Spatial patterns and temporal tendency of mortality related to Chagas disease in an endemic area of northeastern Brazil

Góes, José Augusto Passos; Andrade, Lucas Almeida; Carvalho, Mylena Simões; Araújo, Damião da Conceição; Santos, Márcio Bezerra; Tanajura, Diego Moura; Menezes, Andreia Freire de; Araújo, Karina Conceição Gomes Machado de; Santos, Allan Dantas dos

doi:10.1111/tmi.13471

Cited by 7 publications

(8 citation statements)

References 17 publications

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“…Notwithstanding, the country exhibits serious social inequalities, as people living in extreme poverty, illiteracy, household clusters, and areas with no access to safe-drinking water and sewage system, mainly in slums (IBGE, 2021). Hence, Brazil is endemic for many neglected diseases as Chagas disease ( Góes et al, 2020 ), leprosy ( Souza et al, 2020 ; Damasceno et al, 2021 ), leishmaniasis ( Ribeiro et al, 2021 ), schistosomiasis ( Paz et al, 2020 ; Silva da Paz et al, 2021 ), and TB ( Lima et al, 2019 ).…”

Section: Methodsmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Diagnosis of Tuberculosis in Brazil: Is the WHO End TB Strategy at Risk?

et al. 2022

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Background: In 2014, the World Health Organization (WHO) launched the “post-2015 End TB strategy”, that aims to end the global tuberculosis (TB) epidemic by 2030. However, the COVID-19 pandemic has severely impacted global public health and the strict measures to control the coronavirus spread can affect the management of other diseases, such as TB. Herein, we aimed to assess the impact of the COVID-19 pandemic on the diagnosis of TB in Brazil, during 2020.Methods: We carried out an ecological and population-based study, using spatial analysis techniques. The variables used were the new cases of TB, pulmonary tuberculosis (PTB), and also baciloscopy-positive (BP) cases in Brazil between 2015 and 2020. The percentage of changes (% change) was calculated to verify if there was an increase or decrease of TB cases in 2020, along with time trend analyses given by Joinpoint regression model. Also, interrupted time series analyses were used to assess the trend of TB diagnosis before and after the onset of the COVID-19 in Brazil. Spatial distribution maps were elaborated, considering the % change of each Brazilian state.Findings: Data analyses showed a reduction in the diagnosis of TB (−8.3%) and PTB (−8.1%) in Brazil after the irruption of the COVID-19 pandemic. Likewise, 22 states depicted a reduction in TB diagnosis. An expressive reduction of BP cases (−17.1%) was also observed. Interestingly, interrupted time series analysis showed decline in TB and PTB diagnoses from March 2020. Spatial analyses revealed that all states had a progressive reduction of TB, PTB and PB cases, from March on, with the highest percentages of reduction in December (−100% to −75%).Interpretation: Taken together, our analyses demonstrated a reduction in TB diagnosis after the irruption of the COVID-19 pandemic in Brazil and its regions, signaling a serious impact on the WHO “End TB Strategy” global plan.

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Section: Methodsmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Diagnosis of Tuberculosis in Brazil: Is the WHO End TB Strategy at Risk?

et al. 2022

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“…Some information is available from different series of cohorts and mortality registries, where a range of baseline aspects have been evaluated in various countries. These studies have analyzed different aspects such as rates as well as temporal and geospatial trends of mortality due to CD in general or specifically chagasic cardiomyopathy [ 23 , 24 , 25 , 26 , 27 ]. Other studies analyze excess preventable mortality from the disease and the geo-economic implications of the problem [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…While assessing productivity losses was beyond the scope of the study, we observed that 32 of the 56 patients who died (57.1%) were under 60 years old; thus, in line with an increased loss in productive life-years. Regarding the analysis of mortality in endemic areas in Latin America, several studies in Brazil, Colombia, Chile and Ecuador have examined the spatial patterns of CD mortality, enabling the identification of priority areas for health services planning and control strategies [ 25 , 26 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

