Burden Chapter 1

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Chapter 1 The burden of disease in Malawi

The burden of disease in MalawiCameron Bowie

Department of Community Health, College of Medicine, Blantyre, Malawi

1. Background

This chapter provides an overview of the

epidemiology of Malawi. It offers estimates

of incidence and prevalence of all majordiseases and disease specific death rates. It

also ranks the top diseases according to these

rates and provides an estimate of the risk

factors involved.

The World Health Organisation (WHO) has

developed the use of a measure [1], Disability

Adjusted Life Years (DALYs), to helpcalculate the burden of disease, and has

produced estimates for individual countries

within sub-regions of the world [2]. These

calculations are based on best estimates of

incidence, prevalence and mortality data of

the country in question.

A study of the contribution of diseases to theburden of disease in a resource scarce country

such as Malawi can also assist priority setting

and the choice of an essential health care

package (EHP).

This chapter reports on the WHO results and

compares WHO estimates with known local

surveys of mortality and morbidity. Thechapter discusses the limitations of the

estimates. The results can help to prioritise

public health interventions. The incidence

and prevalence rates can provide health

professionals with best available estimates

2.1.1 Deaths

2.1.1.1 Overall mortality

For member states without a vital registration

system as is Malawi, WHO uses other sourcesof adult mortality such as survey and census

data to estimate the level of adult mortality.

For under-five mortality, again, all available

survey and census data are assessed, adjusted

and averaged to estimate the probable trend in

child mortality over the past few decades. For

Malawi WHO used data from Census 77,Census 87, Census 98, Demographic and

Health Survey 92, Demographic and Health

Survey 2000, Family Formation Survey 84,

National Demographic Survey 82 and the

Population Change Survey 70. A life table

for Malawi is then constructed providing the

number of deaths by age and sex in 2002 [3].

2.1.1.2 Cause specific mortality

The number of deaths, by age and sex,

provides an essential envelope which

constrains individual disease and injury

estimates of deaths. Competing claims for the

magnitude of deaths from various causes must

be reconciled within this envelope. The sumof deaths from all specific causes for any sex-

age group must sum to the total number of

deaths for that age-sex group.

The World Health Organization contacts

member states directly on a routine basis to


2/42


vital registration data from urban and rural

South Africa. Based on this model WHO

then uses data provided by member states,

together with all available other sources ofinformation on causes of death, to estimate

death rates by age and sex for underlying

causes of death as defined by the ICD

classification rules. These death rates are

applied to the UN Population Division

estimates of the de-facto resident population

for 2002 to give numbers of expected deathsby cause for each Member State. (Annex 1

provides a table of population estimates and a

population pyramid for Malawi).

2.1.3 Morbidity

WHO uses disease registers, population

studies, epidemiological surveys and health

facility data, adjusted for each country using

estimates from WHO/UN programmes such

as HIV/AIDS and child nutrition.

2.1.4 Calculation of DALYs

DALYs have been calculated using the

standard formula and central assumptions

used by WHO [4]. The formula calculates theYLLs from the number of deaths for each age

group and sex for each main disease using a

discount rate of 3% and weighting each year

of life lost according to age. YLDs are

calculated using a similar age weighting and

discount rate of 3% and disability weights

published by WHO. A combination of YLLs(representing premature deaths) and YLDs

(representing years with a disability) produce

the total burden of disease for each age group

and disease expressed in DALYs.

2 1 5 Ri k f t

reduced to zero, and is calculated by equation

1)1(

)1(

+

=

RRP

RRPAF

The fraction of burden from a cause (disease

or injury) that is attributed to a risk factor

(AF) can be multiplied by the total burden (B)

due to that cause to obtain the attributable

burden (AB), i.e. AB = AF x B.

This has been done by WHO for developing

countries including Malawi and these AFshave been used to calculate the proportion of

the overall burden of disease to which

common risk factor contribute.

(www.who.int/whr/2002/annex/en/index.html

).

2.2 Local data

2.2.1 Deaths

Local mortality data for maternal and

perinatal death rates have been taken from the

Demographic Health Survey (DHS)

undertaken in 2000 [5]. Road traffic accident

death rates have been taken from the Africa

Road Safety Review of 2000 [6]. The mostrecent (2003) HIV antenatal surveillance

prevalence rates have been adjusted for the

differences found between antenatal testing

and community surveys in Karonga, a district

in Malawi [7]. These have been used to

calculate HIV deaths using projections

produced by UNAIDs EPP and Spectrumsoftware [8].

To avoid double counting, it has been

assumed that a sixth of maternal deaths as

estimated in the Demographic and Health

Survey of 2000 (DHS2000) are HIV/AIDS


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limits. These have been included as HIV

deaths and excluded as maternal deaths.

Deaths in health institutions are recordedroutinely in the Health Management

Information System (HMIS) [9].

WHO estimates of deaths are compared to the

National Statistics Office projections for

2002, found on the NSO website.

2.2.2 Morbidity

The Integrated Disease Surveillance and

Response (IDSR) reporting system provides

data on the incidence of immunization related

and other diseases. Malawi has high

immunisation programme coverage. Very

few measles, pertussis or polio cases have

been reported. Estimates of new HIV cases

are derived from the antenatal surveillancesurveys using EPP and Spectrum. HMIS

reports on disease specific patient attendances

and admissions. The rates for malaria

reported as attending a health facility have

been used (national incidence of 730/1000 for

under 5 year olds) and adjusted upwards to

take into account the fact that only aproportion (26%) of fever cases reported in

the DHS2000 are taken to a health facility and

adjusted downwards to take into account the

fact that only 21% of fever cases are actually

due to malaria as found in a local survey in

Blantyre, Malawi.

DHS2000 reports rates for childhood

malnutrition and diarrhoea prevalence [5].

Recent prevalence surveys are available for

schistosomiasis [10], filariasis associated

hydrocoele and lymphoedema [11], anaemia

[12], soil transmitted helminths [10] and

blindness [13].

3. Results

3.1 Comparing WHO and local data

3.1.1 Deaths

The rates of the common causes of death as

recorded in HMIS have been compared to

those provided by WHO and none are foundto be in excess of these, so the WHO death

rate estimates have been used on the premise

that most deaths in Malawi occur outside a

health facility.

WHO estimates of deaths for Malawi in 2002

are higher than projections provided by the

National Statistics Office (NSO) based on the1998 census and projected forward to 2002

(Table 1).

Table 1. A comparison of WHO and National Statistics Office estimates of deaths in Malawi 2002

Malawi 2002 National Statistics Office WHO

Number of deaths all ages 223110 257510Deaths under 5 years of age 80874 99133

3.1.2Incidence and prevalence

The estimates used by WHO can be compared

higher than data from local sources (Table 2).

The discrepancy concerning AIDS deaths and

maternal mortality are particularly high See


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Table 2. A comparison of Malawi 2002 incidence and prevalence rates used by Global Burden of

Disease (GBD) WHO Unit and estimates from local surveys

DiseaseAgegroup GBD Local Local Source (reference) Comment

Incidence per1000

Diarrhoea 0-4 5154 4570 DHS2000 (4)

Cataract all ages 2.7 3.8Nkhoma blindness preventionsurvey (13) 1

Measles 0-4 0.05 0.06 EPI report

Diphtheria all ages 0.002 0.02 HMIS (9) 2

Pertussis 0-4 0.14 0 EPI reportRoad trafficdeaths all ages 0.29 0.14 NRSMC (6)

HIV 15-44 24 24Spectrum adjusted for age, sex andrurality (7,8)

AIDS 15-44 9.89 13Spectrum adjusted for age, sex andrurality (7,8)

AIDS deaths 15-44 11.53 12Spectrum adjusted for age, sex andrurality (7,8)

Maternal mortality 15-49 3.3 2.4DHS2000 (less 1/6th due to AIDS)(4) 3

Perinatalmortality 0-4 24.3 10.2 DHS2000 (4)

Malaria 0-4 944 1050HMIS adjusted for non specificity offever and non-attenders (4,9)

Prevalence per 1000

TB All 4.7 2.1 TB Control programme 4

Wasting 0-4 81 55 DHS2000 (4)

Stunting 0-4 491 490 DHS2000 (4)Syphilis in

females 15-44 161 27 NAC antenatal surveillance 2003 5Schistosomiasis 5-14 605 69 National survey 2002 (10)

Filariasis adult 81 40 National survey 2004 (11)

Comments

1. Nkoma study reporting number needing surgery

2. HMIS diagnosis suspect

3. DHS2000 uses sisterhood method

4. TB Control programme estimates about 50% unidentified5. Antenatal surveillance will underestimate due to syphilis causing infertility

3.2 WHO estimatesof Medicine website The tables and charts


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Table 3. Top ten diseases in Malawi in 2002 ranked by estimates made by WHO of the number of

deaths, the burden of disease (DALYs), the proportion of disability (YLDs) and years of life lost

(YLLs)

Mortality (YLL) Disability (YLD)

% total % total

Rank Disease or injury YLL Rank Disease or injury YLD

1 HIV/AIDS 35.8 1 HIV/AIDS 10.1

2 Lower respiratory infections 13.1 2 Cataracts 5.6

3 Malaria 9.7 3 Malaria 5.4

4 Diarrhoeal diseases 9.1 4 Unipolar depressive disorders 4.7

5 Conditions arising during the perinatal period 4.1 5 Protein-energy malnutrition 3.7

6 Tuberculosis 2.2 6 Abortion 3.1

7 Road traffic accidents 1.4 7 Conditions arising during the perinatal period 2.7

8 Protein-energy malnutrition 1.3 8 Lymphatic filariasis 2.5

9 Maternal haemorrhage 0.9 9 Asthma 2.5

10 Drownings 0.8 10 Iodine deficiency 2.4

Leading causes of mortality and disability

Malawi, 2002

Distribution of deaths by major cause group

Malawi and region, 2002

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Malawi , 2002 Sub S Africa developedcountries developingcountries

Injuries

Non-communicable

Communicable, maternal, perinatal and nutritionalconditions

Malawi has a similar distribution of communicable, non-communicable disease and injury as other

African countries (Figure 1). The distribution in developed countries is starkly different.


