ABSTRACT
Introducción. Las enfermedades huérfanas se caracterizan por su baja prevalencia, comúnmente son de evolución crónica, debilitantes y potencialmente mortales. Objetivo. Determinar las características y los factores asociados a la mortalidad por enfermedades huérfanas en Chile, entre 2002 y 2017. Materiales y métodos. Es un estudio transversal y analítico a partir de datos secundarios oficiales del Departamento de Estadística e Información en Salud (DEIS) del Ministerio de Salud de Chile. Se calcularon las tasas de mortalidad específica, y las ajustadas por sexo y edad. Se efectuó un análisis de normalidad mediante la prueba de Kolmogórov-Smirnov. Se aplicaron la prueba de ji al cuadrado de independencia para las asociaciones y el análisis de regresión logística multivariada para determinar la probabilidad de muerte. Resultados. Durante el periodo de estudio, 10.718 defunciones se atribuyeron a enfermedades huérfanas; 53,2 % ocurrieron en mujeres. La tasa media anual de mortalidad fue de 3,9 por 100.000 habitantes: 4,1 en mujeres y 3,8 en hombres. Las principales causas de muerte, en mujeres, fueron enfermedad de Creutzfeldt-Jakob, anencefalia, hepatitis autoinmunitaria y, en hombres, enfermedad de Creutzfeldt-Jakob, distrofia muscular y anencefalia. Las mujeres tienen 1,75 más veces la posibilidad de fallecer por este grupo de enfermedades en comparación con los hombres (OR ajustado=1,75; IC95% 1,69-1,82). La mayor probabilidad de morir se presentó en los menores de 0 a 4 años (OR ajustado=15,30; IC95% 14,10-19,20). Conclusión. En Chile, las mujeres constituyeron el grupo de población de mayor riesgo de morir por enfermedades huérfanas durante los años 2002 y 2017.
Introduction: Rare diseases are characterized by their low prevalence, chronically debilitating and life-threatening nature. Objective: To determine the characteristics and factors associated with mortality due to rare diseases in Chile from 2002 to 2017. Materials and methods: We conducted an analytical cross-sectional study based on secondary mortality database from the Departamento de Estadística e Información en Salud (DEIS), Ministerio de Salud de Chile (Department of Statistics and Health Information, Chile Ministry of Health) from 2002 to 2017. The specific mortality rates adjusted by age and sex were calculated. A normality analysis was conducted using the Kolmogorov-Smirnov test. In addition, a chi-square test of independence for associations and multivariate logistic regression was applied to determine the probability of death. Results: Between 2008 and 2012 there were 10,718 deaths due to rare diseases, 53.2% of them occurred among women. The average annual mortality rate was 3.9 per 100,000 inhabitants: 4.1 in women and 3.8 in men. The main causes of mortality among women were Creutzfeldt-Jakob disease, anencephaly and autoinmune hepatitis, and among men, Creutzfeldt-Jakob disease, muscular dystrophy and anencephaly. Women are 1.75 times more likely to die than men (adjusted Odds Ratio (aOR) = 1.75; 95% CI: 1.69 - 1.82). The highest probability of dying occurred among children aged 0-4 years (aOR = 15.30; 95% CI: 14.10 - 19.20). Conclusion: Overall, the burden of mortality due to rare disease was higher among women of all ages in Chile between 2002 and 2017.
