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

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aut.relation.journalThe Lancet Global Healthen_NZ
aut.researcherFeigin, Valery
dc.contributor.authorSingh, Gen_NZ
dc.contributor.authorSharma, Men_NZ
dc.contributor.authorKumar, GAen_NZ
dc.contributor.authorRao, NGen_NZ
dc.contributor.authorPrasad, Ken_NZ
dc.contributor.authorMathur, Pen_NZ
dc.contributor.authorPandian, JDen_NZ
dc.contributor.authorSteinmetz, JDen_NZ
dc.contributor.authorBiswas, Aen_NZ
dc.contributor.authorPal, PKen_NZ
dc.contributor.authorPrakash, Sen_NZ
dc.contributor.authorSylaja, PNen_NZ
dc.contributor.authorNichols, Een_NZ
dc.contributor.authorDua, Ten_NZ
dc.contributor.authorKaur, Hen_NZ
dc.contributor.authorAlladi, Sen_NZ
dc.contributor.authorAgarwal, Ven_NZ
dc.contributor.authorAggarwal, Sen_NZ
dc.contributor.authorAmbekar, Aen_NZ
dc.contributor.authorBagepally, BSen_NZ
dc.contributor.authorBanerjee, TKen_NZ
dc.contributor.authorBender, RGen_NZ
dc.contributor.authorBhagwat, Sen_NZ
dc.contributor.authorBhargava, Sen_NZ
dc.contributor.authorBhatia, Ren_NZ
dc.contributor.authorChakma, JKen_NZ
dc.contributor.authorChowdhary, Nen_NZ
dc.contributor.authorDey, Sen_NZ
dc.contributor.authorDirac, MAen_NZ
dc.contributor.authorFeigin, VLen_NZ
dc.contributor.authorGanguli, Aen_NZ
dc.contributor.authorGolechha, MJen_NZ
dc.contributor.authorGourie-Devi, Men_NZ
dc.contributor.authorGoyal, Ven_NZ
dc.contributor.authorGupta, Gen_NZ
dc.contributor.authorGupta, PCen_NZ
dc.contributor.authorGupta, Ren_NZ
dc.contributor.authorGururaj, Gen_NZ
dc.contributor.authorHemalatha, Ren_NZ
dc.contributor.authorJeemon, Pen_NZ
dc.contributor.authorJohnson, COen_NZ
dc.contributor.authorJoshi, Pen_NZ
dc.contributor.authorKant, Ren_NZ
dc.contributor.authorKataki, ACen_NZ
dc.contributor.authorKhurana, Den_NZ
dc.contributor.authorKrishnankutty, RPen_NZ
dc.contributor.authorKyu, HHen_NZ
dc.contributor.authorLim, SSen_NZ
dc.contributor.authorLodha, Ren_NZ
dc.contributor.authorMa, Ren_NZ
dc.contributor.authorMalhotra, Ren_NZ
dc.contributor.authorMalhotra, Ren_NZ
dc.contributor.authorMathai, Men_NZ
dc.contributor.authorMehrotra, Ren_NZ
dc.contributor.authorMisra, UKen_NZ
dc.contributor.authorMutreja, Pen_NZ
dc.contributor.authorNaghavi, Men_NZ
dc.contributor.authorNaik, Nen_NZ
dc.contributor.authorNguyen, Men_NZ
dc.contributor.authorPandey, Aen_NZ
dc.contributor.authorParmar, Pen_NZ
dc.contributor.authorPerianayagam, Aen_NZ
dc.contributor.authorPrabhakaran, Den_NZ
dc.contributor.authorRath, GKen_NZ
dc.contributor.authorReinig, Nen_NZ
dc.contributor.authorRoth, GAen_NZ
dc.contributor.authorSagar, Ren_NZ
dc.contributor.authorSankar, MJen_NZ
dc.contributor.authorShaji, KSen_NZ
dc.contributor.authorSharma, RSen_NZ
dc.contributor.authorSharma, Sen_NZ
dc.contributor.authorSingh, Ren_NZ
dc.contributor.authorSrivastava, MVPen_NZ
dc.contributor.authorStark, BAen_NZ
dc.contributor.authorTandon, Nen_NZ
dc.contributor.authorThakur, JSen_NZ
dc.contributor.authorThekkePurakkal, ASen_NZ
dc.contributor.authorThomas, SVen_NZ
dc.contributor.authorTripathi, Men_NZ
dc.contributor.authorVongpradith, Aen_NZ
dc.contributor.authorWunrow, HYen_NZ
dc.contributor.authorXavier, Den_NZ
dc.contributor.authorShukla, DKen_NZ
dc.contributor.authorReddy, KSen_NZ
dc.contributor.authorPanda, Sen_NZ
dc.contributor.authorDandona, Ren_NZ
dc.contributor.authorMurray, CJLen_NZ
dc.contributor.authorVos, Ten_NZ
dc.contributor.authorDhaliwal, RSen_NZ
dc.contributor.authorDandona, Len_NZ
dc.date.accessioned2021-07-15T00:10:35Z
dc.date.available2021-07-15T00:10:35Z
dc.date.copyright2021en_NZ
dc.date.issued2021en_NZ
dc.description.abstractSummary 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.
dc.identifier.citationThe Lancet Psychiatry, 7(2), 148-161.
dc.identifier.doi10.1016/s2214-109x(21)00164-9en_NZ
dc.identifier.issn2214-109Xen_NZ
dc.identifier.urihttps://hdl.handle.net/10292/14370
dc.languageenen_NZ
dc.publisherElsevier BVen_NZ
dc.relation.urihttps://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00164-9/fulltext
dc.rights© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
dc.rights.accessrightsOpenAccessen_NZ
dc.titleThe Burden of Neurological Disorders Across the States of India: The Global Burden of Disease Study 1990–2019en_NZ
dc.typeJournal Article
pubs.elements-id434159
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Faculty of Health & Environmental Science
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HY Public Health & Psychosocial Studies 2018 PBRF
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