Visceral leishmaniasis lethality in Brazil: an exploratory analysis of associated demographic and socioeconomic factors.

Autor:	Donato LE; Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil., Freitas LRS; Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil., Duarte EC; Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Tropical, Brasília, DF, Brasil., Romero GAS; Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Tropical, Brasília, DF, Brasil.
Jazyk:	angličtina
Zdroj:	Revista da Sociedade Brasileira de Medicina Tropical [Rev Soc Bras Med Trop] 2020 Sep 11; Vol. 53, pp. e20200007. Date of Electronic Publication: 2020 Sep 11 (Print Publication: 2020).
DOI:	10.1590/0037-8682-0007-2020
Abstrakt:	Introduction: It is believed that delays in diagnosis and treatment of Visceral Leishmaniasis (VL) contribute significantly to the burden of VL lethality in Brazil. Methods: This study included several parts: a descriptive cross-sectional study of the individual characteristics of deaths from disease; a descriptive ecological study of the spatial distribution of deaths from disease; and an ecological analytical study to evaluate the association between disease lethality rates and the demographic, socioeconomic, and health indicators. The study population comprised all cases diagnosed throughout the country per the National Disease Notification System (SINAN) and the total number of disease deaths recorded in the Mortality Information System (SIM) from 2007 to 2012. Results: Of the 223 deaths from disease captured by pairing the databases, 59.1% were reported as "death from other causes". There were significant associations between VL lethality rate and municipalities with the highest proportion of vulnerable individuals (rate ratio (RR)=1.18, 95% confidence interval (CI): 1.01-1.27), with VL lower incidence rate (RR=0.62, 95% CI: 0.58-0.67) and a higher incidence rate of Acquired Immune Deficiency Syndrome (AIDS) (RR=1.20, 95% CI: 1.17-1.51). Conclusions: Linking the SINAN and SIM databases allowed the inclusion of 14% of otherwise underreported deaths from VL for the study period, showing that this method is useful for the surveillance of VL-related deaths. The size of the municipal population, proportion of the vulnerable population, incidence of disease, and the incidence of AIDS were associated with municipal lethality rates related to VL in Brazil.
Databáze:	MEDLINE
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