Paixão Enny Santos, Costa Maria da Conceição Nascimento, Rodrigues Laura Cunha, Rasella Davide, Cardim Luciana Lobato, Brasileiro Alcione Cunha, Teixeira Maria Gloria Lima Cruz
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, BR.
London School of Hygiene and Tropical Medicine, London, GB.
Rev Soc Bras Med Trop. 2015 Jul-Aug;48(4):399-405. doi: 10.1590/0037-8682-0145-2015.
Studies that generate information that may reduce the dengue death risk are essential. This study analyzed time trends and risk factors for dengue mortality and fatality in Brazil from 2001 to 2011.
Time trends for dengue mortality and fatality rates were analyzed using simple linear regression. Associations between the dengue mortality and the case fatality rates and socioeconomic, demographic, and health care indicators at the municipality level were analyzed using negative binomial regression.
The dengue hemorrhagic fever case fatality rate increased in Brazil from 2001 to 2011 (β=0.67; p=0.036), in patients aged 0-14 years (β=0.48; p=0.030) and in those aged ≥15 years (β=1.1; p<0.01). Factors associated with the dengue case fatality rate were the average income per capita (MRR=0.99; p=0.038) and the number of basic health units per population (MRR=0.89; p<0.001). Mortality rates increased from 2001 to 2011 (β=0.350; p=0.002).Factors associated with mortality were inequality (RR=1.02; p=0.001) high income per capita (MRR=0.99; p=0.005), and higher proportions of populations living in urban areas (MRR=1.01; p<0.001).
The increases in the dengue mortality and case fatality rates and the associated socioeconomic and health care factors, suggest the need for structural and intersectoral investments to improve living conditions and to sustainably reduce these outcomes.
开展能够生成有助于降低登革热死亡风险信息的研究至关重要。本研究分析了2001年至2011年巴西登革热死亡率和病死率的时间趋势及风险因素。
采用简单线性回归分析登革热死亡率和病死率的时间趋势。使用负二项回归分析市级层面登革热死亡率、病死率与社会经济、人口统计学及医疗保健指标之间的关联。
2001年至2011年，巴西登革出血热病死率上升（β=0.67；p=0.036），0至14岁患者中病死率上升（β=0.48；p=0.030），≥15岁患者中病死率上升（β=1.1；p<0.01）。与登革热病死率相关的因素有人均平均收入（MRR=0.99；p=0.038）和每人口基本卫生单位数量（MRR=0.89；p<0.001）。2001年至2011年死亡率上升（β=0.350；p=0.002）。与死亡率相关的因素有不平等（RR=1.02；p=0.001）、高人均收入（MRR=0.99；p=0.005）以及城市地区居住人口比例较高（MRR=1.01；p<0.001）。
登革热死亡率和病死率上升以及相关的社会经济和医疗保健因素表明，需要进行结构性和跨部门投资，以改善生活条件并可持续地降低这些结果。
