godwin WW1
  229. Gold AL1
  230. Goldberg EM1
  231. Gona PN279
  232. Goodridge A280
  233. Gopalani SV281
  234. Goto A282
  235. Goulart AC156, 283
  236. Griswold M1
  237. Gugnani HC284
  238. Gupta R285
  239. Gupta R285
  240. Gupta T287, 288
  241. Gupta V289
  242. Hafezinejad N90
  243. Hailu AD229, 292
  244. Hailu GB17, 293
  245. Hamadeh RR294
  246. Hamidi S295
  247. Handal AJ296
  248. Hankey GJ297, 298, 299
  249. Hao Y300
  250. Harb HL104
  251. Hareri HA230
  252. Haro JM301
  253. Harvey J1
  254. Hassanvand MS92
  255. Havmoeller R113
  256. Hawley C1
  257. Hay RJ70, 165, 302
  258. Hay SI1
  259. Henry NJ1
  260. Herediapi IB124
  261. Heydarpour P93
  262. Hoek HW162, 303
  263. Hoffman HJ305
  264. Horita N307
  265. Hosgood HD288
  266. Hostiuc S166
  267. Hotez PJ308
  268. Hoy DG309
  269. Htet AS117, 310
  270. Hu G311
  271. Huang H312
  272. Huynh C1
  273. Iburg KM314
  274. Igumbor EU315, 316
  275. Ikeda C1
  276. Irvine CMS1
  277. Jacobsen KH317
  278. Jahanmehr N37
  279. Jakovljevic MB1, 318
  280. Jassal SK220
  281. Javanbakht M319
  282. Jayaraman SP320
  283. Jeemon P32, 321
  284. Jensen PN3
  285. Jha V75, 322
  286. Jiang G323
  287. John D324
  288. Johnson CO1
  289. Johnson SC1
  290. Jonas JB325
  291. Jurisson M326
  292. Kabir Z327
  293. Kadel R328
  294. Kahsay A17
  295. Kamal R329
  296. Kan H331
  297. Karam NE332
  298. Karch A333, 334
  299. Karema CK266, 335
  300. Kasaeian A90, 94
  301. Kassa GM181
  302. Kassaw NA230
  303. Kassebaum NJ1, 336
  304. Kastor A239
  305. Katikireddi SV337
  306. Kaul A338
  307. Kawakami N339
  308. Keiyoro PN340, 341
  309. Kengne AP343, 345, 494
  310. Keren A346
  311. Khader YS347
  312. Khalil IA1
  313. Khan EA348
  314. Khang YH349, 350
  315. Khosravi A89, 351
  316. Khubchandani J352
  317. Kieling C240, 353
  318. Kim D354
  319. Kim P1
  320. Kim YJ355
  321. Kimokoti RW356
  322. Kinfu Y357
  323. Kisa A358
  324. Kissimovaskarbek KA360
  325. Kivimaki M135, 361
  326. Knudsen AK290, 364
  327. Kokubo Y366
  328. Kolte D367
  329. Kopec JA368
  330. Kosen S369
  331. Koul PA370
  332. Koyanagi A371
  333. Kravchenko M372
  334. Krishnaswami S373
  335. Krohn KJ1
  336. Kuate Defo B374
  337. Kucuk Bicer B375
  338. Kumar GA33
  339. Kumar P239
  340. Kumar S376
  341. Kyu HH1
  342. Lal DK33
  343. Lalloo R5
  344. Lambert N377
  345. Lan Q378
  346. Larsson A379
  347. Lavados PM380
  348. Leasher JL381
  349. Lee JT383
  350. Lee PH384
  351. Leigh J61
  352. Leshargie CT181
  353. Leung J3, 4
  354. Leung R385
  355. Levi M386
  356. Li Y387
  357. Li Y387
  358. Li Kappe D1
  359. Liang X389
  360. Liben ML391
  361. Lim SS1
  362. Linn S392
  363. Liu A1
  364. Liu PY1
  365. Liu S388
  366. Liu Y393
  367. Lodha R27
  368. Logroscino G394
  369. London SJ395
  370. Looker KJ396
  371. Lopez AD56
  372. Lorkowski S397, 398
  373. Lotufo PA158
  374. Low N399
  375. Lozano R1, 124
  376. Lucas TCD70
  377. Macarayan ERK141, 400
  378. Magdy Abd El Razek H401
  379. Magdy Abd El Razek M402
  380. Mahdavi M95, 403
  381. Majdan M404
  382. Majdzadeh R96, 405
  383. Majeed A174
  384. Malekzadeh R97
  385. Malhotra R27
  386. Malta DC406
