Money value of the DALY lost in Mauritius in 2017
In 2017, Mauritius lost a total of 402,565 DALY from all causes with a monetary value of Int$ 9,564,741,771. Of which, Int$7,928,861,951 (82.9%) resulted from NCD; Int$ 973,387,357 (10.2%) from CMNND; and Int$662,492,462 (6.9%) to INJ. About Int$6,052,204,025 (63%) of the monetary value DALY lost occurred among the 15-64 years old, i.e. the most productive age bracket (see Figure 2). Additional File 2 presents the DALY lost in Mauritius in 2017 from all causes and their monetary values in 2019 purchasing power parity (or Int$).
Communicable, maternal, neonatal and nutritional diseases
Out of the Int$973.4 million from CMNND, 12.4% resulted from HIV/AIDS and sexually transmitted infections; 20.7% from respiratory infections and tuberculosis; 6.9% from enteric infections; 9.9% from neglected tropical diseases; 4.9% from other infectious diseases; 28.6% from maternal and neonatal disorders; and 16.5% from nutritional deficiencies. Figure 3 presents the money value of DALY lost from CMNND. About 77.2% of the monetary value was for DALY lost from neonatal disorders, lower respiratory infections, dietary iron deficiency, HIV/AIDS and schistosomiasis alone.
HIV/AIDS and sexually transmitted infections: The money value of DALY lost from HIV/AIDS and sexually transmitted infections (STI) was Int$121,135,767. HIV/AIDS and STI (excluding HIV) accounted for 93.7% and 6.3%, respectively.
Respiratory Infections and TB: The respiratory infections and TB caused a DALY loss valued at Int$201,568,464. Out of which, 7.8% was from TB, 79% from lower respiratory infections, 10.5% from upper respiratory infections, and 2.7% from otitis media.
Enteric infections: The enteric infections bled DALY with a value of Int$ 66,997,219. Out of that, 98.5% was from diarrheal diseases, 0.06% from typhoid and paratyphoid, 1.4% from invasive non-typhoidal salmonella (iNTS), and 0.1% from other intestinal infectious diseases.
Neglected tropical diseases (NTD): Table 2 shows the distribution of monetary values of DALY lost from the various NTDs. The NTDs led to a DALY loss valued at Int$ 96,352,531. Schistosomiasis and cysticercosis accounted for 87.2% of the monetary value of DALY lost from NTDs.
Table 2: Monetary value of DALYs lost from NTDs (2019, Int$ or PPP)
|
Causes
|
Monetary value in Int$
|
Percent
|
Schistosomiasis
|
75,202,993
|
78
|
Cysticercosis
|
8,845,830
|
9.2
|
Dengue
|
5,080,425
|
5.3
|
Intestinal nematode infections
|
425,214
|
0.4
|
Leprosy
|
379,126
|
0.4
|
Rabies
|
1,659
|
0
|
Other neglected tropical diseases
|
6,417,284
|
6.7
|
Total
|
96,352,531
|
100
|
Other infectious diseases: Table 3 shows other infectious diseases caused a DALY loss valued at Int$47,730,413. About 69% of monetary value was attributed to DALY lost from meningitis, encephalitis and acute hepatitis.
Table 3: Monetary value of DALYs lost from other infectious diseases (2019, Int$ or PPP)
|
Causes
|
Monetary value in Int$
|
Percent
|
Meningitis
|
12,122,304
|
25.4
|
Encephalitis
|
10,858,597
|
22.7
|
Acute hepatitis
|
9,990,314
|
20.9
|
Varicella and herpes zoster
|
1,981,210
|
4.2
|
Whooping cough
|
232,712
|
0.5
|
Measles
|
189,082
|
0.4
|
Tetanus
|
21,990
|
0.0
|
Diphtheria
|
2,484
|
0.0
|
Other unspecified infectious diseases
|
12,331,721
|
25.8
|
Total
|
47,730,413
|
100.0
|
Maternal and neonatal disorders: Table 4 portrays the monetary value of DALY lost from maternal and neonatal disorders.
