Trends and spatial patterns of mortality related to neglected tropical diseases in Brazil

• Main Authors: Francisco Rogerlândio Martins-Melo, Alberto Novaes Ramos, Jr., Carlos Henrique Alencar, Jorg Heukelbach
• Format: Article
• Language: English
• Published: Elsevier 2016-06-01
• Series: Parasite Epidemiology and Control
• Subjects: Neglected tropical diseases; Time trend analysis; Spatial analysis; Epidemiology; Mortality; Brazil
• Online Access: http://www.sciencedirect.com/science/article/pii/S2405673115300854

We analysed nationwide trends and spatial distribution of NTD-related mortality in Brazil. We included all death certificates in Brazil from 2000 to 2011, in which NTDs were recorded as any causes of death. A total of 100,814/12,491,280 (0.81%) death certificates were identified, which mentioned at least one NTD. Age-adjusted NTD-related mortality rates showed a significant decrease over time (annual percent change [APC]: −2.1%; 95% CI: −2.8 to −1.3), with decreasing mortality rates in the Southeast, South, and Central-West regions, stability in the Northeast region, and increase in the North region. We identified spatial and spatiotemporal high-risk clusters for NTD-related mortality in all regions, with a major cluster covering a wide geographic range in central Brazil. Despite nationwide decrease of NTD-related mortality in the observation period, regional differences remain, with increasing mortality trends especially in the socioeconomically disadvantaged regions of the country. The existence of clearly defined high-risk areas for NTD-related deaths reinforces the need for integrated prevention and control measures in areas with highest disease burden.