Abstract:LITVOC, J. Doença de Chagas como causa básica de óbito na região sudeste do Brasil: presença de causas contributárias. Rev. Saúde Pública, 28: 69-75, 1994. Estudaram-se os atestados de pessoas falecidas no Estado de São Paulo, Brasil, em 1987, cuja causa básica foi a cardiopatia chagásica, com a finalidade de conhecer a informação adicional que está presente no atestado como "causa contributária". Foram analisadas as informações existentes em 1.308 Declarações de Óbito. As causas contributárias foram identific… Show more
“…We observed that the main conditions associated with death by Chagas' disease have been inserted into the group of diseases of the 15 . Consistent with the clinical descriptions and the predominance of chronic chagasic cardiopathy (CCC) as the main cause of death, cardiac complications were the main associated diseases, particularly arrhythmias/ conduction disorders, heart failure and cardiomyopathies.…”
Section: Discussionmentioning
confidence: 99%
“…Given the fact that multiple causes and conditions often lead to death of an individual, the use of merely the underlying cause of disease is not be sufficient to describe the real epidemiological situation of a chronic condition such as Chagas' disease. In addition, the use of multiple causes of death allows identification of conditions that may be synergistic to death and opens new perspectives for the prevention and treatment of these comorbidities 2 .We observed that the main conditions associated with death by Chagas' disease have been inserted into the group of diseases of the 15 . Consistent with the clinical descriptions and the predominance of chronic chagasic cardiopathy (CCC) as the main cause of death, cardiac complications were the main associated diseases, particularly arrhythmias/ conduction disorders, heart failure and cardiomyopathies.…”
Introduction:Chagas' disease is a major public health problem in Brazil and needs extensive and reliable information to support consistent prevention and control actions. This study describes the most common causes of death associated with deaths related to Chagas' disease (underlying or associated cause of death). Methods: Mortality data were obtained from the Mortality Information System of the Ministry of Health (approximately 9 million deaths). We analyzed all deaths that occurred in Brazil between 1999 and 2007, where Chagas' disease was mentioned on the death certificate as underlying or associated cause (multiple causes of death). Results: There was a total of 53,930 deaths related to Chagas' disease, 44,543 (82.6%) as underlying cause and 9,387 (17.4%) as associated cause. The main diseases and conditions associated with death by Chagas' disease as underlying cause included direct complications of cardiac involvement, such as conduction disorders/arrhythmias (41.4%) and heart failure (37.7%). Cerebrovascular disease (13.2%), ischemic heart disease (13.2%) and hypertensive diseases (9.3%) were the main underlying causes of deaths in which Chagas' disease was identified as an associated cause. Conclusions: Cardiovascular diseases were often associated with deaths related to Chagas' disease. Information from multiple causes of death recorded on death certificates allows reconstruction of the natural history of Chagas' disease and suggests preventive and therapeutic potential measures more adequate and specifics.Keywords: Chagas' disease. Mortality. Underlying cause of death. Multiple causes of death. Epidemiology. Brazil.The World Health Organization (WHO) recommends mortality statistics to be presented by the underlying cause of death. This is defined as the disease or injury, which initiated the cascade of events leading directly to death, or the circumstances of accident or violence that produced fatal injury 1 . However, especially for infectious and parasitic diseases, there is a need for more comprehensive information on fatal events. Additionally, there is a clear relevance to consider all causes of death recorded on death certificates. These include in addition to the underlying causes of death the associated causes that increase the risk of complications, and other contributing causes not directly related to the process that led to death. These three groups together are called multiple causes of death 2,3 .In Brazil, with significant reduction of vector and blood-borne transmission, the number of cases of acute form of Chagas' disease has been drastically reduced in most endemic areas 4 . In addition, both increased knowledge about the natural history of disease and better effectiveness of clinical and surgical interventions, led to the reduction of specific mortality and increased survival of infected individuals 5 . Recent estimates amount to 2 to 3 million individuals infected with the causing agent Trypanosoma cruzi in Brazil [6][7][8] . A large proportion of these cases occurred in o...