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Figure 1. WHO estimates of proportions of deaths in Malawi 2002 causes by infectious and non-

communicable diseases compared to other countries

Unintentional

injuries

5%

Intentional

injuries

1%

Cancer

3%

CVD

7%Other

19%

europsyc

atric

conditions

1%

Infectious

diseases

60%

Perinatalconditions

4%

Total deaths in males: 128,124

Deaths by selected causes and sex

Malawi, 2002

CVD

9%

Neuropsychi

atric

conditions

0%

Other

23%

Unintentional

injuries

2%

Cancer

3%

Intentional

injuries

0%

Infectious

diseases

61%

Perinatal

conditions2%

Total deaths in females:129,386

Figure 2. WHO estimates of deaths in Malawi 2002 by disease category

Intentional

injuries1%

CVD

2%

Neuropsychia

tric conditions4%

Other22%Cancer

1%Perinatal

conditions

5%

DALYs by selected causes and sex

Malawi, 2002

Other

28%

CVD

2%

Neuropsychiatric conditions

3%

Cancer

1%

Perinatal

conditions

2%


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Figure 3. WHO estimates of burden of disease in Malawi 2003 by disease category

Number of deaths by cause, age & sexMalawi, 2002

Perinatal conditions Infectious diseases Unintentional injuries

Intentional injuries Cancer CVD

Neuropsychiatric conditions Other

Males

0

10,000

20,000

30,000

40,000

50,000

60,000

0-4

5-14

15-29

30-44

45-59

60-69

70-79

80+

Age group

Numberofdeaths

Females

0

10,000

20,000

30,000

40,000

50,000

60,000

0-4

5-14

15-29

30-44

45-59

60-69

70-79

80+

Age group

Numberofdeaths

Infectious disease remains the biggest contributor to the burden of disease (Figure 3) and the

biggest cause of death (Figure 2 and 6). Young children have the greatest mortality (Figure 4) and

carry the biggest disease burden (Figure 5).

Figure 4. WHO estimates of number of deaths in 8 disease categories in Malawi 2002

Number of DALYs by cause, age & sexMalawi, 2002




Males

1,000,000

1,500,000

2,000,000

2,500,000

mberofDALYs

Females

800,000

1,000,000

1,200,000

1,400,000

1,600,000

1,800,000

2,000,000

mberofDALYs


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Figure 5. WHO estimates of burden of disease (DALYS) in 8 disease categories in Malawi 2002

Percent of DALYs by cause, age & sexMalawi, 2002




Males

0%

20%

40%

60%

80%

100%

0-4

5-14

1

5-29

3

0-44

4

5-59

6

0-69

7

0-79

80+

Age group

ProportionoftotalDALYs

Females

0%

20%

40%

60%

80%

100%

0-4

5-14

15-29

30-44

45-59

60-69

70-79

80+

Age group

ProportionoftotalDALYs

Figure 6. WHO estimates of proportion of burden of disease (DALYs) in 8 disease categories in

Malawi 2002 by age and sex

Percent of DALYs by cause, age & sex

Malawi, 2002




Males

0%

20%

40%

60%

80%

100%

4 4 9 4 9 9 9 +

ProportionoftotalD

ALYs

Females

0%

20%

40%

60%

80%

100%

ProportionoftotalD

ALYs


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Table 4. WHO estimates of leading risk factors in Malawi 2002

Mortality (deaths) Mortality (deaths)

% total % total

Rank Risk factor deaths Rank Disease or injury deaths

1 Unsafe sex 34.4 1 HIV/AIDS 33.6

2 Childhood and maternal underweight 16.5 2 Lower respiratory infections 11.3

3 Unsafe water, sanitation, and hygiene 6.7 3 Malaria 7.8

4 Zinc deficiency 4.9 4 Diarrhoeal diseases 7.6

5 Vitamin A deficiency 4.8 5 Conditions arising during the perinatal period 3.26 Indoor smoke from solid fuels 4.8 6 Cerebrovascular disease 2.8

7 High blood pressure 3.5 7 Ischaemic heart disease 2.6

8 Alcohol 2.0 8 Tuberculosis 2.4

9 Tobacco 1.5 9 Road traffic accidents 1.3

10 Iron deficiency 1.3 10 Protein-energy malnutrition 1.0

Malawi, 2002

Leading 10 selected risk factors & diseases or injuries

4. Discussion

The ranking of the top diseases in Malawi

allows an assessment of priority diseases andwhich might be included in The Ministry of

Healths EHP if cost effective interventions

are available. The leading cause of disease

burden in Malawi in the early years of the

millennium is HIV/AIDS by a huge margin.

This is followed by lower respiratory

diseases, malaria, diarrhoeal diseases and

perinatal conditions. The EHP includesantiretroviral drugs and treatment of

opportunistic infections and antimalarial

treatment. It also targets cheap effective

interventions for lower respiratory diseases

and diarrhoea (for which a rotavirus vaccine

is a new potential intervention). Safe

motherhood is a national priority. Howeverthere is a huge burden of disease attributable

to psychiatric disease, although there is no

local mental health survey is available to

confirm this. Thought needs to be given to

the possible inclusion of practical low cost

that reason the WHO are likely to be more

accurate. Individual chapters will list the

local data in more detail.

5. Conclusions

HIV/AIDS has overtaken malaria as the

number one disease in Malawi. The two

prominent diseases not included in the

Malawi EHP are mental illness and road

traffic accidents. The incidence, prevalence

and death rates found in the annex tables tothis chapter provide the best contemporary

available estimates.


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6. Jacobs G, Aeron-Thomas A: Africa Road Safety Review Final Report. U.S. Department of

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OJ, Broadhead RL: Haematological profiles of the people of rural southern Malawi: an overview.

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Malawi Ophthalmic Epidemiol 2000 Sep;7(3):219 21
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Page 11 of 42

Annex 1 UN population division estimates for Malawi 2002

Source WHO Global Burden of Disease Malawi tables.

PopulationestimatesMalawi 2002

total 0 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

Males5,598,

828

235,4

89

857,6

50

842,3

45

665,1

08

583,2

42

520,1

44

390,5

88

319,6

47

256,4

62

203,2

73

168,8

71

150,3

75

119,7

31

98,30

6

76,34

7

54,26

4

33,03

4

17,44

2

6,510

Females 5,771,

389231,4

84842,6

88839,2

08670,7

42593,6

02526,7

55418,3

63353,0

08283,8

04228,5

91188,9

83161,2

39124,2

77101,1

4177,60

459,76

639,38

521,68

29,067


12/42


Page 12 of 42

Malawi - 2002

1. Population by Age and Sex

Population

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

0-4

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+Male Female


13/42


Annex 2Incidence and prevalence rates for Malawi 2002 estimated by WHO Global

Burden of Disease Unit

Malawi 2002 WHO EstimatesIncidence per 1000

population

Prevalence per 1000

populationGbd

codeGBD causename

sequela

GBD sequela nameM+F all

agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W003 Tuberculosis 1 Cases 2.80 3.46 2.16 4.72 5.84 3.64W005 Syphilis 1 Congenital syphilis 0.18 0.19 0.18 0.55 0.56 0.53W005 Syphilis 2 Primary 3.77 3.36 4.17 0.19 0.17 0.21

W005 Syphilis 3 Secondary 1.72 1.54 1.91 0.17 0.15 0.19W005 Syphilis 4 Tertiary -- Neurologic 0.05 0.04 0.05 0.49 0.44 0.54W006 Chlamydia 1 Cervicitis 2.97 0.00 5.86 0.15 0.00 0.29

W006 Chlamydia 2 Neonatal pneumonia 0.23 0.24 0.23 0.12 0.12 0.11W006 Chlamydia 3

Ophthalmianeonatorum

1.27 1.30 1.23 0.05 0.05 0.05

W006 Chlamydia 4Pelvic inflammatorydisease

3.51 0.00 6.91 0.11 0.00 0.21

W006 Chlamydia 5 Ectopic pregnancy 0.05 0.00 0.10 0.00 0.00 0.01W006 Chlamydia 6 Tubo-ovarian abscess 0.11 0.00 0.22 0.01 0.00 0.02

W006 Chlamydia 7 Chronic pelvic pain 0.56 0.00 1.11 1.68 0.00 3.32W006 Chlamydia 8 Infertility 0.31 0.06 0.56 3.32 0.00 6.54W006 Chlamydia 9 Symptomatic urethritis 6.31 12.81 0.00 0.25 0.51 0.00

W006 Chlamydia 10 Epididymitis 0.38 0.77 0.00 0.03 0.05 0.00W007 Gonorrhoea 1 Cervicitis 5.13 0.00 10.10 0.26 0.00 0.50

W007 Gonorrhoea 2Corneal scar Blindness

0.02 0.02 0.02 0.37 0.37 0.37

W007 Gonorrhoea 3Ophthalmianeonatorum

0.72 0.74 0.71 0.03 0.03 0.03

W007 Gonorrhoea 4Pelvic inflammatorydisease

1.72 0.00 3.40 0.05 0.00 0.10

W007 Gonorrhoea 5 Ectopic pregnancy 0.03 0.00 0.05 0.00 0.00 0.00W007 Gonorrhoea 6 Tubo-ovarian abscess 0.08 0.00 0.16 0.01 0.00 0.01

W007 Gonorrhoea 7 Chronic pelvic pain 0.28 0.00 0.54 0.83 0.00 1.63W007 Gonorrhoea 8 Infertility 0.19 0.11 0.28 3.46 1.69 5.19W007 Gonorrhoea 9 Symptomatic urethritis 8.20 16.65 0.00 0.33 0.67 0.00

W007 Gonorrhoea 10 Epididymitis 0.74 1.50 0.00 0.05 0.10 0.00

W007 Gonorrhoea 11Corneal scar Lowvision

0.12 0.13 0.12 2.59 2.65 2.53

W007 Gonorrhoea 12 Stricture 0.49 1.00 0.00 1.03 2.09 0.00W008 Other STDs 1 Cases 0.00 0.00 0.00 0.00 0.00 0.00W009 HIV/AIDS 1 HIV cases 9.38 8.64 10.11 68.82 57.86 79.47W009 HIV/AIDS 2 AIDS cases 6.63 6.07 7.18 5.79 5.19 6.38

W010 Diarrhoealdiseases

1 Episodes 1408.15

1434.65

1382.45

24.83 25.30 24.37

W012 Pertussis 1 Episodes 9.19 9.35 9.03 0.74 0.75 0.72W012 Pertussis 2 Encephalopathy 0.04 0.04 0.04 1.00 0.99 1.00W013 Poliomyelitis 1 Cases - lameness 0.00 0.00 0.00 0.14 0.15 0.12W014 Diphtheria 1 Episodes 0.00 0.00 0.00 0.00 0.00 0.00

