10 Leading Causes of Death, World, 1998 Both Sexes

Reference: WHO/HSC/PVI/99.11Distr.: LimitedOriginal: English

Injury:A Leading Cause of the Global Burden of Disease

Edited by Dr. E. Krug

Violence and Injury PreventionDepartment for Disability/Injury Prevention and Rehabilitation

Social Change and Mental Health Cluster,World Health Organization

Acknowledgements:

The Violence and Injury Prevention Unit (PVI) thanks Christepher Yao for his contribution to this document. PVI also thanks the Global

Programme for Evidence and Information for Policy for providing the data on which the tables in this document are based.

Copies of this document are available from:Violence and Injury Prevention TeamWorld Health Organization20 Avenue Appia1211 Geneva 27SwitzerlandFax: 0041 22 791 4332E-mail: [email protected]

The content of this publication is available on the www at http://www.who.int/violence_injury_prevention/index.html

(C) World Health Organization, 1999

This document is not issued to the general public, and all rights are reserved by the World Health Organization (WHO). The document may not be reviewed, abstracted,quoted, reproduced or translated, in part or in whole, without the prior written permission of WHO. No part of this document may be stored in a retrieval system ortransmitted in any form or by any means - electronic, mechanical or other - without the prior written permission of WHO.

http://www.who.int/

1. Introduction

Every day around the world, almost 16 000 people die

from injuries. For every person that dies, several

thousands more are injured, many of them with

permanent sequelae of injuries. Injuries occur in all

regions and countries, and affect people in all age and

income groups. The magnitude of the problem however

varies considerably by age, sex, region and income group.

For example, in the low- and middle-income countries in

the Western Pacific the leading injury-related causes of

death are road traffic injuries, drowning and suicide,

while in Africa they are war, interpersonal violence and

traffic injuries. In the high-income countries of the

Americas, the leading injury-related cause of death

among people aged 15−44 years is traffic injuries, while

in the low- and middle-income countries of the Americas

it is interpersonal violence.

The World Health Organization has prepared this

document to inform policy-makers, health officials,

researchers and the general public about the magnitude

and ranking of injuries to facilitate informed decision-

making. It is intended to serve as a reference document on

the ranking of injuries among other leading causes of

burden of disease.

An injury is a bodily lesion at the organic level resulting

from acute exposure to energy (which can be mechanical,

thermal, electrical, chemical or radiant) interacting with

the body in amounts or rates that exceed the threshold of

physiological tolerance. In some cases (e.g. in drowning,

strangulation or freezing), the injury results from an

insufficiency of a vital element. The time between

exposure and the appearance of the injury needs to be

short.1 Injuries are often classified as unintentional and

intentional. Most traffic injuries, fire-related injuries,

falls, drownings and poisonings are classified as

unintentional. On the other hand, homicides, suicides and

war are classified as intentional.

The traditional view of injuries as “accidents” or random

events has resulted in the historical neglect of this area of

1 Baker SP, O'Neill R, Karpf RS. The Injury Fact Book. Lexington,MA/Toronto, Lexington Books, D.C. Health and Company, 1984.

public health. During the past few decades, public health

officials have recognized injuries as preventable and have

established methods of scientific study to the prevention

of injuries. The public health approach to injury

prevention involves four key steps. The first step is to

determine the magnitude, scope and characteristics of the

problem. The second step is to identify the factors that

increase the risk of disease, injury or disability, and to

determine which factors are potentially modifiable. The

third step is to assess what measures can be taken to

prevent the problem by using the information about

causes and risk factors to design, pilot test and evaluate

interventions. The final step is to implement the most

promising interventions on a broad scale.

This publication contributes to the first step, the

description of the magnitude of the problem. It provides

the most recent estimates on the magnitude of injuries in

the world.

The information provided includes both mortality and

morbidity data. Mortality is a very important indicator of

the magnitude of a health problem. However, it is

important to realize that for each death from injury there

are many more injuries that result in hospitalization,

treatment in emergency departments or by general

practitioners, and treatment outside hospitals. Non-fatal

outcomes must also therefore be measured to characterize

the burden of injury accurately. Disability-adjusted life

years (DALYs) take account of this by combining the

number of years of life lost from premature death with the

loss of health from disability.2 This report includes a

series of tables showing the 15 Leading Causes of Death

and Burden of Disease (DALYs lost) for the world.

Rankings for cause of death and burden of diseases are

summarized by age group, sex, and income group for the

world and for the different regions.

2 Recognizing the need for a method of evaluating thecost−effectiveness of global health policy, a method of quantifyingthe cost per unit of disease burden averted was developed. Theresulting DALY (Disability Adjusted Life Year) allows thecomparison of disability and death on a common scale. TheDALY expresses the number of years of life lost (YLLs) summedwith a comparatively adjusted measure of years living with adisability (YLDs). YLD measurement adjustments are based onthe severity and duration of disease, and age and sex of theindividual. Characteristics such as socioeconomic status, race orlevel of education are not included in the YLD measurement.

2. Methods

All data used in the tables are from the WHO World

Health Report 1999 database. We followed the World

Health Report procedure for creating death and disability

rankings. The World Health Report divides deaths and

disabilities first into three broad groups: communicable

diseases, maternal and, perinatal conditions and

nutritional deficiencies; non-communicable

conditions/diseases; and injuries. Next, deaths and

disabilities within each of these groups are divided into

categories. For example, injuries are divided into

unintentional and intentional. Following this level of

disaggregation, deaths and disabilities are further divided

into subcategories. For example, unintentional injuries are

subdivided into road traffic injuries, poisoning, falls, fires

and drowning, while intentional injuries are sub-divided

into self-inflicted injuries, interpersonal violence

(homicide and violence), and war injuries (see example).

The same procedure is followed for the other two broad

groups of deaths and disabilities.

Example of tree structure used to develop the tables

Group X Category Y Subcategory Y1 Subcategory Y2

I. Communicable diseases, maternal and perinatal conditionsand nutritional deficiencies

A. Infectious and parasitic diseases1. Tuberculosis2. STDs excluding HIV3. HIV/AIDS

4. Diarrhoeal diseases

…III. Injuries

A. Unintentional1. Road traffic injuries2. Poisoning3. Falls4. Fires5. Drowning6. Other unintentional injuries

B. Intentional1. Self-inflicted injuries2. Homicide and violence (interpersonal

violence) 3. War injuries

Deaths and disabilities are coded based on the WHO

International Classification of Diseases (see Appendix 1).

The rankings are produced by ordering the subcategories.

Two sets of tables were developed for this report. The

first set of tables (Tables 1−18) present the global burden

of the 15 Leading Causes of Deaths and Burden of

Disease for the world. The second set of tables (Tables

19−42) present the 15 Leading Causes of Death and

Burden of Diseases by region and income groups. The

geographical regions and income status were classified as

presented in Appendix 2.

The 15 leading causes of death/burden of disease are

presented in tables by geographical region and income

levels, by age and sex. All injury-related groups or

categories are highlighted in each table for illustration.

The numbers listed below for each subcategory represent

either the total number of deaths or DALYs. It is

important to realize that these are a measure of magnitude

and are not directly comparable to another region, sex or

income group. A table describing the population is

provided to allow the calculation of rates of disease or

injury which may then be more accurately compared

between tables (Appendix 3).

3. Results

It is estimated that 5.8 million people worldwide died

from injuries in 1998, which corresponds to a rate of 97.9

per 100,000 population (appendix 4). 3.8 million (128.6

per 100,000 population) of them were males and 1.9

million (66.7 per 100,000 population) were females.

Injuries are leading causes of deaths in all age groups

(Table 1). Road traffic and self-inflicted injuries are the

leading causes of injury-related deaths worldwide. Five

of the top ten causes of death in the world for persons

aged 15−44 years are the result of injuries. Road traffic

injuries, interpersonal violence, self-inflicted injuries, war

injuries, drowning and injuries resulting from exposure to

fire are all among the leading causes of death for persons

aged 15−44 years (Table 1). The leading injury-related

cause of death among youths is traffic injuries, while

among persons aged 45 years and older it is self-inflicted

injuries. Although falls do not appear among the leading

causes of death in the world, they are the leading cause of

burden of disease for children aged 5−14 years and the

14th leading cause for all age groups combined (Table 2).

Worldwide, road traffic injuries are the leading injury-

related cause of death and burden of disease in males

(Tables 3 and 4). For females, self-inflicted injuries are

the leading injury-related cause of death (Table 5). In

high- income countries, road traffic injuries, self-inflicted

injuries and interpersonal violence are the three leading

causes of death among people aged 15−44 years (Table

7). Among persons 15−44 years of age in high-income

countries there are twice as many suicides and three times

as many traffic-related deaths as homicides. These

differences are much less marked in low-and middle-

income countries (Table 12).

