Burden of injuries in Nepal, 1990-2017: findings from the Global Burden of Disease Study 2017.


Journal

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
ISSN: 1475-5785
Titre abrégé: Inj Prev
Pays: England
ID NLM: 9510056

Informations de publication

Date de publication:
10 2020
Historique:
received: 16 05 2019
revised: 01 08 2019
accepted: 02 08 2019
pubmed: 10 1 2020
medline: 31 8 2021
entrez: 10 1 2020
Statut: ppublish

Résumé

Nepal is a low-income country undergoing rapid political, economic and social development. To date, there has been little evidence published on the burden of injuries during this period of transition. The Global Burden of Disease Study (GBD) is a comprehensive measurement of population health outcomes in terms of morbidity and mortality. We analysed the GBD 2017 estimates for deaths, years of life lost, years lived with disability, incidence and disability-adjusted life years (DALYs) from injuries to ascertain the burden of injuries in Nepal from 1990 to 2017. There were 16 831 (95% uncertainty interval 13 323 to 20 579) deaths caused by injuries (9.21% of all-cause deaths (7.45% to 11.25%)) in 2017 while the proportion of deaths from injuries was 6.31% in 1990. Overall, the injury-specific age-standardised mortality rate declined from 88.91 (71.54 to 105.31) per 100 000 in 1990 to 70.25 (56.75 to 85.11) per 100 000 in 2017. In 2017, 4.11% (2.47% to 6.10%) of all deaths in Nepal were attributed to transport injuries, 3.54% (2.86% to 4.08%) were attributed to unintentional injuries and 1.55% (1.16% to 1.85%) were attributed to self-harm and interpersonal violence. From 1990 to 2017, road injuries, falls and self-harm all rose in rank for all causes of death. The increase in injury-related deaths and DALYs in Nepal between 1990 and 2017 indicates the need for further research and prevention interventions. Injuries remain an important public health burden in Nepal with the magnitude and trend of burden varying over time by cause-specific, sex and age group. Findings from this study may be used by the federal, provincial and local governments in Nepal to prioritise injury prevention as a public health agenda and as evidence for country-specific interventions.

Sections du résumé

BACKGROUND
Nepal is a low-income country undergoing rapid political, economic and social development. To date, there has been little evidence published on the burden of injuries during this period of transition.
METHODS
The Global Burden of Disease Study (GBD) is a comprehensive measurement of population health outcomes in terms of morbidity and mortality. We analysed the GBD 2017 estimates for deaths, years of life lost, years lived with disability, incidence and disability-adjusted life years (DALYs) from injuries to ascertain the burden of injuries in Nepal from 1990 to 2017.
RESULTS
There were 16 831 (95% uncertainty interval 13 323 to 20 579) deaths caused by injuries (9.21% of all-cause deaths (7.45% to 11.25%)) in 2017 while the proportion of deaths from injuries was 6.31% in 1990. Overall, the injury-specific age-standardised mortality rate declined from 88.91 (71.54 to 105.31) per 100 000 in 1990 to 70.25 (56.75 to 85.11) per 100 000 in 2017. In 2017, 4.11% (2.47% to 6.10%) of all deaths in Nepal were attributed to transport injuries, 3.54% (2.86% to 4.08%) were attributed to unintentional injuries and 1.55% (1.16% to 1.85%) were attributed to self-harm and interpersonal violence. From 1990 to 2017, road injuries, falls and self-harm all rose in rank for all causes of death.
CONCLUSIONS
The increase in injury-related deaths and DALYs in Nepal between 1990 and 2017 indicates the need for further research and prevention interventions. Injuries remain an important public health burden in Nepal with the magnitude and trend of burden varying over time by cause-specific, sex and age group. Findings from this study may be used by the federal, provincial and local governments in Nepal to prioritise injury prevention as a public health agenda and as evidence for country-specific interventions.

Identifiants

pubmed: 31915272
pii: injuryprev-2019-043309
doi: 10.1136/injuryprev-2019-043309
pmc: PMC7571348
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

i57-i66

Informations de copyright

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: SLJ reports grants from Sanofi Pasteur outside the submitted work.

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Auteurs

Puspa Raj Pant (PR)

Centre for Academic Child Health (CACH), University of the West of England, Bristol, UK puspa.pant@uwe.ac.uk.

Amrit Banstola (A)

Centre for Academic Child Health (CACH), University of the West of England, Bristol, UK.
Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal.

Santosh Bhatta (S)

Centre for Academic Child Health (CACH), University of the West of England, Bristol, UK.

Julie A Mytton (JA)

Department of Nursing and Midwifery, University of the West of England, Bristol, UK.

Dilaram Acharya (D)

Department of Preventive Medicine, Dongguk University, Gyeongju, South Korea.
Department of Community Medicine, Kathmandu University, Devdaha, Nepal.

Suraj Bhattarai (S)

London School of Hygiene & Tropical Medicine, London, UK.
Nepal Academy of Science & Technology, Patan, Nepal.

Catherine Bisignano (C)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

Chris D Castle (CD)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

Govinda Prasad Dhungana (G)

Department of Microbiology, Far Western University, Mahendranagar, Nepal.

Zachary V Dingels (ZV)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

Jack T Fox (JT)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

Pawan Kumar Hamal (P)

Department of Anaesthesiology and Intensive Care, National Academy of Medical Sciences, Kathmandu, Nepal.
Journal of Nepal Health Research Council, Nepal Health Research Council, Kathmandu, Nepal.

Zichen Liu (Z)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

Narayan Bahadur Mahotra (N)

Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Deepak Paudel (D)

Health, Nutrition and HIV/AIDS Program, Save the Children, Kathmandu, Nepal.
Center for International Health, Ludwig Maximilians University, Munich, Germany.

Khem Narayan Pokhrel (K)

HIV and Mental Health Department, Integrated Development Foundation Nepal, Kathmandu, Nepal.

Chhabi Lal Ranabhat (C)

Policy Research Institute, Kathmandu, Nepal.
Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, South Korea.

Nicholas L S Roberts (NLS)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

Dillon O Sylte (DO)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

Spencer L James (SL)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

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