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

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Creator
  • Rios-Blancas M.J.
    • Other Affiliation: Carlos Slim Foundation
  • Pando-Robles V.
    • Other Affiliation: National Institute of Public Health, Cuernavaca
  • Razo C.
    • Other Affiliation: University of Washington
  • Carcamo C.P.
    • Other Affiliation: Universidad Peruana Cayetano Heredia
  • Mendoza W.
    • Other Affiliation: United Nations Population Fund (UNFPA)
  • Pacheco-Barrios K.
    • Other Affiliation: Universidad San Ignacio de Loyola
  • Miranda J.J.
    • Other Affiliation: Universidad Peruana Cayetano Heredia
  • Lansingh V.C.
    • Other Affiliation: Mexican Institute of Ophthalmology
  • Demie T.G.
    • Other Affiliation: St. Paul's Hospital Millennium Medical College
  • Saha M.
    • Other Affiliation: Monash University
  • Okonji O.C.
    • Other Affiliation: University of the Western Cape
  • Yigit A.
    • Other Affiliation: Süleyman Demirel Üniversitesi
  • Cahuana-Hurtado L.
    • Other Affiliation: Universidad Peruana Cayetano Heredia
  • Chacón-Uscamaita P.R.
    • Other Affiliation: Universidad Peruana Cayetano Heredia
  • Bernabe E.
    • Other Affiliation: King’s College London
  • Culquichicon C.
    • Other Affiliation: Universidad Privada Norbert Wiener
  • Chirinos-Caceres J.L.
    • Other Affiliation: Universidad Peruana Cayetano Heredia
  • Cárdenas R.
    • Other Affiliation: Metropolitan Autonomous University
  • Alcalde-Rabanal J.E.
    • Other Affiliation: National Institute of Public Health, Cuernavaca
  • Barrera F.J.
    • Other Affiliation: Harvard University
  • Quintanilla B.P.A.
    • Other Affiliation: La Trobe University
  • Shorofi S.A.
    • Other Affiliation: Flinders University
  • Wickramasinghe N.D.
    • Other Affiliation: Rajarata University of Sri Lanka
  • Ferreira N.
    • Other Affiliation: University of Nicosia
  • Almidani L.
    • Other Affiliation: University of California, Los Angeles
  • Gupta V.K.
    • Other Affiliation: Macquarie University
  • Karimi H.
    • Other Affiliation: Tehran University of Medical Sciences
  • Alayu D.S.
    • Other Affiliation: University of Gondar
  • Benziger C.P.
    • Other Affiliation: Essentia Health
  • Fukumoto T.
    • Other Affiliation: Kobe University
  • Mostafavi E.
    • Other Affiliation: Stanford University
  • Redwan E.M.M.
    • Other Affiliation: King Abdulaziz University
  • Gebrehiwot M.
    • Other Affiliation: Wollo University
  • Khatab K.
    • Other Affiliation: Sheffield Hallam University
  • Koyanagi A.
    • Other Affiliation: Catalan Institution for Research and Advanced Studies
  • Krapp F.
    • Other Affiliation: Katholieke Universiteit Leuven
  • Lee S.
    • Other Affiliation: Sungkyunkwan University
  • Noori M.
    • Other Affiliation: Iran University of Medical Sciences
  • Qattea I.
    • Other Affiliation: Case Western Reserve University
  • Rosenthal V.D.
    • Other Affiliation: International Nosocomial Infection Control Consortium
  • Sakshaug J.W.
    • Other Affiliation: Ludwig Maximilians University
  • Wagaye B.
    • Other Affiliation: Ludwig Maximilians University
  • Zare I.
    • Other Affiliation: Sina Medical Biochemistry Technologies Co. Ltd.
  • Ortega-Altamirano D.V.
    • Other Affiliation: National Institute of Public Health, Cuernavaca
  • Murillo-Zamora E.
    • Other Affiliation: Universidad de Colima
  • Vervoort D.