When analysed by region the differences are also

important. In most of the regions, road traffic injuries are

the leading cause of injury-related deaths. However, wars

are the leading injury-related cause of death in Africa

(Table 19), and self-inflicted injuries are the leading

injury-related cause death in China (Table 39). China and

the Other Low- and Middle Income Western Pacific

Countries are the only regions to count drownings among

the 15 leading causes of death and burden of disease.

India is the only country where fire is classified among

the 15 leading causes of death.

4. Conclusion

The goal of this publication is to provide the most recent

estimates on the magnitude of injuries in the world and

compare the burden of injuries to other leading public

health problems. Such information is the basis for

informed priority-setting and decision- making. Injuries

have been shown to account for a significant health

burden on all populations regardless of their age, sex,

income or geographical region.

Injuries are preventable non-random events. The data in

this report clearly show the importance of injuries as a

public health problem. The time has come to develop

effective injury prevention strategies that will decrease

the impact of injuries on the health of the world’s

population.

List of Tables

World

Table 1. Leading Causes of Death, Both Sexes, 1998

Table 2. Leading Causes of Burden of Disease, Both Sexes,

1998

Table 3. Leading Causes of Death, Males, 1998

Table 4. Leading Causes of Burden of Disease, Males, 1998

Table 5. Leading Causes of Death, Females, 1998

Table 6. Leading Causes of Burden of Disease, Females, 1998

Table 7. Leading Causes of Death High-Income Countries,

Both Sexes, 1998

Table 8. Leading Causes of Burden of Disease, High-Income

Countries, Both Sexes, 1998

Table 9. Leading Causes of Death, High-Income Countries,

Males, 1998


Countries, Males, 1998

Table 11. Leading Causes of Death, High-Income Countries,

Females, 1998


Countries, Females 1998

Table 13. Leading Causes of Death, Low- and Middle-Income


Table 14. Leading Causes of Burden of Disease, Low- and

Middle-Income Countries, Both Sexes, 1998

Table 15. Leading Causes of Death, Low- and Middle- Income Countries, Males,

1998

Table 16. Leading Causes of Burden of Disease, Low- and Middle-Income

Countries, Males, 1998

Table 17. Leading Causes of Death, Low- and Middle-Income Countries,

Females, 1998

Table 18. Leading Causes of Burden of Disease, Low- and Middle-Income

Countries, Females, 1998

Regional

Table 19. Leading Causes of Death, African Region, Both Sexes, 1998

Table 20. Leading Causes of Burden of Disease, African Region, Both Sexes,

1998

Table 21. Leading Causes of Death Region of the Americas – High-Income


Table 22. Leading Causes of Burden of Disease, Region of the Americas – High-

Income Countries, Both Sexes, 1998

Table 23. Leading Causes of Death, Region of the Americas – Low- and Middle-


Table 24. Leading Causes of Burden of Disease, Region of the Americas – Low-

and Middle-Income Countries, Both Sexes, 1998

Table 25. Leading Causes of Death, Eastern Mediterranean Region –High-


Table 26. Leading Causes of Burden of Disease, Eastern Mediterranean Region

– High-Income Countries, Both Sexes, 1998

Table 27. Leading Causes of Death, Eastern Mediterranean Region –Low- and


Table 28. Leading Causes of Burden of Disease, Eastern

Mediterranean Region – Low- and Middle-Income


Table 29. Leading Causes of Death, European Region – High-


Table 30. Leading Causes of Burden of Disease, European

Region – High-Income Countries, Both Sexes, 1998

Table 31. Leading Causes of Death, European Region – Low-

and Middle-Income Countries, Both Sexes, 1998

Table 32. Leading Causes of Burden of Disease, European

Region – Low- and Middle-Income Countries, Both

Sexes, 1998

Table 33. Leading Causes of Death, South-East Asia Region –

India, Both Sexes, 1998

Table 34. Leading Causes of Burden of Disease, South-East

Asia Region – India, Both Sexes, 1998

Table 35. Leading Causes of Death, South-East Asia Region –

Other Low- and Middle-Income Countries, Both

Sexes, 1998

Table 36. Leading Causes of Burden of Disease, South-East

Asia Region – Other Low- and Middle-Income


Table 37. Leading Causes of Death, Western Pacific Region – High- Income


Table 38. Leading Causes of Burden of Disease, Western Pacific Region – High-


Table 39. Leading Causes of Death, Western Pacific Region – China, Both

Sexes, 1998

Table 40. Leading Causes of Burden of Disease, Western Pacific Region –

China, Both Sexes, 1998

Table 41. Leading Causes of Death, Western Pacific Region – Other Low- and


Table 42. Leading Causes of Burden of Disease, Western Pacific Region – Other

Low- and Middle-Income Countries, Both Sexes, 1998

Table 1. Leading Causes of Death, Both Sexes, 1998

Rank 0-4 years 5-14 years 15-44 years 45-59 years AAAA60 years All ages

1 Perinatal conditions2 155 000

Acute lowerrespiratory infections

213 429

HIV/AIDS1 629 726

Ischaemic heart disease887 146

Ischaemic heart disease6 239 562


2Acute lower

respiratory infections1 850 412

Malaria209 109

Road traffic injuries600 312

Cerebrovascular disease600 854

Cerebrovascular disease4 247 080


3 Diarrhoeal diseases1 814 158


Interpersonal violence509 844

Tuberculosis407 737

Chronic obstructivepulmonary disease

1 974 652

Acute lower respiratoryinfections3 452 178

4 Measles887 671

Drowning157 573

Self-inflicted injuries508 621

Trachea/bronchus/lung cancers

305 982

Acute lowerrespiratory infections

1 184 698

HIV/AIDS2 285 229

5 Malaria793 368

Diarrhoeal diseases133 883

Tuberculosis427 314

Cirrhosis of the liver264 117


889 873


2 249 252

6Congenital

abnormalities404 849

War injuries57 285

War injuries372 935

HIV/AIDS214 571

Tuberculosis570 513

Diarrhoeal diseases2 219 032

7 HIV/AIDS349 885

Nephritis/nephrosis44 640


Liver cancers205 394

Stomach cancers561 527

Perinatal conditions2 155 000

8 Pertussis345 771

Congenital abnormalities43 056



Diabetes mellitus426 964

Tuberculosis1 498 061

9 Tetanus302 668

Inflammatory cardiac disease40 802



203 192

Colon/rectum cancer424 463


1 244 407

10Protein−energy

malnutrition214 717

HIV/AIDS39 042

Drowning141 922



Road traffic injuries1 170 694

11 Drowning125 301

Fires38 968

Fires122 666



Malaria1 110 293

12 STDs excluding HIV118 178


Maternal haemorrhage116 771

Breast cancers132 238

Oesophaguscancers296 550


13 War injuries103 323

Tuberculosis38 093

Acute lower respiratoryinfections115 100

Oesophagus cancers117 352


Measles887 671

14 Road traffic injuries82 429


Rheumatic heart disease104 635




15 Meningitis60 198

Leukaemia34 503


Inflamatory cardiac disease97 511



Source: World Health Report 1999 Database

Table 2. Leading Causes of Burden of Disease, Both Sexes, 1998



Falls10 956 652

Unipolar major depression48 723 776



Acute lower respiratoryinfections

82 344 294

2Acute lower respiratory

infections64 228 262


HIV/AIDS45 990 984








7 737 631


13 856 850


4 Malaria28 377 796

Malaria7 786 061

Alcohol dependence16 399 139


Dementias5 345 048

HIV/AIDS70 929 569

5 Measles25 431 470

Drowning5 913 678

Interpersonal violence16 379 055

Osteoarthritis7 343 566

Trachea/bronchus/lungcancers

5 059 575


6 Congenital abnormalities25 000 333


Self-inflicted injuries16 258 293




7 HIV/AIDS18 802 590

Anaemias5 233 961

War injuries15 074 260

Cirrhosis of the liver5 129 074

Cataracts4 711 846


8 Protein−energy malnutrition14 143 562

Measles4 726 253

Bipolar affective disorder14 957 032


4 747 878

Diabetes mellitus4 117 836

Malaria39 267 129

9 Pertussis11 740 117

Fires4 354 125





10 Tetanus10 121 217

Tropical diseases3 265 006

Psychoses14 008 554

Cataracts3 623 541

Stomach cancers3 258 550

Measles30 255 379

11 STDs excluding HIV5 782 412

