ABSTRACT
Introduction: Infectious intestinal diseases (diarrhea) are a major cause of morbidity and mortality worldwide. In 2015, it constituted the ninth leading cause of death for all ages. Objective: To describe the epidemiological characteristics of mortality due to infectious intestinal diseases (diarrhea) in Paraguay from 2015 to 2019. Methods: Descriptive, ecological, cross-sectional, retrospective, and non-probabilistic sampling of consecutive cases was performed. ICD-10 deaths included cholera (A01), typhoid and paratyphoid fever (A01), shigellosis (A03), other bacterial intestinal infections (A04), other bacterial food poisoning (A05), amebiasis (A06), other intestinal diseases due to protozoa (A07), intestinal infections due to viruses (A08), and diarrhea and gastroenteritis of presumed infectious origin (A09). Open access data were obtained from the WEB page of the General Directorate of Strategic Information in Health of the MSP and BS of all the Departments of the country. Crude and adjusted rates (per 100,000 inhabitants) were calculated. Excel and EPI INFO 7.0 were used. Results: 495 deaths were registered; the highest prevalence was in 2019 (adjusted rate of 1.83) and the lowest in 2017 (1.36). The months with the highest mortality rates were January and July (9.9%). 51.72% were women (256), 30.91% were over 80 years old and 28.28% (140) were under 5 years old, average age 50.8, single 56.77% (281) and without any type of education 41.82% (207). A total of 80.61% (399) of the respondents resided in urban areas. The highest rates were registered in Boquerón (33.3) and Amambay (15.2). Diarrhea and gastroenteritis of infectious origin accounted for 95.56% of the cases (473). Discussion: There was a high percentage of mortality from infectious diarrhea. Extremes of life were the most vulnerable populations.
Introducción: Las enfermedades infecciosas intestinales (diarrea) son una causa importante de morbilidad y mortalidad a nivel mundial. En 2015, constituyeron la novena causa principal de muerte para todas las edades. Objetivo: describir las características epidemiológicas de la mortalidad por enfermedades infecciosas intestinales (diarreas) en Paraguay durante los años 2015 al 2019. Metodología: Estudio descriptivo, ecológico, transversal, retrospectivo, muestreo no probabilístico de casos consecutivos. Se consideraron los óbitos del CIE - 10, que incluyen al cólera (A01), fiebres tifoidea y paratifoidea (A01), shigelosis (A03), otras infecciones intestinales bacterianas (A04), otras intoxicaciones alimentarias bacterianas (A05), amebiasis (A06), otras enfermedades intestinales debidas a protozoarios (A07), infecciones intestinales debidas a virus (A08) y diarrea y gastroenteritis de presunto origen infeccioso (A09). Se utilizaron datos de acceso abierto de la página WEB de la Dirección General de Información Estratégica en Salud del MSP y BS de todos los Departamentos del país. Se calcularon tasas crudas y ajustadas (por 100.000 habitantes). Se utilizaron Excel y EPI INFO 7.0. Resultados: Se registraron 495 muertes, la mayor prevalencia fue en 2019 (tasa ajustada de 1,83) y menor en 2017 (1,36). Los meses con mayor mortalidad fueron enero y julio (9,9%). El 51,72% fueron mujeres (256), 30,91% mayores de 80 años y 28,28% (140) menores de 5 años, edad promedio 50,8, solteros 56,77% (281) y sin ningún tipo de educación 41,82% (207). El 80,61% (399) residía en área urbana. Las mayores tasas se registraron en Boquerón (33,3) y Amambay (15,2). El 95,56% (473) fueron diarreas y gastroenteritis de origen infeccioso. Discusión: Se registra alto porcentaje de mortalidad de diarreas de origen infeccioso. Los extremos de la vida constituyen la población más vulnerable.
ABSTRACT
BACKGROUND: The number of suicides has been increasing worldwide, year after year, becoming the fourth leading cause of death among young people between 15 and 29 years of age. AIM: In this study, we explored the frequency and characteristics of suicides among the adult general population in Paraguay between 2004 and 2022, considering that suicide attempts and suicidal risk/ideation are frequent and relevant issues in the consultation activity, even if epidemiological evidence on the national rates of suicide is scarce. METHODS: In this observational, descriptive, and exploratory study, official records of all deaths by suicide were reviewed and information analyzed. In addition, an attempt was made to predict the number of suicides in the next 5 years according to a mathematical modeling. RESULTS: In the 18-year period, 5,527 suicides of adults were recorded. Patients' mean age was 36.8 ± 17 years old. A 76.77% of them were males, 77.44% were from an urban area and 25.98% from the Greater Asunción and Central Department of Paraguay. The most frequently used method of suicide was intentional self-inflicted injury by hanging, strangulation, or suffocation (all 67.6%). The expected number of national suicides in the following years from 2023 to 2027 will range between 462 and 530. Limitations include the lack of information regarding diagnoses and personal history in the suicide reports as well as the possibility of underreporting of national suicide cases. CONCLUSION: Our results represent the first large national epidemiological report of suicides in Paraguay and may be of interest for mental health professionals and health authorities in order to reduce the suicide mortality rate within the country.
