Revista de Saúde Pública (Dec 2000)
Causas básicas e associadas de morte por Aids, Estado de São Paulo, Brasil, 1998 Aids as underlying and associated causes of death, State of S. Paulo, Brazil, 1998
Abstract
OBJETIVOS: Descrever o padrão da mortalidade devida a Aids segundo causas básica e associadas de morte no Estado de São Paulo, em 1998. MÉTODOS: Os dados sobre a mortalidade e a população residente no Estado de São Paulo, SP, para 1998, foram obtidos na Fundação Sistema Estadual de Análise de Dados (Seade). As causas de morte foram codificadas pelas disposições da Décima Revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde. Os registros de Aids como causa básica e associada de morte foram recuperados e revistos. RESULTADOS: A Aids foi a causa básica em 4.619 mortes, correspondendo à décima causa (2,0%) e ao coeficiente de mortalidade de 13,1 por 100.000 habitantes. As razões das mortes e os respectivos coeficientes entre homens e mulheres foram de 2,4 e 2,5. A Aids foi a segunda causa entre os homens de 20 a 34 anos de idade e entre as mulheres de 25 a 34. A idade média ao morrer entre as mulheres (34,1±12,2 anos) foi estatisticamente menor que a dos homens (36,4±10,7 anos) -- pOBJECTIVES: To describe the Aids mortality according to its underlying and associated causes of death in the State of S. Paulo in 1998. METHODS: Mortality and population data for 1998 were obtained from the State Data Analysis System Department (Fundação Sistema Estadual de Análise de Dados - Seade). Causes of death were coded according to the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems. RESULTS: Aids was the underlying cause in 4,619 deaths, corresponding to the 10th leading cause of death (2.0%) and a mortality rate of 13.1/100,000 population. Male/female death ratio and rate ratios were respectively 2.4 and 2.5. Aids was the second leading cause of death among men aged 20--34 and women aged 25--34 years. Median age at death for women (34.1±12.2 years old) was lower than men (36.4±10.7 years old) -- p<0,001. The main associated causes of Aids deaths were respiratory insufficiency (36.1%), pneumonia (27.0%), tuberculosis (19.6%), septicemia (18.6%), toxoplasmosis (12.2%), P. carinii pneumonia (8.3%) and cachexia (7.9%). Aids was an associated cause of death in additional 84 cases. The main underlying causes of these deaths were malignant neoplasms (28/84), conditions secondary to alcohol abuse (23/84) and diabetes mellitus (7/84). The median age at death due to Aids as an underlying cause (35.7±11.2 years old) was lower than the age at death with Aids as an associated cause (39.9±11.8 years old -- p<0.001). CONCLUSIONS: Multiple causes of death allow to track part of the Aids natural history and provide additional data to develop adequate and specific preventive actions.
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