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Global, Regional, and National Deaths, Prevalence, Disability-Adjusted Life Years, and Years Lived With Disability for Chronic Obstructive Pulmonary Disease and Asthma, 1990–2015: A Systematic Analysis for the Global Burden of Disease Study 2015 Publisher Pubmed



Soriano JB1, 2 ; Abajobir AA3 ; Abate KH5 ; Abera SF6, 9 ; Agrawal A10, 11 ; Ahmed MB4 ; Aichour AN12 ; Aichour I13 ; Eddine Aichour MT14 ; Alam K15, 16 ; Alam N17 ; Alkaabi JM18 ; Almaskari F18 ; Alvisguzman N19 Show All Authors
Authors
  1. Soriano JB1, 2
  2. Abajobir AA3
  3. Abate KH5
  4. Abera SF6, 9
  5. Agrawal A10, 11
  6. Ahmed MB4
  7. Aichour AN12
  8. Aichour I13
  9. Eddine Aichour MT14
  10. Alam K15, 16
  11. Alam N17
  12. Alkaabi JM18
  13. Almaskari F18
  14. Alvisguzman N19
  15. Amberbir A20
  16. Amoako YA21
  17. Ansha MG22
  18. Anto JM23
  19. Asayesh H24
  20. Atey TM8
  21. Avokpaho EFGA25, 26
  22. Barac A27
  23. Basu S28
  24. Bedi N29
  25. Bensenor IM30
  26. Berhane A31
  27. Beyene AS32
  28. Bhutta ZA34, 35
  29. Biryukov S36
  30. Boneya DJ38
  31. Brauer M36, 40
  32. Carpenter DO41
  33. Casey D36
  34. Christopher DJ42
  35. Dandona L36, 43
  36. Dandona R36, 43
  37. Dharmaratne SD44
  38. Do HP45
  39. Fischer F46
  40. Gebrehiwot TT5
  41. Geleto A33, 47
  42. Ghoshal AG48
  43. Gillum RF50
  44. Mohamed Ginawi IA51
  45. Gupta V52
  46. Hay SI36, 53
  47. Hedayati MT54
  48. Horita N55
  49. Hosgood HD56
  50. Jakovljevic MMB37, 57
  51. James SL58
  52. Jonas JB59
  53. Kasaeian A60, 61
  54. Khader YS62
  55. Khalil IA36
  56. Khan EA63
  57. Khang YH64, 65
  58. Khubchandani J66
  59. Knibbs LD3
  60. Kosen S67
  61. Koul PA68
  62. Kumar GA43
  63. Leshargie CT39
  64. Liang X69
  65. Magdy Abd El Razek H70
  66. Majeed A71
  67. Malta DC73
  68. Manhertz T36
  69. Marquez N36
  70. Mehari A49
  71. Mensah GA74
  72. Miller TR75, 76
  73. Mohammad KA77, 78
  74. Mohammed KE7
  75. Mohammed S79, 80
  76. Mokdad AH36
  77. Naghavi M36
  78. Nguyen CT45
  79. Nguyen G36
  80. Nguyen QL45
  81. Nguyen TH45
  82. Ningrum DNA81, 82
  83. Nong VM45
  84. Obi JI83
  85. Odeyemi YE83
  86. Ogbo FA84
  87. Oren E85
  88. Mahesh PA86
  89. Park EK87
  90. Patton GC88
  91. Paulson K36
  92. Qorbani M89
  93. Quansah R90, 91
  94. Rafay A92, 93
  95. Rahman MHU94
  96. Rai RK95
  97. Rawaf S72
  98. Reinig N36
  99. Safiri S96
  100. Sarmientosuarez R97
  101. Sartorius B98, 99
  102. Savic M101
  103. Sawhney M102
  104. Shigematsu M103, 104
  105. Smith M36
  106. Tadese F105
  107. Thurston GD106
  108. Topormadry R107, 108
  109. Tran BX109, 110
  110. Ukwaja KN111
  111. Van Boven JFM112
  112. Vlassov VV113
  113. Vollset SE36, 100, 114
  114. Wan X36, 115
  115. Werdecker A116
  116. Hanson SW36
  117. Yano Y117
  118. Yimam HH118
  119. Yonemoto N119
  120. Yu C120, 121
  121. Zaidi Z122
  122. Sayed Zaki ME123
  123. Lopez AD124
  124. Murray CJL36
  125. Vos T36

