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Epidemiology of soil-transmitted helminthiases-related mortality in Brazil

Published online by Cambridge University Press:  20 January 2017

FRANCISCO R. MARTINS-MELO ,
ALBERTO N. RAMOS JR ,
CARLOS H. ALENCAR ,
MAURICÉLIA S. LIMA  and
JORG HEUKELBACH
FRANCISCO R. MARTINS-MELO*
Affiliation:
Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil Federal Institute of Education, Science and Technology of Ceará, Caucaia, Brazil
ALBERTO N. RAMOS JR
Affiliation:
Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
CARLOS H. ALENCAR
Affiliation:
Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
MAURICÉLIA S. LIMA
Affiliation:
Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil São José Hospital for Infectious Diseases, Fortaleza, Brazil
JORG HEUKELBACH
Affiliation:
Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
*
*Corresponding author: Federal Institute of Education, Science and Technology of Ceará, Rua Francisco da Rocha Martins, s/n, Pabussu, CEP 61609-090, Caucaia, Ceará, Brazil. E-mail: [email protected]
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Summary

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.

Keywords

soil-transmitted helminthiasisneglected tropical diseasesmortalityspatial analysistime trend analysisBrazil
Type
Research Article
Information
Parasitology , Volume 144 , Issue 5 , April 2017 , pp. 669 - 679
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Copyright
Copyright © Cambridge University Press 2017 

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