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Chagas Disease-Related Mortality in Spain, 1997 to 2018

et al. 2021

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Background. Chagas disease (CD) is associated with excess mortality in infected people in endemic countries, but little information is available in non-endemic countries. The aim of the study was to analyze mortality in patients admitted to the hospital with CD in Spain. Methods. A retrospective, observational study using the Spanish National Hospital Discharge Database. We used the CD diagnostic codes of the 9th and 10th International Classification of Diseases to retrieve CD cases from the national public registry from 1997 to 2018. Results. Of the 5022 hospital admissions in people with CD, there were 56 deaths (case fatality rate (CFR) 1.1%, 95% confidence interval (CI) 0.8%, 1.4%), 20 (35.7%) of which were considered directly related to CD. The median age was higher in those who died (54.5 vs. 38 years; p < 0.001). The CFR increased with age, peaking in the 70–79-year (7.9%, odds ratio (OR) 6.27, 95% CI 1.27, 30.90) and 80–89-year (16.7%, OR 14.7, 95% CI 2.70, 79.90) age groups. Men comprised a higher proportion of those who died compared to survivors (50% vs. 22.6%; p < 0.001). Non-survivors were more likely to have neoplasms (19.6% vs. 3.4%; p < 0.001), heart failure (17.9% vs. 7.2%; p = 0.002), diabetes (12.5% vs. 3.7%; p = 0.001), chronic kidney failure (8.9% vs. 1.6%; p < 0.001), and HIV (8.9% vs. 0.8%; p < 0.001). In the multivariable analysis, the variables associated with mortality were age (adjusted OR (aOR) 1.05; 95% CI: 1.03, 1.07), male sex (aOR 1.79, 95% CI 1.03, 3.14), cancer (aOR: 4.84, 95% CI 2.13, 11.22), and HIV infection (aOR 14.10 95% CI 4.88, 40.73). Conclusions. The case fatality rate of CD hospitalization was about 1%. The mortality risk increased with age, male sex, cancer, and HIV infection.

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“…For political and operational purposes, the states are grouped into five regions (North, Northeast, Southeast, South, and Midwest) with distinct geographic, economic and cultural characteristics ( Supplementary material 1 ). 15 Importantly, despite being the 12th largest economy in the world (US$ 1.434 trillion in 2021), Brazil has serious social inequalities and it is endemic for several NTDs, such as Leishmaniasis, 16 Chagas Disease, 17 Schistosomiasis 18 , 19 and Leprosy. 20 , 21 …”

Section: Methodsmentioning

confidence: 99%

Impact of the COVID-19 pandemic on the diagnosis of leprosy in Brazil: An ecological and population-based study

Paz

Souza

Tavares

et al. 2022

The Lancet Regional Health - Americas

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Background The pandemic caused by COVID-19 has seriously affected global health, resulting in the suspension of many regular health services, making the diagnosis of other infections difficult. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on the diagnosis of leprosy in Brazil during the year 2020. Methods We evaluated the monthly incidence of leprosy and calculated the percentage change to verify whether there was an increase or decrease in the number of leprosy cases in 2020, considering the monthly average of cases over the previous 5 years. We used interrupted time series analysis to assess the trend in the diagnosis of leprosy before and after the start of COVID-19 in Brazil and prepared spatial distribution maps, considering the percentage variation in each state. Findings We verified a reduction of 41.4% of leprosy cases in Brazil in 2020. Likewise, there was a reduction of leprosy notifications in children under 15 years-old (-56.82%). Conversely, the diagnosis of multibacillary leprosy increased (8.1%). There was a decreasing trend in the leprosy incidence in the general population between 2015 and 2020 in Brazil. Spatial distribution maps depicted a reduction of up to 100% in new cases of leprosy in some states. Interpretation Along with COVID-19 spread there was a reduction in leprosy diagnosis in the general population and children under 15 years-old, and also an increase in multibacillary cases diagnosed, signalling a serious impact of the pandemic on leprosy control strategies in Brazil. Funding This research received no specific grants.

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Spatial patterns and temporal tendency of mortality related to Chagas disease in an endemic area of northeastern Brazil

Cited by 7 publications

References 17 publications

Impact of the COVID-19 Pandemic on the Diagnosis of Tuberculosis in Brazil: Is the WHO End TB Strategy at Risk?

Impact of the COVID-19 Pandemic on the Diagnosis of Tuberculosis in Brazil: Is the WHO End TB Strategy at Risk?

Chagas Disease-Related Mortality in Spain, 1997 to 2018

Impact of the COVID-19 pandemic on the diagnosis of leprosy in Brazil: An ecological and population-based study

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