HIV/AIDS2 957 143

Anaemias13 668 409




28 653 713

12 Falls5 635 576

Intestinal nematodeinfections2 826 447

STDs excluding HIV10 835 570


Colon/rectum cancers2 461 593


13 Drowning4 191 300

Asthma2 649 491

Obsessive−compulsivedisorders9 178 795

Liver cancers3 137 898


Congenital abnormalities28 146 782

14 War injuries3 942 734





Falls27 020 881

15 Road traffic injuries3 122 911

Nephritis/nephrosis2 003 418

Falls7 796 120

HIV/AIDS2 694 108


Anaemias24 746 124


Table 3. Leading Causes of Death, Males, 1998



Drowning105 746

HIV/AIDS793 410





infections967 919

Malaria105 377





3 Diarrhoeal diseases960 418



Tuberculosis249 929


1 078 693


4 Measles456 041


98 019



235 558


640 198


1 239 658

5 Malaria416 892


Tuberculosis244 364



HIV/AIDS1 163 808

6 Congenital abnormalities208 297

War injuries33 917

War injuries227 217


Tuberculosis351 636


7 Pertussis178 246



HIV/AIDS146 560



8 HIV/AIDS169 886






910 971

9 Tetanus155 834

Self –inflicted injuries21 307

Drowning109 568


124 148

Prostate cancers221 605

Tuberculosis893 387

10 Protein−energy malnutrition105 520




Colon/rectum cancers210 434


11 Drowning73 364


Liver cancers84 288





Leukaemia19 910

Poisoning60 961

Oesophagus cancer82 969


Malaria572 411

13 War injuries51959



Mouth and oropharynxcancers68 012




HIV/AIDS18 507


59 633




15 Meningitis31 274

Tuberculosis17 989

Falls55 627



Stomach cancer517 821


Table 4. Leading Causes of Burden of Disease, Males, 1998



Falls7 532 099

HIV/AIDS22 103 635




42 405 506









Drowning3 963 228



4 579 920


7 923 127


4 Malaria14 826 431

Malaria3 915 755




3 709 747

HIV/AIDS34 985 250

5 Measles13 103 117







Anaemias2 786 954



3 604 287



7 HIV/AIDS9 395 203







Measles2 366 428



Dementias2 108 940






Cataracts2 091 595

Malaria20 187 610

10 Tetanus5 308 209

Asthma1 581 869

Psychoses7 380 240





Fires1 540 036

Anaemias5 545 460



Falls17 073 927

12 Falls2 823 695

HIV/AIDS1 449 383

Falls5 407 850




16 393 270




Cataracts1 794 107

Prostate cancers1 242 080





Benign prostatic hypertrophy1 754 018





Drug dependence4 555 664


Oesophagus cancers1 123 024

Measles15 526 243


Table 5. Leading Causes of Death, Females, 1998




HIV/AIDS836 316





infections882 493

Malaria103 732







Tuberculosis182 950

Tuberculosis157 808


895 959


4 Measles431 630


War injuries145 717



HIV/AIDS1 121 421

5 Malaria376 476

Drowning51 828


Cervix cancers90 046




Fires24 965



79 044

Trachea/bronchus/lungcancers249 675


7 HIV/AIDS179 998

War injuries23 368





1 009 594

8 Pertussis167 525


Fires77 309


Tuberculosis218 876

Tuberculosis604 674

9 Tetanus146 834



HIV/AIDS68 011


Malaria537 882






Measles431 630


HIV/AIDS20 535

Maternal sepsis70 561




12 Drowning51 937

Tuberculosis20 104

Abortion63 317





Tetanus18 021

Hypertensive disorders ofpregnancy

58 870








Dementias114 217


15 Meningitis28 925

Leukaemia14 593


55 467

Liver cancers46 861




Table 6. Leading Causes of Burden of Disease, Females, 1998








39 938 788



Malaria3 870 306

HIV/AIDS23 887 349





Childhood diseases3 778 869

Anaemias8 122 949



5 933 723


4 Malaria13 551 365

Falls3 424 553



Dementias3 236 109

HIV/AIDS35 944 319

5 Measles12 328 353




3 157 710

Cataracts2 620 251








7 HIV/AIDS9 407 387

Fires2 814 089

Obstructed labour6 994 148

Breast cancers2 213 579




Anaemias2 447 008

Psychoses6 628 315



Malaria19 079 519


Drowning1 950 449


Cataracts1 829 434


Measles14 729 136

10 Tetanus4 913 008

HIV/AIDS1 507 760


Cervix cancers1 463 839




Intestinal nematodeinfections Maternal sepsis

5 874 005Cirrhosis of the liver

1 372 634

Trachea/bronchus/lungcancers Anaemias

13 680 229
1 379 134 1 349 828
12 Falls2 811 881


Abortion5 419 923

Anaemias1 306 013



12 260 443




Glaucoma1 242 426




Asthma1 067 622



1 143 591



15 Meningitis1 393 103


Maternal haemorrhage3 683 957





Table 7. Leading Causes of Death, High-Income Countries, Both Sexes, 1998


1 Perinatal conditions53 198













infections5 744

Leukaemia1 470





4 Measles5 342

Drowning1 159






Interpersonal violence926

HIV/AIDS23 462



264 968


280 168

6 Pertussis3 475


821






Nutritional/endocrinedisorders

775





8Nutritional/endocrine

disorders1 853

Self-inflicted injuries702





9 Drowning1 512

Fires666





10 Interpersonal violence1 311

Cerebrovascular disease407

Poisoning7 700

Pancreas cancers13 814



11 Meningitis1 144

Inflammatory cardiac disease396

Leukaemia6 753

Chronic obstructivepulmonary disease Dementias

97 966Self-inflicted injuries

129 935
13 759
12 Fires1 048

Lymphoma337

Lymphoma6 286




13 Dementias959

War injuries301


Lymphoma13 412



14 Inflammatory cardiac disease851

Dementias297



Lymphoma70 824

Dementias104 719

15 Tetanus741

Falls272

Falls5 218





Table 8. Leading Causes of Burden of Disease, High-Income Countries, Both Sexes, 1998









Asthma202 047






infections199 970

Dental caries141 063



Dementias2 278 483



Falls131 177

Psychoses2 224 976



1 856 794



disorders178 868

Obsessive−compulsivedisorders123 431



1 059 043


1 704 296


6 Pertussis131 874

Drug dependence115 840





7 Measles112 274

Anaemias109 008





3 122 003


Nutritional/endocrinedisorders100 741






Epilepsy98 708


Alcohol dependence605 397

Osteoarthritis636 118

Dementias2 983 207

10 Meningitis89 593

Otitis media67 944

HIV/AIDS826 178


571 630



2 448 746

11 Falls86 850

Fires65 128





12 Asthma76 566

Measles63 848


Dementias522 875


Psychoses2 280 326

13 Dementias69 466

Leukaemia57 331









Unipolar major depression462 934


15 Drowning50 560


Asthma579 165





Table 9. Leading Causes of Death, High-Income Countries, Males, 1998









Drowning934






infections3 126

Leukaemia858





4 Measles2 730

Congenital abnormalities778

HIV/AIDS19 269



174 444


184 196







6 Pertussis1 928








424






disorders988


407

Poisoning6 043




9 Drowning973

Fires363





10 Interpersonal violence659

Lymphoma239

Falls4 437




11 Meningitis656






12 Fires576


Lymphoma4 183


8 833



13 Dementia494

Falls193

Leukaemia4 053

Liver cancers8 758

Bladder cancers37 444



Dementia181

Drowning4 052

Lymphoma8 478

Lymphoma36 156

Lymphoma49 113

15 Tetanus380

War injuries178



Dementias35 768



Table 10. Leading Causes of Burden of Disease, High-Income Countries, Males, 1998









Asthma122 814






infections108 484

Falls93 130




1 243 487







1 139 228



disorders91 612

Dental caries72 281

Psychoses1 163 653


Dementias828 413


6 Measles77 691






2 073 083

7 Pertussis67 911

Anaemias55 744







Bipolar affective disorder785 646




1 610 281

9 Falls51 907

Epilepsy45 276

HIV/AIDS664 297


358 920




Fires35 350




Psychoses1 192 664

11 Meningitis48 197

Drowning35 010




Dementia1 187 589

12 Asthma47 401

Otitis media34 944

Falls415 201


Bladder cancers275 092


13 Dementia35 292

Leukaemia33 295


Dementia261 092



14 Drowning32 516

Measles31 073



Lymphoma185 521









Table 11. Leading Causes of Death, High-Income Countries, Females, 1998















infections2 618

Leukaemia612





4 Measles2 613


415











6 Pertussis1 547


351


Ovary cancers9 979




Fires303

HIV/AIDS4 193



90 524



disorders865

Drowning225





95 972





Dementias62 198

Dementias64 979

10 Drowning539


Cervix uteri cancers2 767




11 Meningitis488


Leukaemia2 700




12 Fires471

War injuries123


Lymphoma4 934



13 Dementias464

Dementia116



4 925

Falls41 372

Ovary cancers45 296


Diarrhoeal diseases101

Lymphoma2 103


Lymphoma34 668

Falls43 589

15 Tetanus360

Asthma101

Ovary cancers2 096

Cervix cancers4 142

Ovary cancers33 204

Lymphoma41 841


Table 12. Leading Causes of Burden of Disease, High-Income Countries, Females, 1998









