Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil.
Secretaria Municipal de Saúde de Campinas, Departamento de Vigilância em Saúde, Programa Municipal de Controle de Arboviroses, Campinas, SP, Brasil.
Rev Soc Bras Med Trop. 2020 Apr 9;53:e20190580. doi: 10.1590/0037-8682-0580-2019. eCollection 2020.
In 2014, the first cases of autochthonous chikungunya (CHIK) were recorded in Brazil. Lethality associated with this disease is underestimated. Thus, this study aimed to analyze the causes of death among individuals with CHIK in Brazil.
A descriptive observational study was conducted on individuals with CHIK who died within 6 months from symptom onset. Data pairing between the Information System for Notifiable Diseases and the Mortality Information System was performed. Deaths were classified according to case confirmation criterion, mention of CHIK in the death certificates (DCs), and disease phase. The lethality rate per 1,000 cases was corrected for underreporting and was estimated according to region, sex, age, years of education, race/color, and cause groups.
We identified 3,135 deaths (mention of CHIK in the DCs, 764 [24.4%]). In 17.6% of these cases, CHIK was the underlying cause. Most deaths occurred in the acute (38.1%) and post-acute (29.6%) phases. The corrected LR (5.7; x1,000) was 6.8 times higher than that obtained from the Information System for Notifiable Diseases (0.8). The highest corrected LRs were estimated for among individuals living in the Northeast region (6.2), men (7.4), those with low years of education and those aged <1 year (8.6), 65-79 years (20.7), and ≥80 years (75.4).
The LR of CHIK estimates based on information system linkage help to reveal the relevance of this disease as the direct cause or as a cause associated with serious or fatal events, provide timely interventions, and increase the knowledge about this disease.
2014 年，巴西首次记录到本地基孔肯雅热（CHIK）病例。该疾病的致死率被低估。因此，本研究旨在分析巴西 CHIK 患者的死亡原因。
对发病后 6 个月内死亡的 CHIK 患者进行描述性观察研究。对传染病报告信息系统和死亡信息系统进行数据配对。根据病例确诊标准、死亡证明（DC）中对 CHIK 的提及情况以及疾病阶段对死亡进行分类。根据地区、性别、年龄、受教育年限、种族/肤色和死因组别对每 1000 例的死亡率进行校正，并进行估计。
我们共发现 3135 例死亡（DC 中提及 CHIK），占 764 例（24.4%）。在这些病例中，17.6%的死亡是由 CHIK 引起的。大多数死亡发生在急性（38.1%）和后期急性（29.6%）阶段。校正后的 LR（5.7；x1000）比传染病报告信息系统（0.8）高 6.8 倍。校正后的最高 LR 估计值出现在东北部地区（6.2）、男性（7.4）、受教育年限较低和年龄<1 岁（8.6）、65-79 岁（20.7）和≥80 岁（75.4）的人群中。
基于信息系统关联的 CHIK 估计 LR 有助于揭示该疾病作为直接原因或与严重或致命事件相关的原因的相关性，以便及时干预，并增加对该疾病的认识。
