UGANDAN LIFE EXPECTANCY INCREASES BUT HIV, MALARIA, AND LOWER RESPIRATORY INFECTION TAKE A DEADLY TOLL

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Annual Global Burden of Disease study  world’s largest scientific collaboration on population health — reveals new trends in illnesses, deaths, and risk factors leading to poor health

Life expectancy is growing in Uganda but the country continues to struggle with communicable diseases like HIV and malaria, as well as neonatal ailments that kill infants.

Globally, countries have saved more lives over the past decade, especially among children under age 5, but persistent health problems, such as obesity, conflict, and mental illness, comprise a “triad of troubles,” and prevent people from living long, healthy lives, according to a new scientific study.

“Life expectancy in Uganda is growing, but communicable diseases like HIV, malaria, and lower respiratory infection are still taking the lives of far too many Ugandans. Children are at particular risk, and neonatal ailments like sepsis, pre-term birth, and encephalopathy kill thousands of infants. There is still a lot of work to be done by all concerned stakeholders and players in ensuring that the health of the people of Uganda is further improved to achieve even better strides towards improving the quality of life and our life expectancy as a nation,” said Dr. Dan Kajungu, Executive Director – Makerere University Centre for Health and Population Research (MUCHAP)

This year’s version of the annual Global Burden of Diseases Study (GBD) is composed of five peer-reviewed papers, and was published today in the international medical journal The Lancet.  The five papers provide in-depth analyses of life expectancy and mortality, causes of death, overall disease burden, years lived with disability, and risk factors that lead to health loss.

The study’s main findings for Uganda include:

• A Ugandan man born in 2016 can expect to live 59.8 years, an increase in life expectancy of 8 years over the past decade. A woman has a life expectancy of 64.8 years, up 9.2 years from 2006.
• But illness and injuries take away years of healthy life. A Ugandan male born in 2016 will live approximately 52.5 years in good health; a female only 56.3 years.
• The top five causes of premature death in Uganda are HIV, malaria, lower respiratory infection, neonatal encephalopathy, and tuberculosis. The ailments that cause illness can be very different. Iron-deficiency anemia, depression, and back pain are the top causes of years that people live with disability in Uganda.
• Deaths of children under 5 are a persistent health challenge. For every 1,000 live births, 62.4 Ugandan children under the age of 5 die. That far exceeds both the global figure of 38.4 and the eastern sub-Saharan Africa average of 59.6. Kenya, Ethiopia, and Tanzania all have lower rates of under-5 death.

Moreover, in 2016, for the first time in modern history, fewer than 5 million children under age 5 died in one year, as compared to 1990 when 11 million died.

Researchers attribute this global health landmark to improvements in increased educational levels of mothers, rising per capita incomes, declining levels of fertility, increased vaccination programs, mass distribution of insecticide-treated bed nets, improved water and sanitation, and a wide array of other health programs funded by development funding for health.

“Death is a powerful motivator, both for individuals and for countries, to address diseases that have been killing us at high rates,” said Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. “But, we’ve been much less motivated to address issues leading to illnesses. A ‘triad of troubles’ – obesity, conflict, and mental illness, including substance use disorders – poses a stubborn and persistent barrier to active and vigorous lifestyles.”

Visualizations have been created from which to compare and contrast data among nations and by health conditions. See: https://vizhub.healthdata.org/gbd-compare/.

Despite progress on reducing deaths, this “triad of troubles” – obesity, conflict, and mental illness, including substance use disorders – is preventing further progress.

• One of the most alarming risks in the GBD is excess body weight. The rate of illness related to people being too heavy is rising quickly, and the disease burden can be found in all sociodemographic levels. High body mass index (BMI) is the fourth largest contributor to the loss of healthy life, after high blood pressure, smoking, and high blood sugar.
• Deaths over the past decade due to conflict and terrorism more than doubled. Recent conflicts, such as those in Syria, Yemen, South Sudan, and Libya, are major public health threats, both in regard to casualties and because they lead to long-term physical and mental consequences.
• Mental illness and substance use disorders continued to contribute substantially to the loss of healthy life in 2016, affecting all countries regardless of their socioeconomic status. Treatment rates for mental and substance use disorders remain low. Even in high-income countries where treatment coverage has increased, the prevalence of the most common disorders has not changed.

The GBD is the largest and most comprehensive epidemiological effort to quantify health loss across places and over time. It draws on the work of over 2,500 collaborators from more than 130 countries and territories. IHME coordinates the study. This year, more than 13 billion data points are included; the papers comprise a complete edition of The Lancet.

This year’s GBD improves upon the previous annual update through new data, improvements in methodology, and a measure for tracking completeness of vital registration information.

The study’s other findings include:

• Poor diet is associated with 1 in 5 deaths globally.
• Non-communicable diseases were responsible for 72% of all deaths worldwide in 2016, in contrast to 58% in 1990. Within the past decade, diabetes rose in rank order from 17^th to 9^th leading cause of death in low-middle income countries.
• Tobacco is linked to 7.1 million deaths, and in more than 100 countries, smoking was among the leading risk factors for loss of healthy life.
• The leading causes of premature death globally included: ischemic heart disease, stroke, lower respiratory infections, diarrhea-related diseases, and road injuries. Ischemic heart disease was the leading cause of premature death for men in 113 countries and for women in 97 countries.
• Only four of the leading 20 causes of disability in 2016 – stroke, COPD, diabetes, and falls –were also leading causes of death.

In addition, the top conditions in 2016 that made people sick, but were not necessarily fatal were: low back pain, migraine headaches, hearing loss, iron-deficiency anemia, and major depressive disorders.

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