Asthma79 233

Psychoses1 061 323








Dementias1 450 070



infections91 486

Dental caries68 782






disorders87 255

Epilepsy53 433




Dementias1 795 618

6 Pertussis63 963

Anaemias53 265










565 067



Falls38 047

STDs excluding HIV375 327

Dementias261 783



9 Meningitis41 396

Otitis media33 000




Psychoses1 087 662

10 Falls34 943

Measles32 775

Panic disorder359 964


212 710



1 048 920

11 Measles34 583

Fires29 778

Rheumatoid arthritis330 714




12 Dementias34 175






13 Asthma29 165





Perinatal conditions870 817


Post-traumatic stress disorder26 757


Ovary cancers163 173

Falls204 606


15 Anaemias22 855

Leukaemia24 035

Anaemias280 760




838 465


Table 13. Leading Causes of Death, Low- and Middle-Income Countries, Both Sexes, 1998




HIV/AIDS1 606 263





infections1 844 668

Malaria209 109








Tuberculosis405 265


1 709 684


4 Measles882 329

Drowning156 414




HIV/AIDS2 253 201

5 Malaria793 368


Tuberculosis426 104


Tuberculosis556 458



War injuries56 984

War injuries370 497

HIV/AIDS207 788



7 HIV/AIDS349 712






1 969 084

8 Pertussis342 296




189 433



9 Tetanus301 927


Drowning137 297



Malaria1 110 293


HIV/AIDS38 876





11 Drowning123 790

Fires38 302

Fires119 867



Measles882 329


Tuberculosis38 076

















15 Meningitis59 054

Leukaemia33 033






Table 14. Leading Causes of Burden of Disease, Low- and Middle-Income Countries, Both Sexes, 1998



Falls10 825 475

HIV/AIDS45 164 806




80 989 604












7 166 000


12 152 555


4 Malaria28 377 796

Malaria7 786 061



Cataracts4 668 183

HIV/AIDS69 907 361

5 Measles25 319 196

Drowning5 870 198











7 HIV/AIDS18 770 689

Anaemias5 124 953




3 202 781

Malaria39 267 129


Measles4 662 405



3 688 835

Dementias3 066 566



Fires4 288 997

Anaemias13 314 272

Cataracts3 603 490



10 Tetanus10 096 448





Measles30 069 492


HIV/AIDS2 950 670

Psychoses11 783 578




12 Falls5 548 727












26 204 967


Asthma2 447 443


HIV/AIDS2 551 951


Falls25 623 754



Falls7 224 622


Oesophagus cancers1 508 702

Anaemias23 972 657


Table 15. Leading Causes of Death, Low- and Middle-Income Countries, Both Sexes, 1998



Malaria105 377

HIV/AIDS774 141





infections964 793

Drowning104 812








Tuberculosis248 030


904 249


4 Measles453 311


97 612





5 Malaria416 892


Tuberculosis243 473



HIV/AIDS1 137 247


War injuries33 739

War injuries225 672


Tuberculosis342 598


7 Pertussis176 318



HIV/AIDS140 578



1 055 462

8 HIV/AIDS169 801





Tuberculosis881 528

9 Tetanus155 453


Drowning105 516


115 315









11 Drowning72 391


Liver cancers83 357



Malaria572 411




56 937





Leukaemia19 051






HIV/AIDS18 415

Poisoning54 918



Measles453 311

15 Meningitis30 617

Tuberculosis17 979






Table 16. Leading Causes of Burden of Disease, Low- and Middle-Income Countries, Males, 1998



Falls7 438 969

HIV/AIDS21 439 338




41 667 998









Drowning3 928 218



4 221 000


6 783 899


4 Malaria14 826 431

Malaria3 915 755




2 466 260

HIV/AIDS34 169 282

5 Measles13 025 426










2 903 185

Cataracts2 071 167


7 HIV/AIDS9 379 896

Anaemias2 731 210




Malaria20 187 610


Measles2 335 355









Dementias1 280 527


10 Tetanus5 195 494

Fires1 504 686

Psychoses6 216 587



Falls16 241 953


Asthma1 459 055

Anaemias5 472 082




12 Falls2 771 788

HIV/AIDS1 446 764

Falls4 992 649

Cataracts1 783 005






Benign prostatic hypertrophy1 627 868


Measles15 412 257




HIV/AIDS1 597 494



14 782 990








Table 17. Leading Causes of Death, Low- and Middle-Income Countries, Females, 1998




HIV/AIDS832 122





infections879 875

Malaria103 732







Tuberculosis182 631

Tuberculosis157 235


805 435


4 Measles429 017


War injuries144 825



HIV/AIDS1 115 954

5 Malaria376 476

Drowning51 603



Tuberculosis213 860



Fires24 663



74 119



7 HIV/AIDS179 912

War injuries23 245

Fires76 473

HIV/AIDS67 210



913 622

8Pertussis165 978 Nephritis/nephrosis

22 982Ischaemic heart disease

73 312Cirrhosis of the liver

58 730


Tuberculosis598 745

9 Tetanus146 474





Malaria537 882






Measles429 017


HIV/AIDS20 461





12 Drowning51 398

Tuberculosis20 097

Abortion63 146





Tetanus18 005


58 350







54 009

Liver cancers45 368



15 Meningitis28 437

Leukaemia13 982



Liver cancers97 968



Table 18. 15 Leading Causes of Burden of Disease, Low- and Middle-Income Countries, Females, 1998








39 321 606



Malaria3 870 306

HIV/AIDS23 725 468





Falls3 386 506

Anaemias7 842 189



5 368 656

HIV/AIDS35 738 079

4 Malaria13 551 365




Cataracts2 597 016


5 Measles12 293 771




2 945 000




Fires2 784 312



Dementias1 786 039

Malaria19 079 519

7 HIV/AIDS9 390 794

Anaemias2 393 743


Cataracts1 820 485




Measles2 327 050






Drowning1 941 980




Measles14 657 234

10 Tetanus4 900 955

HIV/AIDS1 503 906

Maternal sepsis5 824 923

Cervix cancers1 395 846


Anaemias13 148 434


Intestinal nematodeinfections Psychoses

5 566 991Glaucoma1 219 050


1 378 356
12 Falls2 776 938


Abortion5 401 781

Anaemias1 211 286









11 421 978




HIV/AIDS954 456



15 Meningitis1 351 707

Asthma988 389

Maternal haemorrhage3 659 138



Falls9 381 801


Table 19. Leading Causes of Death, African Region, Both Sexes, 1998


1 Malaria744 163

Malaria168 801

HIV/AIDS1 250 047

HIV/AIDS173 098


HIV/AIDS1 829 729



62 946




Malaria960 734


infections552 133


War injuries192 587





Drowning46 595

Tuberculosis98 573

Tuberculosis45 661


78 279


5 Measles502 510



Liver cancers23 022



6 HIV/AIDS340 283

HIV/AIDS37 809

Malaria44 289



Measles502 510

7 Pertussis130 468

War injuries30 743



20 420

Tuberculosis30 222


8 Tetanus80 543

Fires14 774


War injuries15 170


War injuries308 425


Tropical diseases14 538



HIV/AIDS28 492



Tuberculosis14 235

Abortion24 671








Liver cancers25 583

Tuberculosis209 293




23 216




13 Fires23 434





Pertussis130 468

14 Drowning22 604

Vitamin A deficiency8 862


22 233




110 145

15 Poisoning22 584





Tetanus103 438


Table 20. Leading Causes of Burden of Disease, African Region, Both Sexes, 1998


1 Malaria26 611 615

Malaria6 287 868

HIV/AIDS34 181 137

HIV/AIDS1 714 753


HIV/AIDS54 100 841


Measles2 770 226




Malaria34 506 494


HIV/AIDS2 471 386



Cataracts738 080






Cataracts861 720



22 817 647

5 HIV/AIDS15 419 011



Tuberculosis737 934


521 404


6 Measles14 356 931




HIV/AIDS314 553

Measles17 132 438





536 982

Tuberculosis233 093



Drowning1 748 360



Glaucoma219 198



Fires1 585 023





10 Tetanus2 693 335


Maternal sepsis1 889 801





Falls1 046 705






Anaemias859 795

Abortion1 735 893

War injuries315 519

Trachoma155 433


13 Fires1 078 924


Malaria1 553 172




14 Poisoning772 121

Tuberculosis587 562





15 Drowning755 996




Dementias135 764

Pertussis4 793 469


Table 21. Leading Causes of Death, Region of the Americas - High-Income Countries, Both Sexes, 1998














