Burden and Health Loss Due to Maternal Hypertensive Disorders in Ethiopia: A systematic analysis of Global Burden of Diseases, 2019.

Abstract

AbstractBackground: Worldwide, maternal hypertensive disorders complicate one in ten pregnancies. As a result of changes in the life styles of the society, currently, it is becoming a common public life encounter. However, Ethiopia lacks comprehensive and comparable maternal hypertensive disorders, caused burden and health loss to inform policy and practice.Objective: To describe the incidence and prevalence of maternal hypertensive disorders and deaths, Disability Adjusted Life Years, and Years Life Lost attributable to maternal hypertensive disorders in Ethiopia and its regional distributions from 1990 to 2019 as part of a collaborative Global Burden of Diseases, 2019 Study.Methods: The data for this study were collected from surveys, demographic surveillances, medical record reviews, health facility observations and interviews of socio-demographic, health care service utilizations, and other data sources such as case notifications, scientific literatures, and unpublished data as per the Global Burden of Diseases protocol and analysis techniques to produce national and regional estimates of maternal hypertensive disorders in Ethiopia. Cause of death ensemble modeling and Bayesian meta-regression disease modeling was employed to ascertain cause of death and morbidity. Each metric was estimated per 100,000 populations with a 95% uncertainty interval (UI).Results: In the last thirty years, in Ethiopia, the incidence of maternal hypertensive disorders among young women was raised by 52,596 cases per 100,000 populations [199,707 (95% UI 150,261-267,221) to 252,303 (95% UI 191,335-332,524)], while decreased among adolescents from 67,206 (95% UI 46,887-90,883) to 64, 622 (95% UI; 47,587-84,664) per 100,000 populations. The prevalence among women of reproductive age had increased from 94, 818 (95% UI 59,434-135,332) in 1990 to 138, 263 (95% UI 88,447-196,029) in 2019. Between 1990 and 2019, deaths attributable to maternal hypertensive disorders among adolescents and young women had increased by 1.5 and 1.17 times, respectively. In 2019, disability adjusted life years among adolescents, young women and women of reproductive age due to maternal hypertensive disorders was 8,493 (UI 95% 5,370-12,849), 21,812 (UI 95% 14,682-32,139) and 57,867 (UI 95% 41,751-79,165) respectively. The highest daily adjusted life years due to maternal hypertensive disorders had occurred among young women, 13,319 (UI 95% 8,592-19,931) which was 759 daily adjusted life years higher than 1990 whereas the young women years of life lost had increased by 169 cases. Regarding sub-national distributions, Oromia region has the highest burden and health loss due to maternal hypertensive disorders.Conclusions: Based on our finding, increasingly high new cases, prevalence and burden of maternal hypertensive disorders and significant health loss were observed in the last three decades in Ethiopia. Hence, prevention of cases, disabilities, deaths and health losses caused by maternal hypertensive disorders can be properly done by advocating lifestyle modifications with specifically designed age-specific interventions. On the top of continuing prevention efforts with newly devised magnesium sulphate administration in the new ANC initiative of the ministry, contextualized, need based, localized, and targeted interventions could be reconstituted. [Ethiop. J. Health Dev. 2023;37 (SI-2)]Keywords: Maternal hypertensive disorders, Global Burden of Diseases, Incidence, Prevalence, Deaths, Disability Adjusted Life Years, Years Lived with Disability, Years Life Lost, Ethiopia.