Parasitic Biology Graduate Program, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil.
Tropical Medicine Graduate Program, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
J Glob Health. 2021 Oct 9;11:04061. doi: 10.7189/jogh.11.04061. eCollection 2021.
Schistosomiasis is a persistent public health problem in Brazil. Regardless advances in diagnosis and mass treatment, schistosomiasis has a severe impact on morbimortality in the country and remains a neglected tropical disease. Herein, we assessed the basic and associated causes of schistosomiasis-related deaths and the temporal and spatial patterns of mortality from the disease in Brazil between 1999 and 2018.
We conducted an ecological and time series study. The segmented log-linear regression model was applied to assess time trends, considering all deaths recorded in the category B65/ICD-10. Additionally, we elaborated maps of mortality rates from schistosomiasis in Brazil.
A total of 4168 schistosomiasis-related deaths were recorded in Brazil in this period, as an associated cause. Time trend analysis revealed an increase in the average age of deaths from schistosomiasis (annual percentage change (APC) = 0.84), and stable trend in Brazil (APC = 0.31). Concerning schistosomiasis-related deaths, we observed disorders related to the digestive system, liver diseases, septicemias, and chronic diseases. Surprisingly, there were deaths caused by non-endemic species in Brazil. Also, municipalities from non-endemic areas in Brazil presented schistosomiasis-related deaths.
Altogether, our analyses demonstrated that schistosomiasis remains a significant cause of death in Brazil, and it is increasing in some areas, especially in the Northeast region. Additionally, women and the elderly showed a stable time trend of deaths. Thereby, it urgently requires improvements in the control programs strategies, in the sense of an effective reduction in cases and deaths from the disease in Brazil.
在巴西，血吸虫病一直是一个严重的公共卫生问题。尽管在诊断和大规模治疗方面取得了进展，但血吸虫病对该国的发病率和死亡率仍有严重影响，且仍是一种被忽视的热带病。在此，我们评估了 1999 年至 2018 年期间巴西与血吸虫病相关的死亡的基本原因和相关原因，以及该病的死亡时间和空间模式。
我们进行了一项生态学和时间序列研究。应用分段对数线性回归模型来评估时间趋势，考虑了 ICD-10 类别 B65 中记录的所有死亡。此外，我们还制作了巴西血吸虫病死亡率的地图。
在此期间，巴西共有 4168 例血吸虫病相关死亡被记录为相关死因。时间趋势分析显示，血吸虫病死亡的平均年龄呈上升趋势（年变化百分比 (APC)=0.84），且巴西的趋势保持稳定（APC=0.31）。关于与血吸虫病相关的死亡，我们观察到与消化系统、肝脏疾病、败血症和慢性疾病相关的疾病。令人惊讶的是，巴西还出现了非流行地区的血吸虫病死亡。此外，巴西非流行地区的市也出现了与血吸虫病相关的死亡。
总之，我们的分析表明，血吸虫病仍然是巴西的一个重要死亡原因，在某些地区（尤其是东北部地区）呈上升趋势。此外，女性和老年人的死亡呈稳定趋势。因此，迫切需要改进控制项目策略，以有效减少巴西的病例和死亡。
