HDI, Technological and Human Resources in the Diagnosis and Treatment of Malformations of the Circulatory System in Brazil

Arq Bras Cardiol. 2021 Jul;117(1):63-71. doi: 10.36660/abc.20200179.
[Article in English, Portuguese]

Abstract

Background: In 2015, the number of infants with congenital malformations (CMs) per 100 000 live births (LBs) was 2368 (7.6%) worldwide, of whom 10.6% died in the first year of life, 43% due to malformations of the circulatory system (MCSs), a scenario similar to what occurs in Brazil.

Objective: To assess, per Brazilian macroregion, whether diagnosis of MCS at birth and death due to MCS in the first year of life associate with human development index (HDI) and with technological and human resources.

Methods: Ecological study including data available in 2000-2015. Data of LBs, deaths and availability of echocardiography devices were obtained from the DATASUS website. The HDI was obtained from the Atlas of Human Development in Brazil, while other variables were obtained from medical demographic data. Correlation measures between the variables were performed using the Kendall index.

Results: The CM rate was 660.8/100 000 LBs, of which 18 444 were due to MCS (diagnosis rate, 38.55/100 000 LBs). Of all Brazilian macroregions, the Southern and Southeastern regions, with the highest HDI values and resources, had the highest MCS diagnosis rates (56.94/100 000 and 62.83/100 000 LBs, respectively). The Northern and Northeastern regions, with the lowest HDI values and resources, had the lowest MCS diagnosis rates (9.77/100 000 and 13.43/100 000 LBs, respectively). The MCS diagnosis rate was 6.4-fold higher in the Southeastern region as compared to the Northern region, but mortality rates were similar in both regions.

Conclusion: Of the CMs, the MCS accounted for the highest number of deaths in children under the age of 1 year in Brazil.

Fudamento: Em 2015, foram diagnosticados 2.368 portadores de malformação congênita (MC) por 100.000 nascidos vivos (NV) no mundo, uma taxa de 7,6%, dos quais 10,6% morreram no primeiro ano de vida, sendo 43% por malformações do aparelho circulatório (MAC), à semelhança do que ocorre no Brasil.

Objetivo: Verificar a associação de diagnóstico de MAC ao nascimento e morte por MAC no primeiro ano de vida com índice de desenvolvimento humano (IDH) e recursos tecnológicos e humanos para o diagnóstico e tratamento da MAC por macrorregião do Brasil.

Métodos: Estudo ecológico de dados disponíveis de 2000 a 2015. Informações sobre NV, óbitos e ecocardiógrafos foram obtidas do DATASUS, o IDH, do Atlas de Desenvolvimento Humano no Brasil, e as demais foram obtidas da demografia médica. Foram realizadas medidas de correlação entre as variáveis utilizando o índice de Kendall.

Resultados: A taxa de MC foi 660,8/100.000 NV, das quais, 18.444 por MAC (taxa de diagnóstico 38,55/100.000 NV). As regiões Sul e Sudeste, com maiores valores de IDH e recursos, apresentaram as maiores taxas de diagnóstico de MAC (56,94/100.000 e 62,83/100.000 NV, respectivamente). As regiões Norte e Nordeste, com os menores valores de IDH e recursos, apresentaram as menores taxas de diagnóstico de MAC (9,77/100.000 e 13,43/100.000 NV, respectivamente). Essa taxa de diagnóstico foi 6,4 vezes maior no Sudeste do que no Norte, mas as taxas de mortalidade foram similares.

Conclusão: Das MC, as MAC apresentaram a maior mortalidade nos menores de 1 ano no Brasil.

MeSH terms

  • Brazil
  • Cardiovascular System*
  • Child
  • Humans
  • Infant
  • Infant, Newborn
  • Workforce