Table 3.
Population health information available in the public domain on the leading causes of disease burden in India.*
|
Disease or health condition (% of total DALYs lost in 2002 in India [15]) |
Category | Information available | Lowest geographical level available | Comments |
|
1. Perinatal conditions (9.7%) |
Mortality | Perinatal mortality rate [23,58-60]† | State | Based on data from sample registration system and large scale household survey ‡ No cause of perinatal death data. |
| Morbidity & health status | Prevalence of low birth weight [38,58,59,61] | District | Based on data from large scale household survey‡ | |
| Risk factors | Anaemia among women [58,59,62] | District | Most estimates based on data from large scale household survey‡ | |
| Underweight among women [34,58,59] | State | |||
| Contraception non-use [38,43,58-61,63] | District | |||
| Birth spacing [58-60] | State | |||
| Number of children ever born 5 or more [58-61,63] | District | |||
| Antenatal care received [33,34,38,41,43,58-61,63] | District | |||
| Skilled birth attendance [33,34,38,41,58-61,63] | District | |||
| Low birth weight [38,58,59,61] | District | |||
| Prevalence of postpartum complications [58-61,63] | District | |||
| Service provision | Contraception coverage [38,43,58-61,63] | District | Most estimates based on data from large scale household survey‡ | |
| Antenatal care coverage [33,34,38,41,43,58-61,63] | District | |||
| Women receiving iron supplementation [38,41,43,58-61,63] | District | |||
| Skilled birth attendance coverage [33,34,38,41,58-61,63] | District | |||
| Postnatal care coverage [33,38,41,58,59] | State | |||
|
2. Lower respiratory tract infections (8.5%) |
Mortality | None* | ||
| Morbidity & health status | Prevalence of cough in children [34,38,58-61,63] | State | Based on data from large scale household surveys‡ | |
| Risk factors | Type of cooking fuel used [19,34,38,40,58-60,63] | District | Most estimates based on large scale household surveys‡ | |
| Tobacco smoking [34,42,53,58] | State | |||
| Childhood underweight [58-60,62] | State | |||
| Breastfeeding practices [38,58-61,63] | District | |||
| Service provision | Treatment of childhood cough [34,38,58-61,63] | State | Based on data from large scale household surveys‡ | |
|
3. Ischaemic heart disease (5.1%) |
Mortality | Percent of adult deaths attributed to chest pain [34] | National | Estimate based on a small sample of verbal autopsy on sibling deaths§ |
| Morbidity & health status | Self-reported diagnosis with ischaemic heart disease [34] | State|| | Estimate based on household survey conducted in 6 states|| | |
| Self-reported hospitalisations for heart disease [33] | National | |||
| Risk factors | Prevalence of overweight & obesity [34,58] | State | Most risk factors have an estimate based on a large scale household survey‡ 'Lack of physical activity' measured by household survey conducted in 6 states|| |
|
| Tobacco & alcohol use [34,42,53,58] | State | |||
| Fruit and vegetable intake [32,34,58,59] | State | |||
| Lack of physical activity [34] | State|| | |||
| Self-reported diagnosis of diabetes [34,58] | State | |||
| Service provision | Self-reported treatment of disease [34] | State|| | Estimate based on household survey conducted in 6 states|| | |
| 4. Diarrhoeal diseases (5.1%) | Mortality | Percent of adult deaths attributed to diarrhoea [34] | National | Estimate based on a small sample of verbal autopsy on sibling deaths§ |
| Morbidity & health status | Prevalence of diarrhoea in children [34,38,58-61,63] | State | Most estimates based on data from large scale household surveys‡ | |
| Self-reported hospitalisation for diarrhoea [33] | National | |||
| Risk factors | Access to clean water and sanitation [19,33-35,37-41,58-60,63,64] | District | Most estimates based on data from large scale household surveys‡ | |
| Prevalence of childhood underweight [58-60,62] | State | |||
| Vitamin A deficiency in children [38] | State | |||
| Percentage of children receiving food rich in vitamin A in last 24 hrs [58] | State | |||
| Breastfeeding practices [38,58,63] | District | |||
| Service provision | Treatment of childhood diarrhoea [38,58-61,63] | State | Most estimates based on large scale household surveys‡ | |
| Child vitamin A supplementation [38,43,58,59,61,63] | District | |||
|
5. Unipolar depression (4.9%) |
Morbidity & health status | Self-reported diagnosis of depression [34] | State|| | Estimate based on household survey conducted in 6 states|| |
| Risk factors | Alcohol use [34,53,58] | State | Both risk factors estimated by at least one large scale household survey‡ | |
| Prevalence of women who experienced childhood sexual abuse [58] | National | |||
| Service provision | Self-reported treatment coverage [34] | State|| | Estimate based on household survey conducted in 6 states|| | |
|
6. HIV/AIDS (3.4%)¶ |
Mortality | None* | ||
| Morbidity & health status | HIV prevalence [8,58] | State | Estimate based on sentinel surveillance and large scale household survey‡ | |
| Risk factors | Unsafe sex [51,58] | State | Both risk factors estimated by large scale household survey‡ Unsafe sex also estimated by behavioural surveillance | |
| Use of clean injections [58] | State | |||
| Service provision | Coverage of treatment with antiretrovirals [48,65] | State | Estimates mostly based on large scale household surveys and behavioural surveillance‡ | |
| HIV testing uptake [34,51,58] | State | |||
| Condom use [34,51,58] | State | |||
|
7. Maternal conditions (2.9%) |
Mortality | Maternal mortality ratio [59,60,66] | State | Maternal mortality ratio and cause of death estimates based on sample registration system data A large scale household survey has also estimated maternal mortality ratio‡ |
| Cause of maternal death [66] | National | |||
| Percent of total female deaths attributed to maternal conditions [34] | National | |||
