Mortality Trends for Neglected Tropical Diseases in the State of Sergipe, Brazil, 1980-2013.
BACKGROUND
Neglected Tropical Diseases are a set of communicable diseases that affect the population so low socioeconomic status, particularly 1.4 billion people who are living below the poverty level. This study has investigated the magnitude and mortality time trends for these diseases in the state of Sergipe, Northeast Region of Brazil.


METHODS
We conducted an ecological study of time series, based on secondary data derived from the Mortality Information System of the Ministry of Health. The mortality rates (crude, age-standardized rates and proportional ratio) were calculated from the deaths due to Neglected Tropical Diseases in the state of Sergipe, from 1980 to 2013. The time trends were obtained using the Joinpoint regression model.


RESULTS
Three hundred six thousand and eight hundred seventy-two deaths were certified in the state and Neglected Tropical Diseases were mentioned as the underlying cause in 1,203 certificates (0.39%). Mean number of deaths was 35.38 per year, and crude and age-standardized mortality rates were, respectively: 2.16 per 100 000 inhabitants (95% CI: 1.45-2.87) and 2.87 per 100 000 inhabitants (95% CI: 1.93-3.82); the proportional mortality ratio was 0.41% (95% CI: 0.27-0.54). In that period, Schistosomiasis caused 654 deaths (54.36%), followed by Chagas disease, with 211 (17.54%), and by Leishmaniases, with 142 (11.80%) deaths. The other diseases totalized 196 deaths (16.30%). There were increasing mortality trends for Neglected Tropical Diseases, Schistosomiasis and Chagas disease in the last 15 years, according to the age-standardized rates, and stability of the mortality trends for Leishmaniases.


CONCLUSIONS
The Neglected Tropical Diseases show increasing trends and are a real public health problem in the state of Sergipe, since they are responsible for significant mortality rates. The following diseases call attention for showing greater number of deaths in the period of study: Schistosomiasis, Chagas disease and Leishmaniases. We finally suggest that public managers take appropriate actions to develop new strategies in epidemiological and therapeutic surveillance, and in the follow-up of these patients.
University Hospital, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil. albuquerquemac@uol.com.br.|Post-doc Medicine Unit, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil. albuquerquemac@uol.com.br.
Marcos Antônio
MA
Costa de Albuquerque
University Hospital, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil.
Danielle Menezes
DM
Dias
University Hospital, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil.
Lucas Teixeira
LT
Vieira
University Hospital, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil.|Post-doc Medicine Unit, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil.
Carlos Anselmo
CA
Lima
University Hospital, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil.|Post-doc Medicine Unit, Federal University of Sergipe, Rua Claudio Batista s/n, B. Santo Antonio, Aracaju, SE, 49060-108, Brazil.
Angela Maria
AM
da Silva
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D014355:Chagas Disease / Q000453:epidemiology / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007896:Leishmaniasis / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D058069:Neglected Diseases / Q000453:epidemiology / Q000401:mortality*; D012552:Schistosomiasis / Q000453:epidemiology / Q000401:mortality*; D016019:Survival Analysis; D014329:Tropical Climate; D055815:Young Adult
Joinpoint; Mortality; Neglected tropical diseases; Trends