Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019.
Por:
Rios-Blancas MJ, Pando-Robles V, Razo C, Carcamo CP, Mendoza W, Pacheco-Barrios K, Miranda JJ, Lansingh VC, Demie TG, Saha M, Okonji OC, Yigit A, Cahuana-Hurtado L, Chacón-Uscamaita PR, Bernabe E, Culquichicon C, Chirinos-Caceres JL, Cárdenas R, Alcalde-Rabanal JE, Barrera FJ, Quintanilla BPA, Shorofi SA, Wickramasinghe ND, Ferreira N, Almidani L, Gupta VK, Karimi H, Alayu DS, Benziger CP, Fukumoto T, Mostafavi E, Redwan EMM, Gebrehiwot M, Khatab K, Koyanagi A, Krapp F, Lee S, Noori M, Qattea I, Rosenthal VD, Sakshaug JW, Wagaye B, Zare I, Ortega-Altamirano DV, Murillo-Zamora E, Vervoort D, Silva DAS, Oulhaj A, Herrera-Serna BY, Mehra R, Amir-Behghadami M, Adib N, Cortés S, Dang AK, Nguyen BT, Mokdad AH, Hay SI, Murray CJL, Lozano R and García PJ
Publicada:
22 jun 2023
Ahead of Print:
22 jun 2023
Categoría:
Public health, environmental and occupational health
Resumen:
BACKGROUND: Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru's healthcare system performance. METHODS: Using estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We report demographic and epidemiologic trends in terms of population, life expectancy at birth (LE), mortality, incidence, prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by the major diseases and risk factors in Peru. Finally, we compared Peru with 16 countries in the Latin American (LA) region. RESULTS: The Peruvian population reached 33.9 million inhabitants (49.9% women) in 2019. From 1990 to 2019, LE at birth increased from 69.2 (95% uncertainty interval 67.8-70.3) to 80.3 (77.2-83.2) years. This increase was driven by the decline in under-5 mortality (-80.7%) and mortality from infectious diseases in older age groups (+60 years old). The number of DALYs in 1990 was 9.2 million (8.5-10.1) and reached 7.5 million (6.1-9.0) in 2019. The proportion of DALYs due to non-communicable diseases (NCDs) increased from 38.2% in 1990 to 67.9% in 2019. The all-ages and age-standardized DALYs rates and YLLs rates decreased, but YLDs rates remained constant. In 2019, the leading causes of DALYs were neonatal disorders, lower respiratory infections (LRIs), ischemic heart disease, road injuries, and low back pain. The leading risk factors associated with DALYs in 2019 were undernutrition, high body mass index, high fasting plasma glucose, and air pollution. Before the COVID-19 pandemic, Peru experienced one of the highest LRIs-DALYs rates in the LA region. CONCLUSION: In the last three decades, Peru experienced significant improvements in LE and child survival and an increase in the burden of NCDs and associated disability. The Peruvian healthcare system must be redesigned to respond to this epidemiological transition. The new design should aim to reduce premature deaths and maintain healthy longevity, focusing on effective coverage and treatment of NCDs and reducing and managing the related disability.
Filiaciones:
Rios-Blancas MJ:
School of Public Health of Mexico, National Institute of Public Health, Cuernavaca, Mexico
Carlos Slim Foundation, Mexico City, Mexico
Pando-Robles V:
Infectious Disease Research Center, National Institute of Public Health, Cuernavaca, Mexico
Razo C:
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
Carcamo CP:
School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
Mendoza W:
Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
Pacheco-Barrios K:
Spaulding Rehabilitation Hospital, Harvard University, Boston, MA, United States
Universidad San Ignacio de Loyola (University of Saint Ignatius of Loyola), Lima, Peru
Miranda JJ:
CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia (Cayetano Heredia Peruvian University), Lima, Peru
Department of Medicine, Universidad Peruana Cayetano Heredia (Cayetano Heredia Peruvian University), Lima, Peru
Lansingh VC:
HelpMeSee, New York, NY, United States
Mexican Institute of Ophthalmology, Queretaro, Mexico
Demie TG:
School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
Saha M:
Department of Humanities and Social Sciences, Deakin University, Melbourne, VIC, Australia
Department of Human-Centred Computing, Monash University, Melbourne, VIC, Australia
Okonji OC:
School of Pharmacy, University of the Western Cape, Cape Town, South Africa
Yigit A:
Department of Health Management, Süleyman Demirel Üniversitesi (Süleyman Demirel University), Isparta, Türkiye
Cahuana-Hurtado L:
School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
Chacón-Uscamaita PR:
Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
Bernabe E:
Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, United Kingdom
Culquichicon C:
Universidad Privada Norbert Wiener, Centro de Investigación Epidemiológica en Salud Global, Lima, Peru
Chirinos-Caceres JL:
School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
Cárdenas R:
Department of Health Care, Metropolitan Autonomous University, Mexico City, Mexico