3 Road traffic injuries976

Leukaemia588

HIV/AIDS13 473





infections927

Drowning441




90 102


95 636


disorders769





83 225


88 260

6 Drowning597


300






Fires266





8 Meningitis453


Breast cancers4 635




9 Fires428


160





10 Dementias410

Lymphoma129

Poisoning2 850





Dementias124

Leukaemia2 504



44 303
4 540
12 Leukaemia249


Lymphoma2 352

Lymphoma4 526



13 Cerebrovascular disease195

Asthma105





14 Nephritis/nephrosis194

Falls101


Mouth and oropharynx4 296

Lymphoma21 977

Dementias33 205

15 Diarrhoeal diseases161


Falls1 933

HIV/AIDS4 146




Table 22. 15 Leading Causes of Burden of Disease, Region of the Americas, High-Income Countries, Both Sexes, 1998









Asthma82 939






disorders74 831

Dental caries57 934



Dementias691 004



Falls51 209

Psychoses819 519




5 Meningitis36 589





515 558


6 Falls34 303







infections32 266

Anaemias42 098





8 Asthma32 115






9 Dementia29 513

Epilepsy40 139




Dementias940 350


Otitis media27 773



190 961




Fires25 769




Psychoses836 623

12 Drowning19 970

Leukaemia22 937


Dementias176 986









767 490

14 Fires18 817

Post-traumatic stress disorder17 843

HIV/AIDS214 422




15 Anaemias18 289


Asthma213 550





Table 23. Leading Causes of Death, Region of the Americas, Low- and Middle-Income Countries, Both Sexes, 1998









Drowning7 159






infections68 621


5 914

HIV/AIDS52 010









55 561







46 721


6 Pertussis15 723

Leukaemia3 395

Tuberculosis22 058




7 Tetanus12 980







Tuberculosis2 500






disorders6 109

War injuries1 782

Drowning13 934



HIV/AIDS80 493


Lymphoma1 749

War injuries11 941

Tuberculosis10 745



67 702

11 Drowning4 160

Protein−energy malnutrition1 728


11 126

HIV/AIDS10 072



12 Meningitis4 062





Tuberculosis52 735


Anaemias1 533

Breast cancers6 616


8 385

Tuberculosis15 636


14 HIV/AIDS2 873

Falls1 467



7 488

HIV/AIDS14 760


15Chronic obstructivepulmonary disease

2 466

Intestinal nematodeinfections

1 450

Cervix cancers6 435





Table 24. Leading Causes of Burden of Disease, Region of the Americas,Low- and Middle-Income Countries, Both Sexes, 1998









Falls636 933






infections2 441 582

Dental caries481 892






Intestinal nematodeinfections387 886



Dementias389 894




HIV/AIDS1 979 270


Cataracts388 970


6 Pertussis593 042

Asthma279 548

Psychoses1 440 200





disorders511 677

Drowning268 619




373 092


8 Tetanus434 039







Anaemias232 585



288 839



10 Falls259 157






11 Anaemias Epilepsy Cerebrovascular disease Interpersonal violence Cirrhosis of the liver HIV/AIDS
245 278 188 340 836 399 236 285 160 689 2 348 289
12 Meningitis214 985







Leukaemia130 583

Tuberculosis745 088

Benign prostatic hypertrophy194 867



14 HIV/AIDS192 245



Tuberculosis178 827


Falls1 700 462

15 Drowning139 149


Anaemias651 300



Psychoses1 464 840


Table 25. 15 Leading Causes of Death, Eastern Mediterranean Region - High-Income Countries, Both Sexes, 1998


1Diarrhoeal diseases

1 827


228

War injuries1 204





infections1 713

War injuries154

Road traffic injuries561




2 818

3Perinatal conditions


112Ischaemic heart disease

559


380


717


4Measles

393Road traffic injuries

104Self-inflicted injuries

319Cirrhosis of the liver

242


514


5Congenital abnormalities


91Interpersonal violence

260Diabetes mellitus

227Diabetes mellitus

310War injuries

1 825

6Tetanus

344Inflammatory cardiac disease



203


262


7Protein−energy malnutrition

269Cerebrovascular disease

71Cerebrovascular disease

172


196



8Pertussis

245Drowning

58Rheumatic heart disease

148War injuries


183


797

9War injuries

216Rheumatic heart disease

47HIV/AIDS


177Nephritis/nephrosis


758



45Maternal haemorrhage


147Stomach cancers

110


693



41Drowning

103Stomach cancers

137

Mouth and oropharynxcancers

109

Diabetes mellitus659

12Vitamin A deficiency




123Colon/rectum cancers


643

13Drowning

60Leukaemia


92


83

War injuries70

Cirrhosis of the liver536

14STDs excluding HIV


34Diabetes mellitus

81Oesophagus cancers

79Bladder cancers


495

15Meningitis

45


31


77

Breast cancers78

Dementias66



Table 26. 15 Leading Causes of Burden of Disease, Eastern Mediterranean Region –High-Income Countries, Both Sexes, 1998



Acute lowe r respiratoryinfections

8 943

War injuries50 233




75 853


infections59 643

War injuries6 914









Cataracts4 222

War injuries69 672


Falls4 966

Psychoses16 656

Cataracts6 615


4 069



Anaemias4 608




3 597


6 Measles11 550






7 Tetanus11 517


Anaemias12 728

Osteoarthritis4 514



8 Pertussis8 452






9 War injuries8 252



Edentulism4 130



10 Falls3 460

Asthma2 467

Obstructed labour9 265



Anaemias21 506

11 Interpersonal violence Drowning Obsessive−compulsivedisorders

Chronic obstructivepulmonary disease Osteoarthritis Inflammatory cardiac disease

2 840 2 163 8 600 4 104 1 066 17 349

12 Inflammatory cardiac disease2 729

Fires1 990


War injuries3 751

Dementias1 000

Psychoses17 003


disorders2 573




Edentulism978


14 Anaemias2 546

Measles1 860



Trachoma932

Protein−energy malnutrition16 370

15 Meningitis2 245

Dental caries1 823



Nephritis/nephrosis756



Table 27. Leading Causes of Death, Eastern Mediterranean Region - Low- and Middle-Income Countries, Both Sexes, 1998




25 648

War injuries102 794





War injuries16 568

Tuberculosis54 837

Tuberculosis33 568




infections237 732





64 559


4 Measles98 087





44 674


5 Pertussis49 798




Tuberculosis34 144



Malaria10 255




War injuries163 116

7 Tetanus45 921


HIV/AIDS13 898


9 205


Tuberculosis138 607

8 Malaria36 277

Drowning8 480




Measles96 087




War injuries8 383




Tuberculosis5 583





62 918







12 Tuberculosis10 475


Drowning8 365







Breast cancers5 823







War injuries6 166

Malaria52 733

15 Drowning8 527



7 474


4 538

Liver cancers5 747

Tetanus51 585


Table 28. 15 Leading Causes of Burden of Disease, Eastern Mediterranean Region –Low- and Middle-Income Countries, Both Sexes, 1998









War injuries745 609






infections8 258 419


HIV/AIDS2 096 138

Tuberculosis544 111

Cataracts378 761


4 Measles2 816 057

Falls539 093




332 986





Cataracts350 101




Anaemias492 687

Psychoses1 263 359


Tuberculosis250 656



Measles453 615


HIV/AIDS257 119


HIV/AIDS3 420 409

8 Tetanus1 535 610


Anaemias1 098 772



Measles3 420 409

9 Malaria1 295 873

Malaria382 217



225 468









11 HIV/AIDS Drowning Obstructed labour Cirrhosis of the liver Cirrhosis of the liver Road traffic injuries
991 144 318 133 927 904 201 755 98 398 2 533 771
12 Falls439 664

