AUT LibraryAUT
View Item 
  •   Open Research
  • AUT Faculties
  • Faculty of Health and Environmental Sciences
  • School of Public Health and Interdisciplinary Studies
  • View Item
  •   Open Research
  • AUT Faculties
  • Faculty of Health and Environmental Sciences
  • School of Public Health and Interdisciplinary Studies
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

The Burden of Neurological Disorders Across the States of India: The Global Burden of Disease Study 1990–2019

Singh, G; Sharma, M; Kumar, GA; Rao, NG; Prasad, K; Mathur, P; Pandian, JD; Steinmetz, JD; Biswas, A; Pal, PK; Prakash, S; Sylaja, PN; Nichols, E; Dua, T; Kaur, H; Alladi, S; Agarwal, V; Aggarwal, S; Ambekar, A; Bagepally, BS; Banerjee, TK; Bender, RG; Bhagwat, S; Bhargava, S; Bhatia, R; Chakma, JK; Chowdhary, N; Dey, S; Dirac, MA; Feigin, VL; Ganguli, A; Golechha, MJ; Gourie-Devi, M; Goyal, V; Gupta, G; Gupta, PC; Gupta, R; Gururaj, G; Hemalatha, R; Jeemon, P; Johnson, CO; Joshi, P; Kant, R; Kataki, AC; Khurana, D; Krishnankutty, RP; Kyu, HH; Lim, SS; Lodha, R; Ma, R; Malhotra, R; Malhotra, R; Mathai, M; Mehrotra, R; Misra, UK; Mutreja, P; Naghavi, M; Naik, N; Nguyen, M; Pandey, A; Parmar, P; Perianayagam, A; Prabhakaran, D; Rath, GK; Reinig, N; Roth, GA; Sagar, R; Sankar, MJ; Shaji, KS; Sharma, RS; Sharma, S; Singh, R; Srivastava, MVP; Stark, BA; Tandon, N; Thakur, JS; ThekkePurakkal, AS; Thomas, SV; Tripathi, M; Vongpradith, A; Wunrow, HY; Xavier, D; Shukla, DK; Reddy, KS; Panda, S; Dandona, R; Murray, CJL; Vos, T; Dhaliwal, RS; Dandona, L
Thumbnail
View/Open
Journal article (1.017Mb)
Permanent link
http://hdl.handle.net/10292/14370
Metadata
Show full metadata
Abstract
Summary

Background A systematic understanding of the burden of neurological disorders at the subnational level is not readily

available for India. We present a comprehensive analysis of the disease burden and trends of neurological disorders

at the state level in India.

Methods Using all accessible data from multiple sources, we estimated the prevalence or incidence and disabilityadjusted life-years (DALYs) for neurological disorders from 1990 to 2019 for all states of India as part of the Global

Burden of Diseases, Injuries, and Risk Factors Study 2019. We assessed the contribution of each neurological disorder

to deaths and DALYs in India in 2019, their trends in prevalence or incidence and DALY rates over time, and

heterogeneity between the states of India. We also assessed the Pearson correlation coefficient between Sociodemographic Index (SDI) of the states and the prevalence or incidence and DALY rates of each neurological disorder.

Additionally, we estimated the contribution of known risk factors to DALYs from neurological disorders. We calculated

95% uncertainty intervals (UIs) for the mean estimates.

Findings The contribution of non-communicable neurological disorders to total DALYs in India doubled from 4·0%

(95% UI 3·2–5·0) in 1990 to 8·2% (6·6–10·2) in 2019, and the contribution of injury-related neurological disorders

increased from 0·2% (0·2–0·3) to 0·6% (0·5–0·7). Conversely, the contribution of communicable neurological

disorders decreased from 4·1% (3·5–4·8) to 1·1% (0·9–1·5) during the same period. In 2019, the largest contributors

to the total neurological disorder DALYs in India were stroke (37·9% [29·9–46·1]), headache disorders (17·5%

[3·6–32·5]), epilepsy (11·3% [9·0–14·3]), cerebral palsy (5·7% [4·2–7·7]), and encephalitis (5·3% [3·7–8·9]). The

crude DALY rate of several neurological disorders had considerable heterogeneity between the states in 2019, with the

highest variation for tetanus (93·2 times), meningitis (8·3 times), and stroke (5·5 times). SDI of the states had a

moderate significant negative correlation with communicable neurological disorder DALY rate and a moderate

significant positive correlation with injury-related neurological disorder DALY rate in 2019. For most of the noncommunicable neurological disorders, there was an increase in prevalence or incidence from 1990 to 2019. Substantial

decreases were evident in the incidence and DALY rates of communicable neurological disorders during the same

period. Migraine and multiple sclerosis were more prevalent among females than males and traumatic brain injuries

were more common among males than females in 2019. Communicable diseases contributed to the majority of total

neurological disorder DALYs in children younger than 5 years, and non-communicable neurological disorders were

the highest contributor in all other age groups. In 2019, the leading risk factors contributing to DALYs due to noncommunicable neurological disorders in India included high systolic blood pressure, air pollution, dietary risks, high

fasting plasma glucose, and high body-mass index. For communicable disorders, the identified risk factors with

modest contributions to DALYs were low birthweight and short gestation and air pollution.

Interpretation The increasing contribution of non-communicable and injury-related neurological disorders to the

overall disease burden in India, and the substantial state-level variation in the burden of many neurological disorders

highlight the need for state-specific health system responses to address the gaps in neurology services related to

awareness, early identification, treatment, and rehabilitation.
Date
2021
Source
The Lancet Psychiatry, 7(2), 148-161.
Item Type
Journal Article
Publisher
Elsevier BV
DOI
10.1016/s2214-109x(21)00164-9
Publisher's Version
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00164-9/fulltext
Rights Statement
© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Contact Us
  • Admin

Hosted by Tuwhera, an initiative of the Auckland University of Technology Library

 

 

Browse

Open ResearchTitlesAuthorsDateSchool of Public Health and Interdisciplinary StudiesTitlesAuthorsDate

Alternative metrics

 

Statistics

For this itemFor all Open Research

Share

 
Follow @AUT_SC

Contact Us
  • Admin

Hosted by Tuwhera, an initiative of the Auckland University of Technology Library