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Burden of injuries in Nepal, 1990–2017: Findings from the Global Burden of Disease Study 2017

Pant, Puspa Raj; Banstola, Amrit; Bhatta, Santosh; Mytton, Julie A; Acharya, Dilaram; Bhattarai, Suraj; Bisignano, Catherine; Castle, Chris D; Prasad Dhungana, Govinda; Dingels, Zachary V; Fox, Jack T; Kumar Hamal, Pawan; Liu, Zichen; Bahadur Mahotra, Narayan; Paudel, Deepak; Narayan Pokhrel, Khem; Lal Ranabhat, Chhabi; Roberts, Nicholas L S; Sylte, Dillon O; James, Spencer L

Authors

Dilaram Acharya

Suraj Bhattarai

Catherine Bisignano

Chris D Castle

Govinda Prasad Dhungana

Zachary V Dingels

Jack T Fox

Pawan Kumar Hamal

Zichen Liu

Narayan Bahadur Mahotra

Deepak Paudel

Khem Narayan Pokhrel

Chhabi Lal Ranabhat

Nicholas L S Roberts

Dillon O Sylte

Spencer L James



Abstract

Background: Nepal is a low-income country undergoing rapid political, economic and social development. To date, there has been little evidence published on the burden of injuries during this period of transition.

Methods: The Global Burden of Disease Study (GBD) is a comprehensive measurement of population health outcomes in terms of morbidity and mortality. We analysed the GBD 2017 estimates for deaths, years of life lost, years lived with disability, incidence and disability-adjusted life years (DALYs) from injuries to ascertain the burden of injuries in Nepal from 1990 to 2017.

Results: There were 16 831 (95% uncertainty interval 13 323 to 20 579) deaths caused by injuries (9.21% of all-cause deaths (7.45% to 11.25%)) in 2017 while the proportion of deaths from injuries was 6.31% in 1990. Overall, the injury-specific age-standardised mortality rate declined from 88.91 (71.54 to 105.31) per 100 000 in 1990 to 70.25 (56.75 to 85.11) per 100 000 in 2017. In 2017, 4.11% (2.47% to 6.10%) of all deaths in Nepal were attributed to transport injuries, 3.54% (2.86% to 4.08%) were attributed to unintentional injuries and 1.55% (1.16% to 1.85%) were attributed to self-harm and interpersonal violence. From 1990 to 2017, road injuries, falls and self-harm all rose in rank for all causes of death.

Conclusions: The increase in injury-related deaths and DALYs in Nepal between 1990 and 2017 indicates the need for further research and prevention interventions. Injuries remain an important public health burden in Nepal with the magnitude and trend of burden varying over time by cause-specific, sex and age group. Findings from this study may be used by the federal, provincial and local governments in Nepal to prioritise injury prevention as a public health agenda and as evidence for country-specific interventions.

Journal Article Type Article
Journal Injury Prevention
Print ISSN 1353-8047
Electronic ISSN 1475-5785
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
APA6 Citation Pant, P. R., Banstola, A., Bhatta, S., Mytton, J. A., Acharya, D., Bhattarai, S., …James, S. L. (in press). Burden of injuries in Nepal, 1990–2017: Findings from the Global Burden of Disease Study 2017. Injury Prevention, https://doi.org/10.1136/injuryprev-2019-043309
DOI https://doi.org/10.1136/injuryprev-2019-043309
Keywords Nepal, Injury Prevention, Unintentional Injuries, Intentional Injuries
Publisher URL https://injuryprevention.bmj.com/content/early/2020/01/08/injuryprev-2019-043309

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