Expected deaths

Worldmapper deaths Map 367

‘Expected deaths’ are the number of people who would be expected to die in each country if the only determinants of death were someone’s sex and age. In reality, many other factors affect when we will die – the place in which we live, poverty levels and education being some examples. This map shows where people would die if everyone’s life chances were dependent just on two basic biological facts (age and sex). Older populations will be expected to have more deaths, and younger populations fewer. Women are expected to live longer than men given worldwide rates. These expectations have been applied to the sex and age structure of people living in every country.

The difference between numbers of expected and actual deaths can indicate the level of inequality in life expectancies. In India there are fewer expected deaths than actual deaths; 8 million are expected, 10 million occur. This is because in India people’s lives are shorter than the world average. In the United Kingdom 1 million people would be expected to die if world average rates prevailed, whereas only 600,000 do. The United Kingdom has longer life expectancies than the world average. China also has a larger expected than actual death toll: 11.4 million deaths are expected, 8.8 million happen each year.

:.

All Deaths (All cause mortality)

GBD U000

Worldmapper deaths Map 368

The total number of deaths from every possible cause is called All cause mortality. About 57 million people died in 2002, 10.5 million (or nearly 20%) of whom were children less than 5 years of age. Of these child deaths, 98% occurred in poorer territories. Over 60% of deaths in rich territories are people over 70 years old; 30% of deaths in poorer territories are those of people over 70 years old. Apart from the deaths of children, many deaths in poorer territories are of adults aged between 15 and 59 years. Just over 30% of all deaths in poorer territories occur at these ages, compared to 20% in richer regions. This vast child and premature adult mortality in poorer territories is a major public health concern, and has both social and economic consequences.

Poorer territories are a heterogeneous group in terms of mortality. Contrasting poor territories such as China (with more than one-sixth of the world's population) with reasonable life expectancy (average 71 years) and the many very poor territories in Africa (with one-tenth of the global population) with low life expectancy (average 51 years) illustrates the extreme diversity in health conditions experienced in poorer regions. Less than 10% of all deaths in China occur below age 5 years compared with 40% in Africa. Conversely, 48% of deaths in China occur beyond age 70 years, whereas only 10% in Africa do.

All causes of death are grouped into three broad groups of causes:

• Group I

Often Preventable Deaths (Communicable, maternal, perinatal and nutritional conditions), U001 Map 371, (32% of all deaths)

These are conditions that are often easily preventable. They consist of:

1. diseases that can be spread directly or indirectly from person to person [Communicable diseases]
2. illnesses that affect women before, during and after childbirth [Maternal causes]
3. conditions arising in babies before or within one week of birth [Perinatal conditions]
4. conditions due to food, vitamin and mineral shortages [Nutritional deficiencies]

• Group II

Non-communicable diseases, U059 Map 417, (59% of all deaths):

All other diseases that are not transmitted between people.

• Group III

Injuries, U148 Map 473, (9% of all deaths):

Injuries are divided by intent into:

1. accidents [Unintentional injuries]
2. suicide, murder and war [Intentional injuries]

 

Worldwide there was an average of 9185 deaths per million people from all causes.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 27640 
2. Lesotho, 25720
3. Swaziland, 24361
4. Botswana, 23351 
5. Angola, 23253 
6. Zimbabwe, 22145 
7. Malawi, 21692 
8. Zambia, 21686 
9. Liberia, 21412
10. Niger, 21192

Population growth

Worldmapper Map 369

The population increase shown here is a measure how many more births there are than deaths. Changes to population sizes related to the movement of people are not shown. Every region of the world is experiencing overall natural increases in population size; just a few countries have natural decreases in population size.

The United Kingdom currently has more births than deaths occurring there. In recent years 645,000 people were born in the same year that 600,000 people died. Thus there was a net natural population growth of 45,000 in just one year. Part of the reason for this increase is due to improvements in health care that have resulted in longer life expectancies. Lengthening life expectancies (that is postponing deaths) has led to the current natural growth of the population of the United Kingdom – when these people do die the balance between the number of births and deaths will shift, almost certainly resulting in a natural population decline.

Population decline

Worldmapper Map 370

This map shows only natural population decreases: places where there are currently more deaths than births. Changes to population sizes due to migration are not shown here.

Only a few countries, which are mainly located in Europe, rely on immigration to maintain their populations. These countries include Sweden, Germany, Spain, Italy and Greece. Some countries are experiencing natural population declines and their population size is not maintained by the immigration, so overall they experience a real decline in numbers living there. In the Russian Federation almost 1 million more people die than are born there – this already sparsely populated country currently has the largest natural population decline, which is reflected in its large area on the map.

Given current downward fertility trends many more countries will soon appear on this map.

Group I:.

Often Preventable Deaths (Communicable, maternal, perinatal and nutritional conditions)

GBD U001

Worldmapper deaths Map 371

In rich territories, deaths from most of these conditions are much lower except for infections in the elderly. For this reason they can be considered easily preventable conditions.

These conditions are divided into (with their contribution to the total deaths in Group I in 2002):

• A. Infections [Infectious and parasitic diseases], U002 Map 372,(59% of deaths)
  These are diseases spread directly or indirectly from person to person.
• B. Respiratory infections, U038 Map 403,(22% of deaths)
  These are infections of the ears and respiratory tract.
• C. Deaths of women from pregnancy, U042 Map 407,(3% of deaths)
  These are conditions affecting women before, during and after childbirth.
• D. Deaths of Babies from Childbirth, U049 Map 408,(13% of deaths)
  These are conditions arising in babies just before or within one week of birth.
• E. Nutritional deficiencies, U053 Map 411,(3% of deaths)
  These are conditions due to food, vitamin and mineral shortages.

These conditions caused 32% of all deaths worldwide in 2002, an average of 2968 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 21488
2. Lesotho, 20776
3. Swaziland, 20580
4. Botswana, 20417
5. Zambia, 18553
6. Zimbabwe, 18380
7. Angola, 17470
8. Mozambique, 17312
9. Malawi, 17204
10. Niger, 16975

International Classification of Diseases (ICD) codes for all conditions included in category I Often Preventable Deaths (Often Preventable Deaths (Communicable, maternal, perinatal and nutritional conditions)) U001

ICD-9 codes: 001-139, 243, 260-269,279.5, 280-281,285.9, 320-323, 381-382,460-465, 466, 480-487, 614-616, 630-676,760-779

ICD-10 codes: A00-B99, G00-G04, N70-N73, J00-J06, J10-J18,J20-J22, H65-H66, O00-O99, P00-P96, E00-E02,E40-E46, E50, D50-53,D64.9, E51-64

Class I:A.

Infectious and parasitic diseases (Infections)

GBD U002

Worldmapper deaths Map 372

Infectious diseases are caused by germs (bacteria and viruses). A bacteria is a microscopic creature consisting of a single very simple cell which does not have anything complex like a nucleus inside it. A virus is a tiny microscopic infectious agent that can only increase in numbers (multiply) inside living cells of a plant or animal. Bacterial and viral infectious diseases spread directly or indirectly from person to person, for example through coughing up germs.They are all conditions that you catch.

Parasites are microscopic creatures that cause diseases, and worms, large and small, that cause diseases.

Class A, Infectious and parasitic diseases, is the sum of the following (with their contribution to the total deaths in Class A in 2002):

1. Tuberculosis, U003 Map 373, (14% of deaths).
2. HIV/AIDS, U009 Map 374, (27% of deaths).
3. Sexually transmitted diseases (but excluding HIV), U004 Map 375, (2% of deaths).
4. Diarrhoeal diseases, U010 Map 379, (17% of deaths).
5. Five illnesses prevented by standard childhood immunisations (childhood-cluster diseases), U011 Map 380, (10% of deaths).
6. Meningitis, U017 Map 386, (2% of deaths).
7. Hepatitis, U018 and U019 Maps 387 and 388, (1% of deaths).
8. Malaria, U020 Map 389, (8% of deaths).
9. Six tropical diseases, U021 Map 390, (1% of deaths).
10. Leprosy, U028 Map 396, (0.1% of deaths).
11. Dengue, UO29 Map 397, (0.2% of deaths).
12. Japanese encephalitis, U030 Map 398, (0.1% of deaths).
13. Trachoma, U031, (0.001% of deaths).
14. Four groups of intestinal worm infections, U032 Map 399, (0.1% of deaths).
15. Other infectious diseases, U037, (17% of deaths).

Of the deaths recorded here; 27% of deaths were caused by HIV/AIDS, 17% by diarrhoeal diseases , 14% by Tuberculosis, 8% by malaria, and within the childhood-cluster diseases 6% by measles and 3% whooping cough and 2% by tetanus. Also causing 2% of these deaths each, were other Sexually transmitted diseases and meningitis. All other categories were under 2% each.

These infectious and parasitic diseases caused 19% of all deaths worldwide in 2002, an average of 1766 deaths per million people. In the territory with the highest rate of deaths, Botswana, with 19642 deaths per million people, 95% were caused by AIDS. AIDS caused about 85% of deaths in the next 3 highest territories, Lesotho, Swaziland and Zimbabwe.

The ten highest rates of death per million people in 2002 were in:

1. Botswana, 19642 
2. Lesotho, 18919
3. Swaziland, 18460
4. Zimbabwe, 16411 
5. Zambia, 14713 
6. Mozambique, 13944
7. Sierra Leone, 13430 
8. Malawi, 12975 
9. Liberia, 11357
10. Central African Republic, 11261

International Classification of Diseases (ICD) codes for all conditions included in category I-A Infectious and parasitic diseases U002

ICD-9 codes: 001-139, 279.5, 320-323,614-616, 771.3

ICD-10 codes: A00-B99, G00, G03-G04, N70-N73

Section I:A1.

Tuberculosis (TB)

GBD U003

Worldmapper deaths Map 373, cases Map 228, immunisation Map 224

Tuberculosis (TB) is a disease caused by bacteria, the tubercle bacillus. TB can affect many parts of the body, but the commonest type of TB causes an infection of the lungs (pulmonary tuberculosis). It is spread from person to person by coughs and sneezes.

Another form of TB is caught from drinking milk from cows infected with tuberculosis. Its spread can be prevented by heat-treating milk (pasteurising or sterilising). This type of TB starts in the gut and often affects the bones and joints, but TB can take hold almost anywhere. When the main organ affected is not the lungs, it is referred to as extra-pulmonary TB.

Not everyone infected with tuberculosis becomes ill from it. When people do, the illness is slow and prolonged and treatment with antibiotics also has to be prolonged. Strains that are resistant to many, sometimes all, of the drugs currently available are becoming increasingly common.

HIV infection which causes AIDS seriously reduces our resistance to tuberculosis. Statistics now often record whether someone dying of tuberculosis was infected with HIV or not (called HIV sero-positive and HIV sero-negative TB cases).

In 2002 TB caused 3.5% of male deaths (table 3), 6.4% of deaths of adults aged 15 to 59 years, 1.7% of deaths of people over 60 years old (table 5), 3.3% of all deaths in poor territories and 3.6% of all deaths in very poor territories (table 4).

Global Burden of Disease estimated in 2002 TB to cause 2.9% of all Male, 1.8% of all Female, 2.4% of all Poor territory and 2.7% of all Very poor territory burden of disease (Disability Adjusted Lost Years, table 7).

TB caused 2.7% of all deaths worldwide in 2002 or 252 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Somalia, 1166 
2. Swaziland, 941
3. Afghanistan, 922
4. Timor-Leste, 905
5. Cambodia, 895 
6. Mali, 767 
7. Djibouti, 710 
8. Cote d'Ivoire, 698
9. Sierra Leone, 695
10. Zambia, 679

International Classification of Diseases (ICD) codes for all conditions included in category I-A1 Tuberculosis U003

ICD-9 codes: 010-018, 137

ICD-10 codes: A15-A19, B90

Section I:A2.