Fires290 591


Edentulism179 692






War injuries174 781

Trachoma88 283

Protein−energy malnutrition2 183 471


Asthma263 474



Dementias86 687

Anaemias2 020 033


Tuberculosis229 752



Edentulism81 397

Pertussis1 880 397


Table 29. Leading Causes of Death, European Region - High-Income Countries, Both Sexes, 1998















infections2 789

Leukaemia630






Drowning500







HIV/AIDS8 699



132 790


139 745


disorders778


376





7 Measles772


334





8 Drowning643


Breast cancers5 594





Fires286





10 Pertussis508


Poisoning3 535




11 Meningitis486


Leukaemia3 095



61 410
6 296
12 Fires442

War injuries147

Lymphoma2 886




13 Dementias399

Lymphoma145


Lymphoma6 136



14 Tetanus389

Dementias126



Lymphoma35 604

Dementias52 510


Falls118

Falls2 396





Table 30. Leading Causes of Burden of Disease, European Region - High-Income Countries, Both Sexes, 1998



767 076Road traffic injuries

139 632Unipolar major depression

2 414 194Ischaemic heart disease



4 663 904


714 103Asthma86 348






infections97 081

Dental caries60 209



Dementias1 150 391



96 623Falls

56 386Psychoses1 019 407





disorders74 914

Obsessive-compulsivedisorders52 715




856 924


6Protein-energy malnutrition

44 056Drug dependence

49 455Bipolar affective disorder

708 554





39 116Anaemias

46 948Drug dependence


350 103Colon/rectum cancers

571 952


1 510 399

8Meningitis

37 768





Dementias1 469 021

9Falls

36 918Epilepsy42 211





10Asthma32 070

Otitis media29 044



261 875



1 198 084

11Dementias

28 994Fires

27 965HIV/AIDS


245 567Prostate cancers


1 116 539

12Pertussis27 130

Leukaemia24 577


Dementias239 045


Psychoses1 046 668


22 448Congenital abnormalities

24 029Cerebrovascular disease




883 473

14Drowning

21 496Interpersonal violence



210 350Unipolar major depression

234 818Bipolar affective disorder

813 478

15Anaemias

20 404Drowning

18 746Asthma265 238





Table 31. Leading Causes of Death, European Region, Low- and Middle-Income Countries, Both Sexes, 1998



91 814War injuries





1 419 683


infections57 883


6 292

War injuries48 624







45 982





24 122Drowning


39 344Stomach cancers

28 227



5Pertussis14 323





96 354


113 626

6War injuries


2 279Poisoning




111 199

7Tetanus11 165







7 565Inflammatory cardiac disease

2 237Tuberculosis

14 964Tuberculosis



102 164

9Measles

5 982Leukaemia

2 025Drowning

14 234Poisoning

18 238Diabetes mellitus

35 440Perinatal conditions

91 814

10Meningitis



9 068Breast cancers



75 987


2 646Interpersonal violence

1 406Rheumatic heart disease



26 034War injuries

73 279

12Drowning



7 229


13 788




2 370Nephritis/nephrosis

995






1 791Vitamin A deficiency

937Falls6 943


Liver cancers19 524



1 749


916



Falls19 298

Tuberculosis53 335


Table 32. Leading Causes of Burden of Disease, European Region –Low- and Middle-Income Countries, Both Sexes, 1998









infections2 012 444

War injuries288 838












Falls224 878



Dementias751 040


5 Protein-energy malnutrition514 066

Anaemias215 018




646 500


6 Pertussis440 029

Drowning157 538

Psychoses1 257 750


498 791




Pertussis138 693





8 Tetanus323 309

Asthma136 748





9 Falls159 841

Epilepsy127 267











11 Measles Diarrhoeal diseases Obsessive-compulsivedisorders Diabetes mellitus Unipolar major depression Alcohol dependence

116 800 109 289 729 326 305 552 255 026 1 835 204

12 Anaemias110 497



Tuberculosis287 491



1 766 043


disorders99 165

Dental caries92 341

Falls683 455

Poisoning270 466

Cataracts198 487


14 HIV/AIDS97 813






1 467 389



Poisoning509 724



Falls1 377 221


Table 33. Leading Causes of Death, South-East Asia Region - India, Both Sexes, 1998



611 910


71 971

HIV/AIDS159 420





infections550 704


Tuberculosis118 248

Tuberculosis131 841







61 992



4Measles190 000

Drowning31 595



Tuberculosis147 274



126 152Fires

16 117Fires

77 140



122 772


6Tetanus122 144

Tetanus15 726


41 532



Tuberculosis420 928

7Pertussis71 410




32 698




38 875Falls

11 478Diarrhoeal diseases

33 386



Measles190 000

9STDs excluding HIV




29 232


HIV/AIDS179 365


21 976Tropical diseases


32 128Cervix cancers


45 032Tetanus165 020

11Meningitis

17 927Tuberculosis

9 181Maternal haemorrhage


23 193Nephritis/nephrosis


153 481

12Drowning


8 122Drowning


22 623



152 575

13Fires

15 199Dengue7 369



21 016



14Tuberculosis


6 576Childhood diseases

23 935Oesophaguscancers


27 385Fires

134 550


13 648Vitamin A deficiency





124 378


Table 34. Leading Causes of Burden of Disease, South-East Asia Region - India, Both Sexes, 1998



Falls6 964 831





24 806 393




HIV/AIDS3 802 963







Cataracts1 204 468

Cataracts1 521 169



Fires1 868 839





5 Measles5 478 515


Anaemias3 452 262


Tuberculosis918 256

Falls10 897 503

6 Tetanus3 750 146

Anaemias1 518 581




890 557


7 Protein-energy malnutrition3 491 974

Drowning1 186 455

Fires2 808 318


877 049







Dementias458 983


9 Falls1 957 064

Measles983 899







Psychoses1 935 788



Measles6 474 228

11 HIV/AIDS1 248 486

Tetanus591 700




Anaemias6 301 897



Abortion1 695 494



Fires5 722 982


Tuberculosis387 380




HIV/AIDS5 611 121

14 Fires724 272


Obsessive-compulsivedisorders1 540 299

Anaemias484 019


Tetanus5 160 285

15 Drowning591 725

Asthma353 855

Falls1 484 807

Glaucoma472 921

Anaemias262 018



Table 35. Leading Causes of Death, South-East Asia Region - Other Low- and Middle-Income Countries, Both Sexes, 1998




23 846

HIV/AIDS106 060

Tuberculosis74 534




Drowning17 469






infections143 997

Malaria17 001

Tuberculosis55 529


Tuberculosis126 527


4 Measles65 512





Tuberculosis261 058







6 Pertussis35 828



Liver cancers23 171


51 357


7 Tetanus21 996





HIV/AIDS119 329

8 Drowning18 119

Leukaemia6 643

Malaria20 243











Tetanus3 921

Drowning15 473


Liver cancers31 241




Poisoning15 034




12 Malaria7 547

Tuberculosis3 242




Measles65 512


Poisoning3 181

Falls11 633




14 Meningitis4 939



11 268



Liver cancers62 381

15 Vitamin A deficiency4 845


2 714






Table 36. Leading Causes of Burden of Disease, South-East Asia Region –Other Low- and Middle- Income Countries, Both Sexes, 1998















infections5 058 619

Drowning655 481

HIV/AIDS2 223 529


Tuberculosis853 637



Malaria629 850



Cataracts529 978


5 Measles1 907 821

Falls585 550

Anaemias2 065 128









363 983



Anaemias460 424

Psychoses1 949 920

Cataracts431 195



8 Falls863 215




Dementias314 917


9 Tetanus735 532





Anaemias3 098 487


Measles315 806


Glaucoma337 790


HIV/AIDS3 034 115

11 Road traffic injuries Cerebrovascular disease Falls Diabetes mellitus Diabetes mellitus Falls
643 244 299 821 1 183 128 317 454 267 604 2 808 432
12 Drowning606 054

Leukaemia254 613



Edentulism205 218


13 HIV/AIDS542 429

Asthma224 032


Anaemias220 882



14 Malaria272 584

Epilepsy183 891




Measles2 228 772





200 443


Psychoses1 977 180


Table 37. Leading Causes of Death, Western Pacific Region - High-Income Countries, Both Sexes, 1998








2 Measles4 177







Leukaemia214





4 Pertussis2 698

Drowning160


Breast cancers8 106


51 248


54 027






48 439


51 366


infections316


110






disorders273

Fires97

Breast cancers1 871




8 Drowning212








57

Poisoning1 241




10 Meningitis161

Lymphoma47

HIV/AIDS1 180




11 Fires152

Dementias45

Leukaemia1 112



23 579
2 727
12 Dementias146


Lymphoma1 011

Lymphoma2 719




Asthma38





14 Leukaemia89

Falls37

Falls838




15 Cerebrovascular disease69


Colon/rectum cancers815


Lymphoma13 206

Dementias18 911


Table 38. Leading Causes of Burden of Disease, Western Pacific Region - High-Income Countries, Both Sexes, 1998



