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Wednesday, September 2, 2015

Ugandans live longer but health loss from HIV, Malaria and Lower respiratory infections grows

MEDIA RELEASE, 27 AUGUST 2015
  
Significant gains have been made against diarrheal diseases since 1990

SEATTLE — People in Uganda are living longer, but a complex mix of fatal and nonfatal ailments cause a tremendous amount of health loss, according to a new analysis of 306 diseases and injuries in 188 countries.

Thanks to marked declines in death and illness caused by HIV/AIDS and malaria in the past decade and significant advances made in addressing communicable, maternal, neonatal, and nutritional disorders, health has improved significantly around the world. Global life expectancy at birth for both sexes rose by 6.2 years (from 65.3 in 1990 to 71.5 in 2013), while healthy life expectancy at birth rose by 5.4 years (from 56.9 in 1990 to 62.3 in 2013).

Healthy life expectancy takes into account not just mortality but the impact of nonfatal conditions and summarizes years lived with disability and years lost due to premature mortality. The increase in healthy life expectancy has not been as dramatic as the growth of life expectancy, and as a result, people are living more years with illness and disability.

Contrary to this global trend, gains in healthy life expectancy and life expectancy are nearly equal in Uganda between 1990 and 2013. Life expectancy increased by 8.3 years for men and by 8 years for women. Healthy life expectancy increased by 8.1 years for men and 8.2 years for women. Life expectancy for women in Uganda still outpaces that of men, 61.6 years compared to 58.2 years.

“Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition” is the first study to examine fatal and nonfatal health loss across countries.

Published in The Lancet on August 27, the study was conducted by an international consortium of researchers working on the Global Burden of Disease study and led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

For most countries, changes in healthy life expectancy for males and females between 1990 and 2013 were significant and positive, but in dozens of countries, including Botswana, Belize, and Syria, healthy life expectancy in 2013 was not significantly higher than in 1990.

“The fact that healthy life expectancy has increased for people in Uganda is encouraging, as is the decreasing rate of diarrheal diseases,” said Dr. Tom Achoki, Director of African Initiatives and Clinical Assistant Professor at IHME and study co-author. “But ailments like HIV/AIDS and neonatal sepsis are increasingly affecting Ugandans. More effective, targeted interventions are necessary to improve health in this country.”

The study’s researchers use DALYs, or disability-adjusted life years, to compare the health of different populations and health conditions across time. One DALY equals one lost year of healthy life and is measured by the sum of years of life lost and years lived with disability.

In Uganda, the leading causes of health loss, as measured by DALYs, in 2013 were HIV/AIDS, malaria, lower respiratory infections, diarrheal diseases, neonatal preterm birth complications, neonatal encephalopathy, neonatal sepsis, protein-energy malnutrition, tuberculosis, and road injuries. Neonatal encephalopathy, neonatal sepsis, protein-energy malnutrition, and tuberculosis were not among the leading causes of health loss globally.
Causes of health loss differed by gender in Uganda as well. For Ugandan men, the top-five causes of DALYs in 2013 were HIV/AIDS, malaria, lower respiratory infections, diarrheal diseases, and neonatal preterm birth complications. 

For women, the top five were HIV/AIDS, malaria, lower respiratory infections, diarrheal diseases, and neonatal encephalopathy. For Ugandan men, the fastest-growing leading causes of health loss between 1990 and 2013 were road injuries, neonatal sepsis, and HIV/AIDS, which increased at rates of 127.2%, 89.9%, and 83.8%, respectively. 

For women, the largest increases among the leading causes of DALYs occurred for HIV/AIDS (205%), neonatal sepsis (89.1%), and congenital anomalies (64.2%). Of these fast-growing causes of health loss, only HIV/AIDS was among the 10 leading causes of health loss for men and women in 1990.

The study also examines the role that socio-demographic status – a combination of per capita income, population age, fertility rates, and average years of schooling – plays in determining health loss. Researchers’ findings underscore that this accounts for more than half of the differences seen across countries and over time for certain leading causes of DALYs, including maternal and neonatal disorders. But the study notes that socio-demographic status is much less responsible for the variation seen for ailments including cardiovascular disease and diabetes.

“Factors including income and education have an important impact on health but don’t tell the full story,” said IHME Director Dr. Christopher Murray. “Looking at healthy life expectancy and health loss at the country level can help guide policies to ensure that people everywhere can have long and healthy lives no matter where they live.”

Leading causes of health loss or DALYs in Uganda for both sexes, 2013

1
HIV/AIDS
2
Malaria
3
Lower respiratory infections
4
Diarrheal diseases
5
Neonatal preterm birth complications
6
Neonatal encephalopathy
7
Neonatal sepsis
8
Protein-energy malnutrition
9
Tuberculosis
10
Road injuries

Leading causes of health loss or DALYs in Uganda for males, 2013

1
HIV/AIDS
2
Malaria
3
Lower respiratory infections
4
Diarrheal diseases
5
Neonatal preterm birth complications
6
Road injuries
7
Neonatal encephalopathy
8
Neonatal sepsis
9
Tuberculosis
10
Protein-energy malnutrition

Leading causes of health loss or DALYs in Uganda for females, 2013

1
HIV/AIDS
2
Malaria
3
Lower respiratory infections
4
Diarrheal diseases
5
Neonatal encephalopathy
6
Neonatal preterm birth complications
7
Protein-energy malnutrition
8
Tuberculosis
9
Congenital anomalies
10
Neonatal sepsis

Media contact:
Maria Djordjevic, Meropa Communications
tel +27-11-506-7300

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