Table 4: Monetary value of DALYs lost from maternal and neonatal disorders (2019, Int$ or PPP)
|
Maternal disorders
|
Monetary value in Int$
|
Percent
|
Maternal haemorrhage
|
576,769
|
6.3
|
Maternal sepsis and other maternal infections
|
1,051,918
|
11.5
|
Maternal hypertensive disorders
|
484,637
|
5.3
|
Maternal obstructed labour and uterine rupture
|
154,120
|
1.7
|
Maternal abortion and miscarriage
|
1,995,255
|
21.8
|
Ectopic pregnancy
|
194,042
|
2.1
|
Indirect maternal deaths
|
2,583,137
|
28.3
|
Late maternal deaths
|
340,510
|
3.7
|
Maternal deaths aggravated by HIV/AIDS
|
13,076
|
0.1
|
Other maternal disorders
|
1,746,967
|
19.1
|
Neonatal disorders
|
|
|
Neonatal preterm birth
|
144,497,683
|
53.6
|
Neonatal encephalopathy due to birth asphyxia and trauma
|
47,985,914
|
17.8
|
Neonatal sepsis and other neonatal infections
|
43,341,151
|
16.1
|
Haemolytic disease and other neonatal jaundice
|
1,737,966
|
0.6
|
Other neonatal disorders
|
32,166,138
|
11.9
|
These disorders resulted into a total DALY loss valued at Int$ 278,869,282. About Int$9,140,430 (3.3%) was attributed to maternal disorders; of which 61.6% was from indirect maternal deaths, maternal abortion and miscarriage, and maternal sepsis and other maternal infections. Neonatal disorders accounted for Int$269,728,852 (96.7%); out of which 71.4% was from neonatal preterm birth and neonatal encephalopathy due to birth asphyxia and trauma.
Nutritional deficiencies: The nutritional deficiencies resulted in a DALY loss valued at Int$1,340,157,975. Out of which, 83.1% was attributed to DALY lost from dietary iron deficiency, 10% from protein-energy malnutrition, 3.7% from vitamin A deficiency, 1.5% from iodine deficiency, and 1.7% from other nutritional deficiencies.
Non-communicable diseases
As alluded to earlier, the NCDs combined caused a loss of 333,713.26 DALY, with a monetary value of about Int$ 7.93 billion. We present below the contributions of different groups of NCDs to that monetary value.
Neoplasms: Figure 4 depicts the monetary value of DALY lost form neoplasms (or cancers) was Int$843,622,095, i.e. 10.6%. About half of the monetary value was from breast cancer, colon and rectum cancer, stomach cancer, leukaemia, and tracheal, bronchus, and lung cancer. Of the Int$33.97 million value of DALY lost due to liver cancer, 32.8% was from liver cancer due to hepatitis B, 26.2% from liver cancer due to hepatitis C, 25.4% from liver cancer due to alcohol use, 10.2% from liver cancer due to NASH (non-alcoholic steatoHepatitis), and 5.4% from liver cancer due to other causes. Of the Int$42.41 million DALY worth lost from leukaemia, 11.1% was from acute lymphoid leukaemia, 1.4% from chronic lymphoid leukaemia, 21.4% from acute myeloid leukaemia, 4.6% from chronic myeloid leukaemia, and 61.5% from other leukaemia.
Cardiovascular diseases: Figure 5 displays the monetary value of DALY lost from cardiovascular diseases was Int$1,704,386,581. Around 89.5% of that financial value was from ischemic heart disease, stroke and hypertensive heart disease. Of the Int$543.4 million value of DALY lost due to stroke, 52.1% was from intracerebral haemorrhage, 36.1% from ischemic stroke, and 11.8% from subarachnoid haemorrhage.
Chronic respiratory diseases: The DALY lost from chronic respiratory diseases had a monetary value of Int$393,895,127; out of which 55.8% was from chronic obstructive pulmonary disease; 0.1% from pneumoconiosis; 30.9% from asthma; 8.4% from interstitial lung disease and pulmonary sarcoidosis; and 4.8% from other chronic respiratory diseases.
Digestive diseases: Figure 6 portrays the monetary value of DALY lost from digestive diseases was Int$291,807,418. Cirrhosis and other chronic liver diseases, upper digestive system diseases and pancreatitis made up 86.9% of the monetary value of DALY lost from digestive diseases.
