Andrade Lucas Almeida, de Souza Carlos Dornels Freire, da Paz Wandklebson Silva, de Gois Souza Danilo, Góes José Augusto Passos, Camargo Emerson Lucas Silva, de Sousa Álvaro Francisco Lopes, Moretti Carneiro Liliane, Mendes Isabel Amélia Costa, Machado Araújo Karina, Dos Santos Allan Dantas, Bezerra-Santos Márcio
Graduate Program in Health Sciences, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
College of Medicine, Federal University of Vale do São Francisco, Petrolina, PE, Brazil.
Ther Adv Infect Dis. 2025 Jan 31;12:20499361251313830. doi: 10.1177/20499361251313830. eCollection 2025 Jan-Dec.
Infectious and parasitic diseases (IPDs) encompass a broad range of illnesses predominantly associated with poverty. They are more prevalent in low- and middle-income countries, including Brazil, where they continue to be among the leading causes of mortality.
This study aims to analyze the spatiotemporal dynamics of mortality due to IPDs in Brazil from 2000 to 2019.
We conducted an ecological study using data on mortality by IPDs from the Brazilian Mortality Information System. We applied the segmented log-linear regression model to assess temporal trends. For spatial analysis, we used the local empirical Bayesian estimator and Moran indices. Retrospective spatiotemporal scan statistics were performed using the Poisson Probability Distribution Model.
Between 2000 and 2019, there were 2,155,513 deaths related to IPDs in Brazil. The leading causes of death included acute respiratory infections ( = 1,130,069; 52.49%), septicemia ( = 289,817; 13.46%), human immunodeficiency virus/acquired immunodeficiency syndrome ( = 232,892; 10.82%), tuberculosis ( = 104,121; 4.84%), and neglected tropical diseases such as Chagas disease ( = 94,788; 4.40%) and schistosomiasis ( = 10,272; 0.48%). An increasing temporal trend in the mortality rate from IPDs was observed in Brazil and across all its regions. Additionally, our spatiotemporal scan identified high-risk clusters of death in the Southeast and Northeast regions.
Mortality from IPDs remains a significant public health concern in Brazil, with an increasing trend observed in all regions. Our findings underscore the urgent need for comprehensive intersectoral public policies. These policies should focus on a greater allocation of resources and investments in the most critical areas, aiming to significantly reduce the number of deaths, particularly in the most vulnerable regions.
感染性和寄生虫病（IPD）涵盖了广泛的主要与贫困相关的疾病。它们在包括巴西在内的低收入和中等收入国家更为普遍，在这些国家，它们仍然是主要的死亡原因之一。
本研究旨在分析2000年至2019年巴西因IPD导致的死亡率的时空动态。
我们使用巴西死亡信息系统中IPD死亡率的数据进行了一项生态研究。我们应用分段对数线性回归模型来评估时间趋势。对于空间分析，我们使用局部经验贝叶斯估计器和莫兰指数。使用泊松概率分布模型进行回顾性时空扫描统计。
2000年至2019年期间，巴西有2155513例与IPD相关的死亡。主要死亡原因包括急性呼吸道感染（1130069例；52.49%）、败血症（289817例；13.46%）、人类免疫缺陷病毒/获得性免疫缺陷综合征（232892例；10.82%）、结核病（104121例；4.84%）以及恰加斯病（94788例；4.40%）和血吸虫病（10272例；0.48%）等被忽视的热带病。在巴西及其所有地区，均观察到IPD死亡率呈上升趋势。此外，我们的时空扫描确定了东南部和东北部地区为高死亡风险聚集区。
在巴西，IPD导致的死亡仍然是一个重大的公共卫生问题，所有地区都呈现出上升趋势。我们的研究结果强调了迫切需要制定全面的跨部门公共政策。这些政策应侧重于在最关键领域加大资源分配和投资，旨在大幅减少死亡人数，特别是在最脆弱的地区。
