Trends of disability-adjusted life years for non-communicable diseases in the northern states of Peninsular Malaysia (2005-2021): Sex- and age-based analysis

Abstract

Background: Non-communicable diseases (NCD) are the major silent contributors to mortality and morbidity globally. In Malaysia, 2.5% of adults live with up to four NCD. However, long-term trend analyses and state-specific data on the NCD burden remain limited. This study assessed the burden of disease (BoD) trend of selected NCD in two northern states in Peninsular Malaysia.

Method: This was a descriptive observational study. Mortality data for cardiovascular disease (CVD), respiratory disease (RD), and diabetes mellitus (DM) were obtained from the Department of Statistics Malaysia. Hospital admission data were obtained from the Ministry of Health Malaysia, covering 2005-2021 for the states of Kedah and Kelantan. The BoD was estimated using Global Burden of Disease study methodology, which included the estimation of years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY). The descriptive findings were presented as the total DALY, DALY %, and DALY per 100,000 population, and stratified by sex and age.

Results: CVD and RD were notably increased in both states in Q4 (2017-2021). The CVD DALY % was highest in 2021 in Kelantan (14.4%) and in 2020 in Kedah (14.5%). The RD DALY % was highest in Kelantan in 2019 (6.2%) and in Kedah in 2020 (8.2%). The DM burden fluctuated over the years. The YLL component consistently exceeded the YLD for CVD and RD, while DM was YLD-driven. Males experienced a higher CVD and RD burden, while DM affected both sexes. The CVD and RD burden was highest in the elderly (>60 years), while DM affected the elderly and young adults.

Conclusion: The CVD and RD DALY increased in Q4 in both states, whereas the DM burden fluctuated across the years. These results emphasize the pressing need for sex- and age-specific interventions to mitigate the long-term effects of NCD.

Keywords: Burden of disease; cardiovascular disease; diabetes mellitus; disability-adjusted life years; respiratory disease.