Chagas Disease-Related Mortality in Spain, 1997 to 2018
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Base and Extractionn of Variables
2.2. Statistics Analysis
2.3. Ethical Aspects
3. Results
3.1. CD Hospitalization and Incidence Rate
3.2. Fatality and Case Fatality Rate
3.3. Risk Factorrelated with Mortality
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Year | No. Deaths/No. Cases | % of Total Death | CFR % (95% CI) |
---|---|---|---|
1997 | 0/8 | 0.0 | 0.0 (0–32.4) |
1998 | 0/2 | 0.0 | 0.0 (0–65.7) |
1999 | 0/4 | 0.0 | 0.0 (0–48.6) |
2000 | 0/5 | 0.0 | 0.0 (0–43.6) |
2001 | 0/13 | 0.0 | 0.0 (0–22.8) |
2002 | 2/21 | 3.6 | 9.5 (2.6–28.9) |
2003 | 0/22 | 0.0 | 0.0 (0–14.7) |
2004 | 0/24 | 0.0 | 0.0 (0–13.8) |
2005 | 2/49 | 3.6 | 4.1 (1.1–13.7) |
2006 | 0/89 | 0.0 | 0.0 (0–4.1) |
2007 | 5/185 | 8.9 | 2.7 (1.1–6.2) |
2008 | 2/221 | 3.6 | 0.9 (0.3–3.0) |
2009 | 4/287 | 7.1 | 1.4 (0.5–3.5) |
2010 | 2/399 | 3.6 | 0.5 (0.1–1.8) |
2011 | 4/402 | 7.1 | 1.0 (0.4–2.5) |
2012 | 5/413 | 8.9 | 1.2 (0.5–2.8) |
2013 | 6/434 | 10.7 | 1.4 (0.6–2.9) |
2014 | 3/471 | 5.4 | 0.6 (0.2–1.8) |
2015 | 0/476 | 0.0 | 0.0 (0–0.8) |
2016 | 7/465 | 12.5 | 1.5 (0.7–3.1) |
2017 | 5/474 | 8.9 | 1.1 (0.5–2.4) |
2018 | 9/558 | 16.1 | 1.6 (0.8–3.1) |
Total | 56/5022 | 100 | 1.1. (0.9–1.5) |
Age in Years | No. Deaths/ No. Cases | % of Total Deaths | CFR (95% CI) | OR (95% CI) | p-Value |
---|---|---|---|---|---|
0–9 | 2/149 | 3.6 | 1.3 (0.4–4.7) | 1 | - |
10–19 | 1/50 | 1.8 | 2.0 (0.4–10.5) | 1.50 (1.13–16.90) | 0.74 |
20–29 | 2/699 | 3.6 | 0.3 (0.08–1.0) | 0.21 (0.03–1.50) | 0.12 |
30–39 | 7/1888 | 12.5 | 0.4 (0.2–0.8) | 0.27 (0.56–1.32) | 0.11 |
40–49 | 8/1086 | 14.3 | 0.7 (0.4–1.5) | 0.54 (0.11–2.59) | 0.45 |
50–59 | 12/684 | 21.4 | 1.8 (1.0–3.0) | 1.31 (0.29–5.92) | 0.72 |
60–69 | 11/340 | 19.6 | 3.2(1.8–5.7) | 2.45 (0.53–11.22) | 0.25 |
70–79 | 7/89 | 12.5 | 7.9 (0.4–15.4) | 6.27 (1.27–30.90) | 0.024 |
80–89 | 5/30 | 8.9 | 16.7 (0.7–33.5) | 14.7 (2.70–79.90) | 0.002 |
90–100 | 1/7 | 1.8 | 14.3 (2.6–51) | 12.50 (0.98–154.12) | 0.53 |
Demographic Variables | Total Cases | Non-Obstetrics/Gynecology Cases | |||
---|---|---|---|---|---|
Non-Survivors (n = 56) | Survivors (n = 4966) | p-Value | Survivors (n = 2937) | p-Value | |
Age, median (IQR) | 54.5 (41, 68) | 38 (31,48) | <0.001 | 45 (36, 54) | <0.001 |
Men, n (%) | 28 (50) | 1121 (22.6) | <0.001 | 1816 (61.8) | 0.071 |
Comorbidities, n (%) | |||||
Neoplasms | 11 (19.6) | 169 (3.4) | <0.001 | 152 (5.2) | <0.001 |
Heart failure | 10 (17.9) | 359 (7.2) | 0.002 | 357 (12.2) | 0.20 |
Diabetes mellitus | 7 (12.5) | 186 (3.7) | 0.001 | 182 (6.2) | 0.055 |
Chronic kidney failure | 5 (8.9) | 80 (1.6) | <0.001 | 78 (2.7) | 0.018 |
HIV infection | 5 (8.9) | 40 (0.8) | <0.001 | 36 (1.2) | <0.001 |
Chronic lung diseases | 4 (7.1) | 140 (2.8) | 0.054 | 111 (3.8) | 0.20 |
Ischemic cardiopathy | 4 (7.1) | 165 (3.3) | 0.12 | 161 (5.5) | 0.59 |
Cerebrovascular diseases | 3 (5.4) | 130 (2.6) | 0.20 | 127 (4.3) | 0.71 |
Lymphoma/leukemia | 3 (5.4) | 52 (1.0) | 0.023 | 52 (1.8) | 0.082 |
Hospital admission, n (%) | |||||
Obstetrics/gynecology Wards | 0 (0) | 2029 (40.9) | <0.001 | - | - |
Medical wards | 48 (85.7) | 1758 (35.4) | <0.001 | 1758 (59.8) | <0.001 |
Surgical wards | 4 (7.1) | 744 (15) | 0.10 | 744 (25.3) | 0.002 |
Pediatric wards | 2 (3.6) | 140 (2.8) | 0.67 | 140 (4.8) | 0.67 |
Days of admission, median (IQR) | 10 (3.25, 23.5) | 3 (2.0. 7.0) | <0.001 | 5 (2.0.10–0) | <0.001 |
