Epidemiology of soil-transmitted helminthiases-related mortality in Brazil

Abstract

Soil-transmitted helminth (STH) infections are widely distributed in tropical and subtropical areas, including Brazil. We performed a nationwide population-based study including all deaths in Brazil from 2000 to 2011, in which STHs (ascariasis, trichuriasis and/or hookworm infection) were mentioned on death certificates, either as underlying or as associated causes of death. Epidemiological characteristics, time trends and spatial analysis of STH-related mortality were analysed. STHs was identified on 853/12 491 280 death certificates: 827 (97·0%) deaths related to ascariasis, 25 (2·9%) to hookworm infections, and 1 (0·1%) to trichuriasis. The average annual age-adjusted mortality rate was 0·34/1 000 000 inhabitants (95% confidence interval: 0·27-0·44). Females, children <10 years of age, indigenous ethnic groups and residents in the Northeast region had highest STH-related mortality rates. Nationwide mortality decreased significantly over time (annual percent change: -5·7%; 95% CI: -6·9 to -4·4), with regional differences. We identified spatial high-risk clusters for STH-related mortality mainly in the North, Northeast and South regions. Diseases of the digestive system and infectious/parasitic diseases were the most commonly associated causes of death mentioned in the STH-related deaths. Despite decreasing mortality in Brazil, a considerable number of deaths is caused by STHs, with ascariasis responsible for the vast majority. There were marked regional differences, affecting mainly children and vulnerable populations.

The burden of Neglected Tropical Diseases in Brazil, 1990-2016: A subnational analysis from the Global Burden of Disease Study 2016

“…The high burden due to Chagas disease corroborates findings of previous large-scale studies in Brazil, using mortality data [ 10 , 11 , 39 ]. Other major NTDs with predominantly chronic evolution were important causes of disability and/or premature death, such as schistosomiasis, leishmaniasis, cysticercosis, STHs, and trachoma [ 36 , 37 , 41 , 42 , 49 – 51 ]. For some chronic NTDs, such as Chagas disease, the highest disease burden is a result of infection in previous years.…”

“…STHs are important causes of disease burden throughout the national territory, mainly among the most underprivileged population groups [ 49 , 53 ]. Dengue fever is ranked as the third leading NTD cause in 2016.…”

“…Other factors not related to disease-specific control programs, in particular for NTDs without systematic surveillance and control programs or compulsory notification, such as cysticercosis and STHs, may have played an important role in the decline of burden for some NTDs in Brazil, such as improvements in socio-economic and sanitary conditions, increased urbanization, improved health education and access to healthcare services [ 8 , 9 , 11 , 41 , 49 ].…”

“…HIV/AIDS), since the presence of these NTD patients could aggravate the disease evolution, increasing the morbidity and mortality [ 26 , 47 , 75 ]. In addition, the implementation and sustainability of appropriate surveillance and control mechanisms and a mandatory reporting system for some important NTDs, such as cysticercosis, STHs and chronic Chagas disease, throughout the national territory could provide more accurate epidemiological data on the population prevalence and would allow geographical mapping of the affected areas [ 39 , 41 , 49 ]. In fact, the knowledge of true NTD burden is essential to track health progress, assess the impact of public health interventions, and inform evidence-based policy decisions [ 16 ].…”

Análise do perfil epidemiológico dos casos de leishmaniose visceral no estado do Piauí no período de 2009 a 2018

“…Os animais domésticos (cão e gato) são os principais reservatórios dessas espécies causadoras da LV. (Brasil, 2014;Costa, Pereira, & Araújo, 1990;Martins-Melo, Lima, Ramos, Alencar, & Heukelbach, 2014;Neves;Linardi, & Vitor, 2016;OMS, 2017) Das espécies mencionadas, o agente etiológico da LV no Brasil é o Leishmania infantum chagasi. Essa espécie apresenta tropismo pelo baço, fígado e linfonodos.…”