Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019

Rios-Blancas, MJ; Pando-Robles, V; Razo, C; Carcamo, CP; Mendoza, W; Pacheco-Barrios, K; Miranda, JJ; Lansingh, VC; Demie, TG; Saha, M; Okonji, OC; Yigit, A; Cahuana-Hurtado, L; Chacón-Uscamaita, PR; Bernabe, E; Culquichicon, C; Chirinos-Caceres, JL; Cárdenas, R; Alcalde-Rabanal, JE; Barrera, FJ; Ayala Quintanilla, Beatriz; Shorofi, SA; Wickramasinghe, ND; Ferreira, N; Almidani, L; Gupta, VK; Karimi, H; Alayu, DS; Benziger, CP; Fukumoto, T; Mostafavi, E; Redwan, EMM; Gebrehiwot, M; Khatab, K; Koyanagi, A; Krapp, F; Lee, S; Noori, M; Qattea, I; Rosenthal, VD; Sakshaug, JW; Wagaye, B; Zare, I; Ortega-Altamirano, DV; Murillo-Zamora, E; Vervoort, D; Silva, DAS; Oulhaj, A; Herrera-Serna, BY; Mehra, R; Amir-Behghadami, M; Adib, N; Cortés, S; Dang, AK; Nguyen, BT; Mokdad, AH; Hay, SI; Murray, CJL; Lozano, R; García, PJ

doi:10.26181/24939201.v1

Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019

journal contribution

posted on 2024-01-03, 23:37 authored by MJ Rios-Blancas, V Pando-Robles, C Razo, CP Carcamo, W Mendoza, K Pacheco-Barrios, JJ Miranda, VC Lansingh, TG Demie, M Saha, OC Okonji, A Yigit, L Cahuana-Hurtado, PR Chacón-Uscamaita, E Bernabe, C Culquichicon, JL Chirinos-Caceres, R Cárdenas, JE Alcalde-Rabanal, FJ Barrera, Beatriz Ayala QuintanillaBeatriz Ayala Quintanilla, SA Shorofi, ND Wickramasinghe, N Ferreira, L Almidani, VK Gupta, H Karimi, DS Alayu, CP Benziger, T Fukumoto, E Mostafavi, EMM Redwan, M Gebrehiwot, K Khatab, A Koyanagi, F Krapp, S Lee, M Noori, I Qattea, VD Rosenthal, JW Sakshaug, B Wagaye, I Zare, DV Ortega-Altamirano, E Murillo-Zamora, D Vervoort, DAS Silva, A Oulhaj, BY Herrera-Serna, R Mehra, M Amir-Behghadami, N Adib, S Cortés, AK Dang, BT Nguyen, AH Mokdad, SI Hay, CJL Murray, R Lozano, PJ García

Background: Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru’s healthcare system performance. Methods: 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. Results: 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. Conclusion: 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.

Funding

BAQ acknowledges support from Belgian Directorate of Development Cooperation (DGD) through the Framework Agreement between the Belgian DGD and the Institute of Tropical Medicine, Belgium; Fogarty International Center of the National Institutes of Health and the University of California Global Health Institute under Award Number D43TW009343; and Fogarty International Center, and National Institute of Child Health & amp; Human Development of the National Institutes of Health under award number D43 TW009763. PRC-U, acknowledges support from training grant D43 TW007393 awarded by the Fogarty International Center of the US National Institutes of Health. SC acknowledges support from Fondo de Financiamiento de Centros de Investigacion en Areas Prioritarias (FONDAP) (grant number 15130011). This study was also supported by the Bill & Melinda Gates Foundation.

History

Publication Date

2023-01-01

Journal

Frontiers in Public Health

Volume

11

Article Number

1189861

Pagination

14p.

Publisher

Frontiers

ISSN

2296-2565

Rights Statement

© 2023 The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.