Медицина/ 3 Организация
здравоохранения
Aubakirova A.S., Dzhaksibekova G.K., Batpenov N.G., Kim S.V.
Institute of Public
Health, Astana Medical University, Kazakhstan
Lost years of human life
(DALY) due to
premature death from injuries in the Republic of Kazakhstan
Introduction. Various factors of priority importance influence
the population health status: genetic background, living and working conditions,
environmental and public health conditions.
Population health status
is an integral indicator,
depending on many factors. Primarily, the interaction between a person and his environment, including the factor of production,
financial support of vital human needs, healthcare system level.
Comprehensive assessment of health status based on data on mortality,
morbidity and / or prevalence of disease in the studied population.
A new approach
to integrated assessment of health
is the method of the
global burden of disease (GBD), which includes
data on mortality,
incidence of disease among the population and
its disabling effects
and the consequences of injuries,
poisonings and accidents.
Purpose: The purpose of this study was to determine
the number of lost life years (units DALY) due to premature mortality
from trauma population
of Kazakhstan in 2008.
Materials and Methods: The method of the global burden of
disease is based on an assessment
of the number of years lost population due to
premature death and because of the debilitating
effects of diseases, injuries, poisoning and
accidents.
To study
used data of the
Agency for Statistics of the Republic of Kazakhstan (Form C51) for 2008.
Currently existing formula for calculating the number of lost life years (units
DALY) is quite complicated and laborious. To simplify its use applied table
DALY - indexes in health care.
Results: The results of the years lost due to premature mortality from injuries
in Tables 1-4.
Table 1. Distribution
of lost life years (DALY) by age groups and causes of death in
2008 among men
due to premature death from injuries and
poisonings.
|
Terms of life, age |
Transport accidents |
Accidental falls |
Accidental drowning and submersion |
Exposure to smoke, fire and flame |
Accidental poisoning and exposure
to toxic substances |
Intentional self-harm |
Assaultive act |
All other external causes of death
|
|
0-4 |
1543.6 |
857.5 |
2161.0 |
686.0 |
857.6 |
0 |
411.6 |
7614.8 |
|
5-9 |
2211.3 |
181.3 |
1341.3 |
145.0 |
507.5 |
253.8 |
145.0 |
1232.5 |
|
10-14 |
1680.2 |
146.1 |
1095.8 |
109.6 |
73.1 |
2155.1 |
36.5 |
1570.7 |
|
15-19 |
5557.0 |
460.1 |
2902.4 |
177.0 |
672.5 |
8211.6 |
2619.2 |
5415.4 |
|
20-24 |
13634.4 |
1400.1 |
3300.3 |
500.0 |
4067.0 |
14167.8 |
5967.1 |
10367.5 |
|
25-29 |
11789.6 |
1136.0 |
2793.9 |
614.0 |
7736.9 |
13478.2 |
5772.0 |
13140.5 |
|
30-34 |
9737.8 |
1609.1 |
3218.2 |
221.9 |
7934.5 |
11679.8 |
4966.0 |
12956.0 |
|
35-39 |
6996.0 |
1157.8 |
2217.0 |
591.2 |
5641.2 |
8671.2 |
4508.0 |
10272.4 |
|
40-44 |
5738.1 |
709.2 |
1783.8 |
709.2 |
4556.1 |
6533.3 |
3008.7 |
10186.7 |
|
45-49 |
4339.8 |
643.6 |
1287.2 |
551.7 |
4744.4 |
5663.8 |
2905.5 |
9543.9 |
|
50-54 |
2766.6 |
430.4 |
860.7 |
399.6 |
3734.9 |
3289.2 |
1660.0 |
6885.8 |
|
55-59 |
1294.8 |
261.5 |
498.0 |
199.2 |
1805.3 |
2016.9 |
697.2 |
3946.7 |
|
60-64 |
520.0 |
105.9 |
144.5 |
144.5 |
587.4 |
751.1 |
317.8 |
1685.3 |
|
65-69 |
379.3 |
144.8 |
117.3 |
48.3 |
469.0 |
586.2 |
234.5 |
972.5 |
|
70-74 |
181.7 |
33.8 |
46.5 |
50.7 |
164.8 |
245.0 |
63.4 |
367.6 |
|
75-79 |
26.9 |
6.3 |
4.8 |
12.7 |
36.4 |
93.5 |
17.4 |
69.7 |
|
80-82 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Total |
68397.1 |
9283.5 |
23772.4 |
5160.6 |
43588.4 |
77796.5 |
33330.0 |
96227.8 |
|
|
19,1 |
2,6 |
6,6 |
1,4 |
12,2 |
21,8 |
9,3 |
27 |
Among men, the
largest share of lost life years (DALY) accounts
for self-harm -
21,8 %, followed by transport accidents and
poisoning, accounting for 19.1
and 12.2 % respectively. Among women, the distribution of life years lost from injury
has a slightly different distribution (Table 2).
