全球疾病负担统计

World Health Organization Organisation Mondiale de la Santé
Department of Measurement and HeES
April 2011
(a) This workbook contains summary estimates of mortality for WHO Member States for the year 2008. This update of estimates of deaths by cause, age and sex uses the same general methods as previous revisions carried out by WHO for 2002 and 2004 (1,2). Mortality estimates are based on analysis of latest available national information on levels of mortality and cause distributions as at the end of 2010 together with latest available information from WHO programs, IARC and UNAIDS for specific causes of public health importance. Data, methods and cause categories are described in an accompanying text document available on the WHO website (3). Member States were consulted on these estimates in late 2010 and comments or data provided by them were considered and incorporated where appropriate. These summary tables represent the best estimates of WHO – based on evidence available at the end of 2010 – rather than the official estimates of Member States. These estimates have been computed using standard categories and methods to ensure crossnational comparability . Therefore, they are not always the same as official national estimates, nor necessarily endorsed by specific Member States. (b) Underlying cause of death categories are defined in an Annex Table in the Data sources and methods documentation (3). (c) The data sources and methods used for the estimation of total deaths (all causes), and deaths by cause, for each Member State are summarized in Annex Table 4 of reference (3).
(f)
Maternal HIV deaths (deaths during pregnancy or within 42 days of end of pregnancy) exacerbated by HIV infection are classified as maternal deaths and counted there rather than as HIV deaths. (g) Does not include liver cancer and cirrhosis deaths or DALYs resulting from chronic hepatitis virus infection. (h) This cause category includes 'Causes arising in the perinatal period' as defined in the International Classification of Diseases, principally low birthweight, prematurity, birth asphyxia and birth trauma, and does not include all disability or deaths occurring in the neonatal period (under 28 days after birth). For example, congenital anomalies and injuries may also occur in the neonatal period but are classified to other cause categories. (i) Includes severe neonatal infections and other non-infectious causes arising in the perinatal period. (j) Includes macular degeneration and other age-related causes of vision loss not correctable by provision of glasses or contact lenses, together with deaths due to other sense organ disorders.
(d) Colour codes are used to summarize the levels of evidence for causes of death available for each Member State. Levels of uncertainty are highest for the last category, and caution should be used in comparing mortality levels across these countries for causes without country-specific information. Reasonably complete death registration data available with underlying cause of death coded using ICD-9 or ICD-10 without excessive use of inappropriate or non-specific codes. Incomplete death registration data, and/or other forms of nationally representative information on causes of death (eg. verbal autopsy, sample registration data) available. Cause of death models may be used to adjust for biases due to incomplete population coverage, other adjustments made using countryspecific information for specific causes. Country information on causes of death not available for most causes. Cause of death modelling used to estimate broad distribution of causes of death for Groups I, II and III by age and sex for the country level of all cause mortality and per capita income. Cause of death patterns within the three major cause groups based on death registration data from other countries in the region. Further country-level information and data on specific causes listed above was also used. Separate specific multicause models used for the major causes of child death. Note that levels of evidence will vary for specific causes within a country, and the above colour coded scheme does not attempt to provide that level of detail for specific causes. In general, country-level adjustments were made for cause-specific mortality estimates obtained from WHO technical programmes, IARC, UNAIDS and other sources for the following conditions: AIDS, TB, measles, pertussis, tetanus, dengue, malaria, schistosomiasis, trypanosomiasis, Japanese encephalitis, Chagas, maternal conditions (including abortion), cancers, drug use disorders, rheumathoid arthritis, road traffic accidents and war. See reference (3) for details. (e) UN estimates of de-facto population (2008 Revision) (4). Estimated death rates by age, sex for underlying causes of death as defined by the ICD classification rules, are applied to the UN estimates of de-facto resident population for 2008 to give numbers of expected deaths by cause for each Member State.