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High burden of hospital morbidity and mortality due to Chagas disease in Bahia state, Northeast Brazil, 2000-2022

2025-05-17Journal article Restricted access
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datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorGarcía, Gabriela Soledad Márdero
dc.contributor.authorLeite, Andreia
dc.contributor.authorde Souza, Eliana Amorim
dc.contributor.authorFerreira, Anderson Fuentes
dc.contributor.authorde Sousa, Andrea Silvestre
dc.contributor.authorLuiz, Ronir Raggio
dc.contributor.authorLuquetti Ostermayer, Alejandro
dc.contributor.authorHeukelbach, Jorg
dc.contributor.authorPalmeira, Swamy Lima
dc.contributor.authorde Castro, Cleudson Nery
dc.contributor.authorde Carvalho, Cristiane Medeiros Moraes
dc.contributor.authorRibeiro, Suzana Cristina Silva
dc.contributor.authorOliveira, Cândida Carolina Lima
dc.contributor.authorRamos, Alberto Novaes
dc.date.accessioned2025-11-11T13:23:23Z
dc.date.available2025-11-11T13:23:23Z
dc.date.issued2025-05-17
dc.description.abstractChagas disease (CD) is a chronic condition associated with high morbidity and mortality in endemic regions of Brazil, particularly in the state of Bahia. The clinical-epidemiologic analysis of hospital admissions is strategic due to limited data on chronic CD infections and the general lack of access to diagnosis and treatment. This study examines sociodemographic and clinical-epidemiological patterns of hospital morbidity and mortality from CD and its temporal trends from 2000 to 2022 in Bahia, Northeast Brazil. A mixed ecological study was conducted using data from hospital and mortality information systems. We calculated the hospital case fatality and all-cause mortality rates for CD, analysing temporal trends through joinpoint regression. Out of 20,189,658 hospital admissions, 4,557 (0.02%) were associated with CD, yielding a hospital lethality of 0.10 per 100,000 inhabitants. Of 1,832,325 Death Certificates, 16,960 (0.93%) were attributed to CD, equating to 5.16 deaths per 100,000 inhabitants. The risk ratios for hospital case fatality and mortality were higher among males, residents of municipalities with a 'medium' Brazilian Deprivation Index, those in the Central-North region, and patients with megacolon. Hospital case fatality significantly increased among males, the elderly (≥70 years) and residents in municipalities with 'high' or 'very high' Brazilian Deprivation Index in the Central-North and Central-East regions. The all-cause mortality trend for CD also rose among women and in municipalities with 'high' and 'very high' Brazilian Deprivation Index across the Southwest, West, North and Central-East regions. Programmatic vulnerabilities related to healthcare access within the Unified Health System likely contributed to delayed diagnoses and the increasing severity of specific forms of CD.eng
dc.description.sponsorshipThis study was supported by the IntegraChagas Brazil Project of the Ministry of Health of Brazil (TED No. 161/2019). Additional funding was provided by the Bahia State Research Support Foundation (FAPESB) through the 003/2017 Research Program for the Unified Health System (PPSUS), and by the Netherlands Hanseniasis Relief of Brazil (NHR Brazil). The National Council for Scientific and Technological Development (CNPq) also contributed, under the call MCTI/CNPq No. 01/2016, Process No. 433078/2016–2 and the Research Productivity Grant (PQ - CNPq - 316316/2023-7). Further support came from the Coordination for the Improvement of Higher Education Personnel (CAPES) through the Graduate Support Program (PROAP) of the Federal University of Ceará.
dc.identifier.citationTrop Med Int Health. 2025 May;30(5):368-381. doi: 10.1111/tmi.14085. Epub 2025 Mar 17
dc.identifier.doihttps://doi.org/10.1111/tmi.14085
dc.identifier.eissn1365-3156
dc.identifier.issn1360-2276
dc.identifier.pmid40091511
dc.identifier.urihttp://hdl.handle.net/10400.18/10587
dc.language.isoeng
dc.peerreviewedyes
dc.publisherWiley
dc.relation.hasversionhttps://onlinelibrary.wiley.com/doi/epdf/10.1111/tmi.14085
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectChagas Disease
dc.subjectEpidemiology
dc.subjectHospitalisation
dc.subjectMorbidity
dc.subjectMortality
dc.subjectBrazil
dc.subjectEstados de Saúde e de Doença
dc.titleHigh burden of hospital morbidity and mortality due to Chagas disease in Bahia state, Northeast Brazil, 2000-2022eng
dc.typejournal article
dcterms.referenceshttps://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1111%2Ftmi.14085&file=tmi14085-sup-0001-supinfo.docx
dspace.entity.typePublication
oaire.citation.endPage381
oaire.citation.issue5
oaire.citation.startPage368
oaire.citation.titleTropical Medicine & International Health
oaire.citation.volume30
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameLeite
person.givenNameAndreia
person.identifier1052436
person.identifier.ciencia-id2F10-F9A9-E8A7
person.identifier.orcid0000-0003-0843-0630
person.identifier.scopus-author-id57109931300
relation.isAuthorOfPublication838ff85b-16c9-4992-b13f-e3099f916717
relation.isAuthorOfPublication.latestForDiscovery838ff85b-16c9-4992-b13f-e3099f916717

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