Table 2. Distribution
of lost life years (DALY) by age groups and causes of death in
2008 among women
due to premature death from injuries and
poisonings.
|
Terms of life, age |
Transport accidents |
Accidental falls |
Accidental drowning and submersion |
Exposure to smoke, fire and flame |
Accidental poisoning and exposure
to toxic substances |
Intentional self-harm |
Assaultive act |
All other external causes of death
|
|
0-4 |
1308.0 |
619.6 |
929.4 |
378.6 |
654.0 |
0 |
172.1 |
4887.9 |
|
5-9 |
1564.7 |
72.8 |
436.7 |
109.2 |
436.7 |
72.8 |
145.6 |
473.0 |
|
10-14 |
1027.2 |
0 |
843.8 |
73.4 |
293.5 |
623.7 |
73.4 |
330.2 |
|
15-19 |
2882.0 |
106.7 |
889.5 |
35.6 |
711.6 |
4696.7 |
533.7 |
1067.4 |
|
20-24 |
3825.0 |
335.5 |
436.2 |
100.7 |
1207.9 |
3590.2 |
905.9 |
2248.1 |
|
25-29 |
2754.9 |
371.4 |
742.9 |
154.8 |
1857.2 |
2476.3 |
1176.3 |
2104.9 |
|
30-34 |
2018.6 |
280.4 |
252.3 |
28.0 |
1710.2 |
2018.6 |
1373.8 |
2803.6 |
|
35-39 |
1948.0 |
174.9 |
249.7 |
274.7 |
1123.8 |
1623.3 |
1073.9 |
2247.7 |
|
40-44 |
1685.2 |
131.3 |
197.0 |
43.8 |
1116.2 |
1203.7 |
700.4 |
2188.6 |
|
45-49 |
1394.8 |
56.5 |
207.3 |
169.6 |
1338.2 |
1055.5 |
735.1 |
1828.3 |
|
50-54 |
954.2 |
159.0 |
143.1 |
127.2 |
938.3 |
652.0 |
540.7 |
1987.9 |
|
55-59 |
823.3 |
143.8 |
52.3 |
117.6 |
666.5 |
405.1 |
365.9 |
1137.0 |
|
60-64 |
351.9 |
51.7 |
31.0 |
31.0 |
362.3 |
217.4 |
155.3 |
496.8 |
|
65-69 |
309.3 |
46.4 |
30.9 |
23.2 |
371.1 |
224.2 |
116.0 |
603.1 |
|
70-74 |
140.3 |
31.2 |
10.4 |
31.2 |
88.3 |
62.4 |
93.5 |
285.8 |
|
75-79 |
81.4 |
22.0 |
10.8 |
8.1 |
48.8 |
70.5 |
40.7 |
116.7 |
|
80-82 |
8.9 |
6.7 |
0.7 |
2.2 |
11.1 |
7.4 |
9.6 |
23.7 |
|
Total |
23077.7 |
2609.6 |
5464.2 |
1709.0 |
12935.8 |
18999.8 |
8211.7 |
24830.5 |
|
|
23,6 |
2,7 |
5,6 |
1,7 |
13,2 |
19,4 |
8,4 |
25,4 |
Among women, the
greatest share of lost life years (DALY) in
all age groups accounted for
transport accidents - 23,6 %.
