Chagas disease-related mortality in Colombia from 1979 to 2018: temporal and spatial trends

• Published in: Revista da Sociedade Brasileira de Medicina Tropical Vol. 54; p. e07682020
• Main Authors: Olivera, Mario Javier, Porras-Villamil, Julián Felipe, Villar, Juan Carlos, Herrera, Eliana Váquiro, Buitrago, Giancarlo
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Medicina Tropical - SBMT 01-01-2021; Sociedade Brasileira de Medicina Tropical (SBMT)
• Subjects: Aged; Cause of Death; Chagas Disease; Colombia; Colombia - epidemiology; Epidemiology; Humans; Major; Male; Mortality; Public Health; Time trends; TROPICAL MEDICINE; Colombia; Chagas disease; Colombia; Time trends; Epidemiology; Mortality
• DOI: 10.1590/0037-8682-0768-2020
• EISSN: 1678-9849
• ISSN: 0037-8682; 1678-9849

Studies on Chagas disease-related mortality assist in decision-making in health policies. We analyzed the epidemiological characteristics, temporal trends, and regional differences in Chagas disease-related mortality in Colombia from 1979 to 2018.
A time-series study was conducted using death records and population data from the National Administrative Department of Statistics, using categorizations from the International Classification of Disease (ICD)-9 and ICD-10 systems. All deaths with Chagas disease as an underlying or associated cause of death were included. Crude and age-sex standardized mortality rates per 100,000 inhabitants and the annual percent change (APC) were calculated.
Of the 7,287,461 deaths recorded in Colombia during 1979-2018, 3,276 (0.04%) deaths were related to Chagas disease-2,827 (86.3%) as an underlying cause and 449 (13.7%) as an associated cause. The average annual age-sex standardized mortality rate was 0.211 (95% confidence interval [CI]: 0.170-0.252) deaths/100,000 inhabitants, with a significant upward trend (APC = 6.60%; 95% CI: 5.9-7.3). The highest Chagas disease-related death rates were in males (0.284 deaths/100,000 inhabitants), those ≥65 years old (1.296 deaths/100,000 inhabitants), and residents of the Orinoco region (1.809 deaths/100,000 inhabitants). There was a significant increase in mortality in the Orinoco (APC = 8.28%; 95% CI: 6.4-10.2), Caribbean (APC = 5.06%; 95% CI: 3.6-6.5), and Andean (APC = 4.63%; 95% CI: 3.9-5.3) regions.
Chagas disease remains a major public health issue in Colombia with high mortality rates in older age groups, a wide geographic distribution, regional differences, and the potential to increase.