Initial burden of disease estimates for South Africa, 2000

Bradshaw, Debbie, Groenewald, Pam, Laubscher, Ria, Nannan, Nadine, Nojilana, Beatrice, Norman, Rosana, Pieterse, Desiréé, Schneider, Michelle, Bourne, David E., Timæus, Ian M., Dorrington, Rob and Johnson, Leigh (2003) Initial burden of disease estimates for South Africa, 2000. SAMJ South African Medical Journal, 93 9: 682-688.

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Author Bradshaw, Debbie
Groenewald, Pam
Laubscher, Ria
Nannan, Nadine
Nojilana, Beatrice
Norman, Rosana
Pieterse, Desiréé
Schneider, Michelle
Bourne, David E.
Timæus, Ian M.
Dorrington, Rob
Johnson, Leigh
Title Initial burden of disease estimates for South Africa, 2000
Journal name SAMJ South African Medical Journal   Check publisher's open access policy
ISSN 0256-9574
2078-5135
Publication date 2003-09-01
Year available 2003
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 93
Issue 9
Start page 682
End page 688
Total pages 7
Place of publication Claremont, South Africa
Publisher Health and Medical Publishing Group
Language eng
Subject 11 Medical and Health Sciences
Formatted abstract
Background.
This paper describes the first national burden of disease study for South Africa. The main focus is the burden due to premature mortality, i.e. years of life lost (YLLs). In addition, estimates of the burden contributed by morbidity, i.e. the years lived with disability (YLDs), are obtained to calculate disability-adjusted life years (DALYs); and the impact of AIDS on premature mortality in the year 2010 is assessed.

Method.
Owing to the rapid mortality transition and the lack of timely data, a modelling approach has been adopted. The total mortality for the year 2000 is estimated using a demographic and AIDS model. The non-AIDS cause-of-death profile is estimated using three sources of data: Statistics South Africa, the National Department of Home Affairs, and the National Injury Mortality Surveillance System. A ratio method is used to estimate the YLDs from the YLL estimates.

Results.
The top single cause of mortality burden was HIV/AIDS followed by homicide, tuberculosis, road traffic accidents and diarrhoea. HIV/AIDS accounted for 38% of total YLLs, which is proportionately higher for females (47%) than for males (33%). Pre-transitional diseases, usually associated with poverty and underdevelopment, accounted for 25%, non-communicable diseases 21% and injuries 16% of YLLs. The DALY estimates highlight the fact that mortality alone underestimates the burden of disease, especially with regard to unintentional injuries, respiratory disease, and nervous system, mental and sense organ disorders. The impact of HIV/AIDS is expected to more than double the burden of premature mortality by the year 2010.

Conclusion.
This study has drawn together data from a range of sources to develop coherent estimates of premature mortality by cause. South Africa is experiencing a quadruple burden of disease comprising the pre-transitional diseases, the emerging chronic diseases, injuries, and HIV/AIDS. Unless interventions that reduce morbidity and delay morbidity become widely available, the burden due to HIV/AIDS can be expected to grow very rapidly in the next few years. An improved base of information is needed to assess the morbidity impact more accurately.
Keyword Mortality
Disease
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Public Health Publications
 
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Created: Fri, 15 Jan 2010, 00:22:39 EST by Sue Green on behalf of Faculty Of Health Sciences