Table 3. Distribution
the lost life years (DALY) to localize the external causes of death from
injury and poisoning
in 2008 among men.
|
Head injury |
Neck injury |
Chest injuries |
Injuries to abdomen, lower back, lumbar spine and
pelvis |
Injuries to the extremities |
Consequences of foreign body entering through
natural way |
Thermal and chemical burns |
Chilblain |
Poisoning by drugs, medicaments and biological substances |
All other and unspecified injuries and other
external causes |
|
|
0-4 |
2778.3 |
171.5 |
240.1 |
68.6 |
0 |
2984.2 |
1372.0 |
0 |
1234.8 |
4836.4 |
|
5-9 |
1993.7 |
36.3 |
362.5 |
36.3 |
0 |
398.8 |
217.5 |
0 |
833.8 |
2138.8 |
|
10-14 |
1570.6 |
36.5 |
182.6 |
182.6 |
73.0 |
219.2 |
182.6 |
0 |
255.7 |
4164.1 |
|
15-19 |
5557.0 |
920.3 |
2902.4 |
637.1 |
247.8 |
637.1 |
247.8 |
35.4 |
1097.2 |
13733.3 |
|
20-24 |
14034.5 |
1333.4 |
5700.5 |
1600.1 |
800.1 |
766.7 |
566.7 |
66.7 |
5067.1 |
23468.5 |
|
25-29 |
12618.5 |
1136.0 |
5065.8 |
1964.9 |
736.8 |
829.0 |
798.3 |
429.8 |
9732.5 |
23149.3 |
|
30-34 |
10431.4 |
1359.4 |
5132.5 |
1858.8 |
721.3 |
776.8 |
693.6 |
388.4 |
9626.8 |
21334.4 |
|
35-39 |
8868.2 |
1034.6 |
3769.0 |
1207.1 |
492.7 |
714.4 |
615.9 |
443.4 |
6749.7 |
16159.9 |
|
40-44 |
6705.2 |
666.2 |
3116.2 |
924.1 |
451.3 |
601.7 |
838.1 |
451.3 |
5587.7 |
13883.2 |
|
45-49 |
5737.4 |
827.5 |
2500.9 |
919.5 |
441.3 |
514.9 |
698.8 |
367.8 |
5332.8 |
12339.0 |
|
50-54 |
3873.2 |
522.6 |
1598.5 |
338.1 |
276.7 |
507.2 |
553.3 |
322.8 |
4103.8 |
7930.9 |
|
55-59 |
1867.5 |
249 |
859.0 |
249 |
62.3 |
149.4 |
323.7 |
224.1 |
2091.6 |
4643.9 |
|
60-64 |
963 |
86.7 |
327.4 |
96.3 |
38.5 |
134.8 |
134.8 |
48.2 |
693.4 |
1733.4 |
|
65-69 |
579.3 |
41.4 |
227.6 |
20.7 |
27.6 |
62.1 |
110.4 |
34.5 |
538.0 |
1310.4 |
|
70-74 |
219.7 |
21.1 |
97.2 |
8.5 |
12.7 |
29.6 |
67.6 |
4.2 |
207.0 |
485.9 |
|
75-79 |
41.2 |
7.9 |
20.6 |
4.8 |
3.2 |
1.6 |
11.1 |
1.6 |
46.0 |
129.9 |
|
80-82 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Total |
77838.7 |
8450,4 |
32102,8 |
10116,5 |
4385,3 |
9327,5 |
7432,2 |
2818,2 |
53197,9 |
151441,3 |
|
|
21,8 |
2,4 |
9 |
2,8 |
1,2 |
2,6 |
2,1 |
0,8 |
14,9 |
42,4 |
Table 4. Distribution
the lost life years (DALY) to
localize the external causes
of death from injury
and poisoning in
2008 among women.