Source: The Lancet Respiratory Medicine Published:2017


Abstract

Background Chronic obstructive pulmonary disease (COPD) and asthma are common diseases with a heterogeneous distribution worldwide. Here, we present methods and disease and risk estimates for COPD and asthma from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 study. The GBD study provides annual updates on estimates of deaths, prevalence, and disability-adjusted life years (DALYs), a summary measure of fatal and non-fatal disease outcomes, for over 300 diseases and injuries, for 188 countries from 1990 to the most recent year. Methods We estimated numbers of deaths due to COPD and asthma using the GBD Cause of Death Ensemble modelling (CODEm) tool. First, we analysed data from vital registration and verbal autopsy for the aggregate category of all chronic respiratory diseases. Subsequently, models were run for asthma and COPD relying on covariates to predict rates in countries that have incomplete or no vital registration data. Disease estimates for COPD and asthma were based on systematic reviews of published papers, unpublished reports, surveys, and health service encounter data from the USA. We used the Global Initiative of Chronic Obstructive Lung Disease spirometry-based definition as the reference for COPD and a reported diagnosis of asthma with current wheeze as the definition of asthma. We used a Bayesian meta-regression tool, DisMod-MR 2.1, to derive estimates of prevalence and incidence. We estimated population-attributable fractions for risk factors for COPD and asthma from exposure data, relative risks, and a theoretical minimum exposure level. Results were stratified by Socio-demographic Index (SDI), a composite measure of income per capita, mean years of education over the age of 15 years, and total fertility rate. Findings In 2015, 3·2 million people (95% uncertainty interval [UI] 3·1 million to 3·3 million) died from COPD worldwide, an increase of 11·6% (95% UI 5·3 to 19·8) compared with 1990. There was a decrease in age-standardised death rate of 41·9% (37·7 to 45·1) but this was counteracted by population growth and ageing of the global population. From 1990 to 2015, the prevalence of COPD increased by 44·2% (41·7 to 46·6), whereas age-standardised prevalence decreased by 14·7% (13·5 to 15·9). In 2015, 0·40 million people (0·36 million to 0·44 million) died from asthma, a decrease of 26·7% (−7·2 to 43·7) from 1990, and the age-standardised death rate decreased by 58·8% (39·0 to 69·0). The prevalence of asthma increased by 12·6% (9·0 to 16·4), whereas the age-standardised prevalence decreased by 17·7% (15·1 to 19·9). Age-standardised DALY rates due to COPD increased until the middle range of the SDI before reducing sharply. Age-standardised DALY rates due to asthma in both sexes decreased monotonically with rising SDI. The relation between with SDI and DALY rates due to asthma was attributed to variation in years of life lost (YLLs), whereas DALY rates due to COPD varied similarly for YLLs and years lived with disability across the SDI continuum. Smoking and ambient particulate matter were the main risk factors for COPD followed by household air pollution, occupational particulates, ozone, and secondhand smoke. Together, these risks explained 73·3% (95% UI 65·8 to 80·1) of DALYs due to COPD. Smoking and occupational asthmagens were the only risks quantified for asthma in GBD, accounting for 16·5% (14·6 to 18·7) of DALYs due to asthma. Interpretation Asthma was the most prevalent chronic respiratory disease worldwide in 2015, with twice the number of cases of COPD. Deaths from COPD were eight times more common than deaths from asthma. In 2015, COPD caused 2·6% of global DALYs and asthma 1·1% of global DALYs. Although there are laudable international collaborative efforts to make surveys of asthma and COPD more comparable, no consensus exists on case definitions and how to measure disease severity for population health measurements like GBD. Comparisons between countries and over time are important, as much of the chronic respiratory burden is either preventable or treatable with affordable interventions. Funding Bill & Melinda Gates Foundation. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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