26
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Global Skin Disease Morbidity and Mortality : An Update From the Global Burden of Disease Study 2013

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Key Points

          Question

          What is the burden of skin disease worldwide?

          Findings

          In this observational study, skin diseases contributed 1.79% to the global burden of disease measured in disability-adjusted life years (DALYs). Skin diseases arranged in order of decreasing global DALYs are as follows: dermatitis (atopic, contact, seborrheic), acne vulgaris, urticaria, psoriasis, viral skin diseases, fungal skin diseases, scabies, melanoma, pyoderma, cellulitis, keratinocyte carcinoma, decubitus ulcer, and alopecia areata.

          Meaning

          Skin diseases remain a major cause of disability worldwide. An objective measure of burden, such as the DALY, allows for comparison of diverse diseases across geography and time.

          Abstract

          This study measures the burden of skin diseases worldwide.

          Abstract

          Importance

          Disability secondary to skin conditions is substantial worldwide. The Global Burden of Disease Study 2013 includes estimates of global morbidity and mortality due to skin diseases.

          Objective

          To measure the burden of skin diseases worldwide.

          Data Sources

          For nonfatal estimates, data were found by literature search using PubMed and Google Scholar in English and Spanish for years 1980 through 2013 and by accessing administrative data on hospital inpatient and outpatient episodes. Data for fatal estimates were based on vital registration and verbal autopsy data.

          Study Selection

          Skin disease data were extracted from more than 4000 sources including systematic reviews, surveys, population-based disease registries, hospital inpatient data, outpatient data, cohort studies, and autopsy data. Data metrics included incidence, prevalence, remission, duration, severity, deaths, and mortality risk.

          Data Extraction and Synthesis

          Data were extracted by age, time period, case definitions, and other study characteristics. Data points were modeled with Bayesian meta-regression to generate estimates of morbidity and mortality metrics for skin diseases. All estimates were made with 95% uncertainty intervals.

          Main Outcomes and Measures

          Disability-adjusted life years (DALYs), years lived with disability, and years of life lost from 15 skin conditions in 188 countries.

          Results

          Skin conditions contributed 1.79% to the global burden of disease measured in DALYs from 306 diseases and injuries in 2013. Individual skin diseases varied in size from 0.38% of total burden for dermatitis (atopic, contact, and seborrheic dermatitis), 0.29% for acne vulgaris, 0.19% for psoriasis, 0.19% for urticaria, 0.16% for viral skin diseases, 0.15% for fungal skin diseases, 0.07% for scabies, 0.06% for malignant skin melanoma, 0.05% for pyoderma, 0.04% for cellulitis, 0.03% for keratinocyte carcinoma, 0.03% for decubitus ulcer, and 0.01% for alopecia areata. All other skin and subcutaneous diseases composed 0.12% of total DALYs.

          Conclusions and Relevance

          Skin and subcutaneous diseases were the 18th leading cause of global DALYs in Global Burden of Disease 2013. Excluding mortality, skin diseases were the fourth leading cause of disability worldwide.

          Related collections

          Most cited references19

          • Record: found
          • Abstract: found
          • Article: found

          Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

          Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

            Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time. We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights. Global DALYs remained stable from 1990 (2·503 billion) to 2010 (2·490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results. Bill & Melinda Gates Foundation. Copyright © 2012 Elsevier Ltd. All rights reserved.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found

              Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

              The Lancet, 385(9963), 117-171
                Bookmark

                Author and article information

                Journal
                JAMA Dermatol
                JAMA Dermatol
                JAMA Dermatology
                American Medical Association
                2168-6068
                2168-6084
                1 March 2017
                May 2017
                10 May 2017
                29 March 2017
                : 153
                : 5
                : 406-412
                Affiliations
                [1 ]University Hospitals Case Western Medical Center, Cleveland, Ohio
                [2 ]now with Department of Dermatology, University of Colorado, Denver
                [3 ]Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health Care System, Denver
                [4 ]University of Colorado School of Medicine, Aurora
                [5 ]Colorado School of Public Health, Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora
                [6 ]Institute for Health Metrics and Evaluation, University of Washington, Seattle
                [7 ]Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
                [8 ]Unit for Population-Based Dermatology Research, St John’s Institute of Dermatology, Guy’s & St Thomas’ NHS Foundation Trust and King’s College London, London, United Kingdom
                [9 ]Department of Dermatology, Kings College NHS Trust, London, United Kingdom
                [10 ]Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
                [11 ]School of Public Health, University of Queensland, Herston, Queensland, Australia
                [12 ]Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
                [13 ]Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
                [14 ]Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
                [15 ]Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
                Author notes
                Article Information
                Corresponding Author: Chante Karimkhani, MD, University Hospitals Case Western Medical Center, 408 W St Clair Ave, Unit 317, Cleveland, OH 44113 ( ck2525@ 123456caa.columbia.edu ).
                Accepted for Publication: November 19, 2016.
                Correction: This article was corrected on May 10, 2017, to add the Open Access paragraph to the acknowledgments section. This article was corrected online March 29, 2017, to fix errors in the Key Points and the Abstract.
                Published Online: March 1, 2017. doi:10.1001/jamadermatol.2016.5538
                Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2017 Karimkhani C et al. JAMA Dermatology.
                Author Contributions: Drs Karimkhani and Naghavi had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
                Study concept and design: Coffeng, Hay, Vos, Naghavi.
                Acquisition, analysis, or interpretation of data: All authors.
                Drafting of the manuscript: Karimkhani, Nsoesie, Erskine.
                Critical revision of the manuscript for important intellectual content: Karimkhani, Dellavalle, Coffeng, Flohr, Hay, Langan, Nsoesie, Ferrari, Silverberg, Vos, Naghavi.
                Statistical analysis: Karimkhani, Coffeng, Ferrari, Erskine, Silverberg, Vos, Naghavi.
                Administrative, technical, or material support: Karimkhani, Naghavi.
                Supervision: Vos, Dellavalle, Coffeng, Hay, Langan, Vos, Naghavi.
                Conflict of Interest Disclosures: Drs Coffeng, Nsoesie, Ferrari, Erskine, Vos, and Naghavi are or have been employed by the Institute for Health Metrics and Evaluation during the time of study. Drs Karimkhani, Dellavalle, Hay, Langan, and Silverberg are GBD collaborators without funding. Dr Dellavalle is an employee of the US Department of Veterans Affairs. Dr Langan is supported by a National Institute for Health Research Clinician Scientist award from the United Kingdom Department of Health. Drs Ferrari and Erskine are affiliated with the Queensland Centre for Mental Health research, which receives funding from the Queensland Department of Health. No other disclosures are reported.
                Funding/Support: This study was supported in part by the Bill and Melinda Gates Foundation (principal investigator: Christopher J. L. Murray).
                Role of the Funder/Sponsor: The Bill and Melinda Gates Foundation had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
                Article
                doi160074
                10.1001/jamadermatol.2016.5538
                5817488
                28249066
                11aa6e88-b5cc-4150-bacb-a0c83998faf6
                Copyright 2017 Karimkhani C et al. JAMA Dermatology.

                This is an open access article distributed under the terms of the CC-BY License. ©2017 Karimkhani C et al. JAMA Dermatology.

                History
                : 25 June 2016
                : 11 October 2016
                : 19 November 2016
                Funding
                Funded by: Bill and Melinda Gates Foundation
                Categories
                Research
                Research
                Original Investigation
                Featured
                Online First

                Comments

                Comment on this article

                scite_

                Similar content165

                Cited by177

                Most referenced authors4,277