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. 2021 Sep 20;9(9):1991.
doi: 10.3390/microorganisms9091991.

Chagas Disease-Related Mortality in Spain, 1997 to 2018

Jose-Manuel Ramos-Rincon  1   2 , Jara Llenas-García  3 , Hector Pinargote-Celorio  1 , Veronica Sánchez-García  4 , Philip Wikman-Jorgensen  5 , Miriam Navarro  6   7 , Concepción Gil-Anguita  8 , Violeta Ramos-Sesma  9 , Diego Torrus-Tendero  10   11
Affiliations

Chagas Disease-Related Mortality in Spain, 1997 to 2018

Jose-Manuel Ramos-Rincon et al. Microorganisms. .

Abstract

Background: Chagas disease (CD) is associated with excess mortality in infected people in endemic countries, but little information is available in non-endemic countries. The aim of the study was to analyze mortality in patients admitted to the hospital with CD in Spain.

Methods: A retrospective, observational study using the Spanish National Hospital Discharge Database. We used the CD diagnostic codes of the 9th and 10th International Classification of Diseases to retrieve CD cases from the national public registry from 1997 to 2018.

Results: Of the 5022 hospital admissions in people with CD, there were 56 deaths (case fatality rate (CFR) 1.1%, 95% confidence interval (CI) 0.8%, 1.4%), 20 (35.7%) of which were considered directly related to CD. The median age was higher in those who died (54.5 vs. 38 years; p < 0.001). The CFR increased with age, peaking in the 70-79-year (7.9%, odds ratio (OR) 6.27, 95% CI 1.27, 30.90) and 80-89-year (16.7%, OR 14.7, 95% CI 2.70, 79.90) age groups. Men comprised a higher proportion of those who died compared to survivors (50% vs. 22.6%; p < 0.001). Non-survivors were more likely to have neoplasms (19.6% vs. 3.4%; p < 0.001), heart failure (17.9% vs. 7.2%; p = 0.002), diabetes (12.5% vs. 3.7%; p = 0.001), chronic kidney failure (8.9% vs. 1.6%; p < 0.001), and HIV (8.9% vs. 0.8%; p < 0.001). In the multivariable analysis, the variables associated with mortality were age (adjusted OR (aOR) 1.05; 95% CI: 1.03, 1.07), male sex (aOR 1.79, 95% CI 1.03, 3.14), cancer (aOR: 4.84, 95% CI 2.13, 11.22), and HIV infection (aOR 14.10 95% CI 4.88, 40.73).

Conclusions: The case fatality rate of CD hospitalization was about 1%. The mortality risk increased with age, male sex, cancer, and HIV infection.

Keywords: Chagas disease; HIV infection; Spain; aged; cardiopathy; female; male; mortality; neoplasm.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Number of hospitalizations by sex and in-hospital mortality in people with Chagas disease.
Figure 2
Figure 2
Incidence rates of hospitalizations with CD per (a) 107 hospitalizations and (b) 105 people from Central and South America.
See this image and copyright information in PMC

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