Measles51 350











3 Pertussis88 515

Asthma30 293



Dementias436 089


4 Measles83 438

Pertussis24 705

Psychoses369 394





disorders26 550

Dental caries21 097

HIV/AIDS284 215



327 745



Falls18 617





7 HIV/AIDS13 164






8 Meningitis12 991






9 Falls12 170

Anaemias15 354




Dementias571 014

10 Asthma11 421




114 690




infections10 980

Epilepsy14 644





469 523

12 Dementias10 498

Otitis media10 140


Dementias106 113




Fires9 404




Psychoses380 032


Leukaemia8 367




HIV/AIDS352 872



Asthma96 228





Table 39. Leading Causes of Death, Western Pacific Region - China, Both Sexes, 1998



Drowning33 872




1 244 601



infections171 681






1 382 668



Liver cancers71 654


110 714



4 Drowning42 301

Leukaemia8 891







6 384

Tuberculosis43 641










7 Pertussis13 099


4 681






Poisoning3 838


Tuberculosis65 410

Tuberculosis142 005


9 Tetanus9 218


Drowning34 447



Tuberculosis258 503


8 879






11 Meningitis8 128

Tuberculosis2 207

Leukaemia30 956












Poisoning28 110




14 Poisoning4 996

Appendicitis1 982





15 Leukaemia4 807



18 203


Falls42 270

Drowning135 109


Table 40. Leading Causes of Burden of Disease, Western Pacific Region - China, Both Sexes, 1998



Drowning1 271 228



4 480 862


8 912 877


17 008 546


infections6 209 295

Anaemias1 160 390







Anaemias3 827 109




4 Drowning1 415 024







Asthma646 668




1 366 654



Falls591 363


3 307 666




7 Falls1 040 434


Psychoses2 681 178


1 351 340


Anaemias6 770 202

8 Pertussis534 042

Leukaemia341 130

Obsessive-compulsivedisorders2 118 861


Tuberculosis914 139






Dementias831 344




Falls1 898 804


Cataracts747 995


11 Anaemias403 304






12 Tetanus308 231

Otitis media211 364


Anaemias975 916


Falls4 174 986

13 Dental caries306 910







296 987

Epilepsy196 079

Asthma1 528 405



Drowning3 918 624

15 Iodine deficiency250 174

Fires184 873






Table 41. Leading Causes of Death, Western Pacific Region - Other Low- and Middle-Income Countries, Both Sexes, 1998




9 607


Tuberculosis24 501




Drowning7 046

Tuberculosis18 253





infections61 915

Malaria6 960

HIV/AIDS14 651


Tuberculosis41 591


4 Measles17 053





31 865

Tuberculosis85 814







6 Pertussis11 647



Liver cancers6 602


16 085


7 Tetanus9 457






8 Drowning7 791

Leukaemia2 677

Malaria6 698







Cervix cancers3 664




Tetanus1 579

Drowning5 147

Breast cancers3 389


Drowning21 590



Poisoning5 011


Liver cancers9 585



Poisoning1 281





13 Malaria2 498


Falls3 849




14 Meningitis2 123


1 094


3 753



Malaria19 586

15 Vitamin A deficiency2 083

Tuberculosis1 066






Table 42. Leading Causes of Burden of Disease, Western Pacific Region –Other Low- and Middle-Income Countries, Both Sexes, 1998





Tuberculosis426 025










infections2 175 068

Drowning264 384

HIV/AIDS722 617


Tuberculosis280 603



Malaria257 833

Anaemias690 175


Cataracts164 742



Falls236 123

Tuberculosis683 743




6 Measles496 289





111 156


7 Pertussis406 166

Anaemias185 473

Psychoses650 077

Cataracts125 322

Dementias97 937

Anaemias1 078 343

8 Falls371 152






9 Tetanus316 246





Falls1 051 642







Road traffic injuries Leukaemia Falls Glaucoma Diabetes mellitus STDs excluding HIV
11 276 559 102 614 393 141 99 504 84 225 986 300
12 Drowning260 593

Asthma90 293



Edentulism63 767

HIV/AIDS985 713

13 HIV/AIDS176 090

Measles82 152


Anaemias64 576




Epilepsy74 059




Drowning689 300



Obstructed labour241 579



Psychoses658 223


Appendix 1: ICD Codes of the Leading Causes of GlobalBurden of Disease

Title of GBD cause ICD-9 Code ICD 9 BTLCODES

ICD-10 Code

Communicable, maternal, perinatal and nutritional conditionsInfectious and parasitic diseases1. Tuberculosis 010-018, 137 B02, B077 A15-A19, B902. Sexually transmitted

diseases excluding HIV090-099, 614-616 B06, B371-B373 A50-A64, N70-

N733. HIV/AIDS 279.5 (=042-044) B184 B20-B244. Diarrhoeal diseases 001, 002, 004,

006-009B01 minus B013 A00, A01,A03,

A04, A06-A09

5. Childhood diseasesa. Pertussis 033 B034 A37b. Poliomyelitis 045, 138 B040, B078 A80,B91c. Diphtheria 032 B033 A36d. Measles 055 B042 B05e. Tetanus 037, 771.3 B037 A33-A35

6. Bacterial meningitis 036, 320-322 B036, B220 A39, G007. Hepatitis 070.2-070.9 B046 B16-B198. Malaria 084 B052 B50-B549. Tropical-cluster diseases 085, 086, 120, 125 B053, B054,

B072, B074B55-B57, B65,B73-B74

10. Leprosy 030 B032 A3011. Dengue 061 A90-A9112. Japanese encephalitis 062.0 A83.013. Trachoma 076 B048 A71

A.

14. Intestinal nematodeinfections

126-129 B075, B076 B76-B81

Respiratory infections1. Lower respiratory

infections466, 480-487 B320-B322 J10-J18, J20-J22

2. Upper respiratoryinfections

460-465 B310-B312 J00-J06

B.

3. Otitis media 381-382 B240 H65-H66

I.

C. Maternal conditions

1. Maternal haemorrhage 640, 641, 666 B390 O44-O46, O67,O72

2. Maternal sepsis 670 O85-O863. Hypertensive disorders of

pregnancy642 O10-O16

4. Obstructed labour 660 B393 O64-O66

C.

5. Abortion 630-639 B38 O00-O08D. Perinatal conditions 760-779 B45 P00-P96

Nutritional deficiencies1. Protein-energy

malnutrition260-263 B190-B192 E40-E46

2. Iodine deficiency 243 E00-E023. Vitamin A deficiency 264 E50

I.

E.

4. Anaemias 280 B200 D50

Noncommunicable diseasesMalignant neoplasms1. Mouth and oropharynx

cancers140-149 B08 C00-C14

2. Oesophagus cancer 150 B090 C153. Stomach cancer 151 B091 C164. Colon and rectum cancers 153, 154 B093, B094 C18-C215. Liver cancer 155 B095 C226. Pancreas cancer 157 B096 C257. Trachea, bronchus and

lung cancers162 B101 C33-C34

8. Melanoma and other skincancers

172-173 B111, B112 C43-C44

9. Breast cancer 174 B113 C5010. Cervix uteri cancer 180 B120 C5311. Corpus uteri cancer 179, 182 B122 C54-C5512. Ovary cancer 183 B123 C5613. Prostate cancer 185 B124 C6114. Bladder cancer 188 B126 C6715. Lymphoma 200-202 B14 [minus B141] C81-C90, C96

A.

16. Leukaemia 204-208 B141 C91-C95

II.

C. Diabetes mellitus 250 B181 E10-E14

D. Nutritional/Endocrine disorders 240-242, 244-246,251-259, 270-279,286-289

B18, B20 [minusB181, B184,B200]

D51-D89, E03-E07, E15-E16,E20-E34, E51-E89

Neuro-psychiatric conditions1. Unipolar major depression F32-F332. Bipolar disorder 296 B212 F30-F313. Psychoses 295 B211 F20-F294. Epilepsy 345 B225 G40-G415. Alcohol dependence 291, 303, 305.0 B215 F106. Dementia and other

degenerative andhereditary CNS disorders

330, 331, 290 B222, B210 F01, F03, G30-G31

7. Parkinson disease 332 B221 G20-G218. Multiple sclerosis 340 B223 G359. Drug dependence 304, 305.2-305.9 B216 F11-F16, F18-F1910. Post-traumatic stress disorder F4311. Obsessive-compulsive

disorders300.3 F42

E.