W014 Diphtheria 2Neurological

0 00 0 00 0 00 0 00 0 00 0 00


14/42



populationPrevalence per 1000

population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W018 Hepatitis B 1 Episodes 0.24 0.42 0.06 0.22 0.38 0.06W019 Hepatitis C 1 Episodes 0.11 0.19 0.03 0.10 0.17 0.03W020 Malaria 1 Episodes 392.74 399.53 386.16 4.32 4.39 4.25

W020 Malaria 2 Neurological sequelae 0.43 0.44 0.42 9.66 9.50 9.81W020 Malaria 3 Anaemia 58.59 59.40 57.81 58.59 59.40 57.81

W022Trypanosomiasis

1 Episodes 0.07 0.08 0.05 0.29 0.36 0.22

W023 Chagas disease 1 Infection 0.00 0.00 0.00 0.00 0.00 0.00

W023 Chagas disease 2

Cardiomyopathy with

congestive heartfailure 0.00 0.00 0.00 0.00 0.00 0.00

W023 Chagas disease 3Cardiomyopathywithout congestiveheart failure

0.00 0.00 0.00 0.00 0.00 0.00

W023 Chagas disease 4 Megaviscera 0.00 0.00 0.00 0.00 0.00 0.00W024 Schistosomiasis 1 Infection 336.86 404.29 271.45 332.73 399.62 267.83

W025 Leishmaniasis 1 Visceral 0.15 0.18 0.12 0.43 0.51 0.34W025 Leishmaniasis 2 Cutaneous 0.01 0.01 0.01 0.01 0.01 0.01

W026Lymphatic

filariasis

1 Hydrocele > 15cm 1.09 2.22 0.00 23.18 47.08 0.00

W026Lymphaticfilariasis

2Bancroftianlymphoedema

0.54 0.42 0.66 11.23 8.38 13.99

W026Lymphaticfilariasis

3 Brugian lymphoedema 0.00 0.00 0.00 0.00 0.00 0.00

W027 Onchocerciasis 1 Blindness 0.04 0.05 0.03 0.36 0.45 0.28W027 Onchocerciasis 2 Itching 0.12 0.15 0.10 3.25 4.07 2.46

W027 Onchocerciasis 3 Low vision 0.05 0.06 0.04 0.61 0.75 0.48W028 Leprosy 1 Cases 0.03 0.03 0.03 0.14 0.14 0.14W028 Leprosy 2 Disabling leprosy 0.00 0.00 0.00 0.15 0.15 0.15

W029 Dengue 1 Dengue haemorrhagicfever 0.01 0.01 0.01 0.01 0.01 0.01

W030JapaneseEncephalitis

1 Episodes 0.00 0.00 0.00 0.00 0.00 0.00


2 Cognitive impairment 0.00 0.00 0.00 0.00 0.00 0.00


3 Neurological sequelae 0.00 0.00 0.00 0.00 0.00 0.00

W031 Trachoma 1 Blindness 0.70 0.35 1.04 4.29 2.10 6.42W031 Trachoma 2 Low vision 0.52 0.26 0.77 4.89 2.45 7.25

W033 Ascariasis 1 High intensity infection 0.00 0.00 0.00 15.06 15.36 14.76W033 Ascariasis 2

Contemporaneouscognitive deficit

1.21 1.23 1.19 2.85 2.91 2.79

W033 Ascariasis 3 Cognitive impairment 0.03 0.03 0.03 0.03 0.03 0.03

W033 Ascariasis 4 Intestinal obstruction 0.45 0.46 0.44 3.89 3.89 3.90W034 Trichuriasis 1 High intensity infection 0.00 0.00 0.00 14.97 15.22 14.72

W034 Trichuriasis 2Contemporaneouscogniti e deficit

1.77 1.80 1.74 3.65 3.72 3.59


15/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

respiratoryinfections

W040Upperrespiratoryinfections

1 Episodes 0.00 0.00 0.00 0.00 0.00 0.00

W040Upperrespiratoryinfections

2 Pharyngitis 45.99 46.30 45.68 0.63 0.63 0.63

W041 Otitis media 1 Episodes 188.10 191.91 184.40 14.47 14.76 14.18W041 Otitis media 2 Deafness 0.01 0.01 0.01 0.23 0.23 0.24

W043Maternalhaemorrhage

1 Episodes 7.99 0.00 15.74 0.00 0.00 0.00

W043Maternalhaemorrhage

2 Severe anaemia 1.35 0.00 2.67 2.60 0.00 5.11

W044 Maternal sepsis 1 Episodes 3.35 0.00 6.60 0.00 0.00 0.00W044 Maternal sepsis 2 Infertility 0.79 0.00 1.55 11.63 0.00 22.91

W045Hypertensivedisorders ofpregnancy

1 Episodes 5.54 0.00 10.91 0.00 0.00 0.00

W046Obstructedlabour 1 Episodes 1.50 0.00 2.96 0.00 0.00 0.00

W046Obstructedlabour

2Caesarean section forOL

0.82 0.00 1.62 0.03 0.00 0.06


3 Stress incontinence 0.33 0.00 0.65 7.29 0.00 14.37


4 Rectovaginal fistula 0.03 0.00 0.06 0.70 0.00 1.39

W047 Abortion 1 Episodes 4.20 0.00 8.28 0.00 0.00 0.00

W047 Abortion 2 Infertility 1.43 0.00 2.82 20.73 0.00 40.83

W047 Abortion 3 Reproductive tractinfection 4.77 0.00 9.40 0.19 0.00 0.38

W048Other maternalconditions

1Other maternalconditions

34.24 0.00 67.46 37.45 0.00 73.79

W048Other maternalconditions

2 Stress incontinence 2.38 0.00 4.69 49.87 0.00 98.24

W050 Low birth weight 1 All sequelae 0.23 0.28 0.19 10.47 12.38 8.62

W051Birth asphyxiaand birth trauma

1 All sequelae 0.26 0.33 0.20 12.33 15.15 9.59

W052Other perinatal

conditions

1 Cases 0.08 0.10 0.07 4.02 4.72 3.35

W054Protein-energymalnutrition

1 Wasting 3.09 3.17 3.02 15.41 15.80 15.04


2 Stunting 18.73 19.20 18.27 93.64 95.98 91.37


3Developmentaldisability

4.68 4.80 4.57 120.71 120.75 120.68

Total goitre rate (G1 +


16/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W058Other nutritionaldisorders

1 Cases 0.01 0.01 0.02 0.01 0.01 0.02

W061Mouth andoropharynxcancers

1 All sequelae 0.02 0.02 0.01 0.03 0.03 0.03

W062Oesophaguscancer

1 All sequelae 0.24 0.29 0.19 0.42 0.47 0.37

W063 Stomach cancer 1 All sequelae 0.01 0.02 0.00 0.02 0.03 0.00

W064Colon andrectum cancers

1 Cases 0.02 0.03 0.01 0.07 0.09 0.04

W064Colon andrectum cancers

2Long-term sequelaeafter cure

0.00 0.00 0.00 0.01 0.02 0.00

W065 Liver cancer 1 All sequelae 0.06 0.08 0.04 0.09 0.12 0.07

W066Pancreascancer

1 All sequelae 0.01 0.00 0.01 0.01 0.01 0.02

W067Trachea,bronchus andlung cancers

1 All sequelae 0.01 0.03 0.00 0.02 0.04 0.00

W068Melanoma andother skincancers

1 All sequelae 0.02 0.01 0.04 0.07 0.03 0.10

W069 Breast cancer 1 Cases 0.05 0.00 0.11 0.19 0.00 0.38

W069 Breast cancer 2Long-term sequelaeafter cure

0.00 0.00 0.00 0.05 0.00 0.10

W070Cervix utericancer

1 Cases 0.17 0.00 0.33 0.34 0.00 0.67

W070Cervix utericancer


0.00 0.00 0.01 0.05 0.00 0.11

W071Corpus utericancer

1 Cases 0.01 0.00 0.01 0.01 0.00 0.03

W071Corpus utericancer


0.00 0.00 0.00 0.00 0.00 0.00

W072 Ovary cancer 1 Cases 0.02 0.00 0.03 0.03 0.00 0.05

W072 Ovary cancer 2Long-term sequelaeafter cure

0.00 0.00 0.00 0.00 0.00 0.01

W073 Prostate cancer 1 Cases 0.09 0.18 0.00 0.10 0.21 0.00

W073 Prostate cancer 2Long-term sequelaeafter cure

0.00 0.00 0.00 0.02 0.03 0.00

W074 Bladder cancer 1 Cases 0.08 0.12 0.05 0.27 0.38 0.17

W074 Bladder cancer 2 Long-term sequelaeafter cure 0.00 0.00 0.00 0.03 0.04 0.03

W075Lymphomas andmultiplemyeloma

1 All sequelae 0.07 0.08 0.06 0.18 0.19 0.18

W076 Leukaemia 1 All sequelae 0.01 0.01 0.01 0.03 0.03 0.04

W077Other malignantneoplasms

1 All sequelae 0.09 0.10 0.08 0.20 0.19 0.20


17/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W082Unipolardepressivedisorders

2 Dysthymia 0.59 0.39 0.77 3.50 2.33 4.64

W083Bipolar affectivedisorder

1 Cases 0.28 0.29 0.26 3.56 3.67 3.46

W084 Schizophrenia 1 Cases 0.23 0.22 0.24 2.84 2.64 3.03W085 Epilepsy 1 Cases 0.75 0.77 0.72 9.74 9.79 9.69

W086Alcohol usedisorders

1 Cases 0.62 1.13 0.12 2.55 4.62 0.55

W087Alzheimer andother dementias 1 Cases 0.30 0.26 0.34 1.01 0.91 1.11

W088Parkinsondisease

1 Cases 0.03 0.03 0.03 0.20 0.19 0.22

W089Multiplesclerosis

1 Cases 0.01 0.01 0.02 0.23 0.16 0.29

W090Drug usedisorders

1 Cases 1.50 2.27 0.76 6.49 9.74 3.34

W091Post-traumaticstress disorder

1 Cases 0.75 0.39 1.10 3.09 1.64 4.49

W092Obsessive-compulsivedisorder

1 Cases 0.90 0.85 0.94 6.08 5.06 7.07

W093 Panic disorder 1 Cases 0.51 0.34 0.68 4.13 2.74 5.48

W094Insomnia(primary)

