title: Multiple causes of death related to Chagas' disease in Brazil, 1999 to 2007.
abstract: BACKGROUND
  Chagas' disease is a major public health problem in Brazil and needs extensive and reliable information to support consistent prevention and control actions. This study describes the most common causes of death associated with deaths related to Chagas' disease (underlying or associated cause of death).
  
  
  METHODS
  Mortality data were obtained from the Mortality Information System of the Ministry of Health (approximately 9 million deaths). We analyzed all deaths that occurred in Brazil between 1999 and 2007, where Chagas' disease was mentioned on the death certificate as underlying or associated cause (multiple causes of death).
  
  
  RESULTS
  There was a total of 53,930 deaths related to Chagas' disease, 44,543 (82.6%) as underlying cause and 9,387 (17.4%) as associated cause. The main diseases and conditions associated with death by Chagas' disease as underlying cause included direct complications of cardiac involvement, such as conduction disorders/arrhythmias (41.4%) and heart failure (37.7%). Cerebrovascular disease (13.2%), ischemic heart disease (13.2%) and hypertensive diseases (9.3%) were the main underlying causes of deaths in which Chagas' disease was identified as an associated cause.
  
  
  CONCLUSIONS
  Cardiovascular diseases were often associated with deaths related to Chagas' disease. Information from multiple causes of death recorded on death certificates allows reconstruction of the natural history of Chagas' disease and suggests preventive and therapeutic potential measures more adequate and specifics.
authors.affiliation: Departamento de Saúde Comunitária, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Francisco Rogerlândio
authors.initials: FR
authors.lastname: Martins-Melo
authors.forename: Alberto Novaes
authors.initials: AN
authors.lastname: Ramos Junior
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Alencar
authors.forename: Jorg
authors.initials: J
authors.lastname: Heukelbach
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D014355:Chagas Disease / Q000150:complications / Q000401:mortality*; D002908:Chronic Disease; D003644:Death Certificates; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data