| Morbidity & health status | Prevalence of postpartum complications [58] | State | Both estimates based on large scale household survey‡ | |
| Prevalence of delivery complications [63] | State | |||
| Risk factors | Anaemia among women [58,59,62] | District | Most estimates based on data from large scale household survey‡ | |
| Underweight among women [34,58,59] | State | |||
| Contraception non-use [38,43,58-61,63] | District | |||
| Birth spacing [58-60] | State | |||
| Number of children ever born 5 or more [58-61,63] | District | |||
| Vitamin A deficiency in pregnant women [58,61,63] | National | |||
| Antenatal care received [33,34,38,41,43,58-61,63] | District | |||
| Skilled birth attendance [33,34,38,41,58-61,63] | District | |||
| Low birth weight [38,58,59,61] | District | |||
| Prevalence of postpartum complications [58-61,63] | District | |||
| Service provision | Contraception coverage [38,43,58-61,63] | District | Most estimates based on data from large scale household survey‡ | |
| Antenatal care coverage [33,34,38,41,43,58-61,63] | District | |||
| Women receiving iron supplementation [38,41,43,58-61,63] | District | |||
| Skilled birth attendance coverage [33,34,38,41,58-61,63] | District | |||
| Postnatal care coverage [33,38,41,58,59] | State | |||
| 8. Tuberculosis (2.8%) | Mortality | Percent of adult deaths attributed to tuberculosis [34] | National | Estimate based on a small sample of verbal autopsy on sibling deaths§ |
| Morbidity & health status | Self-reported tuberculosis diagnosis [34,58-60,63] | State | Most estimates based on large scale household surveys‡ | |
| Self-reported hospitalisations for tuberculosis [33] | National | |||
| Risk factors | Tobacco & alcohol use [34,42,53,58] | State | Most estimates based on large scale household surveys‡ | |
| Type of cooking fuel used [19,34,38,40,58,59,63] | District | |||
| Malnutrition [32,34,38,58,60,62] | District | |||
| Service provision | Annualised case detection rate for new smear positive cases [45] | District | Most estimates based on tuberculosis surveillance system Self-reported tuberculosis treatment estimates mostly based on large scale household surveys‡ | |
| Proportion of new sputum positive out of total new pulmonary cases [45] | District | |||
| Smear conversion rate [45] | District | |||
| Treatment success rate [45] | District | |||
| Self-reported tuberculosis treatment [34,58,59,63] | State | |||
|
9. Cerebrovascular disease (2.5%) |
Mortality | Percent of adult deaths attributed to paralysis [34] | National | Estimate based on a small sample of verbal autopsy on sibling deaths§ |
| Morbidity & health status | None* | |||
| Risk factors | Prevalence of overweight & obesity [34,58] | State | Most risk factors have an estimate based on a large scale household survey‡ 'Lack of physical activity' measured only by household survey conducted in 6 states| |
|
| Tobacco & alcohol use [34,42,53,58] | State | |||
| Fruit and vegetable intake [32,34,58,59] | State | |||
| Lack of physical activity [34] | State|| | |||
| Self-reported diagnosis of diabetes [34,58] | State | |||
| Service provision | None | |||
|
10. Cataract (2.2%) |
Morbidity & health status | Prevalence of blindness [36,60,63] | State | Estimates based on both large scale household survey and household survey conducted in 6 states ‡ || |
| Previous diagnosis of cataracts [34] | State|| | |||
| Self-reported hospitalisations for cataracts [33] | National | |||
| Risk factors | Tobacco smoking [34,42,53,58] | State | Estimates based on of large household surveys, household survey conducted in 6 states and sample registration system ‡ || | |
| Self-reported diagnosis of diabetes [34,58] | State | |||
| Service provision | Number of cataract operations performed [44] | State | Estimates based on household survey conducted in six states and service generated data|| | |
| Those with previous diagnosis who have accessed surgery [34] | State|| | |||
|
11. Road traffic injuries (2.1%) |
Mortality | Deaths from road traffic injuries [25] | State | Estimate based on surveillance |
| Morbidity & health status | Prevalence of road traffic injury in last one year [34] | National | Estimate based on household survey conducted in 6 states || | |
| Risk factors | Alcohol use [34,53,58] | State | Estimates based on both large scale household survey and household survey conducted in 6 states‡ || | |
| Service provision | Those with previous road traffic injury who had accessed emergency care [34] | State|| | Estimate based on household survey conducted in 6 states || | |
*Other than that generated by modelling and projections
†Only the latest National Family Health Survey provides the perinatal mortality rate specifically, the earlier surveys and the sample registration system give the infant mortality rate.
‡The large scale household surveys include: National Family Health Survey (2005/6 survey sampled 109,041 households), Reproductive and Child Health District Level Household Survey (2002/4 survey sampled 620,107 households), National Sample Survey on morbidity, health care and the condition of the aged (sampled 73,868 households), National Sample Survey on nutritional intake in India (sampled 124,644 households) and United Nations Children's Fund Multiple Indicator Survey (sampled 119,305 households).
§The World Health Survey examined a total of 1954 deaths of which cause of death was attributed to 55% of female and 61% of male deaths.
||The World Health Survey was conducted in six states and state level estimates available only for the states of Assam, Karnataka, Maharashtra, Rajasthan, Uttar Pradesh, West Bengal; national pooled estimates also available; sampled 10,729 households.
¶ The estimated burden of HIV/AIDS in India was reduced recently to about half of the previous estimate based on new population-based data [67]; the estimated DALYs lost in 2002 shown in this table is therefore an overestimate.