[Trends in infectious diseases mortality in Spain].
OBJECTIVE
The aim of this study was to describe the trend and geographical distribution of mortality by infectious diseases in Spain between 1980 and 1993.


METHODS
Deaths caused by infectious diseases ocurred in Spain between 1980-1993 were studied. Data were obtained from the national mortality registry from the Instituto Nacional de Estadística. Deaths included in the International Diseases Classification (ICD-9) in group I were included, and also deaths by infectious diseases included in other groups. The trend in mortality risk was evaluated by means of a log-lineal Poisson model. Standardized mortality rates (SMR) by age for each Spanish province in 1980-83 and 1990-93, were calculated to identify geographical differences in mortality. These SMR were compared using Spearman correlation coefficient.


RESULTS
Between 1980 and 1993, the adjusted mortality rate by infectious diseases decreased around 1.4% each year. In 1980 and also in 1993 respiratory tract infections were the first cause of death, 29.6 and 20.3 deaths for 105 inhabitants, respectively. The second cause of death was tuberculosis in 1980, 3.9 x 10⁵ and HIV infection in 1993, 10.7 x 10⁵. This decrease in infectious diseases mortality during the studied period was shown in all age groups, except for the 25 to 44 age group, were mortality rate increased by seven times. The geographical distribution showed that the provinces with the highest mortality rate were the same in 1980-83 and in 1990-93 (Spearman coefficient: 0.49; p < 0.001).


CONCLUSIONS
Because deaths by infectious diseases are distributed in different groups in the ICD-9, their impact on mortality is underestimated, although they are the fourth cause of death in Spain. However, between 1980 and 1993 it has been shown a decrease in mortality by these diseases, except for the 25-44 age group where an impressive increase ocurred due to HIV infection. No differences between provinces have been shown.
Fernández de la Hoz
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Subdirección General de Sanidad Penitenciaria, Dirección General de Instituciones Penitenciarias, Ministerio del Interior, Madrid, 28014, España.
de Mateo
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S
Regidor
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E
D003141:Communicable Diseases / Q000401:mortality*; D006801:Humans; D009026:Mortality / Q000639:trends; D013030:Spain / Q000453:epidemiology; D013997:Time Factors