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Thursday, December 18, 2014

Road Injuries and Heart Disease Killing more Ugandans today

By Esther Nakkazi

Boda Bodas or motor cycles are popular in Uganda. They beat the traffic jam, are fast and take you to your next meeting and you arrive on time. At the same time, Uganda like all other developing countries is coping with increasing deaths from non communicable diseases.

So if you live in Uganda, today and you are not HIV positive, you are more likely to die from road injuries or ischemic heart disease. More-so, you will die of road injuries if you are a man. In Uganda, road injuries took a greater toll on men, killing 9,917 males and 3,100 females in 2013.

If all is well, then, you will live to a ripe age of 58.2 years if you are a man and 61.6 years if you are a woman because average life expectancy has increased to those levels. By contrast, women lived an average of 53.6 years and men had a life expectancy of 49.9 years in 1990.

But you will most likely not die from from African trypanosomiasis and diarrheal diseases in Uganda. Mortality from African trypanosomiasis dropped 95% between 1990 and 2013. In 1990, these diseases killed 46,571 people. Twenty-three years later, they claimed 30,480 fewer lives.

This is according to a new, comprehensive analysis of trend data from 188 countries published in The Lancet on December 18, "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

The research was conducted by an international consortium of researchers coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

According to a press release from Meropa Communications, the study shows that the leading killers in Uganda were HIV/AIDS, malaria, and pneumonia, accounting for 34% of all deaths in 2013.

For young people aged 15 to 49 years old, HIV/AIDS and tuberculosis were the top two causes of death, resulting in 43,815 lives lost in 2013.

For older people, 70 years and older, stroke claimed the most lives last year. But more women 6,209 and 4,363 men’s lives died of stroke. And children under the age of 5 years, it was malaria, killing 22,449 children in total.

Progress in Uganda and Internationally:

But generally there was progress with less mortality from a number of diseases that used to take a large toll on the country.

"We have achieved great progress in reducing mortality from a number of diseases, reflecting our country’s investments in improving health for its citizens," said Mr Opio John Nelson, Assistant District Health Officer for Environmental Health from Lira, Uganda.

"But we are still seeing children dying and deaths from other conditions are rising. These data are critical to understanding where we’ve been – and then where we need to go in order to save more lives in the future."

Globally, people live an average of 6.2 years longer than they did in 1990, with life expectancy rising to just under 72 years in 2013. Women showed a slightly larger average gain (an increase of 6.6 years) than men (a rise of 5.8 years). Improvements in health, reduced fertility, and shifts in the world’s age patterns have driven these global gains in life expectancy.

Out of the 188 countries included in the study Uganda ranked 166th for women and for men for longest life expectancies. In 2013, Andorra had the longest life expectancy for women (86.7 years) and Qatar had the longest for men (81.2 years). Lesotho had the shortest life expectancy for both women (51.2 years) and men (45.6 years).

"The fact that people are living longer in most parts of the world is good news but we must do more to address health disparities," said IHME Director Dr. Christopher Murray.

"Only with the best available evidence can we develop policies to improve health and save lives."

Worldwide, ischemic heart disease, stroke, and chronic obstructive pulmonary disease (COPD) claimed the most lives, accounting for nearly 32% of all deaths. Much global progress has been made in reducing mortality from diseases such as measles and diarrhea, with 83% and 51% declines respectively, from 1990 to 2013.

Globally, a number of diseases that have received less attention relative to others are some of the biggest causes of premature death, particularly drug use disorders, diabetes, chronic kidney disease, and cirrhosis. 

The gender gap in death rates for adults between the ages of 20 to 44 is widening and HIV/AIDS, interpersonal violence, road injuries, and maternal mortality are some of the key conditions responsible. For children under 5, diarrheal diseases, pneumonia, neonatal disorders, and malaria are still among the leading causes of death.

Two diseases, HIV/AIDS and malaria, followed very different mortality trends from other diseases. The global death toll from both diseases peaked around 2005 rather than 1990, with deaths from HIV/AIDS and malaria declining 22% and 30%, respectively, from 2005 to 2013. Malaria mortality in Uganda peaked in 2004, with 52,573 deaths, but then fell 44% by 2013.

Leading causes of death in Uganda, with the number of lives lost


1990 (deaths)                                                 
1. Diarrheal diseases (38,336)          2. Pneumonia (24,529)                     3. Malaria (22,872)                           4. HIV/AIDS (19,912)                   5. Tuberculosis (12,319)                 6. Malnutrition (9,616)                     7. Preterm birth complications (8,961)                    
8. Meningitis (8,960)                         9. African trypanosomiasis (8,235) 10. Measles (8,067)                                                    

 2013 (deaths)
 1. HIV/AIDS (52,939) 
2. Malaria (29,545)
3. Pneumonia (28,046
4. Diarrheal diseases (15,710)
5. Tuberculosis (14,738                    6. Road injuries (13,017)
7. Preterm birth complications (10,838)
8. Neonatal encephalopathy (10,733)
9. Stroke (10,572)
10. Malnutrition (9,549)


Find the paper at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61682-2/abstract

The Global Burden of Disease (GBD) Study 2013 is part of an ongoing effort to produce the most timely and up-to-date understanding of what kills and ails people worldwide.

Thousands of collaborators worldwide work together to generate annual estimates of deaths by cause, years of life lost to disability, and rates of premature mortality and illness. To make these data as useful and relevant to policymakers and country leaders as possible, findings from the GBD study can be used at the global, regional, national, and even subnational levels to track trends in health over time.

Researchers found a widening gap between countries with the lowest and highest death rates from a given disease – a potential sign of increasing inequalities in health. They also emphasize the importance of measuring local disease burdens, as the health challenges found in one corner of a country can widely vary from those experienced a few hours away.

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