title: Trends and factors associated with dengue mortality and fatality in Brazil.
abstract: BACKGROUND
  Studies that generate information that may reduce the dengue death risk are essential. This study analyzed time trends and risk factors for dengue mortality and fatality in Brazil from 2001 to 2011.
  
  
  METHODS
  Time trends for dengue mortality and fatality rates were analyzed using simple linear regression. Associations between the dengue mortality and the case fatality rates and socioeconomic, demographic, and health care indicators at the municipality level were analyzed using negative binomial regression.
  
  
  RESULTS
  The dengue hemorrhagic fever case fatality rate increased in Brazil from 2001 to 2011 (β=0.67; p=0.036), in patients aged 0-14 years (β=0.48; p=0.030) and in those aged ≥15 years (β=1.1; p<0.01). Factors associated with the dengue case fatality rate were the average income per capita (MRR=0.99; p=0.038) and the number of basic health units per population (MRR=0.89; p<0.001). Mortality rates increased from 2001 to 2011 (β=0.350; p=0.002).Factors associated with mortality were inequality (RR=1.02; p=0.001) high income per capita (MRR=0.99; p=0.005), and higher proportions of populations living in urban areas (MRR=1.01; p<0.001).
  
  
  CONCLUSIONS
  The increases in the dengue mortality and case fatality rates and the associated socioeconomic and health care factors, suggest the need for structural and intersectoral investments to improve living conditions and to sustainably reduce these outcomes.
authors: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, BR.
authors: Enny Santos
authors: ES
authors: Paixão
authors: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, BR.
authors: Maria da Conceição Nascimento
authors: Mda C
authors: Costa
authors: London School of Hygiene and Tropical Medicine, London, GB.
authors: Laura Cunha
authors: LC
authors: Rodrigues
authors: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, BR.
authors: Davide
authors: D
authors: Rasella
authors: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, BR.
authors: Luciana Lobato
authors: LL
authors: Cardim
authors: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, BR.
authors: Alcione Cunha
authors: AC
authors: Brasileiro
authors: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, BR.
authors: Maria Gloria Lima Cruz
authors: MG
authors: Teixeira
mesh_terms: D000293:Adolescent; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009026:Mortality / Q000639:trends; D012307:Risk Factors; D019595:Severe Dengue / Q000401:mortality; D055815:Young Adult