1 Cases 0.63 0.77 0.50 3.34 3.90 2.80

W095 Migraine 1 Cases 0.78 0.49 1.07 18.06 11.01 24.90

W096

Mild mentalretardationattributable tolead exposure

1 Cases 0.25 0.26 0.25 6.14 6.14 6.13

W097Otherneuropsychiatricdisorders

1 Cases 22.99 24.36 21.67 23.07 24.83 21.36

W099 Glaucoma 1 Low vision 0.24 0.22 0.26 3.14 2.87 3.41W099 Glaucoma 2 Blindness 0.15 0.15 0.16 0.99 0.94 1.05

W100 Cataracts 1 Low vision 2.67 2.22 3.10 16.62 14.32 18.85W100 Cataracts 2 Blindness 0.81 0.73 0.89 5.51 4.82 6.18

W101Vision disorders,age-related

1 Low vision 0.23 0.22 0.24 2.90 2.73 3.06

W101 Vision disorders,age-related 2 Blindness 0.15 0.13 0.17 1.01 0.87 1.14

W102Hearing loss,adult onset

1Mild or greater hearingloss

0.00 0.00 0.00 24.78 24.47 25.08


2Moderate or severehearing loss

1.05 1.13 0.97 16.17 16.93 15.43


3 Severe hearing loss 0.00 0.00 0.00 4.87 4.76 4.98


18/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

disease infarction

W107Ischaemic heartdisease

2 Angina pectoris 0.16 0.19 0.13 1.36 1.57 1.15

W107Ischaemic heartdisease

3Congestive heartfailure

0.08 0.09 0.06 0.26 0.26 0.26

W108Cerebrovasculardisease

1First-ever strokecases

1.47 1.25 1.69 0.04 0.03 0.05

W108Cerebrovasculardisease

2Long-term strokesurvivors

0.96 0.80 1.11 2.39 1.92 2.86

W109Inflammatoryheart disease 1 All sequelae 0.28 0.37 0.19 0.83 1.10 0.56

W110Othercardiovasculardiseases

1 Cases 0.88 1.30 0.47 1.52 1.97 1.09

W112

Chronicobstructivepulmonarydisease

1 Symptomatic cases 0.29 0.43 0.16 1.40 2.33 0.50

W113 Asthma 1 Cases 5.27 6.25 4.31 48.03 51.00 45.15

W114Otherrespiratorydiseases

1 Cases 3.89 4.75 3.06 4.69 5.58 3.82

W116Peptic ulcerdisease

1Cases with antibiotictreatment

0.00 0.00 0.00 0.00 0.00 0.00

W116Peptic ulcerdisease

2Cases not treated withantibiotic

0.24 0.36 0.12 1.15 1.69 0.62

W117Cirrhosis of theliver


W118 Appendicitis 1 Episodes 0.50 0.66 0.35 0.02 0.03 0.01

W119Other digestivediseases 1 Cases 22.34 24.37 20.36 25.86 28.04 23.75

W121Nephritis andnephrosis

1Acuteglomerulonephritis

0.08 0.08 0.07 0.17 0.18 0.15

W121Nephritis andnephrosis

2End-stage renaldisease

0.27 0.30 0.23 1.98 2.71 1.27

W122Benign prostatichypertrophy


W123Othergenitourinarysystem diseases

1 Cases 4.89 4.52 5.26 5.39 5.26 5.51

W124 Skin diseases 1 Cases 19.63 22.73 16.63 19.63 22.73 16.63

W126Rheumatoidarthritis

1 Cases 0.19 0.15 0.23 1.64 1.28 2.00

W127 Osteoarthritis 1 Hip 0.18 0.19 0.17 1.92 2.08 1.77W127 Osteoarthritis 2 Knee 0.90 0.76 1.04 12.72 10.29 15.07

W128 Gout 1 Cases 0.06 0.10 0.02 0.66 1.19 0.16Episode of limiting low


19/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W137Oesophagealatresia

1 Cases 0.00 0.00 0.00 0.00 0.00 0.00

W138 Renal agenesis 1 Cases 0.00 0.00 0.00 0.00 0.00 0.00W139 Down syndrome 1 Cases 0.04 0.04 0.03 0.65 0.73 0.57

W140Congenital heartanomalies

1 Cases 0.12 0.13 0.11 4.17 4.35 4.00

W141 Spina bifida 1 Cases 0.01 0.01 0.01 0.14 0.14 0.14

W142Other congenitalanomalies

1 Cases 0.00 0.00 0.00 0.00 0.00 0.00

W144 Dental caries 1 Episodes 250.45 254.07 246.94 10.41 10.57 10.26

W145Periodontaldisease

1 Cases 28.73 28.19 29.25 57.20 56.03 58.33

W146 Edentulism 1 Cases 0.45 0.43 0.48 7.71 7.08 8.33

W147Other oraldiseases

1 Cases 0.30 0.22 0.39 0.78 0.68 0.88

W150Road trafficaccidents

1Fractured skull - short-term

0.19 0.24 0.14 0.02 0.03 0.02


2 Fractured face bones 0.27 0.39 0.16 0.03 0.05 0.02

W150Road trafficaccidents 3

Fractured vertebralcolumn 0.15 0.19 0.11 0.02 0.03 0.01


4Fractured rib orsternum

0.16 0.21 0.11 0.02 0.02 0.01


5 Fractured pelvis 0.14 0.17 0.10 0.02 0.02 0.01


6Fractured clavicle,scapula or humerous

0.40 0.52 0.28 0.04 0.06 0.03


7Fractured ulna orradius

0.45 0.58 0.33 0.05 0.06 0.04

W150Road trafficaccidents 8 Fractured hand bones 0.17 0.25 0.09 0.01 0.02 0.01


9Fractured femur -short-term

0.62 0.80 0.43 0.11 0.14 0.08


10Fractured patella, tibiaor fibula

0.59 0.80 0.39 0.07 0.10 0.05


11 Factured ankle 0.19 0.24 0.14 0.02 0.03 0.02


12 Fractured foot bones 0.17 0.25 0.10 0.01 0.02 0.01

W150Road trafficaccidents 13 Other dislocation 0.07 0.10 0.04 0.00 0.00 0.00


14Dislocation of sholder,elbow or hip

0.07 0.11 0.04 0.00 0.00 0.00


15 Sprains 0.14 0.18 0.10 0.01 0.01 0.00


16Intracranial injury -short term

1.74 2.21 1.28 0.12 0.15 0.09


20/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

accidents term


26Spinal cord injury -long-term

0.09 0.13 0.05 0.56 0.78 0.34


27Fractured femur -long-term

0.13 0.17 0.09 1.73 2.14 1.34


28Intracranial injury -long-term

0.09 0.11 0.06 0.76 0.95 0.58


29Injury to eyes - long-term

0.04 0.06 0.02 1.35 1.81 0.90

W150Road trafficaccidents 30

Amputated thumb -long-term 0.01 0.01 0.01 0.32 0.34 0.30


31Amputated finger -long-term

0.02 0.02 0.01 0.77 0.88 0.66


32Amputated arm - long-term

0.00 0.00 0.00 0.11 0.13 0.09


33Amputated toe - long-term

0.04 0.04 0.03 1.51 1.62 1.40


34Amputated foot - long-term

0.00 0.01 0.00 0.18 0.20 0.16

W150 Road trafficaccidents

35Above knee andbilateral legamputation - long-term

0.01 0.01 0.01 0.26 0.29 0.23


36Burns 20% and60% - long-term

0.00 0.00 0.00 0.00 0.00 0.00


39Injured nerves - long-term

0.03 0.04 0.02 1.20 1.52 0.89

W151 Poisonings 1Fractured skull - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 2 Fractured face bones 0.04 0.05 0.03 0.01 0.01 0.00

W151 Poisonings 3Fractured vertebralcolumn

0.01 0.02 0.01 0.00 0.00 0.00

W151 Poisonings 4Fractured rib orsternum

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 5 Fractured pelvis 0.02 0.02 0.01 0.00 0.00 0.00

W151 Poisonings 6Fractured clavicle,scapula or humerous

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 7Fractured ulna orradius

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 8 Fractured hand bones 0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 9Fractured femur -short-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 10Fractured patella, tibiaor fibula

0.00 0.00 0.00 0.00 0.00 0.00


21/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W151 Poisonings 23Burns >60% - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 24 Poisoning 0.31 0.37 0.25 0.00 0.00 0.00

W151 Poisonings 25Fractured skull - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 26Spinal cord injury -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 27Fractured femur -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 28Intracranial injury -long-term 0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 29Injury to eyes - long-term

0.00 0.00 0.00 0.04 0.04 0.03

W151 Poisonings 30Amputated thumb -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 31Amputated finger -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 32Amputated arm - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 33Amputated toe - long-term 0.00 0.00 0.00 0.04 0.06 0.03

W151 Poisonings 34Amputated foot - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 35Above knee andbilateral legamputation - long-term

0.00 0.00 0.00 0.01 0.01 0.01

W151 Poisonings 36Burns 20% and60% - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W151 Poisonings 39Injured nerves - long-term

0.00 0.00 0.00 0.04 0.05 0.03

W152 Falls 1Fractured skull - short-term

0.10 0.12 0.08 0.01 0.01 0.01

W152 Falls 2 Fractured face bones 0.06 0.08 0.04 0.01 0.01 0.01

W152 Falls 3Fractured vertebralcolumn

0.09 0.12 0.07 0.01 0.02 0.01

W152 Falls 4Fractured rib orsternum 0.06 0.08 0.04 0.01 0.01 0.00

W152 Falls 5 Fractured pelvis 0.04 0.05 0.03 0.01 0.01 0.00

W152 Falls 6Fractured clavicle,scapula or humerous

0.36 0.43 0.29 0.04 0.05 0.03

W152 Falls 7Fractured ulna orradius

0.60 0.74 0.47 0.07 0.08 0.05

W152 Falls 8 Fractured hand bones 0 07 0 09 0 05 0 00 0 01 0 00


22/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W152 Falls 21Burns 20% and60% - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W152 Falls 24 Poisoning 0.02 0.03 0.02 0.00 0.00 0.00

