Evaluation of AIDS mortality in São Paulo, Brazil, from 1981 to 2007
S. Takahashi1, E.V. Rossetto1, M.E. Lopes1, F.A. Santos1, Z. Khoury1, A.H. Hiraoka2, B. Barrella2, M. Taniguchi3, J.A. Beloqui4, I. Guibu5, R.M.D. Nakazaki2, M.C. Abbate1
1STD / AIDS Program, Health Department of São Paulo City, São Paulo, Brazil, 2Center for Disease Control, Coordination of Health Surveillance, Health Department of São Paulo City, São Paulo, Brazil, 3Program for the Improvement on Mortality Information of São Paulo City, Health Department of São Paulo City, São Paulo, Brazil, 4Group for Life Incentive (GIV), São Paulo, Brazil, 5STD / AIDS Program, Health Department of São Paulo State, São Paulo, Brazil
Background: In April 2007, the STD/AIDS Program of São Paulo City organized a Technical Group, with representatives from different government and non-governmental organizations, aiming to monitor deaths due to HIV/AIDS and evaluate its causes
Methods: Three databases related to death were linked. The São Paulo AIDS surveillance data reported to the National Notifiable Disease Information System (SINAN), the database of the epidemiological surveillance of the STD/AIDS specialized facilities and database of System of Mortality Information, through the RecLink II version 220.127.116.11. The analysis was structured using AIDS as major cause and its association with other infections, checking name, birth date and the mother´s name of the patients.
Results: Of the 69,647 AIDS patients cases reported from 1981 to 2007, 51.7% evolved to death. Of these, 74.8% occurred until 1999. In adults, 30.5% (7,938/26,062) were men who have sex with men. Since 2000, the proportion of deaths has increased among heterosexuals, reaching 38.3% (401/1,030) in 2006. From 2000 to 2006 32.8% of deaths occurred within one year after diagnosis of AIDS. Other factors related to deaths: 56% of the patients had CD4 counts below 200 cells, the mean and median between the date of last medical examination and death were 10 and 3 months, respectively, when AIDS was the main cause and from 8 and 3 months when with other infections.
Conclusions: The linkage of databases has improved the analysis of the AIDS epidemiological situation and the proposals to fight the epidemic. The proportion of early deaths, its occurrence of death within one year after the date of diagnosis of AIDS was considered high and a specific study, still ongoing, was planned to find out its causes. It is recommended the implementation of the diagnostic rapid test in the municipal facilities to improve the access to the diagnosis of HIV infection.
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