Neurological disorders: The DALY lost from neurological disorders had a value of Int$482,770,731; out of which 45.8% was from headache disorders, 29.3% from Alzheimer's disease and other dementias, 15.1% from epilepsy, 5.3% from Parkinson's disease, 0.3% from multiple sclerosis, 0.5% from motor neuron disease, and 3.7% from other neurological disorders.
Mental disorders: Figure 7 shows the monetary value of DALY lost from mental disorders was Int$482,912,628. The depressive disorders, anxiety disorders and Schizophrenia accounted for 70.2% of that monetary value.
Substance use disorders: The DALY lost due to substance use disorders had a monetary value of Int$175.72 million. The drug use disorders led to a loss of DALY valued at Int$62.44 million, of which 46.2% were from opioid use disorders, 13.8% from amphetamine use disorders, 3.6% from cannabis use disorders, 0.5% from cocaine use disorders, and 35.9% from other drug use disorders.
Diabetes and kidney diseases: The DALY lost from diabetes and kidney diseases had a monetary value of Int$2,022,634,430. Out of that, diabetes mellitus accounted for Int$1.37 billion (67.7%), which in turn was made up of 12.9% type 1 diabetes mellitus and 87.1% of type 2 diabetes mellitus.
The chronic kidney disease was responsible for DALY with a monetary value of Int$653.8 million (32.3%). Of which, 32.6% was attributed to chronic kidney disease due to diabetes mellitus type 2; 23.8% to chronic kidney disease due to hypertension; 12.5% to chronic kidney disease due to diabetes mellitus type 1; 11.3% to chronic kidney disease due to glomerulonephritis; and 19.8% to chronic kidney disease due to other unspecified causes.
Skin and subcutaneous diseases: Figure 8 portrays that DALY lost from skin and subcutaneous diseases were worth Int$196,821,441. About 62.2% was attributed to dermatitis, scabies, psoriasis and fungal skin diseases.
Sense organ diseases: The DALY lost from sense organ diseases had a monetary value of Int$ 334,396,273. Out of that, 55.1% was from age-related and other hearing lost, 41.5% was from blindness and vision impairment, and 3.4% from other sense organ diseases.
Musculoskeletal disorders: The DALY lost from musculoskeletal disorders had a value of Int$632,983,114. Nearly, 45.9% of the monetary value was attributed to low back pain; 16.7% neck pain; 8.1% to osteoarthritis; 1.2% to rheumatoid arthritis; 1% to gout; and 27.1% to other musculoskeletal disorders.
Other non-communicable diseases: Figure 9 shows that other NCDs resulted to DALY lost with a monetary value of Int$366,916,157. Out of which, 39.0% was from congenital birth defects; 23.4% from oral disorders; 12.2% from gynaecological diseases; 8.2% from endocrine, metabolic, blood, and immune disorders; 8.1% from haemoglobinopathies and haemolytic anaemias; 7.1% from urinary diseases and male infertility; and 1.9% from sudden infant death syndrome.
Injuries
Figure 10 shows the money value of DALY lost from various forms of injuries was Int$662,492,462. About 35.9% was attributed to transport Injuries; 36.0% to unintentional injuries; and 28.0% from self-harm and interpersonal violence.
Transport injuries: The transport injuries caused a DALY loss valued at Int$238,076,901, i.e. 35.9%. Road injuries resulted in a DALY loss valued at Int$216,339,017, i.e. 90.9% of monetary value related to transport injuries. Other transport injuries caused a DALY loss valued at Int$21,737,884, i.e. 9.1% of monetary value related to transport injuries.
Unintentional injuries: The money value of DALY lost from unintentional injuries was Int$238,783,290. Out of which, 27.3% emanated from falls; 20.9% from drowning; 16.3% from adverse effects of medical treatment; 12.3% from fire, heat, and hot substances; 10.5% from foreign body; 5.3% from exposure to mechanical forces; 1.9% from poisonings; 0.7% animal contact; 0.7% from environmental heat and cold exposure; 0.1% from exposure to forces of nature; and 4.1% from other unintentional injuries. Therefore, 76.7% of the unintentional injuries was attributed to falls, drowning, adverse effects of medical treatment, and fire, heat, and hot substances.
