Over 850,000 people die of 226 diseases in Bangladesh annually

Nearly 55 million people die across the globe every year. Though many of them die in accidents, most of the annual deaths occur due to over 450 diseases and injuries. This was learned from a survey report the Institute for Health Metrics and Evaluation (IHME) of the University of Washington prepared on the state and diseases of which people are dying.

Nearly 500 scientists, public health experts, epidemiologists, statisticians and researchers took part in the survey the Institute for Health Metrics and Evaluation carried out a decade ago. The IHME report was prepared after collecting data from 190 countries. The report, published under the title of Global Burden of Disease (GBD), drew global attention. The full title of the research is ‘The Global Burden of Diseases, Injuries and Risk Factors’.

Based on the survey, for the first time medical journal Lancet in 2012 published a detailed statistics of deaths of people from different countries in various diseases and injuries. The survey report revealed that nearly 847,000 people die in Bangladesh annually. And the reasons are 226 types of diseases and injuries.

This is the largest survey on the sources of diseases that lead to death of people.

The survey report identified three prime reasons of death of people globally -- communicable disease, noncommunicable disease, and any injuries and accidents.

Of the communicable diseases, 62 feature on the list of diseases of Bangladesh. Those 62 diseases have been divided into seven genuses – HIV-AIDS and tuberculosis; diarrhoea, lower respiratory infection and other normal infectious diseases; neglected tropical diseases and malaria; maternal morbidity, neonatal diseases; diseases due to malnutrition and other communicable diseases, maternal, neonatal and malnutrition induced diseases. Except yellow fever of the genus of ‘neglected tropical diseases and malaria’, all the other diseases are prevalent in Bangladesh.

But the noncommunicable diseases are most prevalent in Bangladesh. As per the survey report, noncommunicable diseases are divided into 10 genuses. People of Bangladesh die in 130 of the noncommunicable diseases included in the 10 genuses. Those include cancer, heart disease, diabetes, bone diseases, cirrhosis and other liver diseases, and digestive system, respiratory and chronic respiratory diseases. Besides, there are mental health issues.

There are many types of injuries and accidents ranging from road accidents to deaths in political violence and death sentences. There are 34 types of this, divided into four genuses. These are – road accidents; unintentional injuries; self inflicted injury and interpersonal violence and force; and clashes and violence; death sentence and police violence.

Of the different types of diseases as reasons of death, let’s take a look at cancer. No government department of Bangladesh knows how many people die in cancer every year. The survey report the Institute for Health Metrics and Evaluation says Bangladeshis die of 38 types of cancer. Among them there are lip and oral cavity cancer, pharyngeal cancer, nasopharyngeal cancer, oropharyngeal cancer, stomach cancer, rectal cancer, liver cancer, hepatitis B induced liver cancer, hepatitis C induced liver cancer, other types of liver cancer, gallbladder cancer, pancreas cancer, laryngeal cancer, lung cancer, malignant skin melanoma, non-skin melanoma, breast cancer, cervical cancer, uterine cancer, ovarian cancer, renal cell cancer, testicular cancer, kidney cancer, brain cancer, mesothelioma, Hodgkin lymphoma, non-Hodgkin lymphoma, multiple myeloma, leukemia, acute lymphoid leukemia, chronic lymphoid, acute myeloid leukemia, and chronic myeloid leukemia. There are various other types of cancer too.

Besides this long list of diseases, the researchers have also provided an estimated number of people die of those diseases.

There was a time when diseases like cholera or malaria were fatal for the people of Bangladesh. The number of deaths in communicable diseases has decreased due to advances in science and disease management. But then again, many non-communicable diseases have become prevalent due to increased life expectancy, changes in lifestyle and food habits and so on. With this the number of deaths from these diseases also has increased. The Institute for Health Metrics and Evaluation has given a list of top 10 reasons of deaths in Bangladesh in 2009 and 2019.

The top 10 reasons for deaths in Bangladesh in 2009 were – stroke, ischemic heart disease, lower respiratory infection, chronic respiratory disease, tuberculosis, diarrhoeal diseases, cirrhosis, diabetes, neonatal diseases and drowning.

The top 10 reasons in 2019 were - stroke, ischemic heart disease, lower respiratory infection, chronic respiratory disease, tuberculosis, diarrhoeal diseases, cirrhosis, cancer and neonatal diseases.