HIV/AIDS

GBD U009

Worldmapper deaths Map 374, prevalence Map 227

Deaths given this diagnosis are all due to HIV infection that has progressed to AIDS.

Acquired Immunodeficiency Syndrome, or AIDS, was first identified in 1981 in Los Angeles in the United States. In 2002 nearly 80% of the 2.6 million deaths from AIDS occurred in sub-Saharan Africa, where the disease, usually untreated, caused more than 6000 deaths every day and accounted for almost one in five of all deaths and half of the deaths of adults aged 15 to 59 years. Globally in males AIDS is second only to Illnesses of the newborn U049 Map 408, in causing lost years of healthy life, and in females it is third, after Illnesses of the newborn U049 Map 408, and Pneumonia U039 Map 404. AIDS is caused by the human immunodeficiency virus (HIV), which slowly destroys the body's defences against diseases (the immune system). When this has happened you have AIDS and certain infections and certain cancers can easily develop and easily be fatal.

AIDS is spread sexually, in semen and other genital secretions, and the person's blood is also infectious. People are infectious any time after the initial infection with HIV, long before AIDS occurs, which takes on average 10 years.

In 2002 HIV/AIDS caused 4.0% of deaths in children under 15 years, 14.1% of deaths in adults aged 15 to 59 years (table 5) and 9.6% of all deaths in very poor territories with low life expectancy (table 4c).

Global Burden of Disease estimated in 2002 AIDS to cause 5.8% of all Male, 5.7% of all Female and 9.2% of all Very poor territory burden of disease (Disability Adjusted Lost Years, table 7).

HIV/AIDS caused 5.1% of all deaths worldwide in 2002 or 469 deaths per million people. This does not include deaths due to tuberculosis in people who have HIV/AIDS.

The ten highest rates of death per million people in 2002 were in:

1. Botswana, 18708 
2. Lesotho, 16242
3. Swaziland, 15600
4. Zimbabwe, 14057 
5. Zambia, 9027
6. South Africa, 7940
7. Namibia, 7414 
8. Malawi, 7287
9. Central African Republic, 6237
10. Mozambique, 5837 

International Classification of Diseases (ICD) codes for all conditions included in category I-A2 HIV/AIDS U009

ICD-9 codes: 279.5(=042-044)

ICD-10 codes: B20-B24

 

Section I:A3.

STDs excluding HIV (Sexually transmitted diseases : STDs)

GBD U004

Worldmapper deaths Map 375

STDs stands for sexually transmitted diseases. HIV, the virus that causes AIDS, is not included in the statistics here. All STDs are mainly spread by sexual activity, often by people who have no obvious symptoms at the time, but are infectious. The diseases, described below, are the sum of (with their contribution to the total STDs excluding HIV deaths in 2002):

• a. Syphilis, U005 Map 376, (87% of deaths).
• b. Chlamydia, U006 Map 377, (5% of deaths).
• c. Gonorrhoea, U007 Map 378, (1% of deaths).
• d. Other STDs, U008 no map, (7% of deaths).

STDs caused 0.3% of all deaths worldwide in 2002 or 29 deaths per million people, not including deaths due to HIV/AIDS.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 705
2. Sao Tome and Principe, 374
3. Burkina Faso, 352
4. United Republic of Tanzania, 344
5. Liberia, 322
6. Ethiopia, 312 
7. Benin, 262
8. Niger, 222
9. Guinea-Bissau, 220
10. Cameroon, 215

International Classification of Diseases (ICD) codes for all conditions included in category I-A3 STDs excluding HIV U004

ICD-9 codes: 090-099, 614-616

ICD-10 codes: A50-A64, N70-N73

Subsection I:A3a.

Syphilis

GBD U005

Worldmapper deaths Map 376

Syphilis is a sexually transmitted disease caused by a bacteria (Treponema pallidum).

The first sign of infection is a very infectious but painless sore (primary chancre). There is usually a marked rash in the secondary stage illness, a month or two later. Two to twenty years later the brain can be affected, and also the main artery from the heart (the aorta). Both these consequences can be fatal.

Infants can catch syphilis from their mothers before birth and are then born with a condition known as congenital syphilis. They may also be born underweight.

Syphilis caused 0.3% of all deaths worldwide in 2002 or 25 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 674
2. Burkina Faso, 336
3. United Republic of Tanzania, 328
4. Ethiopia, 308 
5. Liberia, 308
6. Sao Tome and Principe, 295
7. Benin, 250
8. Niger, 212
9. Guinea-Bissau, 210
10. Cameroon, 205

International Classification of Diseases (ICD) codes for all conditions included in category I-A3a Syphilis U005

ICD-9 codes: 090-097

ICD-10 codes: A50-A53

Subsection I:A3b.

Chlamydia

GBD U006

Worldmapper deaths Map 377

Chlamydia is a sexually transmitted disease caused by a bacteria (Chlamydia trachomitis). It is the commonest cause of inflammation of the urethra (the passage urine passes through out of the bladder) that is not caused by Gonorrhoea (non-gonococcal urethritis).

In women chlamydia can infect all the pelvic organs, causing pus to collect in them and chronic pain. Damage to the fallopian tubes which connect the ovaries to the womb (uterus) can result in eggs starting to develop in the tubes instead of in the womb. This is called an ectopic pregnancy and it can kill the mother (deaths from that are counted under maternal conditions, U042). A normal pregnancy can end with the eyes of a baby, born to a mother with chlamydia, becoming infected. Untreated this can cause scarring of the eye, resulting in blindness or low vision. However chlamydia infection often makes it difficult to get pregnant and it is a common cause of infertility.

In men chlamydia can cause inflammation of the urethra (the tube inside the penis through which urine passes), but frequently they don't realize they are infected and infectious. They too can become infertile from chlamydia when the ducts that carry sperm from the testicles (testes) have been damaged by infection.

Chlamydia caused 0.02% of all deaths worldwide in 2002 or 2 deaths per million people, not including deaths due to ectopic pregnancy.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 12
2. Lao People's Democratic Republic, 10
3. Nepal, 9
4. Myanmar, 7
5. Timor-Leste, 7
6. Democratic People's Republic of Korea (North Korea), 7
7. Burkina Faso, 6 
8. Bhutan, 6 
9. India, 5
10. Maldives, 5

International Classification of Diseases (ICD) codes for all conditions included in category I-A3b Chlamydia U006

ICD-9 codes: -

ICD-10 codes: A55-A56

Subsection I:A3c.

Gonorrhoea

GBD U007

Worldmapper deaths Map 378

A sexually transmitted disease caused by a bacteria (Neisseria gonorrhoea).

In men this causes a discharge of pus from the penis due to inflammation of the urethra (the tube inside the penis through which urine passes).

In women it can infect all the pelvic organs, cause collections of pus in them and chronic pain. Damage to the fallopian tubes which connect the ovaries to the womb (uterus) can result in eggs starting to develop in the tubes instead of in the womb. This is called an ectopic pregnancy and it can kill the mother (deaths from that are counted under maternal conditions, U042). A normal pregnancy can end with the eyes of a baby, born to a mother with gonorrhoea, becoming infected. Untreated this can cause scarring of the eye, resulting in blindness or low vision. However gonorrhoea infection often makes it difficult to get pregnant and it is a common cause of infertility.

Gonorrhoea caused 0.002% of all deaths worldwide in 2002 with an average of 0.2 deaths per million people, not including deaths due to ectopic pregnancy.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 6 
2. St Lucia, 3
3. Guatemala, 3
4. Burkina Faso, 3 
5. Benin, 2
6. Egypt, 2
7. Cameroon, 2
8. Niger, 2
9. United Republic of Tanzania, 2
10. Ethiopia, 1

International Classification of Diseases (ICD) codes for all conditions included in category I-A3c Gonorrhoea U007

ICD-9 codes: 098

ICD-10 codes: A54

Subsection I:A3d.

Other STDs

GBD U008

No worldmapper map

Other sexually transmitted diseases (STDs) is a residual category of diseases which are included in Sexually transmitted diseases excluding HIV U004 Map 374, but are not included in any of the 3 sub-categories U005 to U007. They caused 7% of the deaths included in U004.

Other STDs caused 0.02% of all deaths worldwide in 2002 with an average of 2 deaths per million people

Global Burden of Disease did not give any specific data for this residual category in 2002.

International Classification of Diseases (ICD) codes for all conditions included in category I-A3d Other STDs U008

ICD-9 codes: 099, 614-616

ICD-10 codes: A57-A64, N70-N73

Section I:A4.

Diarrhoea

GBD U010

Worldmapper deaths Map 379, childhood diarrhoea Map 233, cholera deaths Map 232, cholera cases Map 231

Diarrhoea is often caused by food poisoning and by bowel (intestinal) infections. As most infections are spread by the faeces to mouth route, good sanitation and clean water and food hygiene all help to control their spread. When diarrhoea is profuse, replacement of fluid by mouth or if necessary by intravenous drip is important. Only some diarrhoeal infections respond to antibiotics.

Among the particularly nasty infections included here are ones caused by bacteria (cholera, typhoid, paratyphoid, salmonella, shigella) and microscopic single celled animals (amoeba causing amoebiasis, giardia causing giardiasis). Not every bowel infection causes diarrhoea.

Combined these diseases caused 13.2% of all deaths of children aged 0-15 years, mostly in poorer territories. When deaths occur in children with both diarrhoea and measles, or diarrhoea and lower respiratory infection, they are counted as being due to the second condition, not with diarrhoeal diseases. Counted in this way, 1.6 million children died from diarrhoeal diseases in 2002.

In 2002 Diarrhoea caused 13.2% of deaths in children under 15 years old (table 5a) and 5.5% of all deaths in very poor territories with low life expectancy (table 4c).

Global Burden of Disease estimated in 2002 Diarrhoea to cause 4.1% of all Male, 4.1% of all Female, 2.4% of all Poor territory and 5.8% of all Very poor territory burden of disease (Disability Adjusted Lost Years, table 7).

Diarrhoea caused 3.3% of all deaths worldwide in 2002 or 301 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Angola, 3699
2. Sierra Leone, 2708
3. Niger, 2193
4. Democratic Republic of Congo, 2192
5. Mali, 1802
6. Afghanistan, 1795
7. Burkina Faso, 1726
8. Malawi, 1643
9. Somalia, 1642 
10. Mozambique, 1625 

International Classification of Diseases (ICD) codes for all conditions included in category I-A4 Diarrhoeal diseases U010

ICD-9 codes: 001, 002, 004, 006-009

ICD-10 codes: A00, A01,A03, A04, A06-A09

Section I:A5.

Vaccine preventable diseases (Childhood-cluster diseases)

GBD U011

Worldmapper deaths Map 380

The conditions referred to as Childhood cluster diseases are (with their contribution to the total Section A5 deaths in 2002):

• Whooping cough, U012 Map 381, (26% of deaths).
• Polio, U013 Map 382, (0.1% of deaths).
• Diphtheria, U014 Map 383, (0.5% of deaths).
• Measles, U015 Map 384, (54% of deaths).
• Tetanus, U016 Map 385, (19% of deaths).

These are all diseases that could be virtually eliminated by universal childhood immunisation with current vaccines. A vaccine does not have to be 100% effective to make a common disease rare throughout a territory. Often if enough people are immunised, the incidence of the disease will fall and fall, and sometimes even disappear. This occurred with smallpox; one of the world's most dreaded diseases. There is a written description of it occurring in China over 3000 years ago. In 1967 it probably caused about 2 million deaths. In 1977 it was declared eradicated. This was achieved by isolating cases and their contacts and by using a vaccine which was not 100% effective and sometimes had serious side effects. No treatment or cure for smallpox had been discovered. Many people consider vaccination as one of the greatest discoveries of modern medicine.

