{"id":2630,"date":"2015-08-28T20:09:00","date_gmt":"2015-08-28T20:09:00","guid":{"rendered":"https:\/\/cdafound.org\/?p=2630"},"modified":"2025-01-16T15:33:42","modified_gmt":"2025-01-16T15:33:42","slug":"global-regional-and-national-disability-adjusted-life-years-dalys-for-306-diseases-and-injuries-and-healthy-life-expectancy-hale-for-188-countries-1990-2013-quantifying-the-epidemiological-tra","status":"publish","type":"post","link":"https:\/\/cdafound.org\/fr\/global-regional-and-national-disability-adjusted-life-years-dalys-for-306-diseases-and-injuries-and-healthy-life-expectancy-hale-for-188-countries-1990-2013-quantifying-the-epidemiological-tra\/","title":{"rendered":"Ann\u00e9es de vie ajust\u00e9es en fonction de l'incapacit\u00e9 (AVCI) aux niveaux mondial, r\u00e9gional et national pour 306 maladies et traumatismes et esp\u00e9rance de vie en bonne sant\u00e9 (HALE) pour 188 pays, 1990-2013: quantification de la transition \u00e9pid\u00e9miologique"},"content":{"rendered":"

R\u00e9sum\u00e9<\/h2>\n\n\n\n

Arri\u00e8re-plan <\/h3>\n\n\n\n

La Global Burden of Disease Study 2013 (GBD 2013) vise \u00e0 rassembler toutes les donn\u00e9es \u00e9pid\u00e9miologiques disponibles en utilisant un cadre de mesure coh\u00e9rent, des m\u00e9thodes d'estimation standardis\u00e9es et des sources de donn\u00e9es transparentes pour permettre des comparaisons de la perte de sant\u00e9 au fil du temps et entre les causes, les groupes d'\u00e2ge-sexe, et les pays. Le GBD peut \u00eatre utilis\u00e9 pour g\u00e9n\u00e9rer des mesures r\u00e9capitulatives telles que les ann\u00e9es de vie corrig\u00e9es de l'incapacit\u00e9 (DALY) et l'esp\u00e9rance de vie en bonne sant\u00e9 (HALE) qui permettent des \u00e9valuations comparatives de grands sch\u00e9mas \u00e9pid\u00e9miologiques \u00e0 travers les pays et le temps. Ces mesures sommaires peuvent \u00e9galement \u00eatre utilis\u00e9es pour quantifier la composante de variation en \u00e9pid\u00e9miologie li\u00e9e au d\u00e9veloppement sociod\u00e9mographique. <\/p>\n\n\n\n

M\u00e9thodes <\/h3>\n\n\n\n

Nous avons utilis\u00e9 les donn\u00e9es publi\u00e9es du GBD 2013 pour la mortalit\u00e9 par \u00e2ge, les ann\u00e9es de vie perdues en raison de la mortalit\u00e9 pr\u00e9matur\u00e9e (YLL) et les ann\u00e9es v\u00e9cues avec une incapacit\u00e9 (YLD) pour calculer les DALY et HALE pour 1990, 1995, 2000, 2005, 2010, et 2013 pour 188 pays. Nous avons calcul\u00e9 HALE en utilisant la m\u00e9thode Sullivan; Les intervalles d'incertitude (UI) 95% repr\u00e9sentent l'incertitude dans les taux de mortalit\u00e9 par \u00e2ge et les YLD par personne pour chaque pays, \u00e2ge, sexe et ann\u00e9e. Nous avons estim\u00e9 les AVCI pour 306 causes pour chaque pays comme la somme des AVI et des AVI; Les UI 95% repr\u00e9sentent l'incertitude des taux YLL et YLD. Nous avons quantifi\u00e9 les sch\u00e9mas de la transition \u00e9pid\u00e9miologique \u00e0 l'aide d'un indicateur composite du statut sociod\u00e9mographique, que nous avons construit \u00e0 partir du revenu par personne, des ann\u00e9es moyennes de scolarit\u00e9 apr\u00e8s 15 ans, de l'indice synth\u00e9tique de f\u00e9condit\u00e9 et de l'\u00e2ge moyen de la population. Nous avons appliqu\u00e9 une r\u00e9gression hi\u00e9rarchique aux taux de DALY par cause \u00e0 travers les pays pour d\u00e9composer la variance li\u00e9e \u00e0 la variable de statut sociod\u00e9mographique, au pays et au temps. <\/p>\n\n\n\n