|
Terms of life, age |
Head injury |
Neck injury |
Chest injuries |
Injuries to abdomen, lower back,
lumbar spine and pelvis |
Injuries to the extremities |
Consequences of foreign body
entering through natural way |
Thermal and chemical burns |
Chilblain |
Poisoning by drugs, medicaments
and biological substances |
All other and unspecified injuries
and other external causes |
|
0-4 |
1549 |
103.3 |
309.8 |
34.4 |
103.3 |
2168 |
619.6 |
0 |
998.2 |
2788.2 |
|
5-9 |
1419.1 |
36.4 |
218.3 |
36.4 |
0 |
145.6 |
181.9 |
0 |
400.3 |
873.3 |
|
10-14 |
807.1 |
36.7 |
183.4 |
0 |
36.7 |
146.8 |
36.7 |
0 |
366.9 |
1650.9 |
|
15-19 |
2312.8 |
284.6 |
498.1 |
391.4 |
106.7 |
391.4 |
71.2 |
35.6 |
1316.5 |
5515.1 |
|
20-24 |
3254.6 |
167.8 |
637.5 |
570.4 |
134.2 |
0 |
201.3 |
67.1 |
1845.4 |
5771.1 |
|
25-29 |
2352.5 |
526.2 |
835.8 |
495.3 |
154.8 |
123.8 |
185.7 |
31 |
2662 |
4271.7 |
|
30-34 |
2074.7 |
140.2 |
1205.5 |
364.5 |
112.1 |
196.3 |
84.1 |
28.0 |
2271 |
4009.1 |
|
35-39 |
1723.2 |
399.6 |
774.2 |
399.6 |
124.9 |
149.8 |
249.7 |
50 |
1648.3 |
3196.7 |
|
40-44 |
1707.1 |
131.3 |
569. |
218.9 |
65.7 |
109.4 |
87.5 |
131.3 |
1488.2 |
2757.6 |
|
45-49 |
1112 |
301.6 |
339.3 |
301.6 |
94.2 |
150.8 |
150.8 |
75.4 |
1677.5 |
2582.2 |
|
50-54 |
1065.5 |
143.1 |
3334 |
190.8 |
47.7 |
174.9 |
95.4 |
159 |
1176.8 |
2115.1 |
|
55-59 |
836.4 |
104.6 |
261.4 |
65.3 |
39.2 |
52.3 |
130.7 |
91.5 |
797.2 |
1333 |
|
60-64 |
320.9 |
10.4 |
144.9 |
31.1 |
31.0 |
20.7 |
62.1 |
41.4 |
445.1 |
590 |
|
65-69 |
324.7 |
38.7 |
131.4 |
38.7 |
15.5 |
54.1 |
61.9 |
7.7 |
479.4 |
572.2 |
|
70-74 |
228.6 |
15.6 |
41.6 |
10.4 |
10.4 |
20.8 |
31.2 |
10.4 |
145.5 |
228.6 |
|
75-79 |
92.2 |
13.6 |
38 |
19 |
0 |
5.4 |
24.4 |
0 |
70.5 |
135.6 |
|
80-82 |
15.5 |
3.7 |
3.7 |
3.7 |
2.2 |
0 |
3 |
0 |
16.3 |
22.2 |
|
Total |
21195.9 |
2457.4 |
9525.9 |
3171.5 |
1078.6 |
3910.1 |
2277.2 |
728.4 |
17805.1 |
38412.6 |
|
|
21,7 |
2,5 |
6,7 |
3,3 |
1,1 |
4,0 |
2,3 |
0,7 |
18,2 |
39,4 |
Conclusions: Distribution of lost life years (DALY) to
localize the external causes
of death from injury
and poisoning has
equal weight, both
among women and among men,
accounting for the largest share of head injuries (men
- 21,8%, female
21.7%).
Other external causes of death in men
were 28.3% of
all injuries and
27.4% in women. Transport
accidents account for 17.9% of men and women 22,2%.
Quite a high percentage of deaths from intentional
self-harm is celebrated as among women (17,5%) and
men (21.3%).
Among the injuries,
poisoning and other consequences of external causes the bulk of the deaths
occurring in unspecified injuries and other external causes. These amounted to
42.17% in males and 38.0% for women, head injuries - 21.16% in males and 21.5%
among women, poisoning, drugs, medicaments and biological substances - 15,9% of
men and 19,7% in women. Greatest
share of losses year falls on the age of 15 to 59 years.
Thus, the major proportion
of deaths from injury have on working age. High percentage
of deaths in the group "transport accidents"
and "deliberate
self-harm. " Most
of the injuries noted in the group of "other
external causes of death"
and "unspecified
injury, which
requires a more complete detailing their reasons, localization
and age.
Keywords: global burden of disease; lost life years; DALY; injuries; Republic of Kazakhstan.
Literature:
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An Intergovernmental Statistical Committee of the CIS countries - Report on
the state of population health, and healthcare systems’ organizations in the
CIS countries. - 2009. - P.4.
2. Murray C.J.L.
Quantifying the burden of disease: the technical basis for disability –
adjusted life years / Global comparative assessments in the health sector. –
Geneva – 1994 – P. 3-19.
3. World Health
Organization. The Global burden of disease-2004 update. – 2004. - Р.39-57.
4. Kim S.V. Essays on
Health Organization. Topical problems of
health care in Kazakhstan. Astana, 2009. – Р.19-23.
5. Kim S.V. Using
tables DALY - indexes in
health care // Problems of Social
Medicine and Health Management – 2004. – 32. – Р.13-16.