Trends and predictions for survival and mortality in individuals with Down syndrome in Brazil: A 21‐year analysis

Abstract

Background Regional heterogeneities and sociodemographic characteristics affect mortality and population survival in Brazil. However, for individuals with Down syndrome (DS) this information remains unknown. In this study, we analysed survival and mortality rates among DS individuals in the five Brazilian geographic regions. In addition, we investigated whether there is an association between mortality and sociodemographic factors across administrative regions. Methods Data between 1996 and 2016, comprising 10 028 records of deaths of individuals with DS, were collected from database records of the Department of Informatics of the Unified Health System. Data on race/ethnicity, sex, age and years of schooling were defined for the association analyses. Survival data were analysed according to the Kaplan–Meier method and Cox regression model. Results The number of deaths among people with DS has increased in recent years. Children are more susceptible to death, especially in the first years of life. Individuals living in the northern region, Indigenous women and people with no years of schooling have higher mortality. In the Southeast and South region, for White and Yellow, survival is related to a higher level of education. Ethnic factors and years of schooling influence risk for mortality across the administrative regions. Conclusions These findings show that sociodemographic characteristics affect survival and are associated with the risk of mortality for people with DS. In addition, this suggests that differences in access to health services among Brazilian regions, especially in the first years of life, may affect the survival of individuals with DS.

Global, Regional, and National Burden and Trends of Down Syndrome From 1990 to 2019

“…Christianson et al (2006) reported that 65% of the infants and children with DS had died by the age of two in South Africa in the early and mid-1990s. Coinciding with the report in Brazil that children were more susceptible to death (de Campos Gomes et al, 2020), the majority of deaths occurred in the children less than 5 years old in different SDI region except high SDI region. Prioritizing a reduction in deaths of newborns and children is one of the seventeen Sustainable Development Goals (Nations, 2014).…”

“…Both age-standardized DALYs and ASDR were negatively correlated with SDI, indicating that difference might be partly attributed to social and economic factors. Analogously, many studies indicated that sociodemographic characteristics impacted the survival and the risk of mortality for patients with DS (Fiscella et al, 2000;de Campos Gomes et al, 2020). According to the literature, the most common reason of death in childhood and adulthood remained as respiratory infection (Bull, 2020); dementia was the direct reason of death in 70% of dead older people with DS (McGlinchey et al, 2020).…”

“…The percentage of women aged greater than 35, who do not have universal screening, prenatal diagnosis, and associated services, was high in middle-and low-income countries (Christianson et al, 2006). In addition, many studies indicated that sociodemographic characteristics impacted the survival and the risk of mortality for patients with DS (Fiscella et al, 2000;de Campos Gomes et al, 2020). Therefore, maternal age, participation rates in prenatal screening and selective termination of pregnancy, and sociodemographic index (SDI) level were associated with burden of DS.…”

Nomograms individually predict the overall survival and cancer-specific survival of adult patients with hemispheres lower-grade gliomas: A SEER-Based Study

“…Indeed, blacks have a higher risk than whites [48,49], which is coherent with the ndings of our study. However, only a few reports of the association between yellows and disease are available in the literature [50,51]. The effect of the level of yellows on the survival of LGGs was similar according to survival models.…”

Risk for Severe Illness and Death among Pediatric Patients with Down Syndrome Hospitalized for COVID-19, Brazil

“…The lower prevalence in Brazil might be because of the difference in the maternal age profile ( 1 ). Nevertheless, death among persons with Down syndrome in Brazil has increased in recent years, particularly among children ( 2 ). Socioeconomic and regional differences in the quality of and access to healthcare, particularly in the North and Northeast regions, might explain increased death rates ( 2 , 3 ).…”