Of the deaths recorded here; 54% of deaths are caused by measles, 26% by Whooping cough and 19% by tetanus.

Childhood-cluster diseases caused 2.0% of all deaths worldwide in 2002 or 180 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Somalia, 2139 
2. Niger, 2035
3. Guinea-Bissau, 1849 
4. Sierra Leone, 1579
5. Guinea, 1550
6. Liberia, 1548 
7. Chad, 1501
8. Nigeria, 1470 
9. Central African Republic, 1243
10. Equatorial Guinea, 1226

International Classification of Diseases (ICD) codes for all conditions included in category I-A5 Childhood-cluster diseases U011

ICD-9 codes: 032, 033, 037, 045, 055, 138, 771.3

ICD-10 codes: A33-A37, A80, B05, B91

Subsection I:A5a.

Whooping cough (Pertussis)

GBD U012

Worldmapper deaths Map 381

More commonly known as whooping cough, pertussis is an infection of the respiratory tract with a bacteria (Bordetella pertussis). It causes a prolonged illness (often over 3 months) with sudden violent coughing followed by a high pitched whoop when at last able to breathe in. This is the reason for its common name: whooping cough. Permanent lung damage (bronchiectasis) can occur. Brain damage, often due to shortage of oxygen from not being able to breathe, can cause mental handicaps. Deaths occur particularly in infants. Vaccination which is effective, started in the 1950s, but it requires a persistent high level of uptake to prevent outbreaks. In 2002 just over 50 territories reported no deaths from pertussis.

In 2002 Whooping cough caused 2.5% of all deaths of children under 15 years old (table 5a).

Whooping cough caused 0.5% of all deaths worldwide in 2002 or 47 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Niger, 472
2. Somalia, 362
3. Nigeria, 340
4. Chad, 339 
5. Democratic Republic of Congo, 335 
6. Burkina Faso, 330
7. Equatorial Guinea, 325
8. Angola, 321
9. Congo Republic, 310 
10. Guinea-Bissau, 293

International Classification of Diseases (ICD) codes for all conditions included in category I-A5a Pertussis U012

ICD-9 codes: 033

ICD-10 codes: A37

Subsection I:A5b.

Polio (Poliomyelitis)

GBD U013

Worldmapper deaths Map 382, cases Map 235

Poliomyelitis (polio) was a common illness caused by the polio virus. About half of the people who catch the infection get paralysis of a group of muscles which is permanent. This can result in a limp (lameness) or a very weak (flaccid) arm. If the muscles used for breathing are affected, it can be fatal. A vaccine for polio which is swallowed was developed in 1960, and is now used worldwide. Like many vaccines there was anxiety about its use initially, but by 2005 polio cases were reported in only 9 territories. However local anxieties about the use of the vaccine may make it difficult to eradicate completely. There is no cure for this disease. There were under 2000 new cases of polio causing paralysis in 2002, of whom about 10% died. Most of the polio deaths that year were of people who had been severely disabled by polio years before, but had eventually died because of polio's long term effects.

Poliomyelitis caused 0.0015% of all deaths worldwide in 2002 with an average of 1 death per 10 million people.

The ten highest, but actually very low, rates of death per million people in 2002 were mainly in territories where there had been no recent new polio cases for years, but people had died from the consequences of polio caught many years before:

1. Sweden, 3.0
2. Finland, 1.6
3. Denmark, 1.4
4. United States, 1.2
5. Canada, 0.9
6. Norway, 0.9
7. Luxembourg, 0.8 
8. New Zealand, 0.8
9. Switzerland, 0.7 
10. Australia, 0.6 

International Classification of Diseases (ICD) codes for all conditions included in category I-A5b Poliomyelitis U013

ICD-9 codes: 045, 138

ICD-10 codes: A80, B91

Subsection I:A5c.

Diphtheria

GBD U014

Worldmapper deaths Map 383

Diphtheria is an acute infection of the nose and throat. It is caused by a bacteria (Corynebacterium diphtheria). The bacteria produces a toxin that damages nerves, usually temporarily. Inflammation of the heart muscle can cause permanent damage to the heart and sometimes death. Diphtheria used to occur throughout the world, but especially during the colder months of the year in temperate regions, causing many deaths mainly in children under 10 years old. A vaccine against the effects of diphtheria toxin was developed in 1939, and the disease has been virtually eliminated from Europe and North America where it used to be common.

Diphtheria caused 0.01% of all deaths worldwide in 2002 with an average of 1 death per million people.

The ten highest rates of death per million people in 2002 were in:

1. Haiti, 24 
2. Sierra Leone, 9 
3. Cambodia, 8
4. Democratic Republic of Congo, 6 
5. Nepal, 5
6. Niger, 4
7. Dominican Republic, 4 
8. Angola, 4 
9. Rwanda, 4 
10. Central African Republic, 4

International Classification of Diseases (ICD) codes for all conditions included in category I-A5c Diphtheria U014

ICD-9 codes: 032

ICD-10 codes: A36

Subsection I:A5d.

Measles

GBD U015

Worldmapper deaths Map 384, immunisation Map 223

Measles is an acute, highly contagious infection with the measles virus. You get a runny nose (catarrh), fever, sore eyes (conjunctivitis) and a rash all over the body. Although complete recovery is usual in rich territories, inflammation of the brain with fits, coma and death can occur. Vaccination is highly effective at preventing the spread of measles. Due to measles vaccination: "between 1999 and 2005, there was a 60% reduction in annual measles deaths worldwide, from 873,000 to 345,000. Africa, where children were most prone to die when they caught measles because of poor nutrition and other infections including HIV, had a 75% drop in deaths. In 1999, 506,000 African children died; 90% aged under five. By 2005, the figure had fallen to 126,000...Measles eradication could conceivably be stymied not by the developing world, but by dissenters [from the vaccination programme] in rich territories such as the United Kingdom." The Guardian, 19/1/07, quoting from United Nations figures reported in the medical journal, the Lancet.

In 2002 Measles caused 6.2% of deaths in children under 15 years old (table 5a), 1.4% of all female deaths (table 3) and 2.5% of all deaths in very poor territories with low life expectancy (table 4c).

Global Burden of Disease estimated in 2002 Measles to cause 1.7% of all Male, 1.9% of all Female and 2.8% of all Very poor territory burden of disease (Disability Adjusted Lost Years, table 7).

Measles caused 1.1% of all deaths worldwide in 2002 with an average of 98 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Guinea-Bissau, 1329 
2. Somalia, 1267 
3. Niger, 1169
4. Sierra Leone, 1143
5. Guinea, 1098
6. Liberia, 1072 
7. Nigeria, 915
8. Congo Republic, 882 
9. Central African Republic, 872
10. Chad, 835

International Classification of Diseases (ICD) codes for all conditions included in category I-A5d Measles U015

ICD-9 codes: 055

ICD-10 codes: B05

Subsection I:A5e.

Tetanus

GBD U016

Worldmapper deaths Map 385

Tetanus is due to an infection with a bacteria (Clostridium tetani). This bacteria produces a toxin, tetanospasmin, which interferes with the function of some nerves. Muscles go into spasm and cannot relax. The jaw muscles are usually affected first, hence the common name Lockjaw. Even in rich territories 40% of people (80% of newborn babies) who develop tetanus can die from it.

The spores of tetanus live in faeces (particularly horse manure), soil and dust. They can get into the body through the tiniest cut. Symptoms can start between 2 and 30 days from the injury and death usually occurs within 10 days. Prior immunisation with tetanus toxoid is completely effective against the effects of tetanospasmin in the individual. Unlike the other infections here, vaccination does not reduce the risk to those who are not immunised, except the newborn who are protected when their mothers are immune. In the newborn in non sterile conditions infection can enter through the unhealed umbilicus (navel/belly button).

In 2002 Tetanus caused 1.9% of all deaths of children under 15 years old (table 5a).

Tetanus caused 0.4% of all deaths worldwide in 2002 with an average of 34 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Somalia, 508
2. Niger, 389
3. Bhutan, 375
4. Chad, 323 
5. Uganda, 308
6. Afghanistan, 293
7. Guinea-Bissau, 223
8. Nigeria, 213
9. Mali, 208 
10. Burkina Faso, 207

International Classification of Diseases (ICD) codes for all conditions included in category I-A5e Tetanus U016

ICD-9 codes: 037, 771.3

ICD-10 codes: A33-A35

Section I:A6.

Meningitis

GBD U017

Worldmapper deaths Map 386

These are a group of acute bacterial diseases of the brain which can kill, sometimes within hours, or cause some permanent brain damage. The brain damage can often affect intelligence severely: it may also cause spasticity or paralysis (where muscles do not relax or contract) of one or more limbs: it may cause recurrent epileptic fits: and it may cause long term deafness.

Several bacteria can cause meningitis and vaccines are available for some of them. Mortality and morbidity are high without fast use of appropriate antibiotics.

Meningitis is more common where there is overcrowding, poverty and malnutrition.

Meningitis caused 0.3% of all deaths worldwide in 2002 with an average of 28 deaths per million people. Meningitis due to tuberculosis is counted as tuberculosis, U003.

The ten highest rates of death per million people in 2002 were in:

1. Haiti, 739
2. Cambodia, 440 
3. Afghanistan, 362
4. Timor-Leste, 266
5. Iraq, 243 
6. Somalia, 193
7. Nauru, 180
8. Tajikistan, 177 
9. Burkina Faso, 158
10. Solomon Islands, 152 

International Classification of Diseases (ICD) codes for all conditions included in category I-A6 Meningitis U017

ICD-9 codes: 036, 320-322

ICD-10 codes: A39, G00, G03

Section I:A7.

Hepatitis

Hepatitis is an infection of the liver. The commonest form of hepatitis is hepatitis A. Hepatitis A is a common viral disease spread from faeces to hands to mouth, where hygiene (hand washing and sanitation) is poor and especially where there is overcrowding. In adults it causes fever and jaundice (yellowing of the eyes and skin), but most infections pass unnoticed in childhood. Usually there is full recovery. A vaccine exists.

Hepatitis is not a specific category in Global Burden of Disease, but Hepatitis B U018 Map 387, and Hepatitis C U019 Map 388, which are much more serious conditions than Hepatitis A, are included as two subsections of Hepatitis.

Subsection I:A7a.

Hepatitis B

GBD U018

Worldmapper deaths Map 387

Hepatitis B is an infection of the liver due to Hepatitis B virus which is spread by contact with infected blood and blood products, sexual secretions and sexual intercourse, causing fever and jaundice. Because of the mode of spread, risk groups include homosexuals and sex workers, haemophiliacs and other people with illnesses treated with blood products, health workers, intra-venous drug users, and people in some armies, in some prison and in other violent institutions. Up to 10% get chronic liver disease, sometimes leading to cirrhosis (scarring of the liver) or cancer of the liver. A vaccine exists.

Hepatitis B caused 0.2% of all deaths worldwide in 2002 with an average of 17 deaths per million people. Deaths from liver cancer and occasionally renal failure are counted separately within U065 Map 423 and within U123, no map.

The ten highest rates of death per million people in 2002 were in:

1. Nauru, 197
2. Sierra Leone, 195
3. Guinea-Bissau, 116
4. Liberia, 114
5. Haiti, 97 
6. Burkina Faso, 89
7. Mali, 64
8. Angola, 61
9. Cambodia, 60
10. Mozambique, 60 

International Classification of Diseases (ICD) codes for all conditions included in category I-A7a Hepatitis B U018

ICD-9 codes: 070.2-070.9

ICD-10 codes: B16-B19 (minus B17.1, B18.2)

Subsection I:A7b.