Readmission, n (%) a | 47 (11.4) | 298 (8.5) | 0.54 | 234 (11.8) | 0.95 |
Country of birth, n (%) b | |||||
Bolivia | 9 (50) | 705 (59.0) | 0.69 | 431 (58.2) | 0.49 |
Spain | 3(16) | 368 (30.8) | 0.20 | 225 (30.4) | 0.21 |
Ecuador | 1 (5.6) | 22 (1.8) | 0.25 | 19 (2.6) | 0.43 |
Paraguay | 0 (0) | 28 (0.6) | 1.00 | 16 (2.2) | 1 |
Argentina | 0 (0) | 21 (0.4) | 0.57 | 18 (2.4) | 1 |
Colombia | 1 (5.6) | 12 (1.0) | 0.18 | 8 (1.1) | 0.20 |
Venezuela | 0 (0) | 10 (0.8) | 1.00 | 7 (0.9) | 1 |
El Salvador | 0 (0) | 9 (0.8) | 1.00 | 5 (0.5) | 1 |
Brazil | 1 (1.8) | 6 (0.1) | 1.00 | 6 (0.8) | 0.16 |
Chile | 0 (0) | 4 (0.3) | 1.00 | 3 (0.4) | 1 |
Type of diagnostic, n (%) | |||||
CD without organ involvement | 20 (35.7) | 2834 (57.1) | 0.001 | 1368 (46.6) | 0.11 |
CD with heart involvement | 28 (50) | 1483 (29.9) | <0.001 | 1211 (41.2) | 0.19 |
CD with organ involvement | 10 (17.9) | 619 (12.5) | 0.23 | 366 (12.5) | 0.29 |
Trypanosomiasis non-specified | 4 (7.1) | 498 (10) | 0.47 | 221 (7.5) | 0.92 |
Variables | Total Cases | Non-Obstetrics/Gynecology Cases | ||||
---|---|---|---|---|---|---|
Crude OR (95% CI) | Adjusted OR (95% CI) | p-Value | Crude OR (95% CIs) | Adjusted OR (95% CI) | p-Value | |
Age | 1.06 (1.04, 1.08) | 1.05 (1.03, 1.07) | <0.001 | 1.04 (1.02, 1.06) | 1.04 (1.02, 1.23) | <0.001 |
Sex, male | 3.42 (2.20, 5.81) | 1.79 (1.03, 3.14) | 0.039 | 1.96 (0.95, 1.48) | 1.40 (0.82, 2.41) | 0.22 |
Neoplasms | 6.97 (3.56, 13.65) | 4.89 (2.13, 11.24) | <0.001 | 4.47 (2.27, 8.83) | 4.46 (1.97, 10.1) | <0.001 |
Heart failure | 2.79 (1.39, 5.57) | 1.45 (0.67, 3.16) | 0.34 | 1.57 (0.78, 3.71) | 1.30 (0.81, 2.79) | 0.69 |
Diabetes mellitus | 3.67 (1.64, 8.21) | 1.21 (0.48, 3.00) | 0.68 | 2.16 (0.96, 4.84) | 1.19 (0.49, 2.93) | 0.69 |
Chronic kidney failure | 5.98 (2.32, 15.40) | 2.25 (0.80, 6.34) | 0.12 | 3.59 (1.39, 9.25) | 2.14 (0.77, 5.95) | 0.15 |
HIV infection | 12.07 (4.57, 31.84) | 14.10 (4.88, 40.73) | <0.001 | 7.90 (2.97, 20.95) | 10.46 (3.65, 30.0) | <0.001 |
Lymphoma/leukemia | 5.34 (1.61, 17.68) | 0.92 (0.21, 3.94) | 0.92 | 3.14 (0.95, 10.3) | 0.78 (0.18, 3.32) | 0.73 |
CD with heart involvement | 2.39 (1.39, 3.98) | 1.57 (0.85, 3.91) | 0.15 | 1.42 (0.84, 2.14) | 0.94 (0.41, 2.15) | 0.89 |
CD without organ involvement | 0.41 (0.24, 0.72) | 0.55 (0.26, 1.17) | 0.13 | 0.63 (0.36, 1.10) | 0.73 (0.31, 1.68) | 0.46 |
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Ramos-Rincon, J.-M.; Llenas-García, J.; Pinargote-Celorio, H.; Sánchez-García, V.; Wikman-Jorgensen, P.; Navarro, M.; Gil-Anguita, C.; Ramos-Sesma, V.; Torrus-Tendero, D. Chagas Disease-Related Mortality in Spain, 1997 to 2018. Microorganisms 2021, 9, 1991. https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms9091991
Ramos-Rincon J-M, Llenas-García J, Pinargote-Celorio H, Sánchez-García V, Wikman-Jorgensen P, Navarro M, Gil-Anguita C, Ramos-Sesma V, Torrus-Tendero D. Chagas Disease-Related Mortality in Spain, 1997 to 2018. Microorganisms. 2021; 9(9):1991. https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms9091991
Chicago/Turabian StyleRamos-Rincon, Jose-Manuel, Jara Llenas-García, Hector Pinargote-Celorio, Veronica Sánchez-García, Philip Wikman-Jorgensen, Miriam Navarro, Concepción Gil-Anguita, Violeta Ramos-Sesma, and Diego Torrus-Tendero. 2021. "Chagas Disease-Related Mortality in Spain, 1997 to 2018" Microorganisms 9, no. 9: 1991. https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms9091991