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Mortality due to chronic non-communicable diseases: Scenario of Parnaíba – Piauí

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DOI: 10.32749/nucleodoconhecimento.com.br/health/scenario-of-parnaiba

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OLIVEIRA, Vanessa Cristina de Castro Aragão [1], RANGEL, Amanda Faria [2], LOBO, Estéfane Costa Silva [3]

OLIVEIRA, Vanessa Cristina de Castro Aragão. Et al. Mortality due to chronic non-communicable diseases: Scenario of Parnaíba – Piauí. Revista Científica Multidisciplinar Núcleo do Conhecimento. Year 05, Ed. 11, Vol. 11, pp. 56-66. November 2020. ISSN: 2448-0959, Access Link: https://www.nucleodoconhecimento.com.br/health/scenario-of-parnaiba, DOI: 10.32749/nucleodoconhecimento.com.br/health/scenario-of-parnaiba

SUMMARY

Introduction: Chronic non-communicable diseases (NCDs) represent a huge obstacle to global health. In addition to causing economic impact on families and communities, they also cause many premature deaths, cause great restrictions and loss of quality of life. Objective: To portray the mortality profile due to chronic non-communicable diseases in the city of Parnaíba (PI) from 2016 to 2019. Methods: This is an ecological design of time series, with data collected from the Mortality Information System (SIM) of the Ministry of Health, between August and January 2020. Data that presented information from other municipalities were excluded. For data collection, version 3.6b of TABWIN, a program provided by DATASUS, was used. Data analysis was performed through the use of descriptive statistical analyses, including the whole number and percentage for non-communicable chronic diseases. Results and Discussion: Mortality rates, in the period from 2016 to 2019, due to NCDs present a high percentage of deaths for cardiovascular diseases (CVD), totaling 52.51%, followed by neoplasms (25.31%), diabetes mellitus (12.75%) and respiratory diseases, responsible for 9.43% of deaths. Conclusion: The study allowed the identification of a conformity of mortality rates between females and males, being higher in men in general, in the period studied, and that deaths from cardiovascular diseases total more than half of deaths from NCDs in the municipality of Parnaíba.

Keyword: chronic non-communicable diseases, primary health care, mortality.

INTRODUCTION

Chronic non-communicable diseases (NCDs) represent a huge obstacle to global health. In addition to causing economic impact on families and communities, they also cause many premature deaths, cause great restrictions and loss of quality of life.

The World Health Organization ensures that NCDs worldwide account for approximately 70% of deaths, that is, around 38 million people die each year and that of these deaths, 16 million die under the age of 70, and almost 28 million of these deaths occur in countries where it has income between the middle and low range. (MALTA et al., 2017).

The data set out above should serve as an alert, not only to health systems, but also to the world’s own population. In view of the view that the occurrence of the problem is not caused only by the inefficiency of control strategies, having as one of the primary reasons the lack of personal health care and access to information (MOGRE JOHNSON et al., 2017).

Studies show that NCDs infer economic chaos in the health system, reflecting in society, and that these diseases create a vicious cycle with poverty, negatively impacting on the macroeconomic development of Brazil, especially in middle and low income municipalities.

In Brazil, as well as in the city of Parnaíba (PI), NCDs constitute a health dilemma of supreme relevance, reflecting in the increase in mortality and this fact is closely related to life habits, such as inadequate nutrition, sedentary lifestyle, alcohol and tobacco use.

The worsening of the clinical picture of NCDs contributes greatly to hospitalizations sensitive to primary care and reflects the low participation of patients with these pathologies to treatments offered free of charge by the Brazilian health system, increasing the mortality rate mainly due to cardiovascular diseases and diabetes mellitus.

In view of the above, this study proposes to portray the mortality profile due to chronic non-communicable diseases in the city of Parnaíba (PI) in the period from 2016 to 2019.

MATERIAL AND METHODS

ETHICAL ASPECTS

According to Resolution No. 510/2016 of the National Health Council, these databases do not need to be approved by the Research Ethics Committee because they contain aggregated information.

DESIGN, STUDY SITE AND PERIOD

It is an ecological design of time series, with data collected from the Mortality Information System (SIM) of the Ministry of Health. Between August and January 2020.

POPULATION, INCLUSION AND EXCLUSION CRITERIA

Mortality data of residents in the municipality of Parnaíba (PI) by NCDs were used, using as search filters in the SIM, the codes of the 10th Revision of the International Classification of Diseases (ICD X) such as diseases of the respiratory system (Codes J30-J98), diseases of the circulatory system (Codes I00-I99), diabetes mellitus (Codes E10-E14) and malignant neoplasms (Codes C00-C97), between the years 2016 to 2019. Data that presented information from other municipalities were excluded.

DATA COLLECTION AND ANALYSIS

For data collection, version 3.6b of TABWIN, a program provided by DATASUS, was used. This tool facilitated the processing and tabulation of the data, which was exported to an Excel program spreadsheet in order to follow with statistical analysis and construction of charts and tables.

ANALYSIS OF THE RESULTS

Data analysis was performed through the use of descriptive statistical analyses, including the whole number and percentage for non-communicable chronic diseases.

RESULTS AND DISCUSSION

Of the 4,226 deaths reported by the Mortality Information System (SIM) of the municipality of Parnaíba in the years 2016 to 2019 (graph 1) for all causes, 2,017 (47.73%) were female and 2,197 (51.98%) males and 12 (0.28%) had sex, being undetermined, of these deaths, 1,992 (47.14%) caused by DCNTs.