Hepatitis C

GBD U019

Worldmapper deaths Map 388

Hepatitis C is an infection of the liver due to Hepatitis C virus which is spread, like hepatitis B, by blood products and sexual activities. Often there is no obvious initial infection, but about 50% eventually get chronic liver disease (chronic hepatitis). About 5% get cirrhosis (scarring of the liver) of whom perhaps 15% get cancer of the liver. A vaccine exists.

Hepatitis C caused 0.09% of all deaths worldwide in 2002 with an average of 9 deaths per million people, but deaths from liver cancer are counted separately in U065.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 88
2. Guinea-Bissau, 52
3. Liberia, 51
4. Japan, 35 
5. Mali, 29
6. Thailand, 28
7. Angola, 27
8. Mozambique, 27
9. Djibouti, 27
10. Qatar, 27

International Classification of Diseases (ICD) codes for all conditions included in category I-A7b Hepatitis C U019

ICD-9 codes: -

ICD-10 codes: B17.1, B18.2

Section I:A8.

Malaria

GBD U020

Worldmapper deaths Map 389, cases Map 229

Malaria is an infectious disease caused by a microscopic single celled animal (protozoa of the genus Plasmodium). They are parasites that live in some blood sucking mosquitoes (anopheline mosquitoes). People get infected not directly by other people, but when bitten by an infected mosquito. Mosquitoes get infected when biting an infected person, and become carriers of the disease. All types of malaria cause you to become ill with high fevers; but death rates during the acute illness and the tendency to get relapses depends on the species of plasmodium. Prevention is by getting rid of the mosquito breeding grounds, and avoiding being bitten by the mosquitoes, which particularly bite at night, by using screens and insecticides, and, for travellers and pregnant women, taking preventative (prophylactic) drugs. However these drugs have side effects and are not completely effective. Over half the people in the world live in territories where the anopheline mosquitoes cannot live, and so you cannot catch malaria there. The few people recorded as having malaria in those territories caught it elsewhere.

Apart from the high fever, malaria can cause the blood to become thin (chronic anaemia), kidney damage (chronic renal failure), and brain and nerve damage (neurological sequelae). The neurological problems include difficulty walking, talking and seeing. There are about 250 million cases of malaria worldwide each year and it causes 9.3% of all deaths in children aged 0-14 years worldwide.

Global Burden of Disease estimated in 2002 Malaria to cause 2.8% of all Male, 3.2% of all Female and 5.1% of all Very poor territory burden of disease (Disability Adjusted Lost Years, table 7).

In 2002 Malaria caused 9.3% of all deaths of children under 15 years old (table 5a) and 4.4% of all deaths in very poor territories with low life expectancy (table 4c).

Malaria caused 1.6% of all deaths worldwide in 2002 with an average of 147 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Liberia, 2052 
2. Niger, 2041
3. Burkina Faso, 2037
4. Guinea, 2013 
5. Sierra Leone, 1987
6. Chad, 1964
7. Democratic Republic of Congo, 1909
8. Benin, 1904
9. Mozambique, 1838
10. Nigeria, 1810

International Classification of Diseases (ICD) codes for all conditions included in category I-A8 Malaria U020

ICD-9 codes: 084

ICD-10 codes: B50-B54

Section I:A9.

Local tropical diseases (Tropical-cluster diseases)

GBD U021

Worldmapper deaths Map 390

Tropical-cluster diseases are six conditions that are largely limited to territories in Africa and the tropical parts of South America. They are all caused by parasites that have complex life cycles, a period inside humans and a period inside insects; except Schistosomiasis which does not have a period in insects but in snails. The six conditions are (with their contribution to the total deaths within tropical-cluster diseases A in 2002):

1. Sleeping sickness [Trypanosomiasis] U022 Map 391, (30% of deaths).
2. American trypanosomiasis [Chagas' disease] U023 Map 392, (9% of deaths).
3. Schistosomiasis [Bilharzia] U024 Map 393, (28% of deaths).
4. Leishmaniasis [Espundia and kalar-azar] U025 Map 394, (32% of deaths).
5. Elephantiasis [Lymphatic filariasis] U026 Map 395, (0.3% of deaths).
6. River blindness [Onchocerciasis] U027 no map, (0.001% of deaths).
7. Tropical-cluster diseases caused 0.3% of all deaths worldwide in 2002, with an average of 25 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 314
2. Ethiopia, 235
3. United Republic of Tanzania, 233
4. Angola, 232
5. Mali, 223
6. Nigeria, 185
7. Mozambique, 171
8. Malawi,148
9. Madagascar,142
10. Guinea,137

International Classification of Diseases (ICD) codes for all conditions included in category I-A9 Tropical-cluster diseases U021

ICD-9 codes: 085, 086, 120, 125.0, 125.1, 125.3

ICD-10 codes: B55-B57, B65, B73, B74.0-B74.2

Subsection I:A9a.

Sleeping sickness (Trypanosomiasis)

GBD U022

Worldmapper deaths Map 391

Trypanosomiasis is any infection with single celled microscopic animals (protozoa), of the genus Trypanosoma. However American trypanosomiasis (Chagas' disease) U023 Map 392, is counted separately.

African Trypanosomiasis are forms of sleeping sickness caused by Tsetse fly. Tsetse flies become infected when they bite and suck blood from an infected person or other mammal. The fly's saliva infects other people when feeding on their blood.

Trypanosomiasis starts with an infected sore and a feverish illness. The earlier it is diagnosed and treated, the better the chance of recovery. The West African form affects the brain, with symptoms that can include excessive sleepiness (hypersomnolence), and can cause death in 2 or 3 years. The East African form can cause death within weeks.

Prevention is by avoiding the flies, which live in woodland; treatment of carriers of the disease; and regular preventive medication of people who must enter jungle areas where there are many tsetse flies.

Trypanosomiasis caused 0.08% of all deaths worldwide in 2002, with an average of 8 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 169
2. United Republic of Tanzania, 158
3. Ethiopia, 142
4. Mali,135
5. Nigeria, 114
6. Angola, 99
7. Madagascar, 86
8. Guinea,78
9. Malawi,69
10. Chad, 58

International Classification of Diseases (ICD) codes for all conditions included in category I-A9a Trypanosomiasis U022

ICD-9 codes: 086.3, 086.4, 086.5

ICD-10 codes: B56

Subsection I:A9b.

Chagas' disease (American trypanosomiasis)

GBD U023

Worldmapper deaths Map 392

Chagas' disease is an infection with a single celled microscopic animal (the protozoa Trypanosoma cruzi). Also known as American trypanosomiasis, Chagas' disease occurs almost exclusively in Central and South America. Chagas' disease is spread by a bloodsucking assassin bug, the barber beetle. Treatment has no effect unless given early and even then is often unsatisfactory.

Chagas' disease can damage the heart muscle and muscles in the gut sometimes 20 years after the initial infection. This can cause heart disorders and failure, and also cause internal hollow organs like the oesophagus and colon to enlarge (megaviscera). Death is more likely in children than in adults. Prevention is by killing the insects and screening blood used for transfusions, which can also spread it.

Chagas' disease caused 0.03% of all deaths worldwide in 2002, with an average of 2 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Bolivia, 104
2. Ecuador, 54
3. Guatemala, 50
4. Brazil, 48
5. Honduras, 44
6. El Salvador, 43
7. Nicaragua, 42
8. Peru, 41
9. Venezuela, 35
10. Jamaica, 17

International Classification of Diseases (ICD) codes for all conditions included in category I-A9b Chagas' disease U023

ICD-9 codes: 086.0, 086.1, 086.2, 086.9

ICD-10 codes: B57

Subsection I:A9c.

Schistosomiasis (Bilharzia)

GBD U024

Worldmapper deaths Map 393

Schistosomiasis is also called bilharzia. It is a chronic conditions caused by small flatworms (flukes) that live inside blood vessels where they lay hundreds of eggs a day. The fluke's eggs are eventually passed out in faeces or urine. They hatch in fresh water and then enter the right kind of snail. Inside the snail they develop to a further stage which is released back into the water and that subsequently can enter a person through the skin. The initial illness is due to an allergic reaction to these parasites. Within 1 to 3 months they develop into adult flukes inside the liver which then find places in the body to lay their eggs. The eggs can damage the liver or bladder and sometimes other organs. The adult flukes can live for 20 years. Treatment to kill them is usually effective if started early.

Prevention is by improved hygiene and not swimming or bathing in water where there are infected snails.

Parasite is a term for all organisms larger than bacteria and viruses that can cause disease by living inside a person, animal or plant. After malaria, Schistosomiasis is probably the most serious worldwide human parasite infection, affecting about 200 million people.

Schistosomiasis caused 0.08% of all deaths worldwide in 2002, with an average of 7 deaths per million people. But that is only death directly from schistosomiasis, and does not include estimates of deaths that may be due to schistosomiasis from subsequent bladder cancer U074 Map 432, cirrhosis of the liver U117 Map 462, or colon cancer UO64 Map 422.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 124
2. Niger, 123
3. Angola, 116
4. Egypt, 113
5. Mozambique, 112
6. Guinea-Bissau, 70
7. Malawi, 68
8. Ethiopia, 68
9. Mali, 65
10. Ghana, 65

International Classification of Diseases (ICD) codes for all conditions included in category I-A9c Schistosomiasis U024

ICD-9 codes: 120

ICD-10 codes: B65

Subsection I:A9d.

Leishmaniasis

GBD U025

Worldmapper deaths Map 394

Leishmaniasis is an infection with microscopic single celled animals (flagellate protozoa of the genus Leishmania).

These parasites are spread by the saliva of bloodsucking sandflies. They can infect various animals with backbones (vertebrates) such as humans, rodents and dogs. These animals can in turn infect other sandflies when sucking their blood.

The infection can cause sores on the skin (cutaneous leishmaniasis) which can take months to heal and is a major health problem probably affecting over 300,000 people at any time. Another form (espundia) which occurs in the Americas, can affect the inside of the mouth and throat years after the initial skin lesion has healed. A third form (kalar-azar), affects internal organs, and is usually fatal if not treated.

Leishmaniasis caused 0.09% of all deaths worldwide in 2002, with an average of 8 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Lao People's Democratic Republic, 89
2. Papua New Guinea, 53
3. Nepal, 43
4. India, 33
5. Pakistan, 30
6. Ethiopia, 25
7. Mali, 23
8. United Republic of Tanzania, 21
9. Sierra Leone, 21
10. Guinea-Bissau, 20

International Classification of Diseases (ICD) codes for all conditions included in category I-A9d Leishmaniasis U025

ICD-9 codes: 085

ICD-10 codes: B55

Subsection I:A9e

Elephantiasis (Lymphatic filariasis)

GBD U026

Worldmapper deaths Map 395

Lymphatic filariasis, which can cause elephantiasis, is an infectious disorder caused by threadlike worms (filariae). Spread by blood-sucking mosquitoes, the infective larvae take about a year to develop inside humans into adult worms. They live in the lymph glands and lymphatic vessels, especially those draining the genital area and legs. Untreated, this disease can cause massive swelling of the legs called elephantiasis because the leg of an affected person can resemble an elephant's leg. In men it can also cause a large collection of fluid (a hydrocele), in the scrotum. The adult worms also cause allergic reactions and give birth to embryos which migrate to near the skin. From there they pass into mosquitoes mixed up with their bloody meal.

Prevention is by avoiding being bitten by, and by eradicating the mosquitoe carriers.

Lymphatic filariasis caused only 0.0007% of all deaths worldwide in 2002 or an average of 1 death per 10 million people, but is included here because of the chronic disability it causes.

The highest rates of death per million people in 2002 were in:

1. Burkina Faso, 14
2. Guyana, 4
3. Trinidad and Tobago, 1

There were a few deaths in 34 other territories.

International Classification of Diseases (ICD) codes for all conditions included in category I-A9e Lymphatic filariasis U026

ICD-9 codes: 125.0, 125.1

ICD-10 codes: B74.0-B74.2

Subsection I:A9f.