  387. Mamun AA407
  388. Manguerra H1
  389. Manhertz T1
  390. Mantilla A4
  391. Mantovani LG408
  392. Mapoma CC212
  393. Marczak LB1
  394. Martinezraga J213, 410
  395. Martinsmelo FR411
  396. Martopullo I1
  397. Marz W412, 413
  398. Mathur MR33, 136
  399. Mazidi M414
  400. Mcalinden C415, 416
  401. Mcgaughey M1
  402. Mcgrath JJ6, 313
  403. Mckee M417
  404. Mcnellan C1
  405. Mehata S418
  406. Mehndiratta MM419
  407. Mekonnen TC420
  408. Memiah P421
  409. Memish ZA422, 423
  410. Mendoza W424
  411. Mengistie MA41
  412. Mengistu DT15
  413. Mensah GA306
  414. Meretoja A57, 425
  415. Meretoja TJ363, 426
  416. Mezgebe HB17
  417. Micha R427
  418. Millear A1
  419. Miller TR429, 430
  420. Mills EJ431
  421. Mirarefin M1, 432
  422. Mirrakhimov EM433, 434
  423. Misganaw A1
  424. Mishra SR7, 435
  425. Mitchell PB185
  426. Mohammad KA436, 437
  427. Mohammadi A438
  428. Mohammed KE15
  429. Mohammed S143, 439
  430. Mohanty SK239
  431. Mokdad AH1
  432. Mollenkopf SK1
  433. Monasta L441
  434. Hernandez JM124
  435. Montico M441
  436. Moradilakeh M443
  437. Moraga P446
  438. Mori R447
  439. Morozoff C1
  440. Morrison SD3
  441. Moses M1
  442. Mountjoyvenning C1
  443. Mruts KB160
  444. Mueller UO450
  445. Muller K1
  446. Murdoch ME451
  447. Murthy GVS31, 417
  448. Musa KI452
  449. Nachega JB26, 453, 454
  450. Nagel G455
  451. Naghavi M1
  452. Naheed A456
  453. Naidoo KS459
  454. Naldi L460
  455. Nangia V461
  456. Natarajan G462
  457. Negasa DE169
  458. Negoi I166, 167
  459. Negoi RI166
  460. Newton CR463
  461. Ngunjiri JW464
  462. Nguyen CT235
  463. Nguyen G1
  464. Nguyen M1
  465. Nguyen QL235
  466. Nguyen TH235
  467. Nichols E1
  468. Ningrum DNA465, 466
  469. Nolte S81, 467
  470. Nong VM235
  471. Norrving B35
  472. Noubiap JJN345, 469
  473. Odonnell MJ470
  474. Ogbo FA471
  475. Oh IH473
  476. Okoro A474
  477. Oladimeji O475
  478. Olagunju AT85, 476, 477
  479. Olagunju TO478, 480
  480. Olsen HE1
  481. Olusanya BO481
  482. Olusanya JO481
  483. Ong K1
  484. Opio JN482
  485. Oren E483
  486. Ortiz A484
  487. Osgoodzimmerman A1
  488. Osman M485, 549
  489. Owolabi MO486, 487
  490. Pa M488
  491. Pacella RE489, 490
  492. Pana A489, 490
  493. Panda BK239
  494. Papachristou C491
  495. Park EK492
  496. Parry CD25, 493
  497. Parsaeian M89, 98
  498. Patten SB495
  499. Patton GC58
  500. Paulson K1
  501. Pearce N417
  502. Pereira DM497
  503. Perico N179
  504. Pesudovs K224
  505. Peterson CB107
  506. Petzold M498, 499
  507. Phillips MR393, 500
  508. Pigott DM1
  509. Pillay JD501
  510. Pinho C1
  511. Plass D502
  512. Pletcher MA1
  513. Popova S50
  514. Poulton RG223
  515. Pourmalek F368
  516. Prabhakaran D321
  517. Prasad N503
  518. Prasad NM504, 505
  519. Purcell C1
  520. Qorbani M506
  521. Quansah R507, 508
  522. Rabiee RHS112
  523. Radfar A509
  524. Rafay A510, 511
  525. Rahimi K75
  526. Rahimimovaghar A99
  527. Rahimimovaghar V100
  528. Rahman M512
  529. Rahman MHU239
  530. Rai RK513
  531. Rajsic S514
  532. Ram U239
  533. Ranabhat CL515, 516
  534. Rankin Z1
  535. Rao PV517, 518
  536. Rao PC1
  537. Rawaf S176
  538. Ray SE1
  539. Reiner RC1
