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风湿热:一种无“颜色”的疾病。

Rheumatic Fever: A Disease without Color.

机构信息

Faculdade de Medicina de Ribeirão Preto (FMRP) da Universidade de São Paulo (USP), Ribeirão Preto, SP - Brazil.

Universidade Federal de Alfenas, Alfenas, MG - Brazil.

出版信息

Arq Bras Cardiol. 2019 Jul 29;113(3):345-354. doi: 10.5935/abc.20190141. eCollection 2019.

Abstract

BACKGROUND

Brazil has approximately 30.000 cases of Acute Rheumatic Fever (ARF) annually. A third of cardiovascular surgeries performed in the country are due to the sequelae of rheumatic heart disease (RHD), which is an important public health problem.

OBJECTIVES

to analyze the historical series of mortality rates and disease costs, projecting future trends to offer new data that may justify the need to implement a public health program for RF.

METHODS

we performed a cross-sectional study with a time series analysis based on data from the Hospital Information System of Brazil from 1998 to 2016. Simple linear regression models and Holt's Exponential Smoothing Method were used to model the behavior of the series and to do forecasts. The results of the tests with a value of p < 0.05 were considered statistically significant.

RESULTS

each year, the number of deaths due to RHD increased by an average of 16.94 units and the mortality rate from ARF increased by 215%. There was a 264% increase in hospitalization expenses for RHD and RHD mortality rates increased 42.5% (p-value < 0.05). The estimated mortality rates for ARF and RHD were, respectively, 2.68 and 8.53 for 2019. The estimated cost for RHD in 2019 was US$ 26.715.897,70.

CONCLUSIONS

according to the Brazilian reality, the 1-year RHD expenses would be sufficient for secondary prophylaxis (considering a Benzatin Penicillin G dose every 3 weeks) in 22.574 people for 10 years. This study corroborates the need for public health policies aimed at RHD.

摘要

背景

巴西每年约有 30,000 例急性风湿热(ARF)病例。该国进行的三分之一的心血管手术是由于风湿性心脏病(RHD)的后遗症所致,这是一个重要的公共卫生问题。

目的

分析死亡率和疾病成本的历史系列,预测未来趋势,提供新的数据,以证明有必要实施针对 RF 的公共卫生计划。

方法

我们进行了一项基于 1998 年至 2016 年巴西医院信息系统数据的横断面研究,采用时间序列分析。简单线性回归模型和霍尔特指数平滑法用于模拟系列的行为并进行预测。p 值<0.05 的测试结果被认为具有统计学意义。

结果

每年,死于 RHD 的人数平均增加 16.94 个单位,ARF 的死亡率增加 215%。RHD 的住院费用增加了 264%,RHD 死亡率增加了 42.5%(p 值<0.05)。估计 2019 年 ARF 和 RHD 的死亡率分别为 2.68 和 8.53。估计 2019 年 RHD 的费用为 26715897.70 美元。

结论

根据巴西的实际情况,1 年的 RHD 费用足以用于二级预防(考虑每 3 周给予苄星青霉素 G 剂量),可覆盖 10 年的 22574 人。这项研究证实了需要针对 RHD 制定公共卫生政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bf4/6882402/e14165f4a3ca/abc-113-03-0345-g01.jpg

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