River blindness (Onchocerciasis)

GBD U027

No worldmapper map

Onchocerciasis or River Blindness is an infection with threadlike worms of the genus Onchocerca, which cause skin lesions and infect the eyes. It is spread to humans by the bite of a black fly (Simulium species) which breeds on rivers. It eventually causes blindness (river blindness). Twenty years ago, in some communities in tropical Africa and tropical America 70% of the population had been infected, with 40% of those over 50 years being blind. In the early 1990s WHO estimated the prevalence of blindness due to onchocerciasis. It was endemic in 36 territories. The Onchocerciasis Control Programme in Western African territories and the introduction of population wide administration of a drug (ivermectin) in other endemic areas, dramatically reduced the prevalence of onchocerciasis and the amount of blindness from it in all 36 territories.

Virtually no deaths directly due to it worldwide in 2002, and therefore deaths are not mapped. It is included here because the disease is a major cause of blindness where it is endemic. However, deaths due to accidents due to blindness are not counted here, but are included within Unintentional injuries U149 Map 474.

International Classification of Diseases (ICD) codes for all conditions included in category I-A9f Onchocerciasis U027

ICD-9 codes: 125.3

ICD-10 codes: B73

Section I:A10.

Leprosy

GBD U028

Worldmapper deaths Map 396

Leprosy is a chronic mildly contageous disease caused by Mycobacterium leprae, a bacteria similar to that which causes tuberculosis. Leprosy affects about 12 million people in low lying, humid, tropical and subtropical areas found near the equator.

Leprosy causes skin lesions and superficial nerve damage with areas of numbness. Together these can result in deformity and loss of fingers and toes. Like tuberculosis drug treatment has to be prolonged and is complicated. Leprosy rarely causes death but untreated it causes much disability.

Leprosy caused 0.011% of all deaths worldwide in 2002, with an average of 1 death per million people.

The ten highest rates of death per million people in 2002 were in:

1. Suriname, 44
2. Malaysia, 12
3. Thailand, 9
4. Zambia, 5
5. Guinea-Bissau, 5
6. Viet Nam, 4
7. Sierra Leone, 4
8. Mozambique, 4
9. Pakistan, 3
10. Sao Tome and Principe, 3

International Classification of Diseases (ICD) codes for all conditions included in category I-A10 Leprosy U028

ICD-9 codes: 030

ICD-10 codes: A30

Section I:A11.

Dengue (Breakbone Fever)

GBD U029

Worldmapper deaths Map 397

Dengue or breakbone fever (dandy-fever) is a mosquito-borne disease caused by viruses of the family Flaviviridae. The mosquito, often the same type that causes Yellow Fever, becomes infected from biting a person who is in the first 3 days of suffering the illness. The mosquito can then spread the virus in its saliva to other people when they get bitten. The disease causes an acute illness with fever, weakness and pains. The joint and back pains give it the common name "breakbone fever". It can be fatal when it causes widespread bleeding. There is no specific treatment, and control depends on mosquito control measures, including destroying the carrier mosquitoes' breeding grounds.

Dengue caused 0.03% of all deaths worldwide in 2002, with an average of 3 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Haiti, 122
2. Suriname, 71
3. Thailand, 40
4. Philippines, 39
5. Lao People's Democratic Republic, 33
6. Bhutan, 29
7. Dominican Republic, 27
8. Honduras, 17
9. Myanmar,17
10. Nicaragua, 15

International Classification of Diseases (ICD) codes for all conditions included in category I-A11 Dengue U029

ICD-9 codes: 061

ICD-10 codes: A90-A91

Section I:A12.

Japanese encephalitis

GBD U030

Worldmapper deaths Map 398

A mosquito-borne infection caused by the Japanese Encephalitis virus. Domestic pigs and wild birds can carry the virus, which occurs mainly in Southeast Asia and Eastern Asia. Most infected people have no symptoms. In about 1 in 250 cases the virus infects the brain. The illness starts with a fever and headache. If the brain gets infected there may be convulsions (epileptic fits), paralysis (hemiparesis) and mental slowing which often leads to unconsciousness (coma). It is more often fatal in children. If not fatal it can cause long term brain damage. Territories which have had major epidemics in the past include China, Republic of Korea, Japan, Taiwan and Thailand. They have controlled it largely by widespread vaccination. The first vaccine was produced in Japan in the 1930s. The vaccine is expensive, which means that poorer countries have not been able to afford to include it in routine immunisation programmes.

Japanese encephalitis caused 0.02% of all deaths worldwide in 2002, with an average of 2 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Lao People's Democratic Republic, 23
2. Pakistan, 16
3. Timor-Leste, 13
4. Bhutan, 11
5. Papua New Guinea, 10
6. Myanmar, 7
7. Cambodia, 7
8. Nepal, 7
9. India, 7
10. Maldives, 7

International Classification of Diseases (ICD) codes for all conditions included in category I-A12 Japanese encephalitis U030

ICD-9 codes: 062.0

ICD-10 codes: A83.0

Section I:A13.

Trachoma eye infection

GBD U031

Worldmapper children affected Map 234

Trachoma is caused by a bacteria, Chlamydia trachomitis, that infects the eyes. It is spread by towels, fingers and flies, typically where it is hot, dry and dusty and the people are poor and living near their cattle. 400 million people are affected, of whom 100 million are children. Untreated, trachoma commonly results in blindness. Good water, good sanitation and regularly washing faces reduces the spread. The prevalence of blinding trachoma declines with general improvement in health and socio-economic status even without a specific trachoma control programme. Treatment of individual cases lasts 6 weeks, and where endemic the whole population can be treated less intensively with antibiotic eye ointment twice a day for 5 days each month for 6 months. Low vision and blindness caused by scarring may need surgery to correct, but such surgery is rarely available where the disease is common.

Trachoma caused under 0.0003% of all deaths worldwide in 2002. It is included here because of the chronic disability it causes. Deaths due to accidents due to blindness are counted within unintentional injuries U149 Map 474.

International Classification of Diseases (ICD) codes for all conditions included in category I-A13 Trachoma U031

ICD-9 codes: 076

ICD-10 codes: A71

Section I:A14.

Intestinal (nematode) worm infections

GBD U032

Worldmapper deaths Map 399

Intestinal nematode infections are caused by nematode worms which at some stage in their sometimes complicated life cycles live as adult worms inside the human gut (intestine). They include (with their contribution to the total deaths from intestinal nematode infections in 2002):

• a. Roundworm [Ascariasis] U033, Map 400, (29% of deaths).
• b. Whipworm [Trichuriasis] U034, Map 401, (26% of deaths).
• c. Hookworm disease (Ankylostomiasis and Uncinariasis) U035, Map 402, (25% of deaths).
• d. other intestinal worm infections UO36 no map, (20% of deaths).

Intestinal nematode worm infections caused 0.02% of all deaths worldwide in 2002, with an average of 2 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Guatemala, 94
2. Nauru, 62
3. Dominica, 30
4. Timor-Leste, 24
5. Cambodia, 22
6. Solomon Islands, 20
7. Sierra Leone, 18
8. Ethiopia,17
9. Mali, 15
10. Papua New Guinea, 13

International Classification of Diseases (ICD) codes for all conditions included in category I-A14 Intestinal nematode infections U032

ICD-9 codes: 126-129

ICD-10 codes: B76-B81

Subsection I:A14a.

Roundworms (Ascariasis)

GBD U033

Worldmapper deaths Map 400

Ascariasis is an infection caused by roundworms of the genus Ascaris (hence called Ascariasis) which occur worldwide. Ascaris lumbricoides looks like a garden earthworm. Eggs get ingested from soil contaminated with human faeces, either directly or from poorly washed raw vegetables. In a bad infection there are 20 or more worms passed in their faeces each time a person goes to toilet. Prolonged infection can delay the development of mental and motor skills in infants and temporarily impair the ability of school-age children to understand and learn. A tangle of worms can obstruct the gut and might even need surgery to be removed. There is an effective drug treatment. The spread of the infection and recurrent infection can be reduced by better hygiene, especially hand washing, and good sanitation.

Ascariasis caused 0.006% of all deaths worldwide in 2002, with an average of 0.5 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Timor-Leste, 7
2. Lao People's Democratic Republic, 7
3. Guatemala, 6
4. Ethiopia,5
5. Sao Tome and Principe, 5
6. Cambodia, 4
7. Papua New Guinea, 4
8. Swaziland, 4
9. Honduras, 4
10. Haiti, 3

International Classification of Diseases (ICD) codes for all conditions included in category I-A14a Ascariasis U033

ICD-9 codes: 127.0

ICD-10 codes: B77

Subsection I:A14b.

Trichuriasis (Whipworms)

GBD U034

Worldmapper deaths Map 401

Trichuriasis is an intestinal infections caused by whipworms. Whipworms are small worms shaped like a whip, of the species Trichuris (hence Trichuriasis). In a bad infection there are 250 or more worms passed in their faeces each time a person goes to toilet.

Trichuriasis can cause persistent diarrhoea. Prolonged infection can delay the development of mental and motor skills in infants and temporarily impair the ability of school-age children to understand and learn. There is an effective drug treatment. The spread of infection and recurrence of infection can be reduced by better hygiene, especially hand washing, and good sanitation.

Trichuriasis caused 0.005% of all deaths worldwide in 2002, with an average of 0.5 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Ethiopia, 4
2. Lao People's Democratic Republic, 3
3. Nigeria, 2
4. Pakistan, 2
5. Timor-Leste, 2
6. India, 1
7. Bhutan, 1
8. Sierra Leone,1
9. Papua New Guinea, 1
10. Malawi, 1

International Classification of Diseases (ICD) codes for all conditions included in category I-A14b Trichuriasis U034

ICD-9 codes: 127.3

ICD-10 codes: B79

Subsection I:A14c.

Hookworm disease (Ankylostomiasis and Uncinariasis)

GBD U035

Worldmapper deaths Map 402

Hookworms are tiny roundworms whose larvae can bore into the human skin. There are two types of hookworm that affect people, one type in the Eastern hemisphere (Ankylostoma duodenale causing ankylostomiasis) and the other in the Western hemisphere (Necator americanus causing uncinariasis). Both are acquired by direct skin penetration (usually of bare feet) from larvae in soil contaminated by human faeces. The larvae travel through the body to the lungs, then up towards the mouth and down into the upper intestine where they mature and can live by sucking blood. In a high intensity infection there are 80 or more worms passed in their faeces each time a person goes to toilet. Chronic infection is a major cause of shortage of blood (anaemia) because the adult worms live by sucking blood from inside the intestine. The blood shortage can sometimes be severe enough to cause heart failure. In infants development of mental and motor skills can be delayed. There is an effective drug treatment. The spread of infection and recurrence of infection can be reduced by good sanitation and wearing shoes.

Hookworm disease caused 0.005% of all deaths worldwide in 2002, with an average of 0.5 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 13
2. Mali, 13
3. Ethiopia, 8
4. Thailand, 8
5. Zambia, 7
6. Madagascar, 6
7. Guinea, 6
8. Malawi, 6
9. Gabon, 6
10. Democratic Republic of Congo, 5

International Classification of Diseases (ICD) codes for all conditions included in category I-A14c Hookworm disease U035

ICD-9 codes: 126

ICD-10 codes: B76

Subsection I:A14d.

Other intestinal worm infections.

GBD U036

No worldmapper map

Other intestinal infections is a residual category of other intestinal nematode worm infections not included in any of the categories A14a, A14b and A14c but are included in A14 Intestinal nematode infections GBD U032 Map 399.

It includes Strongyloidiasis is a type of threadworm occurring especially in the tropics and subtropics. Most people recover completely, but increasing weakness from frequent watery and bloody diarrhoea is occassionally fatal. This condition probably causes the majority of deaths and disability in this category, which also includes other threadworms and pinworms and other intestinal nematode worms.