    • Other Affiliation: Johns Hopkins University
  • Silva D.A.S.
    • Other Affiliation: Federal University of Santa Catarina
  • Oulhaj A.
    • Other Affiliation: Khalifa University
  • Herrera-Serna B.Y.
    • Other Affiliation: Universidad Autónoma de Manizales
  • Mehra R.
  • Amir-Behghadami M.
    • Other Affiliation: Tabriz University of Medical Sciences
  • Adib N.
    • Other Affiliation: Shahid Bahonar University of Kerman
  • Cortés S.
    • Other Affiliation: Pontifical Catholic University of Chile
  • Dang A.K.
    • Other Affiliation: Duy Tan University
  • Nguyen B.T.
    • Other Affiliation: University of Washington
  • Mokdad A.H.
    • Other Affiliation: University of Washington
  • Hay S.I.
    • Other Affiliation: University of Washington
  • Murray C.J.L.
    • Other Affiliation: University of Washington
  • Lozano R.
    • Other Affiliation: University of Washington
  • García P.J.
    • Other Affiliation: Universidad Peruana Cayetano Heredia
Abstract
  • 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.
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  • Article
Rights statement
  • In Copyright
License
  • Attribution 4.0 International
Journal title
  • Frontiers in Public Health
Journal volume
  • 11
Language
  • English
Version
  • Publisher
Funder
  • Canadian Institutes of Health Research, IRSC
  • National Heart, Lung, and Blood Institute, NHLBI, (1UM1HL134590, 5U01HL114180, HHSN268200900033C)
  • Fondo de Financiamiento de Centros de Investigación en Áreas Prioritarias, FONDAP, (15130011)
  • Health Action International
  • TAG/RI
  • InterAmerican Heart Foundation
  • University of North Carolina at Chapel Hill School of Public Health
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, SNF, (40P740-160366)
  • International Development Research Centre, IDRC, (106887, 108167)
  • Medical Research Council, MRC
  • World Health Organization, WHO
  • Bill and Melinda Gates Foundation, BMGF
  • University of California Global Health Institute, (D43TW009343)
  • Instituto de Investigación Nutricional
  • Latin American Brain Health institute
  • Department for International Development, UK Government, DFID
  • Belgian Directorate of Development Cooperation
  • Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica, CONCYTEC
  • Wellcome Trust, WT, (D71TW010877, MR/M007405/1, R21TW009982, R21TW011740)
  • Inter-American Institute for Global Change Research, IAI, (IAI CRN3036)
  • National Institute of Child Health and Human Development, NICHD, (46129, D43 TW007393, D43 TW009763, HQHSR1206660)
  • British Embassy, (223-2018, 224-2018)
  • National Institute of Mental Health, NIMH, (1U19MH098780)
  • UKRI BBSRC, (BB/T009004/1)
  • Grand Challenges Canada, GCC, (0335–04)
  • UKRI MRC, (074833/Z/04/Z, 093541/Z/10/Z, 103994/Z/14/Z, 107435/Z/15/Z, 205177/Z/16/Z, 214185/Z/18/Z, 218743/Z/19/Z, MR/P008984/1, MR/P02386X/1, MR/P024408/1)
  • UKRI EPSRC, (EP/V043102/1)
  • Novartis Foundation
  • Institute of Tropical Medicine, Belgium
  • DGD
  • Universidad Adolfo Ibáñez
  • National Institutes of Health, NIH
  • National Health and Medical Research Council, NHMRC
  • World Diabetes Foundation, WDF, (WDF15-1224)
  • Fogarty International Center, FIC
  • National Cancer Institute, NCI, (1P20CA217231)
  • International Advisory Board
  • Fondo Nacional de Desarrollo Científico, Tecnológico y de Innovación Tecnológica, FONDECYT
  • Pontificia Universidad Católica del Perú, PUCP
  • British Council
ISSN
  • 2296-2565
Publisher
  • Frontiers Media SA

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