The Burden of Diseases in Children Aged 0-14 Years in Iran

This paper presents the main results of the first National Burden of Disease (NBD) study in Iran for children aged 0-14 years which was conducted for the year 2003 by the Health Programs Management Bureau of Ministry of Health and Medical Education (MOHME) in collaboration with other departments of Health Deputy of MOHME and Universities of Medical Sciences, with the support of Eastern Mediterranean Regional Office (EMRO) of World Health Organization (WHO) and senior consultancy of Professor Alan D. Lopez from Queensland University, School of Population Health. The important objective of this study was to estimate, at the national level, the burden of disease and death of children aged 0-14 years using Disability-Adjusted Life Years (DALYs). Methods developed by the World Health Organization (WHO) for the National Burden of Disease (NBD) studies were applied to estimate disease and injury incidence for estimation of Years of Life Lost (YLL) due to premature mortality, Years Lived with Disability (YLD), and DALY. Adjustments of NBD methodology were made: a revised list of more than 200 disease conditions, development of new and more specific disease modeling templates for cancers and injuries, and adjustment for dependent morbidity. An estimated DALY of 2981919 years incurred in Iranian children aged 0-14 years in both sexes due to all diseases and injuries in the year 2003. From this, 56% was due to premature death (YLL), 44% due to disability (YLD), 37% was due to perinatal diseases and delivery complications, 30% due to external causes (injuries), 7% due to congenital diseases, 5% due to nutritional and metabolic disorders, 4% due to gastrointestinal diseases, and the rest due to other diseases. From total DALYs of about 2981919 years, 1330175 years were in females and 1651744 years in males. The ratio of DALYs in children aged 0-14 to all was 207.44 in 1000. The highest burden in this group was due to perinatal diseases: 480127 years in females and 621875 years in males. Health and disease profile in Iran has well transited from dominance of communicable diseases to that of non-communicable disease and accidents. NBD results are to be used appropriately in health program planning, research, and resource generation policies and practices.