W152 Falls 25Fractured skull - long-term

0.02 0.02 0.01 0.16 0.21 0.12

W152 Falls 26Spinal cord injury -long-term 0.03 0.04 0.02 0.22 0.32 0.13

W152 Falls 27Fractured femur -long-term

0.08 0.09 0.07 0.68 0.83 0.54

W152 Falls 28Intracranial injury -long-term

0.04 0.06 0.03 0.48 0.63 0.33

W152 Falls 29Injury to eyes - long-term

0.01 0.01 0.01 0.37 0.47 0.28

W152 Falls 30Amputated thumb -long-term

0.00 0.00 0.00 0.05 0.06 0.04

W152 Falls 31Amputated finger -long-term 0.00 0.01 0.00 0.20 0.25 0.15

W152 Falls 32Amputated arm - long-term

0.00 0.00 0.00 0.03 0.04 0.03

W152 Falls 33Amputated toe - long-term

0.00 0.00 0.00 0.09 0.10 0.07

W152 Falls 34Amputated foot - long-term

0.00 0.00 0.00 0.02 0.02 0.02

W152 Falls 35Above knee andbilateral legamputation - long-term

0.00 0.00 0.00 0.04 0.05 0.03

W152 Falls 36Burns 20% and60% - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W152 Falls 39Injured nerves - long-term

0.02 0.03 0.02 0.90 1.15 0.66

W153 Fires 1Fractured skull - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 2 Fractured face bones 0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 3Fractured vertebralcolumn

0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 4Fractured rib orsternum

0.07 0.10 0.04 0.01 0.01 0.00

W153 Fires 5 Fractured pelvis 0.00 0.00 0.00 0.00 0.00 0.00Fractured clavicle


23/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W153 Fires 18 Open wound 0.01 0.01 0.00 0.00 0.00 0.00

W153 Fires 19Injury to eyes - short-term

0.02 0.04 0.01 0.00 0.00 0.00

W153 Fires 20 Crushing 0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 21Burns 20% and60% - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 24 Poisoning 0.07 0.11 0.04 0.00 0.00 0.00

W153 Fires 25Fractured skull - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 26Spinal cord injury -long-term

0.00 0.00 0.00 0.02 0.03 0.01

W153 Fires 27Fractured femur -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 28Intracranial injury -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 29Injury to eyes - long-term 0.02 0.04 0.01 1.05 1.61 0.51

W153 Fires 30Amputated thumb -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 31Amputated finger -long-term

0.00 0.01 0.00 0.20 0.31 0.09

W153 Fires 32Amputated arm - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W153 Fires 33Amputated toe - long-term

0.00 0.00 0.00 0.03 0.05 0.02

W153 Fires 34Amputated foot - long-term 0.00 0.00 0.00 0.03 0.05 0.01

W153 Fires 35Above knee andbilateral legamputation - long-term

0.02 0.03 0.01 0.78 1.20 0.37

W153 Fires 36Burns 20% and60% - long-term

0.00 0.00 0.00 0.09 0.14 0.04

W153 Fires 39Injured nerves - long-term

0.00 0.00 0.00 0.04 0.06 0.02

W154 Drownings 1Fractured skull - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 2 Fractured face bones 0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 3Fractured vertebralcolumn

0.00 0.00 0.00 0.00 0.00 0.00


24/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W154 Drownings 15 Sprains 0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 16Intracranial injury -short-term

0.01 0.01 0.00 0.00 0.00 0.00

W154 Drownings 17 Internal injuries 0.00 0.00 0.00 0.00 0.00 0.00W154 Drownings 18 Open wound 0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 19Injury to eyes - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 20 Crushing 0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 21Burns 20% and60% - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 24 Poisoning 0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 25Fractured skull - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 26Spinal cord injury -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 27Fractured femur -long-term 0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 28Intracranial injury -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 29Injury to eyes - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 30Amputated thumb -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 31Amputated finger -long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 32Amputated arm - long-term 0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 33Amputated toe - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 34Amputated foot - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 35Above knee andbilateral legamputation - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 36Burns 20% and60% - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W154 Drownings 39Injured nerves - long-term

0.00 0.00 0.00 0.01 0.01 0.01

Fractured skull shortOther


25/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W155 12 Fractured foot bones 0.25 0.34 0.16 0.02 0.02 0.01W155 13 Other dislocation 0.21 0.28 0.14 0.00 0.01 0.00

W155 14Dislocation of sholder,elbow or hip

0.10 0.13 0.07 0.00 0.00 0.00

W155 15 Sprains 0.91 1.23 0.61 0.03 0.05 0.02

W155 16Intracranial injury -short-term

1.24 1.75 0.74 0.08 0.12 0.05

W155 17 Internal injuries 0.56 0.81 0.32 0.01 0.02 0.01W155 18 Open wound 2.73 3.74 1.75 0.11 0.15 0.07

W155 19

Injury to eyes - short-

term 0.31 0.40 0.22 0.01 0.01 0.00W155 20 Crushing 0.16 0.23 0.10 0.02 0.02 0.01

W155 21Burns 20% and60% - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W155 24 Poisoning 0.33 0.40 0.25 0.00 0.00 0.00

W155 25Fractured skull - long-term 0.02 0.03 0.02 0.24 0.35 0.13

W155 26Spinal cord injury -long-term

0.08 0.12 0.05 0.62 0.92 0.33

W155 27Fractured femur -long-term

0.12 0.16 0.07 1.50 2.13 0.89

W155 28Intracranial injury -long-term

0.06 0.09 0.04 0.60 0.88 0.32

W155 29Injury to eyes - long-term

0.31 0.40 0.22 11.86 15.56 8.26

W155 30Amputated thumb -long-term 0.06 0.09 0.04 2.25 3.19 1.33

W155 31Amputated finger -long-term

0.22 0.32 0.13 7.99 11.18 4.91

W155 32Amputated arm - long-term

0.02 0.03 0.01 0.68 0.94 0.43

W155 33Amputated toe - long-term

0.03 0.04 0.02 1.10 1.49 0.71

W155 34Amputated foot - long-term

0.01 0.01 0.01 0.38 0.52 0.24

W155 35Above knee andbilateral legamputation - long-term

0.01 0.01 0.00 0.18 0.24 0.12

W155 36Burns 20% and60% long


26/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W157 Self-inflictedinjuries

8 Fractured hand bones 0.00 0.00 0.00 0.00 0.00 0.00

W157Self-inflictedinjuries

9Fractured femur -short-term

0.00 0.00 0.00 0.00 0.00 0.00


10Fractured patella, tibiaor fibula

0.00 0.00 0.00 0.00 0.00 0.00


11 Factured ankle 0.00 0.00 0.00 0.00 0.00 0.00


12 Fractured foot bones 0.00 0.00 0.00 0.00 0.00 0.00


13 Other dislocation 0.00 0.00 0.00 0.00 0.00 0.00


14Dislocation of sholder,elbow or hip

0.00 0.00 0.00 0.00 0.00 0.00


15 Sprains 0.00 0.00 0.00 0.00 0.00 0.00


16Intracranial injury -short-term

0.00 0.00 0.00 0.00 0.00 0.00


17 Internal injuries 0.00 0.00 0.00 0.00 0.00 0.00


18 Open wound 0.02 0.03 0.02 0.00 0.00 0.00


19Injury to eyes - short-term

0.00 0.00 0.00 0.00 0.00 0.00


20 Crushing 0.00 0.00 0.00 0.00 0.00 0.00


21Burns 20% and60% - short-term

0.00 0.00 0.00 0.00 0.00 0.00


24 Poisoning 0.25 0.26 0.24 0.00 0.00 0.00


25Fractured skull - long-term

0.00 0.00 0.00 0.00 0.00 0.00


26Spinal cord injury -long-term

0.00 0.00 0.00 0.00 0.00 0.00


27Fractured femur -long-term

0.00 0.00 0.00 0.00 0.00 0.00


28 Intracranial injury -long-term

0.00 0.00 0.00 0.00 0.00 0.00


29Injury to eyes - long-term

0.00 0.00 0.00 0.02 0.01 0.02


30Amputated thumb -long-term

0.00 0.00 0.00 0.00 0.00 0.00

Self-inflicted Amputated finger -


27/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

injuries term

W158 Violence 1Fractured skull - short-term

0.05 0.09 0.02 0.01 0.01 0.00

W158 Violence 2 Fractured face bones 0.25 0.41 0.09 0.03 0.05 0.01

W158 Violence 3Fractured vertebralcolumn

0.01 0.01 0.00 0.00 0.00 0.00

W158 Violence 4Fractured rib orsternum

0.02 0.04 0.01 0.00 0.00 0.00

W158 Violence 5 Fractured pelvis 0.00 0.01 0.00 0.00 0.00 0.00

W158 Violence 6

Fractured clavicle,

scapula or humerous 0.02 0.03 0.01 0.00 0.00 0.00

W158 Violence 7Fractured ulna orradius

0.04 0.07 0.02 0.00 0.01 0.00

W158 Violence 8 Fractured hand bones 0.04 0.07 0.02 0.00 0.00 0.00

W158 Violence 9Fractured femur -short-term

0.04 0.07 0.02 0.01 0.01 0.00

W158 Violence 10Fractured patella, tibiaor fibula

0.03 0.06 0.01 0.00 0.01 0.00

W158 Violence 11 Factured ankle 0.02 0.04 0.01 0.00 0.00 0.00W158 Violence 12 Fractured foot bones 0.01 0.02 0.00 0.00 0.00 0.00

W158 Violence 13 Other dislocation 0.00 0.01 0.00 0.00 0.00 0.00

W158 Violence 14Dislocation of sholder,elbow or hip

0.00 0.01 0.00 0.00 0.00 0.00

W158 Violence 15 Sprains 0.05 0.09 0.02 0.00 0.00 0.00

W158 Violence 16Intracranial injury -short-term

0.25 0.41 0.10 0.02 0.03 0.01

W158 Violence 17 Internal injuries 0.43 0.76 0.11 0.01 0.01 0.00W158 Violence 18 Open wound 0.82 1.42 0.23 0.03 0.06 0.01

W158 Violence 19Injury to eyes - short-term

0.03 0.05 0.01 0.00 0.00 0.00

W158 Violence 20 Crushing 0.00 0.01 0.00 0.00 0.00 0.00

W158 Violence 21Burns 20% and60% - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W158 Violence 24 Poisoning 0.01 0.01 0.00 0.00 0.00 0.00

W158 Violence 25Fractured skull - long-term

0.01 0.01 0.00 0.06 0.10 0.02

W158 Violence 26Spinal cord injury -long-term

0.03 0.04 0.01 0.17 0.30 0.04

W158 Violence 27Fractured femur -long-term

0.01 0.01 0.00 0.10 0.17 0.04

W158 Violence 28Intracranial injury -long-term

0.01 0.02 0.00 0.10 0.16 0.03

Injury to eyes long

Ch t 1 Th b d f di i M l i


28/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

60% - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W158 Violence 39Injured nerves - long-term