  540. Reinig N1
  541. Reitsma MB1
  542. Remuzzi G179, 519, 520
  543. Renzaho AMN472
  544. Resnikoff S184
  545. Rezaei S521
  546. Ribeiro AL108, 522
  547. Ronfani L441
  548. Roshandel G97, 523
  549. Roth GA1
  550. Roy A27
  551. Rubagotti E524
  552. Ruhago GM525
  553. Saadat S100
  554. Sadat N1
  555. Safdarian M100
  556. Safi S38
  557. Safiri S526
  558. Sagar R27
  559. Sahathevan R527, 528
  560. Salama J1
  561. Salomon JA140
  562. Salvi SS529
  563. Samy AM530
  564. Sanabria JR531, 532
  565. Santomauro D1, 4, 208
  566. Santos IS157
  567. Santos JV198, 533
  568. Santric Milicevic MM138
  569. Sartorius B342, 457
  570. Satpathy M534, 551
  571. Sawhney M531
  572. Saxena S176
  573. Schmidt MI240
  574. Schneider IJC535
  575. Schottker B536, 537
  576. Schwebel DC538
  577. Schwendicke F539
  578. Seedat S26
  579. Sepanlou SG97
  580. Servanmori EE124
  581. Setegn T87
  582. Shackelford KA1
  583. Shaheen A540
  584. Shaikh MA541
  585. Shamsipour M101
  586. Shariful Islam SM456, 542
  587. Sharma J543
  588. Sharma R544
  589. She J330
  590. Shi P428
  591. Shields C1
  592. Shigematsu M545, 546
  593. Shinohara Y547
  594. Shiri R362
  595. Shirkoohi R102
  596. Shirude S1
  597. Shishani K548
  598. Shrime MG549
  599. Sibai AM550
  600. Sigfusdottir ID534, 551
  601. Silva DAS552
  602. Silva JP199
  603. Silveira DGA553
  604. Singh JA538
  605. Singh NP554
  606. Sinha DN555, 556
  607. Skiadaresi E557, 558
  608. Skirbekk V304, 365
  609. Slepak EL1
  610. Sligar A1
  611. Smith DL1
  612. Smith M1
  613. Sobaih BHA83, 559
  614. Sobngwi E560, 561
  615. Sorensen RJD1
  616. Sousa TCM562
  617. Sposato LA479
  618. Sreeramareddy CT563
  619. Srinivasan V1
  620. Stanaway JD1
  621. Stathopoulou V564
  622. Steel N565, 566
  623. Stein DJ344, 567
  624. Stein MB221
  625. Steiner C1
  626. Steiner TJ175, 568
  627. Steinke S569
  628. Stokes MA468
  629. Stovner LJ568, 570
  630. Strub B1
  631. Subart M1
  632. Sufiyan MB440
  633. Suliankatchi Abdulkader R571
  634. Sunguya BF525
  635. Sur PJ1
  636. Swaminathan S572
  637. Sykes BL573
  638. Sylte DO1
  639. Tabaresseisdedos R203
  640. Taffere GR16
  641. Takala JS574, 575
  642. Tandon N27
  643. Tavakkoli M576
  644. Taveira N577, 578
  645. Taylor HR59
  646. Tehranibanihashemi A442, 444
  647. Tekelab T257, 272
  648. Temam Shifa G230, 244
  649. Terkawi AS579, 580, 581
  650. Tesfaye DJ12
  651. Tesssema B66
  652. Thamsuwan O1
  653. Thomas KE1
  654. Thrift AG22
  655. Tiruye TY181
  656. Tobegai R583
  657. Tollanes MC292, 584
  658. Tonelli M496
  659. Topormadry R359, 585
  660. Tortajada M409, 586
  661. Touvier M587
  662. Tran BX122, 588
  663. Troeger C1
  664. Truelsen T589
  665. Tsoi D1
  666. Tuem KB17
  667. Tuzcu EM582
  668. Tyrovolas S590
  669. Ukwaja KN591
  670. Undurraga EA592
  671. Uneke CJ593
  672. Updike R1
  673. Uthman OA594
  674. Uzochukwu BSC595
  675. Van Boven JFM163
  676. Varughese S215
  677. Vasankari T596
  678. Venkatesh S597
  679. Venketasubramanian N598
  680. Vidavalur R599
  681. Violante FS600
  682. Vladimirov SK601
  683. Vlassov VV602
  684. Vollset SE1, 291, 364
  685. Wadilo F251
  686. Wakayo T41
  687. Wang YP603
