ANALYSIS OF THE INFANT MORTALITY COEFFICIENT ATTRIBUTED TO SEPTICEMIA IN BRAZILIAN MACROREGIONS
Introduction: sepsis is a main cause of infant mortality in Brazil, as an organic dysfunction caused by one’s inadequate systemic response to infection. So far, clinical manifestations and diagnostic exams remain unspecific, resulting in delayed diagnostic and raising mortality. Considering this context, this study aims to identify the number of deaths due to sepsis in children under one year old in the five Brazilian macroregions, to calculate mortality coefficients attributed to this cause in each Region and to compare their significances to the Municipal Human Development Index (MHDI) from each Region.
Methodology: a quantitative comparative epidemiological study was carried out, with a population-based cross-sectional delimitation, based on data collected from the Informatics Department of the Unified Health System (DATASUS). To analyze information obtained in DATASUS, the GraphPad Prism®? software 5.0 version (USA) was applied, in which Shapiro-Wilk, one-way ANOVA and Bonferoni tests were performed, in which p<0,05 was considered significant, and results were expressed as 95% confidence interval (95CI%) and prevalence ratio.
Results: from 2010 to 2018, 28994 infants under one year old died due to sepsis in Brazil. The average number of deaths per year was 3223, with a peak of 3353 deaths in 2010 and a minimum of 2816 deaths in 2018. Southeast Region had the most elevated number of deaths attributed to sepsis (11.145), in sequence were North (9.572), Northeast (3.917), South (2.378) and Center-West Region (1.982). Regarding the sepsis mortality coefficient, North Region presented the highest average between the eight years, exhibiting 1,39 deaths per thousand born, in a decreasing sequence came Northeast (1,28), Southeast (1,07), Center-West (0,93) and South Region (0,93).
Discussion: Southeast Region presented the highest total number, among all Regions, of deaths attributed to sepsis in children younger than one year old, even though this Region obtained an intermediate mortality coefficient comparing to the other Regions, which is a marker more precise to evaluate on which panorama this pathology is. Analyzing the average number of deaths attributed to sepsis in children under one year old, North Region has approximately 435 deaths, ranking as the third Region, in decreasing order, regarding this parameter; however, North leads the list in which Regions are listed decreasingly according to their mortality rates by sepsis in infants with less than one year old. Moreover, this elevated marker found in North Region did not have significant difference when compared to the one found in Northeast Region, thereby rendering them both areas where infants are at most risk of dying due to sepsis until they reach their first year of life. Therefore, when comparing the MHDIs of the Regions defined by the Brazilian Institute of Geography and Statistics (IBGE) with their respective mortality coefficients by sepsis in this group age, it is affirmable that Regions with the highest mortalities (North and Northeast) are equally the ones with worst MHDIs.
Conclusion: a relevant epidemiological panorama of the number of deaths and of the infant mortality rate due to sepsis in Brazil was obtained, reinforcing the known connection between socioeconomic development indexes and infant mortality. Therefore, there is urgency to meet the exuberating demand for improved medical assistance conditions and for investments from the Public Authorities, especially in Regions presenting worst infant mortality rates and worst human development indexes.
KEY WORDS: Sepsis; Coefficient; Infant Mortality; Deaths; Regions
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cientifico.comau@fcm.unicamp.br
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