12. Panic disorder 300.2 F40.0, F41.0Sense organ diseases1. Glaucoma 365 B230 H40

F.

2. Cataracts 366 B231 H25-H26Cardiovascular diseases

1. Rheumatic heart disease 390-398 B25 I01-I092. Ischaemic heart disease 410-414,

Proportion of:428, 427.1, 427.4,427.5, 440.9,429.0-429.2, 429.9

B27 I20-I25

G.

3. Cerebrovascular disease 430-438 B29 I60-I694. Inflammatory heart

diseases420, 421, 422, 425, Proportion of 428 I30-I33, I38, I40,

I42

H. Respiratory diseases1. Chronic obstructive

pulmonary disease490-492, 495-496 B323-B325 J40-J44

2. Asthma 493 J45-J46I. Digestive diseases

1. Peptic ulcer disease 531-533 B341 K25-K272. Cirrhosis of the liver 571 B347 K70, K743. Appendicitis 540-543 B342 K35-K37Genito-urinary diseases1. Nephritis and nephrosis 580-589 B350 N00-N19

J.

2. Benign prostatichypertrophy

600 B360 N40

K. Skin diseases 680-709 B42 L00-L99

Musculo-skeletal diseases

1. Rheumatoid arthritis 714 B430 M05-M06

L.

2. Osteoarthritis 715 M15-M19M. Congenital anomalies 740-759 B44 Q00-Q99

Oral conditions1. Dental caries 521.0 K022. Periodontal disease 523 K05

N.

3. Edentulism

InjuriesE800-999(minusE980-E989)

B47-B56 minusB560

V01-Y98(minusY10-Y34)

Unintentional injuries E800-949 B47- B53 V01-X59, Y40-Y98

1. Road Traffic injuries E810-919 B47 V02-04, V09,V12-14, V19,V20-79, V86-89

2. Poisonings E850-869 B48 X40-X493. Falls E880-888 B50 W00-W194. Fires E890-899 B51 X00-X095. Drownings E910 B521 W65-W74

A.

6. Firearm accidents E922 B524 W32-W34Intentional injuries E950-978, 990-

999B54-B55, B56minus B560

X60-Y09, Y35-Y36

1. Self-inflicted injuries E950-959 B54 X60-X842. Homicide/interpersonal

violenceE960-969 B55 X85-Y09

III.

B.

3. War E990-999 B561 Y35-Y36

Appendix 2. WHO Regional and Economic GroupingsAfrica Region of the Americas Eastern Mediterranean Region European Region South-East Asia Region Western Pacific Region46 Member States 35 Member States 22 Member States 51 Member States 10 Member States 27 Member States

Low and middle income Low and middle income Low and middle income Low and middle income India ChinaAlgeria Antigua and Barbuda Afghanistan Albania Other low and middle income Other low and middle incomeAngola Argentina Bahrain Armenia Bangladesh CambodiaBenin Barbados Djibouti Azerbaijan Bhutan Cook IslandsBotswana Belize Egypt Belarus Dem. People's Rep. of Korea FijiBurkina Faso Bolivia Iran (Islamic Republic of) Bosnia and Herzegovina Indonesia KiribatiBurundi Brazil Iraq Bulgaria Maldives Lao People's Dem. RepublicCameroon Chile Jordan Croatia Myanmar MalaysiaCape Verde Colombia Lebanon Czech Republic Nepal Marshall IslandsCentral African Republic Costa Rica Libyan Arab Jamahiriya Estonia Sri Lanka Micronesia, (Fed. States of).Chad Cuba Morocco Georgia Thailand MongoliaComoros Dominica Oman Hungary NauruCongo Dominican Republic Pakistan Kazakhstan NiueCote d'Ivoire Ecuador Saudi Arabia Kyrgyzstan PalauDem. Republic of the Congo El Salvador Somalia Latvia Papua New GuineaEquatorial Guinea Grenada Sudan Lithuania PhilippinesEritrea Guatemala Syrian Arab Republic Malta SamoaEthiopia Guyana Tunisia Poland Solomon IslandsGabon Haiti Yemen Republic of Moldova TongaGambia Honduras High income Romania TuvaluGhana Jamaica Cyprus Russian Federation VanuatuGuinea Mexico Kuwait Slovakia Viet NamGuinea-Bissau Nicaragua Qatar Slovenia High incomeKenya Panama United Arab Emirates Tajikistan AustraliaLesotho Paraguay TFYR Macedonia Brunei DarussalamLiberia Peru Turkey JapanMadagascar Saint Kitts and Nevis Turkmenistan New ZealandMalawi Saint Lucia Ukraine Republic of KoreaMali Saint Vincent and the Grenadines Uzbekistan SingaporeMauritania Suriname YugoslaviaMauritius Trinidad and Tobago High incomeMozambique Uruguay AndorraNamibia Venezuela AustriaNiger High income BelgiumNigeria Bahamas DenmarkRwanda Canada FinlandSao Tome and Principe United States of America FranceSenegal GermanySeychelles GreeceSierra Leone IcelandSouth Africa IrelandSwaziland IsraelTogo ItalyUganda LuxembourgUnited Rep. of Tanzania MonacoZambia NetherlandsZimbabwe Norway

PortugalSan MarinoSpainSwedenSwitzerlandUnited Kingdom

Appendix 3. Populations by Age Group

WHO Geographic Regions Population by Age Group (000)0-4 5-14 15-44 45-59 60+ Total

World, Both Sexes 603 648 1186 025 2763 736 757 385 579 097 5889 891World, Males 310 022 609 010 1409 261 379 186 258 961 2966 441World, Females 293 625 577 015 1354 475 378 199 320 136 2923 451World - High Income, Both Sexes 51 014 107 812 367 737 159 814 164 890 851 268World - High Income, Males 26 162 55 244 186 795 79 592 70 593 418 386World - High Income, Females 24 852 52 568 180 942 80 222 94 297 432 881World - Low and Middle Income, Both Sexes 552 634 1078 213 2395 999 597 571 414 207 5038 624World - Low and Middle Income, Males 283 860 553 766 1222 466 299 594 188 368 2548 054World - Low and Middle Income, Females 268 774 524 447 1173 533 297 977 225 839 2490 570Africa, Both Sexes 102 171 164 594 257 299 49 202 28 284 601 550Americas – High Income Countries, Both Sexes 21 513 44 380 135 535 53 653 49 803 304 884Americas – Low and Middle Income Countries, Both Sexes 54 753 106 803 240 917 56 788 38 123 497 383Eastern Mediterranean - High Income Countries, Both Sexes 514 1 167 2 641 890 300 5 512Eastern Mediterranean - Low and Middle Income Countries, Both Sexes 67 371 121 413 212 358 41 844 25 141 468 127Europe - High Income Countries, Both Sexes 21 334 46 050 168 471 73 107 83 311 392 274Europe - Low and Middle Income Countries, Both Sexes 31 835 77 652 219 970 74 477 73 789 477 722South-East Asia - India, Both Sexes 115 615 220 580 459 491 113 400 73 136 982 221South-East Asia - Other Low and Middle Income Countries, Both Sexes 57 568 116 744 281 131 63 866 40 076 559 386Western Pacific - High Income, Both Sexes 7 653 16 214 61 090 32 164 31 476 148 597Western Pacific - China, Both Sexes 98 570 223 400 631 082 179 427 123 219 1255 697Western Pacific - Other Low and Middle Income, Both Sexes 24 751 47 028 93 751 18 568 12 439 196 537

Source: United Nations dataset World population prospects 1950-2050 (the1998 revision), New York, United Nations Population Division, 1998

Appendix 4. Injury related mortality, world, 1998

Both Sexes Males Females

Number of

Deaths

Mortality Rate

(per 100,000)

Number of

Deaths

Mortality Rate

(per 100,000)

Number of

Deaths

Mortality Rate

(per 100,000)

All Injuries 5 764 825 97.9 3 814 757 128.6 1 950 068 66.7

Road Traffic Injuries 1 170 694 19.9 854 939 28.8 315 755 10.8

Suicide 947 697 16.1 565 156 19.1 382 541 13.1

Homicide 735 972 12.5 582 486 19.6 153 485 5.3

War 588 050 10.0 343 762 11.6 244 287 8.4

Drowning 495 463 8.4 332 498 11.2 162 964 5.6

Falls 315 633 5.4 177 022 6.0 138 611 4.7

Fires 282 178 4.8 119 090 4.0 163 088 5.6

Poisoning 251 881 4.3 155 112 5.2 96 769 3.3

Other injuries 977 259 16.6 684 692 23.1 292 567 10.0

Documents

10 Leading Causes of Death, World, 1998 Both Sexes