Mortality of Chagas' disease in Brazil: spatial patterns and definition of high-risk areas

Martins-Melo, Francisco Rogerlândio, Ramos, Alberto Novaes, Alencar, Carlos Henrique, Lange, Wolfram, and Heukelbach, Jorg (2012) Mortality of Chagas' disease in Brazil: spatial patterns and definition of high-risk areas. Tropical Medicine and International Health , 17 (9). pp. 1066-1075.

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Abstract

Objective: To describe patterns of spatial distribution of mortality associated with Chagas disease in Brazil.

Methods: Nationwide study of all deaths in Brazil from 1999 to 2007, where Chagas disease was recorded as a cause of death. Data were obtained from the national Mortality Information System of the Ministry of Health. We calculated the mean mortality rate for each municipality of residence in three-year intervals and the entire period. Empirical Bayes smoothing was used to minimise random variation in mortality rates because of the population size in the municipalities. To evaluate the existence of spatial autocorrelation, global and local Morans I indices were used.

Results: The nationwide mean mortality rate associated with Chagas disease was 3.37/100 000 inhabitants/year, with a maximum of 138.06/100 000 in one municipality. Independently from the statistical approach, spatial analysis identified a large cluster of high risk for mortality by Chagas disease, involving nine states in the Central region of Brazil.

Conclusion: This study defined geographical priority areas for the management of Chagas disease and consequently reducing disease-associated mortality in Brazil. Different spatial-analytical approaches can be integrated to provide data for planning, monitoring and evaluating specific intervention measures.

Item ID: 23547
Item Type: Article (Research - C1)
ISSN: 1365-3156
Keywords: Chagas' disease, spatial analysis, ecological studies, epidemiology, mortality, multiple causes of death, Brazil
Date Deposited: 03 Oct 2012 05:27
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1108 Medical Microbiology > 110803 Medical Parasitology @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 34%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 33%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 34%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920120 Zoonoses @ 33%
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