Spacetime modeling of mortality by infectious and parasitic diseases in Brazil

Abstract

Background: Infectious and parasitic diseases (IPDs) encompass a broad range of illnesses predominantly associated with poverty. They are more prevalent in low- and middle-income countries, including Brazil, where they continue to be among the leading causes of mortality. Objective: This study aims to analyze the spatiotemporal dynamics of mortality due to IPDs in Brazil from 2000 to 2019. Methods: We conducted an ecological study using data on mortality by IPDs from the Brazilian Mortality Information System. We applied the segmented log-linear regression model to assess temporal trends. For spatial analysis, we used the local empirical Bayesian estimator and Moran indices. Retrospective spatiotemporal scan statistics were performed using the Poisson Probability Distribution Model. Results: Between 2000 and 2019, there were 2,155,513 deaths related to IPDs in Brazil. The leading causes of death included acute respiratory infections (n = 1,130,069; 52.49%), septicemia (n = 289,817; 13.46%), human immunodeficiency virus/acquired immunodeficiency syndrome (n = 232,892; 10.82%), tuberculosis (n = 104,121; 4.84%), and neglected tropical diseases such as Chagas disease (n = 94,788; 4.40%) and schistosomiasis (n = 10,272; 0.48%). An increasing temporal trend in the mortality rate from IPDs was observed in Brazil and across all its regions. Additionally, our spatiotemporal scan identified high-risk clusters of death in the Southeast and Northeast regions. Conclusion: Mortality from IPDs remains a significant public health concern in Brazil, with an increasing trend observed in all regions. Our findings underscore the urgent need for comprehensive intersectoral public policies. These policies should focus on a greater allocation of resources and investments in the most critical areas, aiming to significantly reduce the number of deaths, particularly in the most vulnerable regions.