0.06 0.10 0.02 1.94 3.34 0.58

W159 War 1Fractured skull - short-term

0.03 0.01 0.04 0.00 0.00 0.01

W159 War 2 Fractured face bones 0.02 0.04 0.00 0.00 0.01 0.00

W159 War 3Fractured vertebralcolumn

0.00 0.00 0.00 0.00 0.00 0.00

W159 War 4 Fractured rib orsternum

0.00 0.00 0.00 0.00 0.00 0.00

W159 War 5 Fractured pelvis 0.01 0.00 0.01 0.00 0.00 0.00

W159 War 6Fractured clavicle,scapula or humerous

0.03 0.06 0.00 0.00 0.01 0.00

W159 War 7Fractured ulna orradius

0.03 0.06 0.00 0.00 0.01 0.00

W159 War 8 Fractured hand bones 0.02 0.04 0.01 0.00 0.00 0.00

W159 War 9Fractured femur -short-term

0.04 0.08 0.00 0.01 0.02 0.00

W159 War 10 Fractured patella, tibiaor fibula

0.05 0.08 0.01 0.01 0.01 0.00

W159 War 11 Factured ankle 0.01 0.00 0.02 0.00 0.00 0.00W159 War 12 Fractured foot bones 0.02 0.04 0.00 0.00 0.00 0.00W159 War 13 Other dislocation 0.00 0.00 0.00 0.00 0.00 0.00

W159 War 14Dislocation of sholder,elbow or hip

0.01 0.01 0.00 0.00 0.00 0.00

W159 War 15 Sprains 0.02 0.03 0.01 0.00 0.00 0.00

W159 War 16Intracranial injury -short-term

0.12 0.18 0.07 0.01 0.01 0.01

W159 War 17 Internal injuries 0.12 0.19 0.05 0.00 0.00 0.00W159 War 18 Open wound 0.37 0.58 0.18 0.02 0.02 0.01

W159 War 19Injury to eyes - short-term

0.04 0.06 0.02 0.00 0.00 0.00

W159 War 20 Crushing 0.00 0.00 0.00 0.00 0.00 0.00

W159 War 21Burns 20% and60% - short-term 0.00 0.00 0.00 0.00 0.00 0.00

W159 War 24 Poisoning 0.00 0.00 0.00 0.00 0.00 0.00

W159 War 25Fractured skull - long-term

0.00 0.00 0.01 0.04 0.01 0.07

W159 War 26Spinal cord injury -long-term

0.00 0.00 0.00 0.01 0.03 0.00

Fractured femur



29/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

amputation - long-term

W159 War 36Burns 20% and60% - long-term

0.00 0.00 0.00 0.01 0.00 0.01

W159 War 39Injured nerves - long-term

0.06 0.11 0.02 2.03 3.45 0.65

W160 1

Fractured skull - short-

term 0.00 0.00 0.00 0.00 0.00 0.00W160

Other intentionalinjuries2 Fractured face bones 0.00 0.00 0.00 0.00 0.00 0.00

W160 3Fractured vertebralcolumn

0.00 0.00 0.00 0.00 0.00 0.00

W160 4Fractured rib orsternum

0.00 0.00 0.00 0.00 0.00 0.00

W160 5 Fractured pelvis 0.00 0.00 0.00 0.00 0.00 0.00

W160 6Fractured clavicle,scapula or humerous

0.00 0.00 0.00 0.00 0.00 0.00

W160 7

Fractured ulna or

radius 0.00 0.00 0.00 0.00 0.00 0.00W160 8 Fractured hand bones 0.00 0.00 0.00 0.00 0.00 0.00

W160 9Fractured femur -short-term

0.00 0.00 0.00 0.00 0.00 0.00

W160 10Fractured patella, tibiaor fibula

0.00 0.00 0.00 0.00 0.00 0.00

W160 11 Factured ankle 0.00 0.00 0.00 0.00 0.00 0.00

W160 12 Fractured foot bones 0.00 0.00 0.00 0.00 0.00 0.00W160 13 Other dislocation 0.00 0.00 0.00 0.00 0.00 0.00

W160 14

Dislocation of sholder,

elbow or hip 0.00 0.00 0.00 0.00 0.00 0.00W160 15 Sprains 0.00 0.00 0.00 0.00 0.00 0.00

W160 16Intracranial injury -short-term

0.00 0.00 0.00 0.00 0.00 0.00

W160 17 Internal injuries 0.00 0.00 0.00 0.00 0.00 0.00W160 18 Open wound 0.00 0.00 0.00 0.00 0.00 0.00

W160 19Injury to eyes - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W160 20 Crushing 0.00 0.00 0.00 0.00 0.00 0.00

W160 21Burns 20% and60% - short-term

0.00 0.00 0.00 0.00 0.00 0.00

W160 24 Poisoning 0.00 0.00 0.00 0.00 0.00 0.00Fractured skull long



30/42




population

Gbdcode

GBD causename

sequela


agesall

Males

allFemale

s

M+F allages

allMales

allFemale

s

W160 34 Amputated foot - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W160 35Above knee andbilateral legamputation - long-term

0.00 0.00 0.00 0.00 0.00 0.00

W160 36Burns 20% and60% - long-

term 0.00 0.00 0.00 0.00 0.00 0.00

W160 39Injured nerves - long-term

0.00 0.00 0.00 0.00 0.00 0.00



31/42


Page 31 of 42

Annex 3 Estimates of deaths in Malawi 2002 by sex, age and cause Global Burden of Disease Unit All persons totals and males

Deaths by age, sex and cause in Malawi for the year 2002 All persons Male

Code Cause Total 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ Total

W000 All Causes 257510 51087 7118 10854 23220 14477 7990 8318506

0128124

W001Communicable, maternal, perinatal andnutritional conditions

204232 49584 5473 8011 20211 10136 3029 1691 572 98707

W002 A. Infectious and parasitic diseases 154029 30397 4642 7677 19779 9370 2163 976 389 75394W003 1. Tuberculosis 6106 235 129 975 1317 966 357 165 55 4200W004 2. STDs excluding HIV 1007 87 0 39 127 360 73 0 0 685

W005 a. Syphilis 962 83 0 37 121 344 69 0 0 654W006 b. Chlamydia 3 0 0 0 0 0 0 0 0 0W007 c. Gonorrhoea 4 0 0 0 1 2 0 0 0 3W008 d. Other STDs 38 4 0 2 5 14 3 0 0 28W009 3. HIV/AIDS 86509 7251 2863 6059 17441 6432 436 41 1 40524W010 4. Diarrhoeal diseases 19506 9036 25 49 111 158 166 211 227 9983W011 5. Childhood-cluster diseases 2546 1219 40 5 4 3 1 1 0 1274W012 a. Pertussis 812 406 0 0 0 0 0 0 0 406W013 b. Poliomyelitis 0 0 0 0 0 0 0 0 0 0W014 c. Diphtheria 20 12 0 0 0 0 0 0 0 12W015 d. Measles 611 278 28 0 0 0 0 0 0 306W016 e. Tetanus 1102 524 12 5 4 3 1 1 0 551W017 6. Meningitis* 462 67 91 27 25 36 16 8 0 269W018 7. Hepatitis B 600 36 157 25 70 62 46 11 0 406W019 Hepatitis C 269 16 71 11 31 28 21 5 0 183W020 8. Malaria 20008 9185 106 151 160 160 107 107 70 10046W021 9. Tropical-cluster diseases 1761 37 155 123 170 218 145 72 11 930W022 a. Trypanosomiasis 813 25 127 83 62 54 7 4 0 362W023 b. Chagas disease 0 0 0 0 0 0 0 0 0 0W024 c. Schistosomiasis 809 0 0 11 96 161 135 68 11 481W025 d. Leishmaniasis 139 11 28 29 12 3 3 1 0 87W026 e. lymphatic filariasis 0 0 0 0 0 0 0 0 0 0W027 f. Onchocerciasis 0 0 0 0 0 0 0 0 0 0W028 10. Leprosy 22 0 0 0 0 13 0 4 0 17W029 11. Dengue 11 1 2 0 0 0 0 0 0 4W030 12. Japanese encephalitis 0 0 0 0 0 0 0 0 0 0W031 13. Trachoma 0 0 0 0 0 0 0 0 0 0W032 14. Intestinal nematode infections 108 0 12 7 4 8 7 4 2 45



32/42


Page 32 of 42


Code Cause Total 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ TotalW033 a. Ascariasis 19 0 7 0 0 0 0 0 0 7W034 b. Trichuriasis 13 0 5 0 0 0 0 0 0 5W035 c. Hookworm disease 74 0 0 7 4 8 7 4 2 32W036 Other intestinal infections 2 0 0 0 0 0 0 0 0 1W037 Other infectious diseases 15115 3227 992 206 320 926 789 347 22 6828W038 B. Respiratory infections 29350 11939 685 326 414 691 776 665 169 15665W039 1. Lower respiratory infections 29018 11887 615 319 401 688 754 653 169 15486W040 2. Upper respiratory infections 286 52 35 4 6 3 22 12 0 133W041 3. Otitis media 46 0 36 2 7 0 0 0 0 46

W042 C. Maternal conditions 8554 0 0 0 0 0 0 0 0 0W043 1. Maternal haemorrhage 2168 0 0 0 0 0 0 0 0 0W044 2. Maternal sepsis 1583 0 0 0 0 0 0 0 0 0W045 3. Hypertensive disorders* 1132 0 0 0 0 0 0 0 0 0W046 4. Obstructed labour 772 0 0 0 0 0 0 0 0 0W047 5. Abortion 1401 0 0 0 0 0 0 0 0 0W048 Other maternal conditions 1497 0 0 0 0 0 0 0 0 0W049 D. Perinatal conditions* 8252 5726 0 0 0 0 0 0 0 5726W050 1. Low birth weight 3432 2382 0 0 0 0 0 0 0 2382W051 2. Birth asphyxia and birth trauma 3528 2448 0 0 0 0 0 0 0 2448

W052 Other perinatal conditions 1292 896 0 0 0 0 0 0 0 896W053 E. Nutritional deficiencies 4048 1522 146 9 17 76 90 49 13 1922W054 1. Protein-energy malnutrition 2615 1139 83 3 6 39 54 33 13 1370W055 2. Iodine deficiency 118 37 6 1 1 4 3 2 0 53W056 3. Vitamin A deficiency 727 199 33 3 6 19 19 8 0 287W057 4. Iron-deficiency anaemia 516 125 21 2 4 12 12 5 0 180W058 Other nutritional disorders 72 22 4 0 1 2 2 1 0 31