Self-harm and interpersonal violence: Self-harm and interpersonal injuries caused a DALY loss worth Int$185,632,271. Of which, 73% from self-harm, 26.9% from interpersonal violence, and 0.1% from executions and police conflict.
Expected monetary value of DALY lost in 2030
Table 5 shows the monetary value of DALY lost in 2017, monetary value of DALY lost in 2030, and potential savings from DALY lost prevented assuming the five disease-related SDG3 targets are attained.
Table 5: Money value of DALYs lost distributed by SDG health conditions (Int$ or PPP)
|
Health condition/diseases
|
(A). Money Value of DALYS lost in 2017 (Int$)
|
(B). Money Value of DALYS lost in 2030 (Int$)
|
(C). Reduction/Savings in Money Value of DALYS lost in 2030 (Int$) [C=A-B)]
|
SDG 3.1: Maternal disorders
|
9,140,430
|
7,070,899
|
2,069,531
|
SDG 3.2: Neonatal disorders
|
269,728,852
|
202,296,639
|
67,432,213
|
SDG 3.3: Tuberculosis
|
15,742,571
|
1,574,257
|
14,168,314
|
SDG 3.3: HIV/AIDS
|
113,516,975
|
51,598,625
|
61,918,350
|
SDG 3.3: Acute hepatitis
|
9,990,314
|
3,840,263
|
6,422,345
|
SDG 3.3: NTDs (a+b..+l)
|
96,352,531
|
24,088,133
|
72,264,398
|
(a). Schistosomiasis
|
75,202,993
|
18,800,748
|
56,402,245
|
(b). Intestinal nematode infections
|
425,214
|
106,304
|
318,911
|
(c). Cysticercosis
|
8,845,830
|
2,211,458
|
6,634,373
|
(d). Dengue
|
5,080,425
|
1,270,106
|
3,810,319
|
(e). Rabies
|
1,659
|
415
|
1,244
|
(f). Leprosy
|
379,126
|
94,782
|
284,345
|
(h). Other neglected tropical diseases
|
6,417,284
|
1,604,321
|
4,812,963
|
SDG 3.4: Non-communicable diseases (a+b+c+..+l)
|
7,928,861,952
|
5,285,934,398
|
2,642,927,554
|
(a). Neoplasms
|
843,622,095
|
562,417,542.07
|
281,204,553
|
(b). Cardiovascular Diseases
|
1,704,386,581
|
1,136,263,401.96
|
568,123,179
|
(c) Chronic respiratory diseases
|
393,895,127
|
262,598,064
|
131,297,063
|
(d). Digestive diseases
|
291,807,418
|
194,539,251
|
97,268,167
|
(e).Neurological Disorders
|
482,770,731
|
321,848,763
|
160,921,968
|
(f). Mental Disorders
|
482,912,628
|
321,943,362
|
160,969,266
|
(g). Substance Use Disorders
|
175,715,957
|
117,144,557
|
58,571,400
|
(h). Diabetes and Kidney Diseases
|
2,022,634,430
|
1,348,429,695
|
674,204,735
|
(i). Skin and Subcutaneous Diseases
|
196,821,441
|
131,214,950
|
65,606,491
|
(j). Sense Organ Diseases
|
334,396,273
|
222,931,963
|
111,464,310
|
(k). Musculoskeletal Disorders
|
632,983,114
|
421,990,853
|
210,992,261
|
(l).Other non-communicable diseases
|
366,916,157
|
244,611,994
|
122,304,163
|
SDG 3.6: Transport injuries
|
238,076,901
|
119,038,451
|
119,038,451
|
TOTAL (INT$)
|
8,681,410,526
|
5,695,441,665
|
2,986,241,156
|
The DALY lost from the five SDG3 health conditions (maternal disorders, neonatal disorders, TB, HIV/AIDS, acute hepatitis, NTD, NCD and injuries) in 2017 were valued at Int$8,681,410,526. Assuming that the five SDG3 targets (3.1, 3.2, 3.3, 3.4 and 3.6) are fully achieved by 2030, there would still be DALY losses valued at Int$5,695,441,665. Therefore, the reduction/savings in money value of DALY lost by 2030 would be Int$2,986,241,156.