Costa de Albuquerque Marcos Antônio, Dias Danielle Menezes, Vieira Lucas Teixeira, Lima Carlos Anselmo, da Silva Angela Maria
University Hospital, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil.
Post-doc Medicine Unit, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil.
Infect Dis Poverty. 2017 Feb 8;6(1):20. doi: 10.1186/s40249-016-0232-8.
Neglected Tropical Diseases are a set of communicable diseases that affect the population so low socioeconomic status, particularly 1.4 billion people who are living below the poverty level. This study has investigated the magnitude and mortality time trends for these diseases in the state of Sergipe, Northeast Region of Brazil.
We conducted an ecological study of time series, based on secondary data derived from the Mortality Information System of the Ministry of Health. The mortality rates (crude, age-standardized rates and proportional ratio) were calculated from the deaths due to Neglected Tropical Diseases in the state of Sergipe, from 1980 to 2013. The time trends were obtained using the Joinpoint regression model.
Three hundred six thousand and eight hundred seventy-two deaths were certified in the state and Neglected Tropical Diseases were mentioned as the underlying cause in 1,203 certificates (0.39%). Mean number of deaths was 35.38 per year, and crude and age-standardized mortality rates were, respectively: 2.16 per 100 000 inhabitants (95% CI: 1.45-2.87) and 2.87 per 100 000 inhabitants (95% CI: 1.93-3.82); the proportional mortality ratio was 0.41% (95% CI: 0.27-0.54). In that period, Schistosomiasis caused 654 deaths (54.36%), followed by Chagas disease, with 211 (17.54%), and by Leishmaniases, with 142 (11.80%) deaths. The other diseases totalized 196 deaths (16.30%). There were increasing mortality trends for Neglected Tropical Diseases, Schistosomiasis and Chagas disease in the last 15 years, according to the age-standardized rates, and stability of the mortality trends for Leishmaniases.
The Neglected Tropical Diseases show increasing trends and are a real public health problem in the state of Sergipe, since they are responsible for significant mortality rates. The following diseases call attention for showing greater number of deaths in the period of study: Schistosomiasis, Chagas disease and Leishmaniases. We finally suggest that public managers take appropriate actions to develop new strategies in epidemiological and therapeutic surveillance, and in the follow-up of these patients.
被忽视的热带病是一组影响社会经济地位低下人群的传染病,尤其是14亿生活在贫困线以下的人口。本研究调查了巴西东北部塞尔希培州这些疾病的发病规模和死亡时间趋势。
我们基于巴西卫生部死亡率信息系统的二手数据进行了一项时间序列生态研究。计算了1980年至2013年塞尔希培州因被忽视的热带病导致的死亡率(粗死亡率、年龄标准化死亡率和比例死亡率)。使用Joinpoint回归模型得出时间趋势。
该州共认证了306,872例死亡,其中1,203份死亡证明(0.39%)将被忽视的热带病列为根本死因。每年的平均死亡人数为35.38人,粗死亡率和年龄标准化死亡率分别为:每10万居民2.16人(95%置信区间:1.45 - 2.87)和每10万居民2.87人(95%置信区间:1.93 - 3.82);比例死亡率为0.41%(95%置信区间:0.27 - 0.54)。在此期间,血吸虫病导致654例死亡(54.36%),其次是恰加斯病,有211例(17.54%),利什曼病有142例(11.80%)死亡。其他疾病共计196例死亡(16.30%)。根据年龄标准化率,过去15年中,被忽视的热带病、血吸虫病和恰加斯病的死亡率呈上升趋势,而利什曼病的死亡率趋势保持稳定。
被忽视的热带病呈上升趋势,是塞尔希培州一个切实存在的公共卫生问题,因为它们导致了相当高的死亡率。在研究期间,以下疾病因死亡人数较多而值得关注:血吸虫病、恰加斯病和利什曼病。我们最后建议公共管理人员采取适当行动,制定新的流行病学和治疗监测策略,以及对这些患者的随访策略。