[Trends of mortality caused by infectious diseases in Cartagena de Indias, Colombia, 1995-2000: a measure of the epidemiological transition].

OBJECTIVES

Mortality is a definition of, strictly populational nature, different from the concepts of death and decease which reflect the loss of an individ ual biological life. Therefore, mortality expresses the dynamics of deaths along time and space, and only allows for comparisons at this level. Th present study was aimed at describing the tendency of mortality caused b infectious diseases in Cartagena de Indias, Colombia, during the perio 1995-2000, with the purpose of evidencing the epidemiological transition.

MATERIALS AND METHODS

The databases of the mortality registers of Cartagena de Indias between 1995 and 2000 were taken as reference. The im pact of mortality was measured by the sum of Years of Potential Life Lost (YPLL) for each group of death causes. To adjust for the temporal preference for the assessment of YPLL a discount rate of 3% was applied in this study. The computerized GESMOR application was used for estimating YPLL, analyzing the mortality reported in the registers using the 9th and 10th versions of the International Classification of Diseases (ICD) to establish the basic causes of death.

RESULTS

A mean of 3,506 annual deaths occurred during the period studied, generating on average 60,311 YPLL, which gives a rate of 71.5 YPLL per 1000 inhabitants. This represents a 16% increase which can be explained by an increase in the number of deaths in the lower age groups. For 1995, there was a predominance of group II non-infectious diseases causes (41.9%), followed by group I (30.2%). For the year 2000, the proportional distribution of mortality between the different groups of causes changed, causes in group I constituting the main explanation for causes of YPLL (52.9%). Non-infectious diseases occupied the second place (31.2%). These changes can be explained by the importance of perinatal causes of death, which increased from 14.2% of YPLL in 1995 to 32.7% in 2000.

DISCUSSION

It is evident that the greater weight of infectious, maternal, perinatal and nutritional diseases, the slower then the national average decrease in child mortality rates, the greater load of mortality in the male sex, the stability of the group of accidents and injuries at the expense of intentional injuries during the period studied, have caused a stagnation of the epidemiological transition and the instauration of the prolonged polarized model.