Non-nematode worm infections are not included here. Tapeworms (cestodes) are included within A15 Other infectious diseases U037 no map. The most prevalent condition caused by flukes (trematodes) is in A9d Schistosomiasis U024 Map 393.

Together the other intestinal worm infections included here caused 0.004% of all deaths worldwide in 2002, with an average of 0.4 deaths per million people.

The ten highest rates of death per million people in 2002 were in:

1. Guatemala, 88
2. Nauru, 62
3. Dominica, 30 
4. Solomon Islands, 20
5. Cambodia, 18 
6. Timor-Leste, 15
7. St Vincent and the Grenadines, 12
8. Federated States of Micronesia, 11
9. Tuvalu, 10
10. St Lucia, 8

Global Burden of Disease did not give any specific data for this residual category in 2002, and the above figures were obtained by subtraction.

International Classification of Diseases (ICD) codes for all conditions included in category I-A14d Other intestinal [worm] infections. U036

ICD-9 codes: 127.1, 127.2, 127.4-127.9, 128, 129

ICD-10 codes: B78, B80, B81

Section I:A15.

Other infectious diseases

GBD U037

No worldmapper map

Other infectious diseases is a residual category of infectious diseases included in Infectious and parasitic diseases U002 Map 372, but are not included in any of the specific categories U003 to U036. It covers 123 broad ICD-10 code categories (International Statistical Classification of Diseases and Related Health Problems - 10th Revision).

It is everything in Global Burden of Disease's category Class I-A, Infectious and parasitic diseases, not included within Sections A1 to A14. Some infections are not included anywhere in Class I-A. Respiratory infections all come in Class I-B, Respiratory infections U038 Map 403. Infections associated with maternal conditions are included in Class I-C, Maternal conditions U042 Map 407, in Sections C2, Maternal sepsis U044 and C5, Abortion U047. Infections acquired before or just after birth are included in Class I-D, Illnesses of the newborn U049 Map 408, in Section D3, Other perinatal conditions U053.

Illnesses in the Other infectious diseases category caused 3.2% of all deaths worldwide in 2002, an average of 294 deaths per million people per year. These deaths amount to 17% of all deaths in Class I-A.

Global Burden of Disease did not give any specific data for this residual category in 2002.

International Classification of Diseases (ICD) codes for all conditions included in category I-AF Other infectious diseases U037

ICD-9 codes: 003, 005, 020-027, 031, 034, 035, 038-041, 046-049, 050-054, 056-057, 060, 062.1-066, 070.0-070.1, 071-075, 077-079, 080-083, 087-088, 100-104, 110-118, 121-124, 125.2, 125.4, 125.5, 125.6, 125.7, 125.9, 130-136, 139, 323

ICD-10 codes: A02,A05,A20-A28,A31,A32,A38,A40-A49,A65-A70,A74-A79,A81,A82,A83.1-A83.9,A84-A89,A92-A99,B00-B04,B06-B15,B25-B49,B58-B60,B64,B66-B72,B74.3-B74.9,B75,B82-B89,B92-B99, G04

Class I:B.

Respiratory infections

GBD U038

Worldmapper deaths Map 403

Respiratory infections is the sum of conditions caused by (with their contribution to the total deaths within Respiratory infections in 2002):

1. Pneumonia [Lower respiratory infections], U039 Map 404, (98% of deaths).
2. Infections of the nose and throat [Upper respiratory infections], U040 Map 405, (2% of deaths).
3. Ear infections [Otitis media], U041 Map 406, (0.1% of deaths).

Respiratory infections caused 7.0% of all deaths worldwide in 2002, an average of 647 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Burkina Faso, 4074 
2. Sierra Leone, 3750 
3. Angola, 3628 
4. Mali, 3091
5. Niger, 3024
6. Liberia, 2636
7. Zambia, 2572 
8. Chad, 2543
9. Mauritania, 2487
10. Afghanistan, 2474

International Classification of Diseases (ICD) codes for all conditions included in category I-B Respiratory infections U038

ICD-9 codes: 460-466, 480-487, 381-382

ICD-10 codes: J00-J06, J10-J18, J20-J22, H65-H66

Section I:B1.

Lower respiratory infections (Pneumonia)

GBD U039

Worldmapper deaths Map 404, influenza prevalence Map 238

Lower respiratory infections is a category that includes flu (influenza) and lung infections (pneumonia).

Influenza is an infection caused by an Influenza virus. It starts by affecting the upper respiratory tract and makes you generally ill with a fever. When fatal, it has usually progressed to also causing infection of the lower respiratory tract (pneumonia). Periodically there is a worldwide pandemic of influenza. One in 1918 probably killed 50 million people. Many of the extra deaths in an influenza epidemic are attributed to pneumonia and not specifically to influenza. For that reason it is included here within the Lower respiratory infection category, and not with Upper respiratory infections U040.

Pneumonia is an infection of the lung that can be caused by bacteria or viruses. Untreated, especially when caused by bacteria, it is often fatal. Antibiotics have dramatically reduced the number of deaths. Where appropriate treatment is available, death usually occurs only sometimes in the very young, the elderly, people with other diseases or problems such as from past smoking and/or alcoholism.

Infections can cause permanent damage to parts of the lungs, making you more prone to further infections, and impair overall lung function, making you short of breath. Pneumonia is common in the elderly and in people who are malnourished. It is also more common in people with chronic bronchitis U112, often due to smoking; and with lung damage due to working in dusty environments, especially those in mines.

In 2002 Pneumonia caused 16.8% of deaths in children under 15 years old, 2.2% of deaths in adults aged 15 to 59 years and 4.8% of deaths in people over 60 years old (table 5), 3.3% of all deaths in rich territories, 3.7% of all deaths in poor territories and 10.0% of all deaths in very poor territories (table 4).

Global Burden of Disease estimated in 2002 Pneumonia to cause 5.7% of all Male, 6.0% of all Female, 2.6% of all Poor territory and 8.5% of all Very poor territory burden of disease (Disability Adjusted Lost Years, table 7).

Pneumonia caused 6.9% of all deaths worldwide in 2002, an average was 634 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Burkina Faso, 4016 
2. Sierra Leone, 3584 
3. Angola, 3563 
4. Mali, 3015
5. Niger, 2963
6. Zambia, 2521 
7. Chad, 2511
8. Mauritania, 2460
9. Liberia, 2458
10. Malawi, 2444

International Classification of Diseases (ICD) codes for all conditions included in category I-B1 Lower respiratory infections U039

ICD-9 codes: 466, 480-487

ICD-10 codes: J10-J18, J20-J22

Section I:B2.

Nose and throat infections (Upper respiratory infections)

GBD U040

Worldmapper deaths Map 405

Upper respiratory infections include the common cold, tonsillitis and sore throats. In children a particular infection (epiglottitis), just above the windpipe can obstruct breathing and be fatal if a tube is not inserted down into the windpipe (trachea). Otherwise these very common illnesses are rarely serious unless the infection spreads to the lower respiratory tract.

Upper respiratory infections caused 0.13% of all deaths worldwide in 2002, an average of 12 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Greece, 216
2. Liberia, 164 
3. Sierra Leone, 150
4. Guinea-Bissau, 129 
5. Guatemala, 95
6. Kyrgyzstan, 95
7. Mali, 72
8. Angola, 59
9. Niger, 56
10. Lao People's Democratic Republic, 55

International Classification of Diseases (ICD) codes for all conditions included in category I-B2 Upper respiratory infections U040

ICD-9 codes: 460-465

ICD-10 codes: J00-J06

Section I:B3.

Ear infections (Otitis media)

GBD U041

Worldmapper deaths Map 406

Otitis media is an infection inside the ear caused by a bacteria. Occurring mainly in children often after catching a cold, otitis media can cause earache and temporary deafness. Sometimes treatment with antibiotics is needed. Severe recurrent infections can permanently damage the hearing mechanism. Sometimes infection gets into the nearby bone (mastoiditis) and occasionally this is a cause of meningitis U017, which can be fatal.

Otitis media caused 0.0063% of all deaths worldwide in 2002, an average of 1 death per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 16
2. Liberia, 13
3. Guinea-Bissau, 10
4. Haiti, 9
5. Angola, 7
6. Burkina Faso, 5
7. Niger, 5
8. Mozambique, 5
9. Malawi, 4
10. Sao Tome and Principe, 4

International Classification of Diseases (ICD) codes for all conditions included in category I-B3 Otitis media U041

ICD-9 codes: 381-382

ICD-10 codes: H65-H66

Class I:C.

Deaths of women from pregnancy (Maternal conditions)

GBD U042

Worldmapper deaths Map 407

Pregnancy and childbirth [Maternal conditions] are those conditions affecting women because they are pregnant, or from giving birth or shortly after, and a consequence of that.

They are the sum of:

1. Bleeding [Maternal haemorrhage], U043 no map
2. Infection [Maternal sepsis], U044 no map
3. High blood pressure [Hypertensive disorders of pregnancy], U045 no map
4. Difficulties giving birth [Obstructed labour], U046 no map
5. Conditions due to abortions and miscarriages [Abortion], U047 no map
6. Other conditions related to pregnancy, labour or immediately after [Other maternal conditions], U048 no map

Global Burden of Disease does not give the figures for these sub-categories in its 2002 data. They are described and defined individually below. However lack of satisfactory medical care before, during and giving birth (antenatal, maternity and postnatal services) increases the risks of disability and death from all these categories, as also does prior poor health in women.

In 2002 Maternal conditions caused 1.9% of all female deaths (table 3) and 3.2% of all deaths among all adults between ages 15 and 59 years (table 5).

Global Burden of Disease estimated in 2002 Maternal conditions caused 3.3% of all years living with a disability, 6.4% of all female disability (table 6). GBD also estimated it to cause 4.7% of all Female and 3.1% of all Very poor territory burden of disease (Disability Adjusted Lost Years, table 7).

Maternal conditions caused 0.9% of all deaths worldwide in 2002, an average of 82 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 955
2. Angola, 856
3. Afghanistan, 820
4. Niger, 772
5. Malawi, 721
6. United Republic of Tanzania, 589
7. Mali, 543
8. Rwanda, 507
9. Chad, 488
10. Democratic Republic of Congo, 470

International Classification of Diseases (ICD) codes for all conditions included in category I-C Maternal conditions U042

ICD-9 codes: 630-676

ICD-10 codes: O00-O99

Section I:C1.

Maternal haemorrhage

GBD U043

No worldmapper map

Maternal Haemorrhage is bleeding from the womb (uterus) at any time during pregnancy, labour and after delivery of the placenta.

In early pregnancy bleeding can be from a miscarriage. Later it can be from a mal-positioned placenta. If it occurs immediately after the baby is born, it is called a postpartum haemorrhage.

If a large amount of blood is lost, it can make the mother's blood thin (anaemic) and her short of breath, or she might even need an immediate blood transfusion to prevent her death.

Global Burden of Disease gave no data for this category in 2002.

International Classification of Diseases (ICD) codes for all conditions included in category I-C1 Maternal Haemorrhage U043

ICD-9 codes: 40, 641, 666

ICD-10 codes: O44-O46, O67, O72

Section I:C2.

Maternal sepsis

GBD U044

No worldmapper map

Sepsis means infection with bacteria. The main infection included here is one that occurs inside the womb (uterus) after the baby is born, called endometritis, which needs treatment with immediate antibiotics. Without treatment it is often fatal. If not treated promptly it can also cause infertility.

Global Burden of Disease gave no data for this category in 2002.

International Classification of Diseases (ICD) codes for all conditions included in category I-C2 Maternal sepsis U044

ICD-9 codes: 670

ICD-10 codes: O85-O86

Section I:C3.

