van der Lubbe, Stephanie C C and Chong, Lin Siew and Hay, Simon I and Bisignano, Catherine and James, Spencer L and Dai, Xiaochen and Goh, Lay Hoon and Acharya, Swetha and Adnani, Qorinah Estiningtyas Sakilah and Ahmed, Naveed and Aji, Budi and Almazan, Joseph Uy and Antonio, Carl Abelardo T and Anwar, Sumadi Lukman and Aslam, Muhammad Shahzad and Baig, Atif Amin and Bermudez, Amiel Nazer C and Bitar, Ahmad Naoras Naoras and Cenderadewi, Muthia and Chen, Hana and Chew, Nicholas WS and Chong, Bryan and Dalakoti, Mayank and Edinur, Hisham Atan and Estrada, Crystal Amiel M and Faraon, Emerito Jose Aquino and Fauk, Nelsensius Klau and Fitriana, Ida and Fridayani, Ni Kadek Yuni and Garcia, Fernando Barroga and Hargono, Arief and Has, Eka Mishbahatul Marah and Hernandez, Paul Michael Rafa and Ismail, Nahlah Elkudssiah and Jaiswal, Vikash and Jamora, Roland Dominic G and Jonas, Jost B and Kanmodi, Kehinde Kazeem and Khaing, Inn Kynn and Kim, Yun Jin and Kua, Chong-Han and Kurniasari, Maria Dyah and Kusnali, Asep and Kusuma, Dian and Lam, Hilton and Lee, Shaun Wen Huey and Ma, Zheng Feei and Marzo, Roy Rillera and Musa, Kamarul Imran and Nainu, Firzan and Ningrum, Dina Nur Anggraini and Ong, Sok King and Pepito, Veincent Christian Filipino and Porntaveetus, Thantrira and Pribadi, Dimas Ria Angga and Ramazanu, Sheena and Roy, Bedanta and Samodra, Yoseph Leonardo and Selvaraj, Siddharthan and Shaharudin, Shazlin and Sinto, Robert and Solikhah, Solikhah and Sreeramareddy, Chandrashekhar T and Subramaniyan, Vetriselvan and Sukaew, Thitiporn and Tarigan, Ingan Ukur and Ticoalu, Jansje Henny Vera and Venketasubramanian, Narayanaswamy and Wiangkham, Taweewat and Wicaksana, Anggi Lukman and Yi, Siyan and Younis, Mustafa Z and Murray, Christopher J L and Ong, Kanyin Liane and Lim, Yee Wei and Ng, Marie (2025) The epidemiology and burden of injury in countries of the Association of Southeast Asian Nations (ASEAN), 1990–2021: findings from the Global Burden of Disease Study 2021. The Lancet Public Health, 10 (6). e456. ISSN 24682667
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Abstract
Background Injuries are among the top causes of mortality and disability in southeast Asia. Although injury prevention
is a key health priority in the Post-2015 Health Development Agenda of the Association of Southeast Asian Nations
(ASEAN), the focus was placed solely on road injuries. The absence of a broader recognition of injury burden and
trends hinders future intervention efforts. This study aims to provide a comprehensive analysis of the burden and
epidemiological trends of all injuries across ASEAN countries.
MethodsIn this analysis of the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021, we estimated
incidence, cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age, sex, location, and year for ten ASEAN member states (Brunei, Cambodia, Indonesia,
Myanmar, Laos, Malaysia, the Philippines, Singapore, Thailand, and Viet Nam) from 1990 to 2021. Incidence and
non-fatal disease burden were estimated using disease model Bayesian meta-regression (DisMod-MR) 2.1. Mortality
was derived from the GBD Cause of Death Ensemble model. Estimates include 95% uncertainty intervals where
appropriate.
Findings In 2021, an estimated 35·5 million (95% UI 33·5–37·7) injury incident cases were reported in ASEAN,
resulting in approximately 317000 deaths (286000–350 000). Substantial variation was observed across the region,
with the age-standardised mortality ranging from 13·4 per 100 000 people (12·7–14·1) in Singapore to 68·5 per
100000 (54·4–81·9) in Viet Nam. Road injury was the leading cause of mortality and morbidity in most ASEAN
countries, with the highest age-standardised DALY rates in Thailand and Malaysia. Self-harm was the leading cause
of mortality in Singapore, whereas interpersonal violence was the leading cause of injury deaths in the Philippines.
From 1990 to 2021, the region’s age-standardised injury incidence rate declined by 23·0% (21·8–24·1). Agestandardised DALY rates decreased substantially for drowning (60·6% [53·2–66·7]) and road injuries (39·6% [32·1–46·4]), whereas falls saw a smaller and more heterogeneous decline of 12·3% (2·6–21·0) over the past
31 years.
Interpretation The injury epidemiological landscape in ASEAN is complex, with substantial geographical variations
and emerging challenges triggered by the rapid sociodemographic transition in the region. Progress has been uneven. Effective burden reduction across different causes of injury requires strategies addressing the wide range of
socioenvironmental determinants and system shortfalls. Prevention programmes need to be customised to each
country’s unique context and development.
| Item Type: | Article |
|---|---|
| Subjects: | Veterinary Medicine |
| Divisions: | Faculty of Veterinary Medicine |
| Depositing User: | Erlita Cahyaningtyas Cahyaningtyas |
| Date Deposited: | 30 Jun 2025 05:12 |
| Last Modified: | 30 Jun 2025 05:12 |
| URI: | https://ir.lib.ugm.ac.id/id/eprint/19330 |
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