R\u00e9sultats <\/h3>\n\n\n\n

Dans le monde, de 1990 \u00e0 2013, l'esp\u00e9rance de vie \u00e0 la naissance a augment\u00e9 de 6,2 ans (95% UI 5,6\u20136,6), passant de 65,3 ans (65,0\u201365,6) en 1990 \u00e0 71,5 ans (71,0\u201371,9) en 2013, HALE \u00e0 la naissance de 5,4 ans (4,9\u20135,8), de 56,9 ans (54,5\u201359,1) \u00e0 62,3 ans (59,7\u201364,8), les AVCI totales ont chut\u00e9 de 3,61 TP1T (0,3\u20137,4) et les taux normalis\u00e9s de DALY selon l'\u00e2ge pour 100000 personnes ont chut\u00e9 de 26,71 TP1T (24,6 \u201329,1). Pour les troubles transmissibles, maternels, n\u00e9onatals et nutritionnels, les nombres globaux d'AVCI, les taux bruts et les taux normalis\u00e9s selon l'\u00e2ge ont tous diminu\u00e9 entre 1990 et 2013, tandis que pour les maladies non transmissibles, les AVCI mondiales ont augment\u00e9, les taux d'AVCI sont rest\u00e9s presque constants et les taux de DALY normalis\u00e9s selon l'\u00e2ge ont diminu\u00e9 au cours de la m\u00eame p\u00e9riode. De 2005 \u00e0 2013, le nombre d'AVCI a augment\u00e9 pour la plupart des maladies non transmissibles sp\u00e9cifiques, y compris les maladies cardiovasculaires et les n\u00e9oplasmes, en plus de la dengue, des tr\u00e9matodes d'origine alimentaire et de la leishmaniose; Les AVCI ont diminu\u00e9 pour presque toutes les autres causes. En 2013, les cinq principales causes d'AVCI \u00e9taient les cardiopathies isch\u00e9miques, les infections des voies respiratoires inf\u00e9rieures, les maladies c\u00e9r\u00e9brovasculaires, les douleurs lombaires et cervicales et les blessures de la route. Le statut sociod\u00e9mographique expliquait plus de 50% de la variance entre les pays et au fil du temps pour la diarrh\u00e9e, les infections des voies respiratoires inf\u00e9rieures et d'autres maladies infectieuses courantes; troubles maternels; troubles n\u00e9onatals; d\u00e9ficiences nutritionnelles; autres maladies transmissibles, maternelles, n\u00e9onatales et nutritionnelles; troubles musculo-squelettiques; et autres maladies non transmissibles. Cependant, le statut sociod\u00e9mographique expliquait moins de 10% de la variance des taux de DALY pour les maladies cardiovasculaires; maladies respiratoires chroniques; cirrhose; le diab\u00e8te, les maladies urog\u00e9nitales, sanguines et endocriniennes; blessures involontaires; et l'automutilation et la violence interpersonnelle. Comme on pouvait s'y attendre, un statut sociod\u00e9mographique accru \u00e9tait associ\u00e9 \u00e0 un d\u00e9placement du fardeau des YLL aux YLD, en raison de la baisse des YLL et de l'augmentation des YLD dus aux troubles musculo-squelettiques, aux troubles neurologiques et aux troubles mentaux et li\u00e9s \u00e0 l'usage de substances. Dans la plupart des estimations par pays, l'augmentation de l'esp\u00e9rance de vie \u00e9tait sup\u00e9rieure \u00e0 celle de HALE. Les principales causes des AVCI sont tr\u00e8s variables d'un pays \u00e0 l'autre. <\/p>\n\n\n\n

Interpr\u00e9tation <\/h3>\n\n\n\n

La sant\u00e9 mondiale s\u2019am\u00e9liore. La croissance d\u00e9mographique et le vieillissement ont entra\u00een\u00e9 une augmentation du nombre d'AVCI, mais les taux bruts sont rest\u00e9s relativement constants, ce qui montre que les progr\u00e8s en mati\u00e8re de sant\u00e9 ne signifient pas une diminution des demandes sur les syst\u00e8mes de sant\u00e9. La notion de transition \u00e9pid\u00e9miologique - dans laquelle un statut sociod\u00e9mographique croissant entra\u00eene un changement structur\u00e9 de la charge de morbidit\u00e9 - est utile, mais il existe une \u00e9norme variation de la charge de morbidit\u00e9 qui n'est pas associ\u00e9e au statut sociod\u00e9mographique. Cela souligne en outre la n\u00e9cessit\u00e9 d'\u00e9valuations sp\u00e9cifiques aux pays des DALY et HALE pour \u00e9clairer de mani\u00e8re appropri\u00e9e les d\u00e9cisions de politique de sant\u00e9 et les actions connexes.<\/p>\n\n

\n
Lire le rapport complet<\/a><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"

Summary Background The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age\u2013sex groups, and countries. The GBD can be used to generate summary measures 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