As per the survey report, stroke is the prime reason of deaths of the people of Bangladesh. There are two types of strokes - ischemic stroke (when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients) and hemorrhagic stroke (bleeding into the brain by the rupture of a blood vessel).

Speaking to Prothom Alo, National Institute of Neuro Sciences and Hospital assistant director professor Badrul Alam said, “I have been hearing about and seeing many deaths due to strokes. It is hard to say whether this is the prime cause of deaths in the country since there there is no national-level survey to ascertain the reasons of deaths. But this can be said with certainty that stroke would feature as one of top reasons of deaths if any survey is done.”

Last year Bangladesh Bureau of Statistics published a list of 15 main reasons of deaths of people in the country. Stroke was one of the prime reasons. Other reasons were – heart disease, chronic respiratory diseases, diabetes, pneumonia, cirrhosis, other noncommunicable diseases, oropharyngeal cancer, kidney diseases, lung cancer, cervical cancer, diarrhoeal diseases, road accident and deaths from falling from high places.

The Institute for Health Metrics and Evaluation has provided a list of health risks besides the deaths and chronic diseases and disability of the people of Bangladesh.

The top 10 reasons of health risks in Bangladesh in 2009 were malnutrition, air pollution, tobacco intake, high blood pressure, and unhealthy food habits, sewerage systems, high level of sugar in blood, occupational hazards, obesity and high LDL. Those were also the top health risks in for Bangladeshis in 2019.

Malnutrition is long-prevailing problem in the country. The rate of women and child below five suffering from malnutrition is still too high. Though air pollution poses a serious threat to health, awareness about this is very little. Evidence points to the veracity of the list of top health risks the experts provided in a span of 10 years.

Speaking about this, public health expert Mushtaq Husain told Prothom Alo, the nutrition situation has developed in the country, but there are questions about whether the lower income people getting sufficient animal protein or not. We also have highlighted the health risks in the survey. The policy makers have to plan accordingly.”

Researchers involved with the IHME have been bringing forth newer issues. In October 2020 they published the achievements of various countries under Universal Health Coverage. Alongside this they also published stats of treatment of 20 diseases including family planning services and immunisation.

Bangladesh has achieved 54 per cent of Universal Health Coverage, the report says. Nearly 79 per cent capable married couples have been using modern birth control methods through family planning programmes. Over 92 per cent children are getting various types of vaccines under immunisation programmes. Bangladesh has been doing the best in treating diarrhoea. Almost 96 per cent diarrhoea patients get proper treatment. Then there is apendicitis treatment. Nearly 94 per cent can avail the treatment when required. But the treatment of leukemia cancer is in a bad condition. Only 7 per cent of them get treatment. Some 11 per cent of people who suffered from stroke have been getting treatment on time while only 15 per cent of asthma patients get effective treatment.

This study of the Institute for Health Metrics and Evaluation (IHME) of the University of Washington provides an overall picture of global disease conditions. They have been working with nearly 450 types of diseases and reasons of injureis and nearly 100 health risks. This also provides an estimated number of people dying from different diseases, people becoming disabled, and their life expectancy at birth decreasing. This estimation is also getting global recognition as this research is methodologically and scientifically sound.

This research provides various options for assessing and comparing the health status of different countries. It also enables the comparison of health conditions from one region to another. Additionally, it provides the ability to gather separate statistical data for various age groups among both men and women. It gives access to global, regional, and national statistics on adolescent health. This information equips policymakers with valuable insights to take measures for enhancing the overall health situation.

Previously, accessing information on the global health situation relied on waiting for annual reports from organisations like the World Health Organization, UNICEF, UNFPA, or the World Bank. Now these statistics are easily available from the survey of IHME. They regularly evaluate global health situation data. Their statistics, scientific articles and explanatory analyses are becoming increasingly popular with policy makers, researchers and health authorities.

The scientists and researchers involved in this big initiative are not only projecting the current state of health, but in some cases, they are also predicting global trends in health. They are publishing various types of global estimates on public health and disease.

Aliya Naheed, Head of the Non-Communicable Diseases Research of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), was associated with one of their studies on the global situation of non-communicable diseases.

She told Prothom Alo that the research used reliable source of information from the most credible institutions of various countries. The researchers compare data from a specific period with the past. They make projections based on analysis of patterns or trends of one or more disease. Their information facilitates policymakers.

* The report, originally published in the print edition of Prothom Alo, has been rewritten in English by Shameem Reza and Farjana Liakat