02434nas a2200169   4500000000100000008004100001260002300042653001900065100001600084700001500100700002100115245011700136856008600253300000800339520189200347022002502239       2021                            d  bInforma UK Limited10aRehabilitation1 aCarpenter B1 aNyirenda M1 aHanass-Hancock J00aDisability, a priority area for health research in South Africa: an analysis of the burden of disease study 2017  uhttps://www.tandfonline.com/doi/pdf/10.1080/09638288.2021.2000047?needAccess=true  a1-93 a<h2 id="_i2">Purpose</h2>

<p>Disabilities are increasing globally, which is attributed to the overall ageing of populations in affluent countries. This trend may differ in low and middle-income countries. This paper assesses the change over time in Years Lived with Disability (YLD) for South Africa and how this compares to regional and global trends.</p>

<h2 id="_i3">Materials and methods</h2>

<p>This secondary analysis of the Global Burden of Disease Study 2017 dataset describes the observed contribution of YLD to Disability-Adjusted Life Years (DALYs) per 100 000 people over the period 1990–2016, and forecast to 2030 using simple linear prediction. South African trends are compared to global and sub-Saharan African (SSA) trends to highlight the effect of HIV and policy implications.</p>

<h2 id="_i4">Results</h2>

<p>Globally, the contribution of YLD to DALYs has increased from ±21.7% in 1990 to ±34% by 2016, with high socio-demographic index countries having a higher contribution (49%). HIV, mental health, musculoskeletal, neurological, and sense organ disorders are the five main contributors to YLD in South Africa (54%). Removing the effects of HIV/AIDS and sexually transmitted infections on YLD, South Africa’s trend appears similar to the global trend, yet opposite to the SSA trend.</p>

<h2 id="_i5">Conclusion</h2>

<p>Our analysis shows there is a growing burden of disability in South Africa. Differences in trends with the regional and global patterns can be attributed to the high burden of HIV and non-communicable diseases in South Africa. Therefore, strategies are urgently needed to increase integration of disability and rehabilitation services into chronic HIV and non-communicable disease management. This calls for disability screening to identify functional limitations in routine data collection and case management.</p>
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