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. 2020 Oct;26(Supp 1):i57-i66.
doi: 10.1136/injuryprev-2019-043309. Epub 2020 Jan 8.

Burden of injuries in Nepal, 1990-2017: findings from the Global Burden of Disease Study 2017

Puspa Raj Pant  1 , Amrit Banstola  2   3 , Santosh Bhatta  2 , Julie A Mytton  4 , Dilaram Acharya  5   6 , Suraj Bhattarai  7   8 , Catherine Bisignano  9 , Chris D Castle  9 , Govinda Prasad Dhungana  10 , Zachary V Dingels  9 , Jack T Fox  9 , Pawan Kumar Hamal  11   12 , Zichen Liu  9 , Narayan Bahadur Mahotra  13 , Deepak Paudel  14   15 , Khem Narayan Pokhrel  16 , Chhabi Lal Ranabhat  17   18 , Nicholas L S Roberts  9 , Dillon O Sylte  9 , Spencer L James  9
Affiliations

Burden of injuries in Nepal, 1990-2017: findings from the Global Burden of Disease Study 2017

Puspa Raj Pant et al. Inj Prev. 2020 Oct.

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.

Keywords: burden of disease; descriptive epidemiology; epidemiology.

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Conflict of interest statement

Competing interests: SLJ reports grants from Sanofi Pasteur outside the submitted work.

Figures

Figure 1
Figure 1
Deaths for both sexes and all ages by level 1 causes and total population, Nepal, 1990–2017.
Figure 2
Figure 2
DALYs per 100 000 by age group, sex and year (1990–2017) for females and males for level 2 injury causes in the Global Burden of Disease Study (GBD) cause hierarchy.
Figure 3
Figure 3
Age-standardised DALYs per 100 000 by year for females and males for level 3 transport injury subcauses in the Global Burden of Disease Study (GBD) cause hierarchy between 1990 and 2017.
Figure 4
Figure 4
Age-standardised DALYs per 100 000 by year for females and males for level 3 unintentional injury subcauses in the Global Burden of Disease Study (GBD) cause hierarchy between 1990 and 2017.
Figure 5
Figure 5
Age-standardised DALYs per 100 000 by year for females and males for level 3 self-harm and interpersonal violence subcauses in the Global Burden of Disease Study (GBD) cause hierarchy between 1990 and 2017.
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