Universidade Federal Fluminense. Faculdade de Medicina. Mestrado Profissional em Saúde Materno Infantil. Niterói, RJ, Brasil.
Universidade Federal Fluminense. Faculdade de Medicina. Programa de Iniciação Científica. Niterói, RJ, Brasil.
Rev Saude Publica. 2022 Jul 1;56:65. doi: 10.11606/s1518-8787.2022056003681. eCollection 2022.
Estimate rates and describe mortality trends attributed to sickle cell disease in children and adolescents in Brazil from 2000 to 2019.
This is an ecological study of the time-trend of mortality rates that used the autoregressive method, proposed by Prais-Winsten, to evaluate trends in the estimated rates of sickle cell disease deaths in children and adolescents in Brazil. Deaths with code D57 were obtained from the Mortality Information System, considering age groups (0-4, 5-9, 10-14, 15-19 years) and were used to estimate age-specific and standardized rates by gender and age.
From 2000 to 2019, Brazil had 2,422 deaths from sickle cell disease in people under 20 years of age, with higher frequency in the Northeast (40.46%), followed by the Southeast (39.02%), Midwest (9.58%), North (7.84%), and South (3.10%). The main victims were people of Black skin/race (78.73%). In Brazil, the global standardized average rate was 0.20/100,000 people-year, with an elevation trend (annual percentage change - APC = 5.44%; confidence interval - 95%CI: 2.57-8.39). The pattern was repeated in males (APC = 4.38%; 95%CI: 2.17-6.64) and females (APC = 6.96%; 95%CI: 3.05-11.01). Elaborating age-specific rates showed that the range up to four years experienced the highest rates, without distinction by region. The age group of 15 and 19 years was the second most affected in Brazil and in the Northeast, Southeast, and Midwest regions.
Deaths due to sickle cell disorders showed an elevation trend in children and adolescents. Considering that the magnitude of deaths was more evident in the first years (0-4) and late adolescence (15-19), the study suggests that age-specific approaches may impact the control of fatal outcomes caused by sickle cell disease in Brazil.
估算 2000 年至 2019 年巴西儿童和青少年因镰状细胞病导致的死亡率和描述死亡率趋势。
这是一项关于死亡率时间趋势的生态学研究，使用了由 Prais-Winsten 提出的自回归方法，以评估巴西儿童和青少年镰状细胞病死亡估计率的趋势。死亡率信息系统中获得了死因代码为 D57 的死亡数据，考虑了年龄组（0-4、5-9、10-14、15-19 岁），并按性别和年龄计算了特定年龄和标准化的死亡率。
2000 年至 2019 年，巴西有 2422 名 20 岁以下的人死于镰状细胞病，其中东北地区的发病率最高（40.46%），其次是东南部（39.02%）、中西部（9.58%）、北部（7.84%）和南部（3.10%）。主要受害者为黑皮肤/种族的人（78.73%）。在巴西，全球标准化平均发病率为 0.20/100,000 人/年，呈上升趋势（年变化百分比-APC=5.44%；95%置信区间-95%CI：2.57-8.39）。这种模式在男性（APC=4.38%；95%CI：2.17-6.64）和女性（APC=6.96%；95%CI：3.05-11.01）中也有重复。制定特定年龄的发病率表明，0-4 岁的发病率最高，且各个地区之间没有区别。15 岁和 19 岁是巴西和东北地区、东南部和中西部地区第二大受影响的年龄组。
镰状细胞疾病导致的死亡呈上升趋势，在儿童和青少年中更为明显。考虑到在生命早期（0-4 岁）和青春期晚期（15-19 岁）死亡率更高，研究表明，针对特定年龄的方法可能会影响巴西对镰状细胞病致死结果的控制。