Alcalde-Rabanal JE:
Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
Barrera FJ:
Department of Epidemiology, Harvard University, Boston, MA, United States
Quintanilla BPA:
The Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
San Martin de Porres University, Lima, Peru
Shorofi SA:
Medical-Surgical Nursing, Mazandaran University of Medical Sciences, Sari, Iran
College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
Wickramasinghe ND:
Department of Community Medicine, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
Ferreira N:
Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
Almidani L:
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
Doheny Image Reading and Research Lab (DIRRL) - Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA, United States
Gupta VK:
Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
Karimi H:
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Alayu DS:
Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
Benziger CP:
Heart and Vascular Center, Essentia Health, Duluth, MN, United States
Fukumoto T:
Department of Dermatology, Kobe University, Kobe, Japan
Mostafavi E:
Department of Medicine, Stanford University, Palo Alto, CA, United States
Stanford Cardiovascular Institute, Stanford University, Palo Alto, CA, United States
Redwan EMM:
Department Biological Sciences, King Abdulaziz University, Jeddah, Egypt
Department of Protein Research, Research and Academic Institution, Alexandria, Egypt
Gebrehiwot M:
Department of Environmental Health, Wollo University, Dessie, Ethiopia
Khatab K:
Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom
Koyanagi A:
Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Sant Boi de Llobregat, Spain
Catalan Institution for research and Advanced Studies (ICREA), Barcelona, Spain
Krapp F:
Instituto de Medicina Tropical Alexander von Humboldt (Alexander von Humboldt Institute for Tropical Medicine), Cayetano Heredia University, Lima, Peru
Doctoral School of Biomedical Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
Lee S:
Department of Precision Medicine, Sungkyunkwan University, Suwon-si, Republic of Korea
Noori M:
Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
Qattea I:
Department of Neonatology, Case Western Reserve University, Cleveland, OH, United States
Rosenthal VD:
International Nosocomial Infection Control Consortium, Independent Consultant, Buenos Aires, Argentina
Sakshaug JW:
Institute for Employment Research, University of Warwick, Coventry, United Kingdom
Department of Statistics, Ludwig Maximilians University, Munich, Germany
Wagaye B:
Department of Public Health Nutrition, Wollo University, Dessie, Ethiopia
Infection Prevention and Control and Water, Sanitation and Hygiene Unit, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Zare I:
Research and Development Department, Sina Medical Biochemistry Technologies Co. Ltd., Shiraz, Iran
Ortega-Altamirano DV:
Health Systems Research Center, National Institute of Public Health, Cuernavaca, Mexico
Murillo-Zamora E:
Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Mexico
Postgraduate in Medical Sciences, Universidad de Colima, Colima, Mexico
Vervoort D:
Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, United States
Silva DAS:
Department of Physical Education, Federal University of Santa Catarina, Florianópolis, Brazil
Oulhaj A:
Department of Epidemiology and Population Health, Khalifa University, Abu Dhabi, United Arab Emirates
Herrera-Serna BY:
Departamento de Salud Oral (Department of Oral Health), Universidad Autónoma de Manizales (Autonomous University of Manizales), Manizales, Colombia
Mehra R:
Food Science and Technology, Maharishi Markandeshwar (Deemed to be University), Ambala, Haryana, India
Amir-Behghadami M:
Road Traffic Injury Research Center, Iranian International Safe Community Support Center, Tabriz University of Medical Sciences, Tabriz, Iran
Department of Health Service Management, Iranian Center of Excellence in Health Management, Tabriz, Iran
Adib N:
Department of Veterinary Pathobiology, Shahid Bahonar University of Kerman, Kerman, Iran
Cortés S:
Department of Public Health, Pontifical Catholic University of Chile, Santiago, Chile
Research Line in Environmental Exposures and Health Effects at Population Level, Centro de Desarrollo Urbano Sustentable (CEDEUS), Advanced Center for Chronic Diseases (ACCDIS), Santiago, Chile
Dang AK:
Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
Nguyen BT:
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
Mokdad AH:
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
Hay SI:
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
Murray CJL:
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
Lozano R:
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
García PJ:
School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
Open Access
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