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Background: The death toll after SARS-CoV-2 emergence includes deaths directly or indirectly associated with COVID-19. Mexico reported 325,415 excess deaths, 34.4% of them not directly related to COVID-19 in 2020. In this work, we aimed to analyse temporal changes in the distribution of the leading causes of mortality produced by COVID-19 pandemic in Mexico to understand excess mortality not directly related to the virus infection. Methods: We did a longitudinal retrospective study of the leading causes of mortality and their variation with respect to cause-specific expected deaths in Mexico from January 2020 through December 2021 using death certificate information. We fitted a Poisson regression model to predict cause-specific mortality during the pandemic period, based on the 2015-2019 registered mortality. We estimated excess deaths as a weekly difference between expected and observed deaths and added up for the entire period. We expressed all-cause and cause-specific excess mortality as a percentage change with respect to predicted deaths by our model. Findings: COVID-19 was the leading cause of death in 2020-2021 (439,582 deaths). All-cause total excess mortality was 600,590 deaths (38â 2% [95% CI: 36·0 to 40·4] over expected). The largest increases in cause-specific mortality, occurred in diabetes (36·8% over expected), respiratory infections (33·3%), ischaemic heart diseases (32·5%) and hypertensive diseases (25·0%). The cause-groups that experienced significant decreases with respect to the expected pre-pandemic mortality were infectious and parasitic diseases (-20·8%), skin diseases (-17·5%), non-traffic related accidents (-16·7%) and malignant neoplasm (-5·3%). Interpretation: Mortality from COVID-19 became the first cause of death in 2020-2021, the increase in other causes of death may be explained by changes in the health service utilization patterns caused by hospital conversion or fear of the population using them. Cause-misclassification cannot be ruled out. Funding: This study was funded by Conacyt.
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OBJECTIVE: Describe the methodological design of the National Health and Nutrition Survey 2018-19 (Ensanut 2018-19). MATERIALS AND METHODS: Ensanut 2018-19 is a probabilistic household survey. The following design elements are described: survey scope, sampling procedure, measurement procedure, inference procedure, and logistics organization. RESULTS: 44 069 full housing interviews and 82 490 full interviews of individuals were obtained. The home response rate was 87%. The response rate for individuals was 98%. CONCLUSIONS: The probabilistic design of the survey allows to create valid statistical inferences on parameters of public health interest at the national level and for all 32 states. In addition, some of the results are comparable with Ensanut 2012 in order to identify potential changes in the health and nutrition status of the Mexican population, so that health policies can be adjusted if necessary.
OBJETIVO: Describir el diseño metodológico de la Encuesta Nacional de Salud y Nutrición 2018-19 (Ensanut 2018-19). MATERIAL Y MÉTODOS: La Ensanut 2018-19 es una encuesta probabilística de hogares. Se describen los siguientes elementos del diseño: alcance de la encuesta, procedimiento de muestreo, procedimiento de medición, procedimiento de inferencia y organización logística. RESULTADOS: Se obtuvieron 44 069 entrevistas de viviendas completas y 82 490 entrevistas completas de individuos. La tasa de respuesta de hogar fue 87%. La tasa de respuesta de individuos fue de 98%. CONCLUSIONES: El diseño probabilístico de la encuesta permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública a nivel nacional y para las 32 entidades federativas. Además, algunos de sus resultados son comparables con los de la Ensanut 2012 para poder identificar potenciales cambios en los estados de salud y nutrición de la población mexicana, para que en caso de ser necesario s adecuen las políticas de salud.
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Encuestas Nutricionales/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Factores de Tiempo , Adulto JovenRESUMEN
Resumen: Objetivo Describir el diseño metodológico de la Encuesta Nacional de Salud y Nutrición 2018-19 (Ensanut 2018-19). Material y métodos La Ensanut 2018-19 es una encuesta probabilística de hogares. Se describen los siguientes elementos del diseño: alcance de la encuesta, procedimiento de muestreo, procedimiento de medición, procedimiento de inferencia y organización logística. Resultados Se obtuvieron 44 069 entrevistas de viviendas completas y 82 490 entrevistas completas de individuos. La tasa de respuesta de hogar fue 87%. La tasa de respuesta de individuos fue de 98%. Conclusiones El diseño probabilístico de la encuesta permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública a nivel nacional y para las 32 entidades federativas. Además, algunos de sus resultados son comparables con los de la Ensanut 2012 para poder identificar potenciales cambios en los estados de salud y nutrición de la población mexicana, para que en caso de ser necesario se adecuen las políticas de salud.
Abstract: Objective Describe the methodological design of the National Health and Nutrition Survey 2018-19 (Ensanut 2018-19). Materials and methods Ensanut 2018-19 is a probabilistic household survey. The following design elements are described: survey scope, sampling procedure, measurement procedure, inference procedure, and logistics organization. Results 44 069 full housing interviews and 82 490 full interviews of individuals were obtained. The home response rate was 87%. The response rate for individuals was 98%. Conclusions The probabilistic design of the survey allows to create valid statistical inferences on parameters of public health interest at the national level and for all 32 states. In addition, some of the results are comparable with Ensanut 2012 in order to identify potential changes in the health and nutrition status of the Mexican population, so that health policies can be adjusted if necessary.
