02415nas a2200229   4500000000100000008004100001653001100042653002200053653001900075653003400094653001400128653001400142653003900156100002000195700001500215700001600230700001600246700001500262245010600277520178800383022001402171       2019                            d10aBrazil10aBurden of Disease10aChagas disease10aDisability-adjusted life year10aMorbidity10aMortality10aNeglected tropical diseases (NTDs)1 aMartins-Melo FR1 aCarneiro M1 aRibeiro ALP1 aBezerra JMT1 aWerneck GL00aBurden of Chagas disease in Brazil, 1990-2016: findings from the Global Burden of Disease Study 2016.3 a<p>Chagas disease continues to be an important cause of morbidity, mortality and disability in several Latin American countries including Brazil. Using findings from the Global Burden of Disease Study 2016 (GBD 2016), we present years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) due to Chagas disease in Brazil, by sex, age group, and Brazilian states, from 1990 to 2016. Results are reported in absolute numbers and age-standardized rates (per 100,000 population) with 95% uncertainty intervals (UIs). In 2016, 141,640 DALYs (95% UI: 129,065-155,941) due to Chagas disease were estimated in Brazil, with a relative reduction of 36.7% compared with 1990 (223,879 DALYs (95% UI: 209,372-238,591)). Age-standardized DALY rates declined at the national level (-69.7%) and in all Brazilian states between 1990 and 2016, but with different regional patterns. The decrease in the DALY rates was driven primarily by a consistent reduction in the YLL rates, the main component of total DALYs for Chagas disease. The highest fatal and non-fatal burden due to Chagas disease was observed among males, the elderly, and in those Brazilian states encompassing important endemic areas for vector transmission in the past. Despite the consistent reduction in its burden during the period, Chagas disease is still an important and neglected cause of health lost due to premature mortality and disability in Brazil. Efforts should be made to maintain the political interest and sustainability of surveillance and control actions for Chagas disease, prevent the risk of re-emergence of vector transmission in endemic areas, and provide health care to chronically infected individuals, including early diagnosis and treatment interventions.</p>
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