  688. Weaver M1
  689. Weichenthal S604
  690. Weiderpass E111, 605, 606, 607
  691. Weintraub RG59, 608, 609
  692. Werdecker A448
  693. Westerman R449, 610
  694. Whiteford HA1, 4, 208
  695. Wijeratne T59, 611
  696. Wiysonge CS26, 612
  697. Wolfe CDA164, 613
  698. Woodbrook R1
  699. Woolf AD614
  700. Workicho A41, 615
  701. Wulf Hanson S1
  702. Xavier D616
  703. Xu G617
  704. Yadgir S1
  705. Yaghoubi M445, 618
  706. Yakob B458
  707. Yan LL619
  708. Yano Y620
  709. Ye P388
  710. Yimam HH120
  711. Yip P621, 622
  712. Yonemoto N623
  713. Yoon SJ382
  714. Yotebieng M624, 625
  715. Younis MZ626
  716. Zaidi Z627
  717. Zaki MES628
  718. Zegeye EA459, 629
  719. Zenebe ZM17
  720. Zhang X630, 631
  721. Zhou M1, 388
  722. Zipkin B1
  723. Zodpey S33
  724. Zuhlke LJ631
  725. Murray CJL1

Source: The Lancet Published:2017


Abstract

Background As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. Methods We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8-75·9 million [7·2%, 6·0-8·3]), 45·1 million (29·0-62·8 million [5·6%, 4·0-7·2]), 36·3 million (25·3-50·9 million [4·5%, 3·8-5·3]), 34·7 million (23·0-49·6 million [4·3%, 3·5-5·2]), and 34·1 million (23·5-46·0 million [4·2%, 3·2-5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3-3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-communicable diseases has been growing rapidly across all SDI quintiles, partly because of population growth, but also the ageing of populations. The largest absolute increases in total numbers of YLDs globally were between the ages of 40 and 69 years. Age-standardised YLD rates for all conditions combined were 10·4% (95% UI 9·0-11·8) higher in women than in men. Iron-deficiency anaemia, migraine, Alzheimer's disease and other dementias, major depressive disorder, anxiety, and all musculoskeletal disorders apart from gout were the main conditions contributing to higher YLD rates in women. Men had higher age-standardised rates of substance use disorders, diabetes, cardiovascular diseases, cancers, and all injuries apart from sexual violence. Globally, we noted much less geographical variation in disability than has been documented for premature mortality. In 2016, there was a less than two times difference in age-standardised YLD rates for all causes between the location with the lowest rate (China, 9201 YLDs per 100 000, 95% UI 6862-11943) and highest rate (Yemen, 14 774 YLDs per 100 000, 11 018-19 228). Interpretation The decrease in death rates since 1990 for most causes has not been matched by a similar decline in age-standardised YLD rates. For many large causes, YLD rates have either been stagnant or have increased for some causes, such as diabetes. As populations are ageing, and the prevalence of disabling disease generally increases steeply with age, health systems will face increasing demand for services that are generally costlier than the interventions that have led to declines in mortality in childhood or for the major causes of mortality in adults. Up-todate information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response. © The Author(s). Published by Elsevier Ltd.
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