“…We observed that the main conditions associated with death by Chagas' disease have been inserted into the group of diseases of the 15 . Consistent with the clinical descriptions and the predominance of chronic chagasic cardiopathy (CCC) as the main cause of death, cardiac complications were the main associated diseases, particularly arrhythmias/ conduction disorders, heart failure and cardiomyopathies.…”
Section: Discussionmentioning
confidence: 99%
“…Given the fact that multiple causes and conditions often lead to death of an individual, the use of merely the underlying cause of disease is not be sufficient to describe the real epidemiological situation of a chronic condition such as Chagas' disease. In addition, the use of multiple causes of death allows identification of conditions that may be synergistic to death and opens new perspectives for the prevention and treatment of these comorbidities 2 .We observed that the main conditions associated with death by Chagas' disease have been inserted into the group of diseases of the 15 . Consistent with the clinical descriptions and the predominance of chronic chagasic cardiopathy (CCC) as the main cause of death, cardiac complications were the main associated diseases, particularly arrhythmias/ conduction disorders, heart failure and cardiomyopathies.…”
Introduction:Chagas' disease is a major public health problem in Brazil and needs extensive and reliable information to support consistent prevention and control actions. This study describes the most common causes of death associated with deaths related to Chagas' disease (underlying or associated cause of death). Methods: Mortality data were obtained from the Mortality Information System of the Ministry of Health (approximately 9 million deaths). We analyzed all deaths that occurred in Brazil between 1999 and 2007, where Chagas' disease was mentioned on the death certificate as underlying or associated cause (multiple causes of death). Results: There was a total of 53,930 deaths related to Chagas' disease, 44,543 (82.6%) as underlying cause and 9,387 (17.4%) as associated cause. The main diseases and conditions associated with death by Chagas' disease as underlying cause included direct complications of cardiac involvement, such as conduction disorders/arrhythmias (41.4%) and heart failure (37.7%). Cerebrovascular disease (13.2%), ischemic heart disease (13.2%) and hypertensive diseases (9.3%) were the main underlying causes of deaths in which Chagas' disease was identified as an associated cause. Conclusions: Cardiovascular diseases were often associated with deaths related to Chagas' disease. Information from multiple causes of death recorded on death certificates allows reconstruction of the natural history of Chagas' disease and suggests preventive and therapeutic potential measures more adequate and specifics.Keywords: Chagas' disease. Mortality. Underlying cause of death. Multiple causes of death. Epidemiology. Brazil.The World Health Organization (WHO) recommends mortality statistics to be presented by the underlying cause of death. This is defined as the disease or injury, which initiated the cascade of events leading directly to death, or the circumstances of accident or violence that produced fatal injury 1 . However, especially for infectious and parasitic diseases, there is a need for more comprehensive information on fatal events. Additionally, there is a clear relevance to consider all causes of death recorded on death certificates. These include in addition to the underlying causes of death the associated causes that increase the risk of complications, and other contributing causes not directly related to the process that led to death. These three groups together are called multiple causes of death 2,3 .In Brazil, with significant reduction of vector and blood-borne transmission, the number of cases of acute form of Chagas' disease has been drastically reduced in most endemic areas 4 . In addition, both increased knowledge about the natural history of disease and better effectiveness of clinical and surgical interventions, led to the reduction of specific mortality and increased survival of infected individuals 5 . Recent estimates amount to 2 to 3 million individuals infected with the causing agent Trypanosoma cruzi in Brazil [6][7][8] . A large proportion of these cases occurred in o...
“…Of these articles, we have classic texts by Forattini on the biology of Triatominae
63
-
68
. Studies on the burden of Chagas disease in different regions of the Country
40
,
155
,
176
, control strategies
139
-
141
, and alternative transmission types of Chagas disease
175
are also present, as well as the disease social impact and, more recently, an interesting article on the 100th anniversary of the Chagas disease description
6
.…”
In this article, we comment on the main features of infectious diseases in Brazil in the last 50 years, highlighting how much of this path Revista de Saúde Pública could portray. From 1967 to 2016, 1,335 articles focusing on infectious diseases were published in Revista de Saúde Pública. Although the proportion of articles on the topic have decreased from about 50.0% to 15.0%, its notability remained and reflected the growing complexity of the research required for its control. It is noteworthy that studies design and analysis strategies progressively became more sophisticated, following the great development of epidemiology in Brazil in the recent decades. Thus, the journal has followed the success of public health interventions that permitted to control or eliminate numerous infectious diseases – which were responsible, in the past, for high rates of morbidity and mortality –, and also followed the reemergence of diseases already controlled and the emergence of until then unknown diseases, with a strong impact on the Brazilian population, establishing a little predictable and very challenging path.
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