Instituto Nacional de Salud, Grupo de Parasitología, Bogotá D.C., Colombia.
Universidad Nacional de Colombia, Facultad de Medicina, Bogotá D.C., Colombia.
Rev Soc Bras Med Trop. 2021 Feb 26;54:e07682020. doi: 10.1590/0037-8682-0768-2020. eCollection 2021.
Studies on Chagas disease-related mortality assist in decision-making in health policies. We analyzed the epidemiological characteristics, temporal trends, and regional differences in Chagas disease-related mortality in Colombia from 1979 to 2018.
A time-series study was conducted using death records and population data from the National Administrative Department of Statistics, using categorizations from the International Classification of Disease (ICD)-9 and ICD-10 systems. All deaths with Chagas disease as an underlying or associated cause of death were included. Crude and age-sex standardized mortality rates per 100,000 inhabitants and the annual percent change (APC) were calculated.
Of the 7,287,461 deaths recorded in Colombia during 1979-2018, 3,276 (0.04%) deaths were related to Chagas disease-2,827 (86.3%) as an underlying cause and 449 (13.7%) as an associated cause. The average annual age-sex standardized mortality rate was 0.211 (95% confidence interval [CI]: 0.170-0.252) deaths/100,000 inhabitants, with a significant upward trend (APC = 6.60%; 95% CI: 5.9-7.3). The highest Chagas disease-related death rates were in males (0.284 deaths/100,000 inhabitants), those ≥65 years old (1.296 deaths/100,000 inhabitants), and residents of the Orinoco region (1.809 deaths/100,000 inhabitants). There was a significant increase in mortality in the Orinoco (APC = 8.28%; 95% CI: 6.4-10.2), Caribbean (APC = 5.06%; 95% CI: 3.6-6.5), and Andean (APC = 4.63%; 95% CI: 3.9-5.3) regions.
Chagas disease remains a major public health issue in Colombia with high mortality rates in older age groups, a wide geographic distribution, regional differences, and the potential to increase.
有关恰加斯病相关死亡率的研究有助于制定卫生政策决策。我们分析了 1979 年至 2018 年期间哥伦比亚恰加斯病相关死亡率的流行病学特征、时间趋势和地区差异。
使用国家行政统计局的死亡记录和人口数据进行时间序列研究，使用国际疾病分类（ICD）-9 和 ICD-10 系统的分类。所有以恰加斯病为根本或相关死因的死亡均包括在内。计算每 10 万人的粗死亡率和年龄性别标准化死亡率以及年百分比变化（APC）。
在 1979 年至 2018 年期间记录的哥伦比亚 7287461 例死亡中，有 3276 例（0.04%）与恰加斯病有关-2827 例（86.3%）为根本原因，449 例（13.7%）为相关原因。平均每年年龄性别标准化死亡率为 0.211（95%置信区间[CI]：0.170-0.252）/100000 人，呈显著上升趋势（APC=6.60%；95%CI：5.9-7.3）。恰加斯病相关死亡率最高的是男性（0.284/100000 人）、≥65 岁人群（0.1296/100000 人）和奥里诺科地区居民（0.1809/100000 人）。奥里诺科地区（APC=8.28%；95%CI：6.4-10.2）、加勒比地区（APC=5.06%；95%CI：3.6-6.5）和安第斯地区（APC=4.63%；95%CI：3.9-5.3）的死亡率显著增加。
恰加斯病仍然是哥伦比亚的一个主要公共卫生问题，老年人群的死亡率较高，地域分布广泛，存在地区差异，并有可能增加。