Figure 1- Number of general deaths per year and sex in the municipality of Parnaíba (PI) from 2016 to 2019


Source: SIM/MS

Considering the total number of deaths, a homogeneity of occurrence is observed in both females and males, but between 2016 and 2017 there is a decrease in the number of deaths among men, occurring the opposite in women, remaining, both relatively stable between the years 2017 and 2018, growing again in males and decreasing in females in the period marked by 2018 to 2019.

Mortality rates, in the period from 2016 to 2019, due to NCDs presented in Table 1, demonstrate a high percentage of deaths for cardiovascular diseases (CVD), totaling 52.51%, followed by neoplasms (25.31%), diabetes mellitus (12.75%) and respiratory diseases, responsible for 9.43% of deaths.

Table 1- Deaths due to NCDs in the municipality of Parnaíba (PI) from 2016 to 2019

Cause ICD-10 codes Deaths
N %
Cardiovascular Diseases I 00 – I 99 1.046 52,51
Neoplasms C 00 – C 97 504 25,31
Diabetes mellitus E 10 – E 14 254 12,75
Respiratory Diseases J 30 – J 98 188 9,43
Total 1.992 100

Source: SIM/MS

Analyzing CVD in detail, it is possible to observe in Graph 2, a similarity between mortality rates between females and males in the period studied.

It is also observed that in 2016 the number of deaths in men (13.48%) it is higher than in women (11.06%), decreasing this difference in 2017 to 0.58%, remaining at approximately 1% in subsequent years.

Graph 2: Rate of deaths due to Cardiovascular Diseases by sex and year in the city of Parnaíba (PI) from 2016 to 2019.

Source: SIM/MS

On the distribution of deaths from non-communicable diseases in the municipality of Parnaíba, cardiovascular diseases occupy the first place of cause of death, being responsible for more than half of the deaths, not disagreeing with what is already demonstrated in Brazil and in the world. In 2016, according to the World Health Organization, among NCDs, cardiovascular diseases accounted for 28% of deaths (WHO, 2018).

Cardiovascular diseases and their complications translate a high negative impact of productivity at work and family income. To reverse this situation, Brazil needs to achieve the 25% reduction scope recommended in the Global NCD Action Plan. (MALTA, 2019)

Graph 3: Rate of deaths from diabetes mellitus per year and sex in the city of Parnaíba (PI) from 2016 to 2019.

Source: SIM/MS

Graph 3 shows that between 2016 and 2018, of the 254 deaths from diabetes mellitus, there was a higher frequency of mortality among females compared to males and shows that there is an increase in the number of deaths in women and in the opposite hand, the decline of deaths among males. In 2019, the opposite of the previous biennium was observed, a fall in mortality in women and rise in men.

In 2016, around 41 million deaths worldwide were due to non-communicable diseases (NCDs). In this group, diabetes mellitus stands out, responsible for 1.6 million deaths, corresponding to 4%, in Brazil, this pathology was responsible for 5% of all deaths from chronic non-communicable diseases (WHO, 2018; WHO, 2019)

Graph 4 shows deaths due to chronic obstructive pulmonary disease that occurred between 2016 and 2019, portraying a homogeneity in the mortality rate in both sexes in the period studied.

It is observed that in 2019, there was the highest percentage of deaths being 14.90% in females and 15.96% in males, while the lowest mortality rate occurred in 2018, with 10.64% and 11.17% for women and men, respectively.

Graph 4: Rate of deaths due to conical obstructive pulmonary disease, by year and sex, in the municipality of Parnaíba (PI), 2016 to 2019. 

Source: SIM/MS

The mortality rate due to COPD in the municipality of Parnaíba is shown according to what is found in national epidemiological data, as reported by Gonçalves-Macêdo et al, (2019) in their study, which demonstrates the mortality rate due to COPD adjusted for gender and age in Brazil, was greatly reduced. The validated prediction model for 2017 shows that the incidence and mortality of COPD continue to decrease. (GONÇALVES-MACÊDO et al, 2019)

Of the 504 deaths from neoplasms (Graph 5), it was observed a higher frequency in 2016, 16.07% deaths in females and 10.71% in males. In 2017, there was a gradual decrease in deaths in both females, 12.69% deaths and in males, 9.32% deaths, while in 2018 a new increase in mortality is observed in both sexes with a subsequent decrease in the following year (2019), with the same percentage of deaths in both sexes.

Figure 5: Number of deaths due to Neoplasia, per year and sex, in the municipality of Parnaíba (PI), 2016 to 2019.

Source: SIM/MS

FINAL CONSIDERATIONS

The impacts caused by mortality from NCDs embody in advance the magnitude of the public health problem resulting from diseases such as hypertension and diabetes.

The study allowed to identify a conformity of mortality rates between females and males, being higher in men in general, in the period studied, and that deaths from cardiovascular diseases total more than half of the deaths due to NCDs in the municipality of Parnaíba.

The profile outlined by the data provided by SIM – mortality information system of the Ministry of Health, can be compared to national and world findings, making it clear that deaths from DPOCs are decreasing and the frequency of deaths from diabetes mellitus is high in females.

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[1] PhD in Public Health.

[2] Academic of the Medical Course.

[3] Academic of the Medical Course.

Submitted: October, 2020.

Approved: November, 2020.

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