1995年印度主要邦农村地区因九大主要死因导致的寿命损失年数估计。

Indrayan Abhaya, Wysocki M J, Kumar Rajeev, Chawla Anil, Singh Nihal

University College of Medical Sciences, Dilshad Garden, Delhi, India.

Natl Med J India. 2002 Jan-Feb;15(1):7-13.

BACKGROUND

Years-of-life-lost (YLL) contribute nearly two-thirds of the disability-adjusted life-years (DALYs) worldwide and are especially Important for India where infant and child mortality is still high. These were estimated for India under the Global Burden of Disease study for the year 1990. No estimates are available for the different states of India. We aimed to prepare state-wise estimates of YLL for different causes of death in rural areas and to determine the causes responsible for a higher burden in different states.

METHOD

Percentage deaths of the top 9 causes reported in the Registrar-General's Survey of Causes of Deaths (Rural)--1995 in 13 major states of India and different age groups was applied to the expected number of total deaths. The life lost according to the standard life-table was age-weighted and discounted using the methodology of the Global Burden of Disease 1990 study. The causes of death were based on lay reporting which otherwise seem reliable.

RESULTS

The all-cause YLL in rural India in 1995 were 207 per 1,000 population. The minimum was 74 in Kerala and maximum 276 in Madhya Pradesh. Pneumonia was the top cause responsible for 15 YLL. The inter-state variation was high as Tamil Nadu had only 1.6 and Uttar Pradesh 30.5 YLL from this cause. Cancers were a uniform burden across the states. Heart attack, and bronchitis and asthma cut across the more and less developed states. Suicides were a heavy burden in Andhra Pradesh and vehicular accidents in Haryana and Rajasthan. Bihar, Gujarat, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh had communicable and nutritional conditions as predominant causes while Kerala and Punjab had non-communicable diseases as the predominant cause of YLL due to premature mortality.

CONCLUSION

These results provide a new perspective about the causes of death that need more attention in rural areas of different states of India. These will also help prioritize areas which require more inputs at the state-level and hence will be useful for health policymakers.

背景

寿命损失年数（YLL）在全球伤残调整生命年（DALY）中占近三分之二，在印度尤为重要，因为该国婴幼儿死亡率仍然很高。1990年全球疾病负担研究对印度的寿命损失年数进行了估算，但印度各邦尚无相关估算数据。我们旨在编制印度农村地区不同死因的邦级寿命损失年数估算，并确定不同邦负担较高的原因。

方法

将印度13个主要邦1995年总登记官死因调查（农村）报告的前9大死因的死亡百分比应用于总死亡预期数。根据标准生命表计算的寿命损失进行年龄加权，并采用1990年全球疾病负担研究的方法进行贴现。死因基于外行报告，否则似乎是可靠的。

结果

1995年印度农村地区全死因寿命损失年数为每1000人口207人。喀拉拉邦最低，为74人；中央邦最高，为276人。肺炎是导致寿命损失年数最多的首要原因，为15人。各邦之间差异很大，泰米尔纳德邦因该原因导致的寿命损失年数仅为1.6人，而北方邦为30.5人。癌症在各邦的负担较为一致。心脏病发作、支气管炎和哮喘在发达程度不同的邦均有出现。自杀在安得拉邦负担沉重，而车辆事故在哈里亚纳邦和拉贾斯坦邦负担沉重。比哈尔邦、古吉拉特邦、中央邦、奥里萨邦、拉贾斯坦邦和北方邦主要死因是传染病和营养状况，而喀拉拉邦和旁遮普邦由于过早死亡导致寿命损失年数的主要原因是非传染性疾病。