Hypertensive disorders of pregnancy

GBD U045

No worldmapper map

Pregnancy-induced high blood pressure is serious. It can end up causing generalised seizures (eclampsia), strokes, and liver, kidney and heart failure. It is a leading cause of maternal deaths and of death and disability in babies. Good antenatal care is essential to spot risks in time. Treatment initially consists of rest and sometimes drugs, but if this is not successful the only safe thing is to bring on the birth of the baby of the baby early, by operation (Caesarian section) if necessary.

Global Burden of Disease gave no data for this category in 2002.

International Classification of Diseases (ICD) codes for all conditions included in category I-C3 Hypertensive disorders of pregnancy U045

ICD-9 codes: 645

ICD-10 codes: O10-O16

Section I:C4.

Obstructed labour

GBD U046

No worldmapper map

Obstructed labour is when the mother is trying to give birth (in labour), but the baby gets stuck, perhaps because the baby's head is large compared with the bones of the mother's birth passage. Delivery sometimes can be helped by using forceps or other mechanical assistance. If not, an operation (Caesarian section) will be necessary to extract the baby through a cut in the mothers womb and tummy. Very prolonged labours can cause complete exhaustion of the mother, and risk death of both mother and baby. If not fatal to the mother, she can be left with incontinence of faeces due to a hole between vagina and rectum (rectovaginal fistula), or incontinence of urine from a hole between the bladder and vagina. The baby can be brain damaged from a very prolonged labour.

Global Burden of Disease gave no data for this category in 2002.

International Classification of Diseases (ICD) codes for all conditions included in category I-C4 Obstructed labour U046

ICD-9 codes: 660

ICD-10 codes: O64-O66

Section I:C5.

Abortion

GBD U047

No worldmapper map

Maternal deaths due to abortions and miscarriages are counted here. Deaths of fetuses are not included. Miscarriages are unintentionally loosing the baby before 24 weeks gestation. Often the cause is not known. Deliberate abortions are the termination of unwanted pregnancies. When done by persons lacking the necessary skills or in an environment lacking the necessary standards, these "unsafe abortions" carry high risks for the mother, of infection, damage to internal organs and subsequent failure to conceive (infertility). Deaths here are sometimes from miscarriages where no medical help is available, but mostly from unsafe illegal abortions. Therapeutic abortions carried out in legal well run establishments are extremely safe procedures for the mother. In territories where the sexually transmitted diseases Chlamydia U006 Map 376, and Gonorrhoea U007 Map 377, are common and medical services are poor, deaths from ectopic pregnancy (when the fetus starts to develop outside the womb) are significant. When there is an ectopic pregnancy the fetus usually cannot survive and an immediate operation is often needed to prevent the death of the mother from internal bleeding.

Global Burden of Disease gave no data for this category in 2002.

International Classification of Diseases (ICD) codes for all conditions included in category I-C5 Abortion U047

ICD-9 codes: 630-639

ICD-10 codes: O00-O07

Section I:C6.

Other maternal conditions

GBD U048

No worldmapper map

Other maternal conditions is a residual category of all those conditions included in Maternal conditions U042 Map 407, but not included in any of the sub-categories U043 to U047.

Global Burden of Disease gave no data for this category in 2002.

International Classification of Diseases (ICD) codes for all conditions included in category I-C6 Other maternal conditions U048

ICD-9 codes: 643-659, 661-665, 667-669, 671-676

ICD-10 codes: O20-O43,O47-O63,O68-O71,O73-O75,O87-O99

Class I:D.

Deaths of Babies from Childbirth (Perinatal conditions)

GBD U049

Worldmapper deaths Map 408

(Also see Worldmapper Stillbirths Map 259, Early neonatal mortality Map 260.)

Birth problems [Perinatal conditions] are those which occur in babies from the seventh month of pregnancy until the baby is a week old (the perinatal period). For death rates here, the conditions have to start in the perinatal period. Most conditions occur just before or just after birth, but occassionally the actual death occurs after the perinatal period. This is different from perinatal mortality (Stillbirths Map 259 and Early neonatal mortality (first week deaths) Map 260) which includes all deaths from e.g. Congenital anomalies U131 Map 471, which start earlier and e.g. Tetanus U016 Map 385, which also occurs at any age, provided that each death occurs in the perinatal period.

Illnesses of the newborn are the sum of the following (with their contribution to the total Perinatal conditions deaths in 2002):

1. Low birth weight, U050 Map 409, (52% of deaths).

2. Birth Injury related deaths [Birth asphyxia and birth trauma], U051 Map 410, (29% of deaths).

3. Other perinatal conditions, U052 no map, (19% of deaths).

Apart from causing death, perinatal conditions can cause lifelong disability, such as cerebral palsy (spastic paralysis).

In 2002 Birth problems caused 20.6% of deaths of children under age 15 years (table 5a), 3.6% of all deaths in poor territories and 6.6% of all deaths in very poor territories (table 4). Death rates per million people varied from over 2000 deaths in 4 territories, to under 200 in 90 territories and under 20 in 10 territories.

Global Burden of Disease estimated in 2002 Birth problems caused 2.7% of all years spent living with a disability worldwide, 2.8% of all male and 2.6% of all female disability (table 6). GBD also estimated it to cause 6.9% of all Male, 6.2% of all Female, 5.9% of all Poor territory and 8.0% of all Very poor territory Burden of Disease (Disability Adjusted Lost Years, table 7).

Birth problems caused 4.3% of all deaths worldwide in 2002, an average of 396 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Afghanistan, 2703
2. Sierra Leone, 2640 
3. Niger, 2376
4. Somalia, 2096
5. Lao People's Democratic Republic,1679
6. Mauritania,1544
7. Mali, 1445
8. Angola, 1442 
9. Bhutan, 1378 
10. Guinea, 1355

The ten lowest rates of death per million people in 2002 were in:

• Switzerland, 19
• Monaco, 18
• Belgium, 18
• Slovenia, 18 
• Cyprus, 16
• Finland, 14
• Sweden, 12
• San Marino, 12
• Singapore, 5 
• Japan, 5 

International Classification of Diseases (ICD) codes for all conditions included in category I-D Perinatal conditions U049

ICD-9 codes: 760-779 minus 771.3

ICD-10 codes: P00-P96

Section I:D1.

Low birth weight

GBD U050

Worldmapper deaths Map 409

Small or low birthweight babies weigh below about 2500 grammes at birth. The exact figure may be adjusted for ethnic variations. Low birthweight can be due to the baby being born early (prematurity) or the baby can be growth retarded (small for the period it has been in the womb).

Causes and associations include illnesses in the mother, her smoking, her poverty and her malnutrition. Multiple pregnancies (twins etc.) also causes lower birthweights. The lower the birthweight, the higher the need for skilled medical help for the baby to survive.

The following problems can be caused by low birthweight:

Cerebral palsy where there is paralysis affecting use of arms, legs and muscles used in speech

Brain damage can also impair learning ability (mental retardation) or cause fits (epilepsy) or deafness.

Eye problems can cause blindness.

Low birth weight caused 2.22% of all deaths worldwide in 2002, an average of 204 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Afghanistan, 1493
2. Sierra Leone, 1138 
3. Lao People's Democratic Republic, 1079
4. Niger, 1024
5. Bhutan, 981
6. Somalia, 904 
7. Mauritania, 666
8. Mali, 623
9. Angola, 622
10. Nepal, 608 

International Classification of Diseases (ICD) codes for all conditions included in category I-D1 Low birth weight U050

ICD-9 codes: 764-765

ICD-10 codes: P05-P07

Section I:D2.

Birth Injury (Birth asphyxia and birth trauma)

GBD U051

Worldmapper deaths Map 410

Before birth a baby gets oxygen from its mother's placenta via the blood in the umbilical cord. After birth it gets oxygen from its own lungs by breathing. Difficulties during labour can cause a delay between the umbilical cord oxygen supply stopping and breathing starting. The baby then becomes short of oxygen (birth asphyxia). This can be immediately fatal. If not fatal, birth asphyxia can cause brain damage resulting in poor control of some muscles including in the arms, the legs and muscles used in speech (cerebral palsy or spastic paralysis). Brain damage can also impair learning ability (mental retardation) or cause fits (epilepsy) or deafness. Eye problems can cause blindness.

Birth trauma are injuries to the baby that occur during the process of birth. These can also cause brain damage by causing bleeding inside the skull and from skull fractures. The brain damage can be fatal or cause cerebral palsy (spastic paresis).

Birth asphyxia and birth trauma caused 1.3% of all deaths worldwide in 2002, an average of 116 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Sierra Leone, 1088
2. Niger, 979
3. Somalia, 864 
4. Afghanistan, 749
5. Mauritania, 636
6. Mali, 595
7. Angola, 595
8. Guinea, 559
9. Ethiopia, 513
10. Liberia, 493

International Classification of Diseases (ICD) codes for all conditions included in category I-D2 Birth asphyxia and birth trauma U051

ICD-9 codes: 767-770

ICD-10 codes: P03, P10-P15, P20-P29

Section I:D3.

Other perinatal conditions

GBD U052

No worldmapper map

Other perinatal conditions is a residual category for all those conditions included in Deaths of Babies from Childbirth (Perinatal conditions) U049 Map 408, but not included in the two sub-categories U050 and U051.

Other perinatal conditions caused 0.8% of all deaths worldwide in 2002, an average of 75 deaths per million people per year.

Global Burden of Disease did not give any specific data for this residual category in 2002.

International Classification of Diseases (ICD) codes for all conditions included in category I-D3 Other perinatal conditions U052

ICD-9 codes: 760-763, 766, 771 (minus 771.3), 772-779

ICD-10 codes: P00-P02, P04, P08, P35-P96

Class I:E.

Nutritional deficiencies (Nutrition : Sustenance)

GBD U053

Worldmapper deaths Map 411

Nutritional deficiencies are due to inadequate amounts of particular categories of food and nutrients in what you have to eat and drink. All of the conditions here involve essential nutrients without which you cannot survive. You need large amounts of protein and carbohydrates, and small amounts of minerals and vitamins. Fats are essential to obtain some vitamins from food. Nutritional deficiencies are the sum of the following (with their contribution to the total nutritional deficiency deaths in 2002):

1. Starvation [Protein-energy malnutrition], U054 Map 412, (54% of deaths).
2. Iodine deficiency, U055 Map 413, (1% of deaths).
3. Vitamin A deficiency, U056 Map 414, (5% of deaths).
4. Iron-deficiency anaemia, U057 Map 415, (28% of deaths).
5. Other nutritional disorders, U058 Map 416, (12% of deaths).

Nutritional deficiencies caused 0.85% of all deaths worldwide in 2002, an average of 78 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Sao Tome and Principe, 845
2. Mali, 834
3. Sierra Leone, 713
4. Angola, 694
5. Liberia, 621 
6. Haiti, 619
7. Afghanistan, 454
8. Guinea-Bissau, 422 
9. Burkina Faso, 365
10. Lao People's Democratic Republic, 360

International Classification of Diseases (ICD) codes for all conditions included in category I-E Nutritional deficiencies U053

ICD-9 codes: 243, 260-269, 280-281, 285.9

ICD-10 codes: D50-D53,D64.9, E00-E02, E40-E46, E50-E64

Section I:E1.

Starvation (Protein-energy malnutrition)

GBD U054

Worldmapper deaths Map 412

Protein-energy malnutrition is a basic lack of food (from famine) and a major cause of infant mortality and morbidity worldwide.

Starvation is called protein-energy malnutrition because the two most essential things food provides are protein and energy. When primarily a lack of protein in the food, the illness caused in children is called kwashiorkor. When the food supply does not provide enough energy (calories), the illness caused is called marasmus.

In marasmus there is extreme thinness (wasting), especially of the arms. In kwashiorkor you don't look so thin, partly because the body retains more fluid, but you stop growing (stunting).

