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

Abstract

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 analyzed the GBD 2017 estimates for deaths, years of life lost, years lived with disability, incidence, and 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 prioritize injury prevention as a public health agenda and as evidence for country-specific interventions.