Changes in malaria patterns in Brazil over 28 years (1990–2017): results from the Global Burden of Disease Study 2017

Population Health Metrics

Francisco Rogerlândio Martins-Melo¹  Guilherme Loureiro Werneck²  Juliana Maria Trindade Bezerra³  David Soeiro Barbosa³  Mariângela Carneiro⁴  Érika Martins Braga⁵  Pedro Luiz Tauil⁶ 

[1] Federal Institute of Education, Science, and Technology of Ceará, Rua Francisco da Rocha Martins, S/N, Pabussu, 61609-090, Caucaia, Ceará, Brazil;Department of Epidemiology, Social Medicine Institute, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, 20550-013, Rio de Janeiro, Brazil;Institute for Public Health Studies, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo, S/N, Ilha do Fundão – Cidade Universitária, 21941-598, Rio de Janeiro, Brazil;Laboratory of Epidemiology of Infectious and Parasitic Diseases, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Avenida Presidente Antônio Carlos, 6627, Pampulha, 31270-901, Belo Horizonte, Minas Gerais, Brazil;Laboratory of Epidemiology of Infectious and Parasitic Diseases, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Avenida Presidente Antônio Carlos, 6627, Pampulha, 31270-901, Belo Horizonte, Minas Gerais, Brazil;Post-Graduation Program in Health Sciences, Infectology and Tropical Medicine, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, Santa Efigênia, 30130-100, Belo Horizonte, Minas Gerais, Brazil;Laboratory of Malaria, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Avenida Presidente Antônio Carlos, 6627, Pampulha, 31270-901, Belo Horizonte, Minas Gerais, Brazil;School of Medicine, Postgraduate Program in Tropical Medicine, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, 70910-900, Brasília, Distrito Federal, Brazil;

关键词: Malaria;    Burden of disease;    Disability-adjusted life year;    Brazil;   

DOI  :  10.1186/s12963-020-00211-6

来源: Springer

【 摘 要 】

BackgroundThis study presents the malaria burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), by analyzing disease burden indicators in federated units of the Legal Amazon and Extra-Amazon regions, as well as describing malaria cases according to Plasmodium species occurring in the country.MethodsWe used estimates from the GBD 2017 to report years of life lost due to premature death (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for malaria in Brazil, grouped by gender, age group, and Brazilian federated unit, from 1990 to 2017. Results are presented as absolute numbers and age-standardized rates (per 100,000 inhabitants) with 95% uncertainty intervals (UI).ResultsAt the national level, the age-standardized DALYs rate due to malaria decreased by 92.0%, from 42.5 DALYs per 100,000 inhabitants (95% UI 16.6–56.9) in 1990 to 3.4 DALYs per 100,000 inhabitants (95% UI 2.7–4.7) in 2017. The YLLs were the main component of the total DALYs rate for malaria in 1990 (67.3%), and the YLDs were the main component of the metric in 2017 (61.8%). In 2017, the highest sex–age DALYs rate was found among females in the “< 1-year-old” age group, with a 6.4 DALYs per 100,000 inhabitants (95% UI 1.8–14.7) and among males in the age group of “20 to 24 years old”, with a 4.7 DALYs per 100,000 inhabitants (95% UI 3.3–9.9). Within the Brazilian Amazon region, the three federated units with the highest age-standardized DALYs rates in 2017 were Acre [28.4 (95% UI 14.2–39.1)], Roraima [28.3 (95% UI 13.5–40.2)], and Rondônia [24.7 (95% UI 11.4–34.8)]. Concerning the parasite species that caused malaria, 73.5% of the total of cases registered in the period had Plasmodium vivax as the etiological agent.ConclusionsThe results of the GBD 2017 show that despite the considerable reduction in the DALYs rates between 1990 and 2017, malaria remains a relevant and preventable disease, which in recent years has generated more years of life lost due to disability than deaths. The states endemic for malaria in the Amazon region require constant evaluation of preventive and control measures. The present study will contribute to the direction of current health policies aimed at reducing the burden of malaria in Brazil, as knowing the geographical and temporal distribution of the risk of death and disability of this disease can facilitate the planning, implementation, and improvement of control strategies aimed at eliminating the disease.

【 授权许可】

CC BY