The burden of disease and injury in Iran 2003

Naghavi, Mohsen; Abolhassani, Farid; Pourmalek, Farshad; Moradi‐Lakeh, Maziar; Jafari, Nahid; Vaseghi, Sanaz; Hezaveh, Niloufar Mahdavi; Kazemeini, Hossein · 2009 · OpenAlex-citations

DOI: 10.1186/1478-7954-7-9

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Summary

This study presents the findings of the first National Burden of Disease (NBD) study in Iran, estimating the health burden for the year 2003. The research was motivated by the need to provide quantitative evidence to inform health policy, guide intervention priorities, and allocate resources effectively as Iran’s disease profile shifted from communicable diseases to noncommunicable conditions and injuries. The study aimed to calculate Years of Life Lost (YLL), Years Lived with Disability (YLD), and Disability-Adjusted Life Years (DALYs) at the national level and for six selected provinces. The researchers adapted the World Health Organization’s NBD methodology, employing specific adjustments to suit Iran’s epidemiological context. These included a revised list of 213 disease and injury causes, the development of specialized modeling templates for cancers (CANMOD) and injuries, and adjustments for dependent comorbidity. Data sources included the national death registry, cancer registries, disease surveillance systems, and hospital records for trauma patients. Disability weights were derived from Global Burden of Disease (GBD) values, the Dutch Disability Weights Group, and a Delphi method involving clinical specialists for causes not covered by existing lists. Population estimates were derived from census data and vital statistics, while mortality data underwent rigorous quality assurance, including the redistribution of "garbage codes" to specific causes. The results indicated a total burden of 21,572 DALYs per 100,000 people in Iran in 2003. Disability (YLD) accounted for 62% of the total burden, while premature mortality (YLL) accounted for 38%. Noncommunicable diseases represented 58% of the burden, injuries 28%, and communicable, maternal, perinatal, and nutritional conditions 14%. There were significant gender disparities: males accounted for 53% of the total DALYs, with road traffic accidents, natural disasters, opioid use, and ischemic heart disease as leading causes. Females accounted for 47% of DALYs, with ischemic heart disease, major depressive disorder, natural disasters, and road traffic accidents as primary contributors. The study also noted marked variability in disease burden across provinces and found that Iran’s DALY estimates were higher than WHO estimates for the Eastern Mediterranean Region. The study concludes that Iran has undergone an epidemiological transition, characterized by a dominance of noncommunicable diseases and road traffic injuries over communicable diseases. The authors emphasize that these NBD results are critical for health program planning, research direction, and resource allocation policies. By providing a detailed, evidence-based profile of health gaps, the study supports the broader framework of Health System Performance Assessment and aims to improve the equity and efficiency of health interventions in Iran.

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• incidence prevalence