|
|
| |
Levels of anchorage
to local data and NBD Results
|
| |
| |
|
|
| |
|
|
| |
The table for magnitude
shows some results obtained through the
different estimates. First note that
Murray and Lopez have made substantial
revisions between the first GBD estimates
published in WDR93 and the GBD96
estimates. The GBD96 estimate of DALY
loss per 1000 persons are about 20% lower
than the WDR93 estimates. In comparison,
the difference between GBD96 and COD
anchored estimate is marginal, in the
range of 0.6 to 2.5%. For YLL and YLD, we
do not readily have the rates from WDR93.
Comparing GBD96 with COD anchored
estimate, we see that YLD rates remain
the same. This is to be expected, since
both estimates share the same
epidemiological inputs and disability
weights. The change in YLL rates is
between 0 to 3.7%. |
|
| |
|
|
| |
Magnitude
of disease burden in AP, and
mortality-disability composition
obtained by different estimates.
|
| Result |
Group |
Minimally
Anchored
|
Intermediately
anchored
|
| |
|
WDR93
|
GBD96
|
COD
|
HSV-VAS
|
HSV-Tor-TTO
|
| DALY / 1000 |
All |
344
|
283
|
277
|
537
|
394
|
| |
Females |
359
|
276
|
269
|
550
|
396
|
| |
Males |
331
|
291
|
293
|
539
|
403
|
| YLL / 1000 |
All |
|
196
|
189
|
189
|
189
|
| |
Females |
|
185
|
178
|
178
|
178
|
| |
Males |
|
206
|
206
|
206
|
206
|
| YLD / 1000 |
All |
|
88
|
88
|
348
|
204
|
| |
Females |
|
90
|
90
|
372
|
217
|
| |
Males |
|
85
|
87
|
334
|
197
|
| YLL
: YLD Ratio |
All |
2.18
|
2.23
|
2.15
|
0.54
|
0.93
|
| |
Females |
2.27
|
2.06
|
1.98
|
0.48
|
0.82
|
| |
Males |
2.10
|
2.42
|
2.37
|
0.62
|
1.05
|
| Male :
Female Ratio |
DALY |
0.92
|
1.05
|
1.09
|
0.98
|
1.02
|
| |
YLL |
1.11
|
1.11
|
1.16
|
1.16
|
1.16
|
| |
YLD |
0.94
|
0.94
|
0.97
|
0.90
|
0.91
|
|
|
| |
|
|
| |
Changes in YLL : YLD
ratio and Male to Female ratio are
minimal between GBD96 and COD anchored
estimates. The situation changes
completely, however, in case of the
HSV-VAS anchored estimates. Recall that
the disability weights obtained from the
community study in Andhra Pradesh were
all higher than the disability weights
used in GBD96 study. All projected
disability weights based on data from the
community survey, are in the range of
0.28 to 0.803 with a median value of
0.474. Compare this with the GBD96 range
of disability weights, which range from 0
to 0.85 with a median value of 0.145. As
a result the magnitude of HSV anchored
disease burden is inflated to nearly
twice the COD anchored estimate as well
as the GBD96 estimate. The YLL to YLD
ratio changes to reflect the higher
disability component. Burden due to
premature mortality now appears as half
of the burden due to disability. The
HSV-Torrance-TTO estimates give magnitude
of burden intermediate between the COD
anchored and HSV-VAS anchored estimates.
The reader may recall that the life
expectancy at birth in Andhra Pradesh is
about 60 years . This is much lower than
life expectancy achieved elsewhere in the
world. The standard life expectancy used
by us is 80 years for males and 82.5
years for females. This standard is based
on actual experience in some parts of the
world. Considering the intermediate
mortality level in Andhra Pradesh, the
radical shift in relationship of
mortality and disability components
suggested by the HSV anchored estimates
is puzzling. But before we affirm up our
views on the HSV estimates, let's
continue with the comparison of different
estimates, looked at from additional
points of view. |
|
| |
|
|
| |
Age-sex
distribution of DALYs from
different estimates
|
| Sex |
Age |
Minimally
Anchored
|
Intermediately
anchored
|
| |
|
WDR93
|
GBD96
|
Cause of
death
|
HSV-VAS
|
HSV-Tor-TTO
|
| Persons |
0-4 |
51.17
|
35.01
|
34.14
|
28.63
|
30.81
|
| |
5-14 |
7.12
|
11.99
|
12.59
|
16.63
|
15.04
|
| |
15-44 |
7.47
|
30.41
|
30.40
|
37.18
|
34.76
|
| |
45-59 |
13.38
|
11.65
|
10.76
|
9.79
|
10.08
|
| |
60+ |
20.85
|
10.94
|
12.11
|
7.78
|
9.31
|
| Females |
0-4 |
53.05
|
34.64
|
33.89
|
27.24
|
29.69
|
| |
5-14 |
7.44
|
10.73
|
11.40
|
15.33
|
13.89
|
| |
15-44 |
8.21
|
33.03
|
33.16
|
41.79
|
38.87
|
| |
45-59 |
11.52
|
10.46
|
9.56
|
8.28
|
8.63
|
| |
60+ |
19.78
|
11.13
|
11.98
|
7.36
|
8.92
|
| Males |
0-4 |
49.30
|
35.34
|
34.37
|
30.05
|
31.92
|
| |
5-14 |
6.79
|
13.15
|
13.68
|
17.95
|
16.16
|
| |
15-44 |
6.75
|
27.99
|
27.87
|
32.47
|
30.72
|
| |
45-59 |
15.25
|
12.75
|
11.86
|
11.33
|
11.50
|
| |
60+ |
21.91
|
10.77
|
12.22
|
8.20
|
9.70
|
|
|
| |
|
|
|
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