Comparison of calculated DALY rates per 100,000 population and statistic data on the prevalence of epilepsy (per 100,000 persons) shows that more “problematic” regions are in Zone IV (Nenets Autonomous Okrug, the Sakha Republic). It supports the need to pay more attention to the regions of Zone IV and it can serve as an incentive for additional epidemiological, social and economic research. GDP loss depends on GDP per capita. The city of Moscow is the leader in this list (expected loss – 241 million USD in 2018).
However, the value of DALY per 100,000 people for the capital of Russia ranks 66th out of 83 subjects of the Russian Federation. The similar situation can be seen in St. Petersburg, the Republic of Tatarstan and other regions. This means we cannot only focus at the regions of Zone IV.
Economic Aftermaths of Epilepsy
To calculate the economic aftermaths, we used DALY (Disability-Adjusted Life Year) metric, developed by Harvard University for the World Bank and widely used by public health institutions, including WHO.
It has been used to calculate the burden of disease and economic consequences. For a disease or health condition, DALY metric is calculated as the sum of the Years of Life Lost (YLL) due to premature mortality in the population and the Years Lost due to Disability (YLD) for people living with the health condition or its consequences.
DALY does not take the population density into account. Thus, a direct comparison of absolute metric values between different regions within the Russian Federation, or between the Russian Federation and other countries is incorrect. For these purposes, DALY per 100,000 population is a proper metric to use:
DALY in developed countries 205–308 per 100 000 population
DALY in Russian Federation 183 per 100 000 population
Comparison of statistical data on the prevalence of epilepsy types, percentage of deaths in different age groups, and the severity of the disease (according to WHO) allowed calculating that for every region DALY is formed from generalized epilepsy (91.9%) and partial epilepsy (8.1%).
DALY rates in Russia
According to the calculations made, the most challenging territories that have highest DALY values among the employable population (per 100,000 population), are the major part of the Northwestern Federal District (in particular 483.9 — Nenets Autonomous Okrug), partially the Volga and the Siberian Federal Districts (in particular 336.0 — Perm Krai; 381.0 — the Tyva Republic), the Far Eastern Federal District (with the highest record in Russia 637.0 — the Sakha Republic), the North Caucasus Federal District (with the highest 283.6 — the Chechen Republic), and other regions of this district (120 — 130). More favorable situation is in the Central and the South Federal Districts with the lowest DALY rates in Russia: 70–80 (e.g. Kursk, Ryazan, Tambov, Volgograd regions and others).
DALY in Russia increases by 3-4K years annually due to epilepsy. According to estimates, Russian working-age adult citizens who are epileptics, combined, will “lose” more than 268K years of their life due to disability and / or premature death in 2018.
GDP loss in Russia
GDP loss is defined as the potential GDP volume, underproduced due to premature death and/or disability of the epileptic population. GDP losses per region in the Russian Federation were estimated using WHO recommended formula:
GDP loss per federal districts in Russia
It is expected that in 2018 the following regions will face the greatest GDP losses due to epilepsy prevalence: Moscow (241 million USD), Khanty-Mansi Autonomous Okrug (93 million USD), Saint Petersburg, and the republics of Tatarstan and Sakha (70 to 80 million USD each)
Of total underproduced GDP, one forth accounts for the Central Federal District, and one fifth – for Volga and Ural federal districts each.
Salomon JA et al., Lancet, 2013
World Health Organization. Report 2016
Moseyko E. E., 2013