Differing Methods and Definitions Influence DALY estimates: Using Population-Based Data to Calculate the Burden of XXXX in Rural South Africa.

@entity3004 @entity410 @entity302 @entity66
BACKGROUND: The disability adjusted life year (DALY) is a composite measure of disease burden that includes both morbidity and mortality, and is relevant to conditions such as @entity302 that can limit productive functioning. The 2010 Global @entity66 (GBD) study introduced a number of new methods and definitions, including a prevalence-based approach and revised disability weights to calculate morbidity and new standard life expectancies to calculate premature mortality. We used these approaches, and local, population-based data, to estimate the burden of @entity410 in @entity3004 . METHODS _ FINDINGS: Comprehensive prevalence, incidence and mortality data on @entity410 were collected within the Agincourt sub-district in rural northeastern South Africa between 2008 and 2012. We estimated DALYs using both prevalence- and incidence-based approaches for calculating years of life lived with disability. Additionally, we explored how changing the disease model by varying the disability weights influenced DALY estimates. Using the prevalence-based approach, @entity410 in Agincourt resulted in 332 DALYs (95% uncertainty interval (UI): 216-455) and 4.1 DALYs per 1,000 individuals (95%UI: 2.7-5.7) annually. Of this, 26% was due to morbidity while 74% was due to premature mortality. DALYs increased by 10% when using the incidence-based method. Varying the disability weight from 0.072 (treated @entity302 , @entity410 free) to 0.657 (severe @entity302 ) caused years lived with disability to increase from 18 (95%UI: 16-19) to 161 (95%UI: 143-170). CONCLUSIONS: DALY estimates are influenced by both the methods applied and population parameters used in the calculation. Irrespective of method, a significant burden of @entity302 is due to premature mortality in @entity3004 , with a lower burden than rural Kenya. Researchers and national policymakers should carefully interrogate the methods and data used to calculate DALYs as this will influence policy priorities and resource allocation.
