Santo Augusto Hasiak
Department of Epidemiology, University of São Paulo, School of Public Health, São Paulo, Brazil.
J Bras Pneumol. 2006 Nov-Dec;32(6):544-52. doi: 10.1590/s1806-37132006000600012.
To evaluate deaths attributed to multiple causes in which tuberculosis was one of the causes listed.
All deaths among residents of the state of Rio de Janeiro, Brazil, occurring between 1999 and 2001 and for which the death certificate mentioned tuberculosis, were investigated. The World Health Organization guidelines were used in characterizing the underlying and associated (non-underlying) causes of death.
In deaths from tuberculosis, conditions related to its natural history were the principal associated causes, together with alcoholism and diabetes. In approximately three-fifths of all deaths for which tuberculosis was listed as an associated cause, the underlying cause of death was acquired immunodeficiency syndrome. High proportion of ill-defined causes of death, low values found for the number of causes informed per death certificate and for TB as an associated cause point towards a certain degree of underestimation of the actual number of TB-related deaths in Rio de Janeiro State.
The study shows that the rates of tuberculosis-related mortality in the state of Rio de Janeiro, calculated based on the number of times tuberculosis was listed as a cause of death (underlying or associated), are the highest in the country. Epidemiological studies of mortality are recommended as a means of guiding the activities of the tuberculosis control program.
评估以结核病作为所列病因之一的多种病因所致死亡情况。
对1999年至2001年间巴西里约热内卢州居民中所有死亡病例进行调查,这些死亡病例的死亡证明提及了结核病。采用世界卫生组织的指南来确定根本死因和相关(非根本)死因。
在结核病死亡病例中,与其自然病史相关的病症是主要的相关病因,同时还有酗酒和糖尿病。在约五分之三将结核病列为相关病因的所有死亡病例中,根本死因是获得性免疫缺陷综合征。死因不明的比例较高,每份死亡证明所填报的病因数量以及结核病作为相关病因的数值较低,这表明里约热内卢州实际与结核病相关的死亡人数在一定程度上被低估。
该研究表明,根据结核病被列为死因(根本或相关)的次数计算得出的里约热内卢州结核病相关死亡率是全国最高的。建议开展死亡率流行病学研究,以指导结核病控制项目的活动。