W059 Noncommunicable diseases 42723 581 253 720 1483 3340 4520 6363 4412 21672

W060 A. Malignant neoplasms 7944 23 39 91 224 771 1048 1319 726 4240W061 1. Mouth and oropharynx cancers 127 0 1 4 10 17 25 15 7 80W062 2. Oesophagus cancer 2488 0 0 11 86 371 423 413 181 1484W063 3. Stomach cancer 120 0 0 2 6 19 21 36 23 107W064 4. Colon and rectum cancers 155 0 0 3 8 24 22 29 22 107W065 5. Liver cancer 592 3 2 8 30 77 121 121 48 409W066 6. Pancreas cancer 98 0 0 0 3 8 10 0 0 21W067 7. Trachea, bronchus, lung cancers 140 0 0 0 2 8 38 64 27 140



33/42

p

Page 33 of 42


Code Cause Total 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ TotalW068 8. Melanoma and other skin cancers 175 0 1 2 2 6 5 13 9 38W069 9. Breast cancer 360 0 0 0 0 0 0 0 0 0W070 10. Cervix uteri cancer 979 0 0 0 0 0 0 0 0 0W071 11. Corpus uteri cancer 22 0 0 0 0 0 0 0 0 0W072 12. Ovary cancer 122 0 0 0 0 0 0 0 0 0W073 13. Prostate cancer 684 0 0 0 1 57 163 293 170 684W074 14. Bladder cancer 592 0 0 1 4 37 84 172 131 429W075 15. Lymphomas, multiple myeloma 489 15 33 43 32 37 42 49 31 283W076 16. Leukaemia 118 1 1 7 4 9 14 20 13 68

W077 Other malignant neoplasms 683 4 2 11 34 101 81 94 65 391W078 B. Other neoplasms 143 4 6 9 7 13 14 12 7 72W079 C. Diabetes mellitus 1400 1 2 12 32 96 128 163 96 531W080 D. Endocrine disorders 381 30 9 14 25 30 22 29 24 183W081 E. Neuropsychiatric conditions 1318 63 68 138 145 125 109 134 97 879W082 1. Unipolar depressive disorders 0 0 0 0 0 0 0 0 0 0W083 2. Bipolar disorder 0 0 0 0 0 0 0 0 0 0W084 3. Schizophrenia 0 0 0 0 0 0 0 0 0 0W085 4. Epilepsy 529 15 26 93 80 62 48 31 22 377W086 5. Alcohol use disorders 107 0 0 3 26 25 12 13 3 82

W087 6. Alzheimer and other dementias* 144 2 1 1 2 3 9 31 33 82W088 7. Parkinson disease 118 0 0 0 0 2 11 31 25 69W089 8. Multiple sclerosis 5 0 1 0 0 0 0 1 0 2W090 9. Drug use disorders 21 0 0 3 9 6 0 0 0 17W091 10. Post-traumatic stress disorder 0 0 0 0 0 0 0 0 0 0W092 11. Obsessive-compulsive disorder 0 0 0 0 0 0 0 0 0 0W093 12. Panic disorder 0 0 0 0 0 0 0 0 0 0W094 13. Insomnia (primary) 0 0 0 0 0 0 0 0 0 0W095 14. Migraine 0 0 0 0 0 0 0 0 0 0W096 15. Mental retardation, lead-caused 0 0 0 0 0 0 0 0 0 0W097 Other neuropsychiatric disorders 394 46 41 39 28 27 28 28 13 249W098 F. Sense organ diseases 0 0 0 0 0 0 0 0 0 0W099 1. Glaucoma 0 0 0 0 0 0 0 0 0 0W100 2. Cataracts 0 0 0 0 0 0 0 0 0 0W101 3. Vision disorders, age-related 0 0 0 0 0 0 0 0 0 0W102 4. Hearing loss, adult onset 0 0 0 0 0 0 0 0 0 0W103 Other sense organ disorders 0 0 0 0 0 0 0 0 0 0W104 G. Cardiovascular diseases 20714 21 39 196 503 1344 2006 3076 236 9546



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1W105 1. Rheumatic heart disease 106 2 10 13 6 5 2 5 4 48W106 2. Hypertensive heart disease 1108 0 1 4 21 65 88 120 88 387W107 3. Ischaemic heart disease 6773 0 1 14 100 574 913 1289 657 3548W108 4. Cerebrovascular disease 7249 0 7 59 158 429 666 1013 709 3040W109 5. Inflammatory heart diseases 714 14 8 29 47 66 63 85 72 384W110 Other cardiovascular diseases 4763 6 13 76 170 204 274 564 831 2139W111 H. Respiratory diseases 4947 80 23 80 190 445 667 936 630 3051

W112 1.Chronic obstructive pulmonary

disease

2295 3 1 7 43 182 349 559 375 1518

W113 2. Asthma 200 2 1 4 9 21 26 29 19 112W114 Other respiratory diseases 2452 75 20 69 137 243 292 348 236 1420W115 I. Digestive diseases 2669 21 30 115 270 384 317 357 168 1663W116 1. Peptic ulcer disease 275 0 0 15 24 33 27 30 28 158W117 2. Cirrhosis of the liver 948 0 0 22 82 187 145 155 52 643W118 3. Appendicitis 25 0 5 2 3 2 2 4 0 17W119 Other digestive diseases 1420 21 25 77 161 162 143 169 87 845W120 J. Genitourinary diseases 2279 20 14 51 54 95 206 331 299 1071W121 1. Nephritis and nephrosis 2141 19 14 50 52 91 193 298 264 980

W122 2. Benign prostatic hypertrophy 57 0 0 0 0 2 7 19 28 57W123

Other genitourinary systemdiseases

80 2 0 0 2 2 6 14 7 34

W124 K. Skin diseases 256 0 0 0 28 34 0 0 0 62W125 L. Musculoskeletal diseases 39 0 1 2 2 2 2 6 4 19W126 1. Rheumatoid arthritis 8 0 0 0 1 0 1 0 0 2W127 2. Osteoarthritis 0 0 0 0 0 0 0 0 0 0W128 3. Gout 0 0 0 0 0 0 0 0 0 0W129 4. Low back pain* 2 0 0 0 1 1 0 1 0 2W130 Other musculoskeletal disorders 29 0 1 2 1 1 1 5 4 15W131 M. Congenital anomalies 634 318 22 11 3 1 0 0 0 355W132 1. Abdominal wall defect 14 8 0 0 0 0 0 0 0 8W133 2. Anencephaly 19 9 0 0 0 0 0 0 0 9W134 3. Anorectal atresia 5 4 0 0 0 0 0 0 0 4W135 4. Cleft lip 0 0 0 0 0 0 0 0 0 0W136 5. Cleft palate 6 2 0 0 0 0 0 0 0 2W137 6. Oesophageal atresia 0 0 0 0 0 0 0 0 0 0W138 7. Renal agenesis 1 1 0 0 0 0 0 0 0 1



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W139 8. Down syndrome 48 30 1 1 0 0 0 0 0 32W140 9. Congenital heart anomalies 173 82 8 4 1 0 0 0 0 96W141 10. Spina bifida 40 21 1 0 0 0 0 0 0 23W142 Other Congenital anomalies 328 161 11 6 2 1 0 0 0 181W143 N. Oral conditions 0 0 0 0 0 0 0 0 0 0W144 1. Dental caries 0 0 0 0 0 0 0 0 0 0W145 2. Periodontal disease 0 0 0 0 0 0 0 0 0 0W146 3. Edentulism 0 0 0 0 0 0 0 0 0 0W147 Other oral diseases 0 0 0 0 0 0 0 0 0 0

W148 Injuries 10555 922 1392 2123 1527 1000 442 264 76 7746

W149 A. Unintentional injuries 8662 896 1315 1498 1127 736 337 201 59 6170W150 1. Road traffic accidents 3242 212 714 403 416 306 145 84 23 2303W151 2. Poisonings 118 29 19 10 12 6 3 0 0 79W152 3. Falls 310 21 53 21 22 38 25 26 11 217W153 4. Fires 698 141 165 16 14 18 15 10 5 383W154 5. Drownings 1947 202 339 306 377 281 47 0 2 1554W155 6. Other unintentional injuries 2347 292 25 742 286 86 103 80 18 1634

W156 B. Intentional injuries 1893 26 77 624 400 264 104 63 18 1576W157 1. Self-inflicted injuries 834 0 43 218 162 152 67 45 14 700W158 2. Violence 1053 26 34 405 236 112 37 18 3 871W159 3. War 6 0 0 2 2 1 0 0 0 5W160 Other intentional injuries 0 0 0 0 0 0 0 0 0 0



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Annex 4 Estimates of deaths in Malawi 2002 by sex, age and cause Global Burden of Disease Unit Females

Deaths by age, sex and cause in Malawi forthe year 2002

Female

Code Cause 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ Total

W000 All Causes 48046 7333 19282 22700 11844 6341 7970 5868 129386

W001Communicable, maternal,perinatal and nutritionalconditions

46840 6222 18903 22101 8004 1511 1167 776 105525

W002A.

Infectious and parasiticdiseases

32503 5119 13968 18258 6726 947 580 534 78635

W003 1. Tuberculosis 205 116 582 499 247 167 72 18 1906W004 2. STDs excluding HIV 200 0 4 4 61 25 28 0 322W005 a. Syphilis 191 0 3 4 58 24 27 0 308W006 b. Chlamydia 0 0 0 0 2 1 0 0 3W007 c. Gonorrhoea 0 0 0 0 1 0 0 0 1W008 d. Other STDs 9 0 0 0 0 0 1 0 10W009 3. HIV/AIDS 6929 2739 13062 17382 5504 342 26 1 45985W010 4. Diarrhoeal diseases 8663 25 19 43 97 138 193 344 9523

W011 5.Childhood-clusterdiseases

1216 40 5 4 3 1 1 0 1271

W012 a. Pertussis 406 0 0 0 0 0 0 0 406W013 b. Poliomyelitis 0 0 0 0 0 0 0 0 0W014 c. Diphtheria 9 0 0 0 0 0 0 0 9W015 d. Measles 278 28 0 0 0 0 0 0 306W016 e. Tetanus 524 12 5 4 3 1 1 0 551W017 6. Meningitis* 61 117 0 0 11 2 2 0 193W018 7. Hepatitis B 132 28 1 0 26 5 2 0 193W019 Hepatitis C 59 13 0 0 11 2 1 0 87W020 8. Malaria 9014 143 113 159 185 121 114 114 9962

W021 9.Tropical-clusterdiseases

38 174 126 147 191 78 62 14 831

W022 a. Trypanosomiasis 32 158 104 77 68 9 5 0 451W023 b. Chagas disease 0 0 0 0 0 0 0 0 0W024 c. Schistosomiasis 0 0 5 63 121 67 57 14 328W025 d. Leishmaniasis 7 17 17 7 2 2 1 0 52W026 e. lymphatic filariasis 0 0 0 0 0 0 0 0 0W027 f. Onchocerciasis 0 0 0 0 0 0 0 0 0W028 10 Leprosy 0 0 0 0 0 3 2 0 5



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Female

Code Cause 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ Total

.

