Kevin Martinez-Folgar and Usama Bilal are with the Department of Epidemiology and Biostatistics and the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Diego Alburez-Gutierrez is with the Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany. Alejandra Paniagua-Avila is with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Manuel Ramirez-Zea is with the INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.
Am J Public Health. 2021 Oct;111(10):1839-1846. doi: 10.2105/AJPH.2021.306452. Epub 2021 Sep 23.
To describe excess mortality during the COVID-19 pandemic in Guatemala during 2020 by week, age, sex, and place of death. We used mortality data from 2015 to 2020, gathered through the vital registration system of Guatemala. We calculated weekly mortality rates, overall and stratified by age, sex, and place of death. We fitted a generalized additive model to calculate excess deaths, adjusting for seasonality and secular trends and compared excess deaths to the official COVID-19 mortality count. We found an initial decline of 26% in mortality rates during the first weeks of the pandemic in 2020, compared with 2015 to 2019. These declines were sustained through October 2020 for the population younger than 20 years and for deaths in public spaces and returned to normal from July onward in the population aged 20 to 39 years. We found a peak of 73% excess mortality in mid-July, especially in the population aged 40 years or older. We estimated a total of 8036 excess deaths (95% confidence interval = 7935, 8137) in 2020, 46% higher than the official COVID-19 mortality count. The extent of this health crisis is underestimated when COVID-19 confirmed death counts are used. (. 2021;111(10): 1839-1846. https://doi.org/10.2105/AJPH.2021.306452).
描述 2020 年危地马拉 COVID-19 大流行期间按周、年龄、性别和死亡地点划分的超额死亡率。我们使用了危地马拉生命登记系统收集的 2015 年至 2020 年的死亡率数据。我们计算了每周的死亡率，总体上按年龄、性别和死亡地点进行分层。我们拟合了广义加性模型来计算超额死亡人数，调整了季节性和长期趋势，并将超额死亡人数与官方 COVID-19 死亡人数进行了比较。我们发现，与 2015 年至 2019 年相比，2020 年大流行的前几周死亡率下降了 26%。这些下降在 2020 年 10 月之前一直持续，对于年龄小于 20 岁的人群和在公共场所死亡的人群而言。对于 20 至 39 岁的人群，从 7 月开始死亡率恢复正常。我们发现 7 月中旬的超额死亡率达到了 73%的峰值，尤其是在 40 岁或以上的人群中。我们估计 2020 年总共有 8036 人超额死亡（95%置信区间=7935，8137），比官方 COVID-19 死亡人数高出 46%。当使用 COVID-19 确诊死亡人数时，这场健康危机的严重程度被低估了。（. 2021；111(10): 1839-1846. https://doi.org/10.2105/AJPH.2021.306452）。
