Tendência da mortalidade relacionada à doença de Chagas, Estado de São Paulo, Brasil, 1985 a 2006: estudo usando causas múltiplas de morte

Santo, Augusto Hasiak

doi:10.1590/s1020-49892009001000003

Cited by 25 publications

(54 citation statements)

References 31 publications

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“…We observed that the main conditions associated with death by Chagas' disease have been inserted into the group of diseases of the circulatory system, corroborating previous studies 3,15 . 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: Discussionsupporting

confidence: 91%

“…The present study shows that information from multiple causes of death recorded on death certificates allowed partial reconstruction of the natural history and the reconstitution of the morbid process of determining death by Chagas' disease 3 . 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.…”

Section: Discussionmentioning

confidence: 83%

“…In order to reconstruct the disease process that possibly led to death related to Chagas' disease, all causes reported on the death certificate were analyzed, even ill-defined and those characterized by WHO as modes of death, such as cardiorespiratory arrest and multiple organ failure 1,3 .…”

Section: Data Processing and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…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 .…”

mentioning

confidence: 99%

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Multiple causes of death related to Chagas' disease in Brazil, 1999 to 2007

Martins-Melo

Ramos

Alencar

et al. 2012

Rev. Soc. Bras. Med. Trop.

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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...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 83%

Section: Data Processing and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Multiple causes of death related to Chagas' disease in Brazil, 1999 to 2007

Martins-Melo

Ramos

Alencar

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Trends and spatial patterns of mortality related to neglected tropical diseases in Brazil

Martins-Melo

Ramos

Alencar

et al. 2016

Parasite Epidemiology and Control

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We analysed nationwide trends and spatial distribution of NTD-related mortality in Brazil. We included all death certificates in Brazil from 2000 to 2011, in which NTDs were recorded as any causes of death. A total of 100,814/12,491,280 (0.81%) death certificates were identified, which mentioned at least one NTD. Age-adjusted NTD-related mortality rates showed a significant decrease over time (annual percent change [APC]: − 2.1%; 95% CI: − 2.8 to − 1.3), with decreasing mortality rates in the Southeast, South, and Central-West regions, stability in the Northeast region, and increase in the North region. We identified spatial and spatiotemporal high-risk clusters for NTD-related mortality in all regions, with a major cluster covering a wide geographic range in central Brazil. Despite nationwide decrease of NTD-related mortality in the observation period, regional differences remain, with increasing mortality trends especially in the socioeconomically disadvantaged regions of the country. The existence of clearly defined high-risk areas for NTD-related deaths reinforces the need for integrated prevention and control measures in areas with highest disease burden.

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