Massahikhaleghi Parissa, Tehrani-Banihashemi Arash, Saeedzai Sayed Ataullah, Hossaini Sayyed Musa, Hamedi Sayed Amin, Moradi-Lakeh Maziar, Naghavi Mohsen, Murray Christopher J L, Mokdad Ali H
Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran.
Afghanistan Ministry of Public Health, Kabul, Afghanistan.
Arch Iran Med. 2018 Aug 1;21(8):324-334.
Afghanistan is one of the low-income countries in the Eastern Mediterranean Region with young population and myriad of healthcare needs. We aim to report the burden of diseases and injuries in Afghanistan between 1990 and 2016.
We used the Global Burden of Disease (GBD) 2016 study for estimates of deaths, disability-adjusted life years (DALYs), years of life lost, years of life lived with disability, maternal mortality ratio (MMR), neonatal mortality rates (NMRs) and under 5 mortality rates (U5MR) in Afghanistan.
Total mortality rate, NMR and U5MR have progressively decreased between 1990 and 2016. Mortality rate was 909.6 per 100000 (95% UI: 800.9-1023.3) and MMR was 442.8 (95% UI: 328.3-595.8) per 100000 live births in 2016. Conflict and terrorism, ischemic heart disease (IHD) and road injuries were the leading causes of DALY among males of all ages in 2016 with 10.9%, 7.8% and 7.6% of total DALYs respectively, whereas among females of all ages lower respiratory infections (LRIs), IHD and congenital birth defects were the leading causes of DALY with 8.7%, 7.0% and 6.5% of total DALYs respectively.
Despite improvements in certain health indicators, our study suggests an urgent intervention to improve health status of the country. Peace and safety by means of stopping the conflict and terrorism are the mainstay of all other health interventions. Improving health infrastructures, boosting maternal and child health (MCH), battling infectious diseases as well as chronic disease risk factor modification programs can help to decrease burden of diseases.
阿富汗是东地中海区域的低收入国家之一，人口年轻，医疗保健需求众多。我们旨在报告1990年至2016年期间阿富汗的疾病和伤害负担。
我们使用全球疾病负担（GBD）2016研究来估计阿富汗的死亡人数、伤残调整生命年（DALY）、生命损失年数、残疾生存年数、孕产妇死亡率（MMR）、新生儿死亡率（NMR）和5岁以下儿童死亡率（U5MR）。
1990年至2016年期间，总死亡率、NMR和U5MR逐渐下降。2016年，死亡率为每10万人909.6例（95%不确定区间：800.9 - 1023.3），MMR为每10万例活产442.8例（95%不确定区间：328.3 - 595.8）。2016年，冲突与恐怖主义、缺血性心脏病（IHD）和道路伤害是各年龄段男性DALY的主要原因，分别占总DALY的10.9%、7.8%和7.6%，而在各年龄段女性中，下呼吸道感染（LRI）、IHD和先天性出生缺陷是DALY的主要原因，分别占总DALY的8.7%、7.0%和6.5%。
尽管某些健康指标有所改善，但我们的研究表明，迫切需要进行干预以改善该国的健康状况。通过停止冲突和恐怖主义实现和平与安全是所有其他健康干预措施的支柱。改善卫生基础设施、加强母婴健康（MCH）、抗击传染病以及开展慢性病风险因素修正项目有助于减轻疾病负担。