Subject(s)
Mortality Registries , Rare Diseases , Chile , Public Health , Cost of IllnessABSTRACT
Resumen Introducción: El trauma representa la primera causa de mortalidad en edades tempranas en el mundo. Objetivo: Analizar la tendencia en la mortalidad debida a lesiones por trauma en Colombia entre 2007 y 2017. Metodología: Se trata de un estudio a partir de información oficial del Departamento Administrativo Nacional de Estadística (DANE). Incluyó análisis de tendencia de las tasas de mortalidad ajustada por edad y sexo, análisis bivariado para demostrar diferencias de proporciones con la prueba de independencia de ji-cuadrado y un análisis multivariado para calcular la razón de probabilidad (odds ratio, OR) para mortalidad por trauma mediante la regresión logística multivariada. Resultados: Se atribuyeron a trauma 214 258 defunciones; 88,2 % ocurrieron en hombres. La tasa media anual de mortalidad fue de 40,9 por 100 000 habitantes: 75,2 en hombres y 9,7 en mujeres. La primera causa de muerte en la población masculina se atribuye a lesiones por arma de fuego (OR multivariado=2,287; IC 95 % 2,217 - 2,358) mientras que en la población de sexo femenino fueron los accidentes de tránsito (OR multivariado= 2,224; IC 95 % 2,163 - 2,286). Conclusiones: En general, la mortalidad por traumatismos fue mayor en los hombres de todas las edades, sobre todo en el grupo de 25 a 29 años (149,5 por 100 000 hombres/año) y los de 30 a 34 años (133,9 por 100 000 hombres) tenían más probabilidades de morir debido a lesiones relacionadas con la violencia.
Abstract Introduction: Trauma injuries are the leading cause of premature mortality worldwide. Objective: To analyze trends in mortality due to trauma injuries in Colombia from 2007 to 2017. Methods: We conducted a study of association based on official information from the National Administrative Department of Statistics (In Spanish, DANE). It included a trend analysis of mortality rates adjusted for age and sex, bivariate analysis to demonstrate differences in proportions with the chi-square test and multivariate analysis to calculate the Odds Ratio (OR) for trauma mortality using multivariate logistic regression. Results: 214,258 deaths were attributed to trauma injuries, and 88.2 % of them occurred among men of all ages. The mean mortality rate during the study period was 40.9 deaths per 100,000 people (75.2 among men and 9.7 in women). The main causes of death among men were firearms injuries (OR multivariate=2,287; IC 95% 2,217 - 2,358) while road traffic among women (OR multivariate= 2,224; IC 95% 2,163 - 2,286). Conclusion: Overall, mortality rates due to trauma injuries were higher among men of all ages than women, but 25 to 29 (149,5 per 100 000 men/year) and 30 to 34 year-old (133,9 per 100 000 men). males were more likely to die due to violence-related injuries.
Subject(s)
Humans , Male , Female , Wounds and Injuries , Mortality Registries , Public Health , Cause of Death , ColombiaABSTRACT
Salmonella Typhi (S. Typhi) is the causative agent of typhoid fever; a systemic disease affecting ~20 million people per year globally. There are little data regarding the contemporary epidemiology of typhoid in Latin America. Consequently, we aimed to describe some recent epidemiological aspects of typhoid in Colombia using cases reported to the National Public Health Surveillance System (Sivigila) between 2012 and 2015. Over the four-year reporting period there were 836 culture confirmed cases of typhoid in Colombia, with the majority (676/836; 80.1%) of reported cases originated from only seven departments. We further characterized 402 S. Typhi isolates with available corresponding data recovered from various departments of Colombia through antimicrobial susceptibility testing and molecular subtyping. The majority (235/402; 58.5%) of these typhoid cases occurred in males and were most commonly reported in those aged between 10 and 29 years (218/402; 54.2%); there were three (0.74%) reported fatalities. The overwhelming preponderance (339/402; 84.3%) of S. Typhi were susceptible to all tested antimicrobials. The most common antimicrobial to which the organisms exhibited non-susceptibility was ampicillin (30/402;7.5%), followed by nalidixic acid (23/402, 5.7%). Molecular subtyping identified substantial genetic diversity, which was well distributed across the country. Despite the diffuse pattern of S. Typhi genotypes, we identified various geographical hotspots of disease associated with local dominant genotypes. Notably, we found limited overlap of Colombian genotypes with organisms reported in other Latin American countries. Our work highlights a substantial burden of typhoid in Colombia, characterized by sustained transmission in some regions and limited epidemics in other departments. The disease is widely distributed across the country and associated with multiple antimicrobial susceptible genotypes that appear to be restricted to Colombia. This study provides a current perspective for typhoid in Latin America and highlights the importance of pathogen-specific surveillance to add insight into the limited epidemiology of typhoid in this region.
