Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019.
Journal: Frontiers in public health
Volume: 11
Issue:
Year of Publication: 2023
Affiliated Institutions:
School of Public Health of Mexico, National Institute of Public Health, Cuernavaca, Mexico.
Infectious Disease Research Center, National Institute of Public Health, Cuernavaca, Mexico.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States.
School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru.
Spaulding Rehabilitation Hospital, Harvard University, Boston, MA, United States.
CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia (Cayetano Heredia Peruvian University), Lima, Peru.
HelpMeSee, New York, NY, United States.
School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Department of Humanities and Social Sciences, Deakin University, Melbourne, VIC, Australia.
School of Pharmacy, University of the Western Cape, Cape Town, South Africa.
Department of Health Management, Süleyman Demirel Üniversitesi (Süleyman Demirel University), Isparta, Türkiye.
Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, United Kingdom.
Universidad Privada Norbert Wiener, Centro de Investigación Epidemiológica en Salud Global, Lima, Peru.
Department of Health Care, Metropolitan Autonomous University, Mexico City, Mexico.
Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico.
Department of Epidemiology, Harvard University, Boston, MA, United States.
The Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia.
Medical-Surgical Nursing, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Community Medicine, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.
Department of Social Sciences, University of Nicosia, Nicosia, Cyprus.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia.
Heart and Vascular Center, Essentia Health, Duluth, MN, United States.
Department of Dermatology, Kobe University, Kobe, Japan.
Department of Medicine, Stanford University, Palo Alto, CA, United States.
Department Biological Sciences, King Abdulaziz University, Jeddah, Egypt.
Department of Environmental Health, Wollo University, Dessie, Ethiopia.
Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom.
Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Sant Boi de Llobregat, Spain.
Instituto de Medicina Tropical Alexander von Humboldt (Alexander von Humboldt Institute for Tropical Medicine), Cayetano Heredia University, Lima, Peru.
Department of Precision Medicine, Sungkyunkwan University, Suwon-si, Republic of Korea.
Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
Department of Neonatology, Case Western Reserve University, Cleveland, OH, United States.
International Nosocomial Infection Control Consortium, Independent Consultant, Buenos Aires, Argentina.
Institute for Employment Research, University of Warwick, Coventry, United Kingdom.
Department of Public Health Nutrition, Wollo University, Dessie, Ethiopia.
Research and Development Department, Sina Medical Biochemistry Technologies Co. Ltd., Shiraz, Iran.
Health Systems Research Center, National Institute of Public Health, Cuernavaca, Mexico.
Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Mexico.
Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, United States.
Department of Physical Education, Federal University of Santa Catarina, Florianópolis, Brazil.
Department of Epidemiology and Population Health, Khalifa University, Abu Dhabi, United Arab Emirates.
Departamento de Salud Oral (Department of Oral Health), Universidad Autónoma de Manizales (Autonomous University of Manizales), Manizales, Colombia.
Food Science and Technology, Maharishi Markandeshwar (Deemed to be University), Ambala, Haryana, India.
Road Traffic Injury Research Center, Iranian International Safe Community Support Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Veterinary Pathobiology, Shahid Bahonar University of Kerman, Kerman, Iran.
Department of Public Health, Pontifical Catholic University of Chile, Santiago, Chile.
Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States.
Abstract summary
Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru's healthcare system performance.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.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.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.
Authors & Co-authors:
Rios-Blancas Maria Jesus MJ
Pando-Robles Victoria V
Razo Christian C
Carcamo Cesar P CP
Mendoza Walter W
Pacheco-Barrios Kevin K
Miranda J Jaime JJ
Lansingh Van Charles VC
Demie Takele Gezahegn TG
Saha Manika M
Okonji Osaretin Christabel OC
Yigit Arzu A
Cahuana-Hurtado Lucero L
Chacón-Uscamaita Pamela R PR
Bernabe Eduardo E
Culquichicon Carlos C
Chirinos-Caceres Jesus Lorenzo JL
Cárdenas Rosario R
Alcalde-Rabanal Jacqueline Elizabeth JE
Barrera Francisco J FJ
Quintanilla Beatriz Paulina Ayala BPA
Shorofi Seyed Afshin SA
Wickramasinghe Nuwan Darshana ND
Ferreira Nuno N
Almidani Louay L
Gupta Vivek Kumar VK
Karimi Hanie H
Alayu Daniel Shewaye DS
Benziger Catherine P CP
Fukumoto Takeshi T
Mostafavi Ebrahim E
Redwan Elrashdy Moustafa Mohamed EMM
Gebrehiwot Mesfin M
Khatab Khaled K
Koyanagi Ai A
Krapp Fiorella F
Lee Seung S
Noori Maryam M
Qattea Ibrahim I
Rosenthal Victor Daniel VD
Sakshaug Joseph W JW
Wagaye Birhanu B
Zare Iman I
Ortega-Altamirano Doris V DV
Murillo-Zamora Efrén E
Vervoort Dominique D
Silva Diego Augusto Santos DAS
Oulhaj Abderrahim A
Herrera-Serna Brenda Yuliana BY
Mehra Rahul R
Amir-Behghadami Mehrdad M
Adib Nasrin N
Cortés Sandra S
Dang Anh Kim AK
Nguyen Binh Thanh BT
Mokdad Ali H AH
Hay Simon I SI
Murray Christopher J L CJL
Lozano Rafael R
García Patricia J PJ
Study Outcome
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