Subject(s)
Mental Disorders , Self-Injurious Behavior , Male , Humans , Adult , Adolescent , Young Adult , Middle Aged , Female , Paraguay/epidemiology , Suicide, Attempted , Mental Disorders/epidemiology , Suicidal IdeationABSTRACT
BACKGROUND: Suicide and suicide attempts are impacting events for patients and their relatives, and these behaviors are still taboo among adults and may be even more traumatic when involving children and adolescents. AIM: In this study we aimed to describe suicide rates among children and adolescents in Paraguay over the last decades as well as associated factors such as sociodemographic characteristics and methods used for suicide. METHODS: This was an observational and exploratory study describing the frequency and characteristics of suicide among children and adolescents in Paraguay between 2004 and 2022. Official records of all deaths by suicide were reviewed, and statistical analyses were performed. In addition, an attempt was made to predict the number of suicides in the next 5 years using a mathematical model based on simple linear regression. RESULTS: In the 18-year period observed, 940 suicides among children and adolescents were recorded. The mean age was 15.05 ± 1.8 years old. Of these, 51.17% were male, 74.6% were from urban areas, and 22.2% were from the Greater Asunción and Central Department of Paraguay. The most frequently used method of suicide was intentional self-inflicted injury by hanging, strangulation, or suffocation, which all represented 75.3% of the cases. Our mathematical modeling based on simple linear regression determined that the expected yearly number of national suicides in the pediatric population for the following years, from 2023 to 2027, will range between 72 and 81. CONCLUSION: This study is the first large national epidemiological report on the emerging issue of suicide among children and adolescents in Paraguay. It may be a relevant source of information for mental health professionals, health authorities, and decision makers to develop national prevention strategies and actions against suicide among youths.
Subject(s)
Mental Disorders , Self-Injurious Behavior , Adult , Humans , Male , Child , Adolescent , Female , Paraguay/epidemiology , Mental Disorders/epidemiology , Suicide, Attempted/psychology , Self-Injurious Behavior/epidemiology , Health PersonnelABSTRACT
Introducción. La meningitis es una emergencia que requiere diagnóstico y tratamiento inmediato. La epidemiología cambió con las vacunas conjugadas, pero la carga de la enfermedad y las muertes siguen altas. Objetivo. Describir las características epidemiológicas de la mortalidad por meningitis en Paraguay en el periodo 2015-2019. Materiales y métodos. Estudio ecológico y descriptivo en el que se obtuvieron datos de acceso abierto disponibles en la página WEB de la Dirección General de Información Estratégica en Salud del Ministerio de Salud Pública y Bienestar Social de todas las regiones sanitarias del país. Se calcularon las tasas crudas y ajustadas (por 100.000 habitantes) por Excel y EPI INFO 7.0. Resultados. Se registraron 125 muertes, la mayor prevalencia fue en el 2018, con una tasa ajustada de 0,55 por 100.000 habitantes y la menor en 2017, con 0,27 por 100.000 habitantes. Los meses con mayor mortalidad fueron agosto (15,2%) y diciembre (11,2%). El 58,40% de los fallecidos fueron varones (73), 21,60% (27) menores de 4 años, en su mayoría mujeres y 12% (11) adultos mayores (60-70 años), mayoría varones. La edad promedio fue 37,76 años, solteros el 67,20% (84) y no escolarizados el 26,40% (33). El 80,80% (101) residía en el área urbana. Las mayores tasas se registraron en Paraguarí (6,8 por 100.000 habitantes) y Caazapá (3,3 por 100.000 habitantes), no se registraron casos en Alto Paraguay. Conclusión. Los extremos de la vida siguen siendo una población vulnerable para la meningitis.
Introduction.Meningitis is a disease that requires immediate diagnosis and treatment. The epidemiology changed over the years due to the advances in conjugate vaccines, however, the mortality rate, as well as the disease burden, are still very high. Objective.To describe the epidemiological characteristics of meningitis mortality in Paraguay in the 2015-2019 period. Materials and methods.Descriptive and ecological study in which data was obtained from the open and official website of the General Department of Strategic Information of the Ministry of Public Health and Social Welfare. Crude and adjusted rates (per 100,000 inhabitants) were calculated using Excel and EPI INFO 7.0. Results.In the study period, 125 deaths were registered with the highest prevalence in 2018 (adjusted rate of 0.55 per 100,000 inhabitants) and the lowest in 2017 (adjusted rate of 0.27 per 100,000 inhabitants). The months with the highest mortality were August and December with 15.2% and 11.2%, respectively. Males were the predominant gender with 58.40% (73 people), 21.60% (27) were under 4 years of age, mostly women, and 12% (11) were seniors (60-70 years), mostly men. Average age was 37.76 years, 67.20% single (84) and 26.40% (33)had no formal education and 80.80% (101) lived in urban areas. The highest rates were registered in Paraguarí (6.8 per 100,000 inhabitants) and Caazapa (3.3 per 100,000 inhabitants). There were no cases in Alto Paraguay. Conclusion: The extremes of life remain a vulnerable population for meningitis.