W02911.

Dengue 1 4 0 0 0 0 0 0 6

W03012.

Japanese encephalitis 0 0 0 0 0 0 0 0 0

W03113.

Trachoma 0 0 0 0 0 0 0 0 0

W03214

.

Intestinal nematode

infections

0 20 9 6 10 9 5 3 62

W033 a. Ascariasis 0 11 0 0 0 0 0 0 11W034 b. Trichuriasis 0 8 0 0 0 0 0 0 8W035 c. Hookworm disease 0 0 9 5 10 9 5 3 42

W036Other intestinalinfections

0 0 0 0 0 0 0 0 1

W037Other infectiousdiseases

5984170

145 13 379 53 73 39 8288

W038B.

Respiratory infections 9999 962 428 341 650 510 558 237 13685

W039 1.Lower respiratoryinfections 9958 855 428 341 650 507 556 237 13532

W040 2.Upper respiratoryinfections

41 107 0 0 0 3 2 0 153

W041 3. Otitis media 0 0 0 0 0 0 0 0 0

W042C.

Maternal conditions 0 0 4476 3486 592 0 0 0 8554

W043 1. Maternal haemorrhage 0 0 938 1023 207 0 0 0 2168W044 2. Maternal sepsis 0 0 713 722 148 0 0 0 1583W045 3. Hypertensive disorders* 0 0 673 400 59 0 0 0 1132W046 4. Obstructed labour 0 0 514 240 18 0 0 0 772W047 5. Abortion 0 0 1079 322 0 0 0 0 1401W048 Other maternal conditions 0 0 558 779 160 0 0 0 1497

W049D.

Perinatal conditions* 2525 0 0 0 0 0 0 0 2525

W050 1. Low birth weight 1050 0 0 0 0 0 0 0 1050

W051 2.Birth asphyxia and birthtrauma

1080 0 0 0 0 0 0 0 1080



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Female

Code Cause 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ Total

W052 Other perinatal conditions 395 0 0 0 0 0 0 0 395

W053E.

Nutritional deficiencies 1813 141 32 15 36 55 28 6 2126

W054 1.Protein-energymalnutrition

1067 37 31 15 16 50 23 6 1245

W055 2. Iodine deficiency 55 8 0 0 1 0 0 0 65W056 3. Vitamin A deficiency 373 52 0 0 10 3 2 0 440W057 4. Iron-deficiency anaemia 285 40 0 0 8 2 2 0 336

W058 Other nutritional disorders 34 5 0 0 1 0 0 0 40

W059 Noncommunicable diseases 470 239 98 360 3519 4667 6671 5028 21051

W060 A. Malignant neoplasms 27 40 82 264 892 871 1010 518 3704

W061 1.Mouth and oropharynxcancers

0 0 0 2 14 6 16 10 47

W062 2. Oesophagus cancer 0 0 8 59 218 243 310 166 1005W063 3. Stomach cancer 0 0 0 2 10 0 0 0 13

W064 4.Colon and rectum

cancers

0 0 1 11 9 4 13 10 48

W065 5. Liver cancer 2 1 4 11 41 55 49 21 184W066 6. Pancreas cancer 0 0 0 0 6 13 36 21 77

W067 7.Trachea, bronchus,lung cancers

0 0 0 0 0 0 0 0 0

W068 8.Melanoma and otherskin cancers

0 0 1 3 27 33 50 23 137

W069 9. Breast cancer 0 0 1 27 110 87 88 48 360W070 10. Cervix uteri cancer 0 0 29 45 310 290 227 79 979W071 11. Corpus uteri cancer 0 0 0 2 3 4 8 5 22W072 12. Ovary cancer 0 2 1 1 18 24 52 23 122W073 13. Prostate cancer 0 0 0 0 0 0 0 0 0W074 14. Bladder cancer 0 0 1 14 38 41 42 27 163

W075 15.Lymphomas, multiplemyeloma

17 34 25 31 28 18 34 20 206

W076 16. Leukaemia 1 1 7 8 16 16 1 0 50

W077Other malignantneoplasms

6 3 5 47 45 38 83 66 292



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Female

Code Cause 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ Total

W078 B. Other neoplasms 1 8 0 1 17 16 20 9 71W079 C. Diabetes mellitus 0 2 0 4 186 262 295 119 869W080 D. Endocrine disorders 35 4 0 2 41 47 44 24 197

W081 E.Neuropsychiatricconditions

49 55 3 6 82 68 99 79 439

W082 1.Unipolar depressivedisorders

0 0 0 0 0 0 0 0 0

W083 2. Bipolar disorder 0 0 0 0 0 0 0 0 0W084 3. Schizophrenia 0 0 0 0 0 0 0 0 0W085 4. Epilepsy 14 27 1 2 40 20 27 20 152W086 5. Alcohol use disorders 0 0 0 1 11 4 9 0 25

W087 6.Alzheimer and otherdementias*

1 0 0 0 3 10 25 24 62

W088 7. Parkinson disease 0 0 0 0 1 6 13 27 48W089 8. Multiple sclerosis 0 0 0 0 1 1 0 0 3W090 9. Drug use disorders 0 0 0 2 1 0 0 0 4

W091 10.Post-traumatic stressdisorder

0 0 0 0 0 0 0 0 0

W092 11.Obsessive-compulsivedisorder 0 0 0 0 0 0 0 0 0

W093 12. Panic disorder 0 0 0 0 0 0 0 0 0W094 13. Insomnia (primary) 0 0 0 0 0 0 0 0 0W095 14. Migraine 0 0 0 0 0 0 0 0 0

W096 15.Mental retardation,lead-caused

0 0 0 0 0 0 0 0 0

W097Other neuropsychiatricdisorders

34 27 1 1 24 26 25 7 145

W098 F. Sense organ diseases 0 0 0 0 0 0 0 0 0W099 1. Glaucoma 0 0 0 0 0 0 0 0 0

W100 2. Cataracts 0 0 0 0 0 0 0 0 0

W101 3.Vision disorders, age-related

0 0 0 0 0 0 0 0 0

W102 4.Hearing loss, adultonset

0 0 0 0 0 0 0 0 0

W103Other sense organdisorders

0 0 0 0 0 0 0 0 0



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Female

Code Cause 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ Total

W104 G. Cardiovascular diseases 18 53 6 49 1521 2402 3831 3288 11168

W105 1.Rheumatic heartdisease

1 12 1 1 20 11 10 3 58

W106 2.Hypertensive heartdisease

0 0 0 4 103 161 260 192 721

W107 3.Ischaemic heartdisease

0 2 0 7 437 822 1153 803 3226

W108 4.Cerebrovasculardisease

0 11 1 17 627 978 1475 1101 4209

W109 5.Inflammatory heartdiseases

12 10 1 3 71 71 88 74 330

W110Other cardiovasculardiseases

5 18 3 16 263 359 845 1115 2624

W111 H. Respiratory diseases 63 20 2 12 277 407 632 483 1896

W112 1.Chronic obstructivepulmonary disease

4 0 0 1 91 157 295 229 777

W113 2. Asthma 1 1 0 1 16 21 28 19 88

W114Other respiratorydiseases

58 19 2 10 170 228 309 235 1031

W115 I. Digestive diseases 7 23 2 13 234 256 284 187 1006W116 1. Peptic ulcer disease 0 1 0 1 24 25 37 29 118W117 2. Cirrhosis of the liver 1 2 0 4 94 97 82 26 305W118 3. Appendicitis 0 3 0 0 2 1 2 1 8

W119Other digestivediseases

6 17 2 8 115 134 163 131 576

W120 J. Genitourinary diseases 11 19 1 1 217 290 413 256 1208W121 1. Nephritis and nephrosis 9 19 1 1 216 285 397 234 1161

W122 2.Benign prostatichypertrophy

0 0 0 0 0 0 0 0 0

W123Other genitourinarysystem diseases

2 1 0 0 2 5 15 23 47

W124 K. Skin diseases 0 0 0 8 45 44 35 63 194W125 L. Musculoskeletal diseases 0 1 0 1 6 4 7 2 20W126 1. Rheumatoid arthritis 0 0 0 0 1 1 3 1 6W127 2. Osteoarthritis 0 0 0 0 0 0 0 0 0W128 3. Gout 0 0 0 0 0 0 0 0 0



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Female

Code Cause 0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+ Total

W129 4. Low back pain* 0 0 0 0 0 0 0 0 0

W130Other musculoskeletaldisorders

0 1 0 0 5 3 4 1 14

W131 M. Congenital anomalies 260 14 0 0 2 1 2 0 279W132 1. Abdominal wall defect 6 0 0 0 0 0 0 0 6W133 2. Anencephaly 10 0 0 0 0 0 0 0 10W134 3. Anorectal atresia 2 0 0 0 0 0 0 0 2W135 4. Cleft lip 0 0 0 0 0 0 0 0 0W136 5. Cleft palate 4 0 0 0 0 0 0 0 4W137 6. Oesophageal atresia 0 0 0 0 0 0 0 0 0W138 7. Renal agenesis 0 0 0 0 0 0 0 0 0W139 8. Down syndrome 14 1 0 0 0 0 0 0 16

W140 9.Congenital heartanomalies

71 4 0 0 1 0 1 0 77

W141 10. Spina bifida 17 0 0 0 0 0 0 0 17

W142Other Congenitalanomalies

137 8 0 0 0 1 1 0 147

W143 N. Oral conditions 0 0 0 0 0 0 0 0 0W144 1. Dental caries 0 0 0 0 0 0 0 0 0W145 2. Periodontal disease 0 0 0 0 0 0 0 0 0W146 3. Edentulism 0 0 0 0 0 0 0 0 0W147 Other oral diseases 0 0 0 0 0 0 0 0 0

W148 Injuries 735 872 281 240 321 163 133 64 2809

W149 A. Unintentional injuries 709 819 211 185 256 139 117 55 249

Burden Chapter 1

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