MORTALITY AND DISABILITY-ADJUSTED LIFE-YEARS (DALYS) FOR COMMON NEGLECTED TROPICAL DISEASES IN ETHIOPIA, 1990-2015: EVIDENCE FROM THE GLOBAL BURDEN OF DISEASE STUDY 2015

Authors

  • Amare Deribew 1. St. Paul Millennium Medical College, Addis Ababa Ethiopia 2. Nutrition International, Addis Ababa, Ethiopia
  • Biruck Kebede Federal Ministry of Health, Addis Ababa, Ethiopia
  • Gizachew Assefa Tessema 1.School of Public Health, University of Adelaide, Adelaide, Australia; 2. Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
  • Yohannes Adama Melaku School of Medicine, University of Adelaide, Adelaide, Australia; School of Public Health, Mekelle University, Mekelle, Ethiopia
  • Awoke Misganaw Institute for Health Metrics and Evaluation, University of Washington
  • Teshome Gebre International Trachoma Initiative
  • Asrat Hailu Collage of Medicine Addis Ababa University, Ethiopia
  • Sibhatu Biadgilign Independent consultant, Addis Ababa, Ethiopia
  • Alemayehu Amberbir Dignitas International, Zomba Malawi
  • Biruck Desalegn Yirsaw University of South Africa
  • Amanuel Alemu Abajobir University of Debre Markos
  • Oumer Shafi Rollind schools of public Health, Emory University, USA
  • Semaw F. Abera 1. School of Public Health, Mekelle University, Mekelle, Ethiopia; Kilte Awlaelo-Health and Demographic Surveillance Site, Tigray, Ethiopia; 2. Institute of Biological Chemistry and Nutrition, Hohenheim University, Stuttgart, Germany
  • Nebiyu Negussu Federal Ministry of Health, Addis Ababa, Ethiopia
  • Belete Mengistu Federal Ministry of Health, Addis Ababa, Ethiopia
  • Azmeraw T Amare 1.College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; School of Medicine, 2.University of Adelaide, Adelaide, Australia; Department of Epidemiology, University of Groningen, Groningen, the Netherlands
  • Abate Mulugeta WHO Ethiopia country office, Addis Ababa
  • Birhan Mengistu Federal Ministry of Health, Addis Ababa, Ethiopia
  • Zerihun Tadesse The Carter Center, Addis Ababa
  • Mesfin Sileshi 1.Federal Ministry of Health, Addis Ababa, Ethiopia 2.RTI International, Addis Ababa, Ethiopia
  • Mossie Tamiru Federal Ministry of Health, Addis Ababa, Ethiopia
  • Elizabeth Chromwell Institute for Health Metrics and Evaluation, University of Washington
  • Scott D Glenn Institute for Health Metrics and Evaluation, University of Washington
  • Jeffrey Stnaway Institute for Health Metrics and Evaluation, University of Washington
  • Kebede Deribe 1. Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, UK; 2. School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia

Abstract

 

Introduction: Neglected tropical diseases (NTDs) are important public health problems in Ethiopia. In 2013, the Federal Ministry of Health (FMOH) has launched a national NTD master plan to eliminate major NTDs of public health importance by 2020. Benchmarking the current status of NTDs in the country is important to monitor and evaluate the progress in the implementation of interventions and their impacts. Therefore, this study aims to assess the trends of mortality and Disability-adjusted Life-Years (DALY) for the priority NTDs over the last 25 years.

Methods: We used the Global Burden of Disease (GBD) 2015 estimates for this study. The GBD 2015 data source for cause of death and DALY estimation included verbal autopsy (VA), Demographic and Health Surveys (DHS), and other disease specific surveys, Ministry of Health reports submitted to United Nations (UN) agencies and published scientific articles. Cause of Death Ensemble modeling (CODEm) and/or natural history models were used to estimate  NTDs mortality rates. DALY were estimated as the sum of Years of Life Lost (YLL) due to premature mortality and Years Lived with Disability (YLD).

Results: All NTDs caused an estimated of 6,293 deaths (95% uncertainty interval (UI): 3699-10,080) in 1990 and 3,593 deaths (95% UI: 2051 – 6178) in 2015, a 43% reduction over the 25 years. Age-standardized mortality rates due to schistosomiasis, STH and leshmaniasis have declined by 91.3%, 73.5% and 21.6% respectively between 1990 to 2015. The number of DALYs due to all NTDs has declined from 814.4 thousand (95% UI: 548 thousand–1.2million) in 1990 to 579.5 thousand (95%UI: 309.4 thousand–1.3 million) in 2015. Age-standardized DALY rates due to all NTDs declined by 30.7%, from 17.6 per 1000(95%UI: 12.5-26.5) in 1990 to 12.2 per 1000(95%UI: 6.5 – 27.4) in 2015.  Age-standardized DALY rate for trachoma declined from 92.7 per 100,000(95% UI: 63.2 – 128.4) in 1990 to 41.2 per 100,000(95%UI: 27.4–59.2) in 2015, a 55.6% reduction between 1990 and 2015. Age-standardized DALY rates for onchocerciasis, schistosomiasis and lymphiaticfilariasis decreased by 66.2%, 29.4% and 12.5% respectively between 1990 and 2015. DALY rate for ascariasis fell by 56.8% over the past 25 years.

Conclusions: Ethiopia has made a remarkable progress in reducing the DALY rates for most of the NTDs over the last 25 years. The rapid scale of interventions and broader system strengthening may have a lasting impact on achieving the 2020 goal of elimination of most of NTDs. Ethiopia should strengthen the coverage of integrated interventions of NTD through proper coordination with other health programs and sectors and community participation to eliminate NTDs by 2020.

Key words:  NTDs, DALY, Ethiopia

 

Author Biography

Amare Deribew, 1. St. Paul Millennium Medical College, Addis Ababa Ethiopia 2. Nutrition International, Addis Ababa, Ethiopia

Associate Professor at St. Paul Millennium Medical College and Country Director at Nutrition International

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2017-08-14

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