Both can occur together. In both you often have a swollen tummy (distended abdomen due to fluid or gases), reduced resistance to infection, impaired learning ability (mental retardation) and are short (stunted growth). This can limit both physical and mental ability to perform many activities.

Adults are also severely affected in famines by protein-energy malnutrition, but the children usually start dying first.

Protein-energy malnutrition caused 0.46% of all deaths worldwide in 2002, an average of 42 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Mali, 647
2. Angola, 621
3. Sierra Leone, 359
4. Afghanistan, 318
5. Swaziland, 265
6. Ethiopia, 246
7. Zimbabwe, 239
8. Malawi, 220
9. Madagascar, 208
10. United Republic of Tanzania, 206 

International Classification of Diseases (ICD) codes for all conditions included in category I-E1 Protein-energy malnutrition U054

ICD-9 codes: 260-263

ICD-10 codes: E40-E46

Section I:E2.

Iodine deficiency

GBD U055

Worldmapper deaths Map 413

Iodine is essential for the thyroid gland to produce its hormone, thyroxine. People lacking thyroxine become sluggish, mentally and physically. An infant suffering from a shortage of thyroxine is called a cretin. Cretinism (congenital hypothyroidism) can cause stunted growth, severe mental impairment, deafness or even deaf-mutism, and paralysis.

In adults one of the first signs of iodine deficiency is a swelling in the neck of the thyroid gland (goitre).

Iodine occurs naturally in seafoods and can be artificially added to food products. Cases here are all due to iodine deficiency in the diet. Other causes for a failure to be able to produce thyroxine hormone are included within endocrine disorders, U080 Map 437.

Iodine deficiency caused 0.011% of all deaths worldwide in 2002, an average of 1 death per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Sao Tome and Principe, 24
2. Ethiopia, 14 
3. Somalia, 14
4. Jordan, 11
5. Pakistan, 11 
6. Rwanda, 11
7. Liberia. 10
8. Malawi, 10
9. Sierra Leone, 9
10. Guinea-Bissau, 9 

International Classification of Diseases (ICD) codes for all conditions included in category I-E2 Iodine deficiency U055

ICD-9 codes: 243

ICD-10 codes: E00-E02

Section I:E3.

Vitamin A deficiency

GBD U056

Worldmapper deaths Map 414

Vitamin A deficiency is a major cause of blindness in the tropics. The first effect of vitamin A deficiency is difficulty seeing in the dark (night blindness), but persistent severe deficiency, especially in malnourished children, causes a lack of tears, the eyes then become infected and then ulcerated. The sufferer can eventually become blind. Vitamin A is in all animal livers and in many milk products. Carotenes, in carrots and other yellow and green leafy vegetables, is converted to vitamin A in the body. Babies weaned early onto vitamin A deficient milk products, and toddlers whose diet is deficient in vegetables are at risk. Fish liver oil (cod and halibut) can be used to prevent vitamin A deficiency. However excessive amounts of vitamin A can be harmful.

Vitamin A deficiency caused 0.040% of all deaths worldwide in 2002, an average of 4 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Liberia, 231 
2. Sierra Leone, 200
3. Guinea-Bissau, 189 
4. Mali, 158
5. Sao Tome and Principe, 105
6. Niger, 85
7. Burkina Faso, 74
8. Rwanda, 64
9. Malawi, 61
10. Gambia, 60 

International Classification of Diseases (ICD) codes for all conditions included in category I-E3 Vitamin A deficiency U056

ICD-9 codes: 264

ICD-10 codes: E50

Section I:E4.

Iron-deficiency anaemia (Iron deficiency)

GBD U057

Worldmapper deaths Map 415

Iron-deficiency anaemia (anemia) is the commonest form of anaemia (shortage of blood). Specifically it is a shortage of haemoglobin, the red pigment in red blood cells that carries oxygen. The shortage makes you short of breath and feel weak and exhausted. When severe it can cause heart failure. In infants it can cause delayed mental development and impaired performance on language skills and motor skills, including co-ordination. It can reduce children's learning and thinking ability (cognitive impairment).

Iron is needed by everyone to make haemoglobin. You need more iron if you growing rapidly, pregnant, or loosing blood. Iron-deficiency anaemia occurs in many illnesses and in women from bleeding with heavy periods (menstruation).

Most of the iron in food is in a form that is poorly absorbed, but the iron in meat is absorbed better than that from plants. Individually iron-deficiency anaemia is caused by the persons particularly high need for iron, but territorially it is caused by the levels of dietary iron and lack treatment with iron supplements. In rich countries, some food products have added iron content. Good antenatal care includes giving iron supplements when needed.

Iron-deficiency anaemia caused 0.24% of all deaths worldwide in 2002, an average of 22 deaths per million people per year.

The ten highest rates of death per million people in 2002 were in:

1. Sao Tome and Principe, 502
2. Haiti, 404
3. Liberia, 155 
4. Guyana, 149
5. Lao People's Democratic Republic, 143
6. Sierra Leone, 134
7. Seychelles, 130
8. Guinea-Bissau, 127 
9. Kiribati, 117
10. Antigua and Barbuda, 110

International Classification of Diseases (ICD) codes for all conditions included in category I-E4 Iron-deficiency anaemia U057

ICD-9 codes: 280, 285.9

ICD-10 codes: D50, D64.9

Section I:E5.

Other nutritional disorders

GBD U058

Worldmapper deaths Map 416

Other nutritional disorders are those due to vitamin and mineral deficiencies, but excluding Vitamin A Deficiency U055 Map 413, and Iron Deficiency Anaemia U056 Map 414, and Iodine Deficiency U057 Map 415. It includes anaemia due to vitamin B12 and Folic acid (Folate) deficiency. Vitamin B1 (Thiamine) deficiency causes Beri-beri, Niacin (Nicotinic acid and Nicotinamide) deficiency causes Pellagra, Vitamin C (Ascorbic acid) deficiency causes Scurvy, Vitamin D deficiency causes Rickets. Mineral deficiencies include Calcium, Selenium, Zinc, Copper, Magnesium, Manganese, Chromium, Molybdenum and Vanadium deficiencies. Also included are Essential fatty acid (EFA) deficiencies. Altogether they caused 12% of the deaths included in Nutritional deficiencies U053 Map 411.

Other nutritional disorders caused 0.10% of all deaths worldwide in 2002, an average of 9 deaths per million people per year.

Global Burden of Disease did not give specific data for this residual category in 2002, and the figures were calculated from the data for the other categories.

International Classification of Diseases (ICD) codes for all conditions included in category I-E5 Other nutritional disorders U058

ICD-9 codes: 265-269, 281

ICD-10 codes: D51-D53, E51-E64

Group II:.

Non-communicable illnesses

GBD U059

Worldmapper deaths Map 417

Diseases that cannot be passed from person to person are called noncommunicable. These are diseases not directly due to infections, pregnancy and childbirth, or dietary deficiencies.

Included here, with the relative percentages of deaths in this group, Noncommunicable diseases, are

• A. Cancer [Malignant neoplasms] U060 Map 418, (21% of deaths).
• B. Other tumours [Non-malignant neoplasms] U078 Map 435, (0.4% of deaths).
• C. Diabetes mellitus U079 Map 436, (3% of deaths,).
• D. Other Endocrine and other disorders U080 Map 437, (1% of deaths).
• E. Brain disorders [Neuropsychiatric conditions excluding suicide] U081 Map 438, (3% of deaths).
• F. Eye and Ear disease [Sense organ diseases] U098 Map 449, (0.01% of deaths).
• G. Diseases of the heart and of arteries [Cardiovascular diseases] U104 Map 451, (50% of deaths).
• H. Chronic bronchitis and asthma [Respiratory diseases] U111 Map 457, (11% of deaths).
• I. Peptic ulcer etc [Digestive tract diseases], U115 Map 460, (6% of deaths).
• J. Kidney disease etc [Genitourinary tract diseases] U120 Map 464, (3% of deaths).
• K. Skin diseases U124 Map 467, (0.2% of deaths).
• L. Diseases of muscles, bones and joints [Musculoskeletal diseases] U125 Map 467, (0.3% of deaths).
• M. Birth defects [Congenital anomalies] U131 Map 471, (1% of deaths).
• N. Mouth and teeth problems [Dental conditions] U143 Map 472, (0.005% of deaths).

Note that all of the sections usually exclude any conditions directly due to infection, and all conditions due to cancer are put in section A and excluded from all the other sections.

Non-communicable diseases caused 59% of all deaths worldwide in 2002, an average of 5387 deaths per million people per year. 50% of those deaths were due to cardivascular disease U104, and 21 % due to cancer U078.

The ten highest rates of death per million people in 2002 were in:

1. Ukraine, 13890
2. Russian Federation, 13553
3. Bulgaria, 12558
4. Latvia, 12308
5. Belarus, 12285
6. Estonia, 11512
7. Hungary, 11228
8. Georgia, 11038
9. Serbia and Montenegro, 10715
10. Romania, 10393 

International Classification of Diseases (ICD) codes for all conditions included in category II Noncommunicable diseases U059

ICD-9 codes: 140-242, 244-259, 270-279 (minus 279.5),282-285 (minus 285.9), 286-319, 324-380, 383-459, 470-478, 490-611, 617-629, 680-759

ICD-10 codes: C00-C97, D00-D48,D55-D64 (minus D 64.9) D65-D89, E03-E07, E10-E16,E20-E34, E65-E88, F01-F99, G06-G98, H00-H61, H68-H93, I00-I99, J30-J98, K00-K92, N00-N64, N75-N98, L00-L98, M00-M99, Q00-Q99

Class II:A.

All cancer (Malignant neoplasms)

GBD U060

Worldmapper deaths Map 418

Malignant neoplasms are different types of cancer. Cancer is not one disease but a group of over 100 diseases that have in common the uncontrolled multiplication of abnormal cells. The human body is made up of billions of cells of many types. In a particular cancer there will be a particular type of abnormal cell. Usually cancers start with a localized tumour or swelling consisting of abnormal cells, which increases in size and spreads. Further tumours can appear away from the original site; these are called metastases. Most untreated cancers cause death within months or a few years of diagnosis. Treatment is sometimes completely successful (when there are no live cancers cells remaining), sometimes prolongs life by a number of years, sometimes just eases particular symptoms (which may be its purpose), or sometimes turns out to be ineffective in a particular case. There is often a much better chance of successful treatment if treatment is started when a cancer is still small and before it has spread anywhere (no metastases).

Cancers are allocated in the Global Burden of Disease data to 16 sections by site of origin, U061 to U076 Maps 419 to 434. A 17th section (other malignant neoplasm) covers all other sites of origin, U077.

Sometimes cancer is only diagnosed after the cancer has spread. When the origin (primary site) is not known, the deaths have been allocated within each age-sex group on a pro-rata basis to one of the first 16 seactions. Thus they are allocated to what are thought to be the most likely primary sites.

Different types of cancer vary in how they spread, how quickly they spread and how they respond to different treatments. These variations occur within the categories here, as well as between the categories.

Specific causes for cancers are often not known. Some environmental factors (occupation and where and how you live) and genetic factors are known to increase the incidence of particular types of cancer. Smoking tobacco is known to increase the incidence of many types of cancer. Genetic factors used to just mean a family history of the disease, but recently specific genes are being identified as relevant both to the likelihood of getting a specific cancer and of likely response to specific treatments.

There are geographic differences in the incidence of certain types of cancer. Within territories there are differences between the sexes, various ethnic groups, different occupations, smokers and non smokers. There are many predisposing factors which alter the risks of getting particular cancers.

Many cancers, as they spread, cause you to loose weight (cachexia) and get gradually weaker. Specific symptoms (pain and loss of function) usually depend on the actual site of the original cancer and of the secondaries from it. Without treatment dea