Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.
Trop Med Int Health. 2012 Sep;17(9):1066-75. doi: 10.1111/j.1365-3156.2012.03043.x. Epub 2012 Jul 19.
To describe patterns of spatial distribution of mortality associated with Chagas' disease in Brazil.
Nationwide study of all deaths in Brazil from 1999 to 2007, where Chagas' disease was recorded as a cause of death. Data were obtained from the national Mortality Information System of the Ministry of Health. We calculated the mean mortality rate for each municipality of residence in three-year intervals and the entire period. Empirical Bayes smoothing was used to minimise random variation in mortality rates because of the population size in the municipalities. To evaluate the existence of spatial autocorrelation, global and local Moran's I indices were used.
The nationwide mean mortality rate associated with Chagas' disease was 3.37/100 000 inhabitants/year, with a maximum of 138.06/100 000 in one municipality. Independently from the statistical approach, spatial analysis identified a large cluster of high risk for mortality by Chagas' disease, involving nine states in the Central region of Brazil.
This study defined geographical priority areas for the management of Chagas' disease and consequently reducing disease-associated mortality in Brazil. Different spatial-analytical approaches can be integrated to provide data for planning, monitoring and evaluating specific intervention measures.
描述巴西恰加斯病死亡率的空间分布模式。
对 1999 年至 2007 年巴西所有死亡病例进行了全国性研究，恰加斯病被记录为死因。数据来自卫生部国家死亡信息系统。我们计算了每个居住地的市三年期和整个时期的平均死亡率。经验贝叶斯平滑用于最小化由于市人口规模引起的死亡率的随机变化。为了评估空间自相关的存在，使用了全局和局部 Moran's I 指数。
与恰加斯病相关的全国平均死亡率为 3.37/100000 居民/年，在一个市最高达到 138.06/100000。无论采用何种统计方法，空间分析都确定了一个涉及巴西中部九个州的高死亡率风险的大型集群。
本研究确定了巴西恰加斯病管理的地理优先区域，从而降低了与该病相关的死亡率。不同的空间分析方法可以整合起来，为规划、监测和评估特定干预措施提供数据。
