Socioeconomic markers of dengue mortality in the 100 Million Brazilian Cohort (2007-2018): A nationwide registry-based cohort study.
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| Název: | Socioeconomic markers of dengue mortality in the 100 Million Brazilian Cohort (2007-2018): A nationwide registry-based cohort study. |
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| Autoři: | Cardim LL; Centro de Integração de Dados e Conhecimentos para Saúde - CIDACS (Center of Data and Knowledge Integration for Health), Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil., Teixeira MDG; Centro de Integração de Dados e Conhecimentos para Saúde - CIDACS (Center of Data and Knowledge Integration for Health), Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil., Costa MDCN; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil., Mitka WM; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Teixeira CSS; Centro de Integração de Dados e Conhecimentos para Saúde - CIDACS (Center of Data and Knowledge Integration for Health), Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil., Santos AC; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Santos G; Faculdade de Economia, Universidade Federal da Bahia, Salvador, Bahia, Brazil., Souza APF; Fundação Getúlio Vargas, São Paulo, São Paulo, Brazil., Smeeth L; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Barreto ML; Centro de Integração de Dados e Conhecimentos para Saúde - CIDACS (Center of Data and Knowledge Integration for Health), Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil., Brickley EB; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Paixao ES; Centro de Integração de Dados e Conhecimentos para Saúde - CIDACS (Center of Data and Knowledge Integration for Health), Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Pescarini JM; Centro de Integração de Dados e Conhecimentos para Saúde - CIDACS (Center of Data and Knowledge Integration for Health), Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom. |
| Zdroj: | PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2025 Nov 03; Vol. 19 (11), pp. e0013660. Date of Electronic Publication: 2025 Nov 03 (Print Publication: 2025). |
| Způsob vydávání: | Journal Article |
| Jazyk: | English |
| Informace o časopise: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101291488 Publication Model: eCollection Cited Medium: Internet ISSN: 1935-2735 (Electronic) Linking ISSN: 19352727 NLM ISO Abbreviation: PLoS Negl Trop Dis Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: San Francisco, CA : Public Library of Science |
| Výrazy ze slovníku MeSH: | Dengue*/mortality , Dengue*/epidemiology , Socioeconomic Factors*, Humans ; Brazil/epidemiology ; Male ; Female ; Adult ; Middle Aged ; Cohort Studies ; Adolescent ; Young Adult ; Registries ; Child ; Child, Preschool ; Aged ; Infant ; Risk Factors |
| Abstrakt: | Competing Interests: The authors have declared that no competing interests exist. Background: People living in economically disadvantaged circumstances experience higher risks of infections and death from arboviruses. However, more evidence is needed to better understand the socioeconomic factors influencing dengue mortality. We investigated if people of lower socioeconomic conditions in Brazil are more likely to die following dengue infection. Methodology/principal Findings: Linking nationwide socioeconomic data from the 100 Million Brazilian Cohort with dengue disease and death records registered in Brazil between 1st January 2007 and 31st December 2018, we used multivariable hierarchical analysis to investigate the socioeconomic determinants of dengue-specific and all-cause mortality within 15 days of dengue symptom onset. Among the 3,018,131 individuals from the 100 Million Brazilian Cohort diagnosed with dengue, 1810 died from dengue (Case Fatality Rate (CFR)=0.06%, 95%CI = 0.06-0.06%) and 3076 (CFR = 0.10%, 95%CI = 0.10-0.11%) died from any cause within 15 days of dengue symptom onset. People residing in the Northeast (OR=2.32; 95%CI = 1.74-3.10) and Midwest (OR=1.68; 95%CI = 1.25-2.27) regions, self-identifying as black race/ethnicity (OR=1.58; 95%CI = 1.31-1.90), having lower level of education (OR=2.35, 95%CI = 1.17-4.73), being retired/receiving pension (OR=2.24; 95%CI = 1.76-2.86), living in a household with rudimentary sewage (OR=1.19; 95%CI = 1.04-1.37) and having >2 inhabitants per room (OR=1.31; 95%CI = 1.11-1.55) had at higher odds of dengue-specific mortality. Similar characteristics were also associated with higher all-cause mortality after dengue infection, but also included residing in North region (OR=1.60; 95%CI = 1.24-2.06) and rural areas (OR=1.12; 95%CI = 1.01-1.24), self-identifying as Asian (OR=1.65; 95%CI = 1.07-2.54) and mixed race/brown (OR=1.20; 95%CI = 1.10-1.31) and living in households with poorer quality building and sanitary conditions. Conclusions/significance: Our findings provide evidence that individuals in Brazil with lower socioeconomic condition experience increased odds of dengue-specific and all-cause mortality within 15 days of dengue symptom onset. These findings underscore the importance of ensuring equitable access to high-quality treatment for severe dengue and suggest that reducing poverty and social inequality, including through improvement of sanitation and housing, may help mitigate dengue-related mortality. (Copyright: © 2025 Cardim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) |
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| Entry Date(s): | Date Created: 20251103 Date Completed: 20251103 Latest Revision: 20251106 |
| Update Code: | 20251106 |
| PubMed Central ID: | PMC12582496 |
| DOI: | 10.1371/journal.pntd.0013660 |
| PMID: | 41183110 |
| Databáze: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Competing Interests: The authors have declared that no competing interests exist.<br />Background: People living in economically disadvantaged circumstances experience higher risks of infections and death from arboviruses. However, more evidence is needed to better understand the socioeconomic factors influencing dengue mortality. We investigated if people of lower socioeconomic conditions in Brazil are more likely to die following dengue infection.<br />Methodology/principal Findings: Linking nationwide socioeconomic data from the 100 Million Brazilian Cohort with dengue disease and death records registered in Brazil between 1st January 2007 and 31st December 2018, we used multivariable hierarchical analysis to investigate the socioeconomic determinants of dengue-specific and all-cause mortality within 15 days of dengue symptom onset. Among the 3,018,131 individuals from the 100 Million Brazilian Cohort diagnosed with dengue, 1810 died from dengue (Case Fatality Rate (CFR)=0.06%, 95%CI = 0.06-0.06%) and 3076 (CFR = 0.10%, 95%CI = 0.10-0.11%) died from any cause within 15 days of dengue symptom onset. People residing in the Northeast (OR=2.32; 95%CI = 1.74-3.10) and Midwest (OR=1.68; 95%CI = 1.25-2.27) regions, self-identifying as black race/ethnicity (OR=1.58; 95%CI = 1.31-1.90), having lower level of education (OR=2.35, 95%CI = 1.17-4.73), being retired/receiving pension (OR=2.24; 95%CI = 1.76-2.86), living in a household with rudimentary sewage (OR=1.19; 95%CI = 1.04-1.37) and having >2 inhabitants per room (OR=1.31; 95%CI = 1.11-1.55) had at higher odds of dengue-specific mortality. Similar characteristics were also associated with higher all-cause mortality after dengue infection, but also included residing in North region (OR=1.60; 95%CI = 1.24-2.06) and rural areas (OR=1.12; 95%CI = 1.01-1.24), self-identifying as Asian (OR=1.65; 95%CI = 1.07-2.54) and mixed race/brown (OR=1.20; 95%CI = 1.10-1.31) and living in households with poorer quality building and sanitary conditions.<br />Conclusions/significance: Our findings provide evidence that individuals in Brazil with lower socioeconomic condition experience increased odds of dengue-specific and all-cause mortality within 15 days of dengue symptom onset. These findings underscore the importance of ensuring equitable access to high-quality treatment for severe dengue and suggest that reducing poverty and social inequality, including through improvement of sanitation and housing, may help mitigate dengue-related mortality.<br /> (Copyright: © 2025 Cardim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) |
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| ISSN: | 1935-2735 |
| DOI: | 10.1371/journal.pntd.0013660 |