Excess mortality in Guadeloupe and Martinique, islands of the French West Indies, during the chikungunya epidemic of 2014

AbstractIn some chikugunya epidemics, deaths are not fully captured by the traditional surveillance system, based on case reports and death reports. This is a time series study to evaluate the excess of mortality associated with epidemic of chikungunya virus (CHIKV) in Guadeloupe and Martinique, Antilles, 2014. The population (total 784,097 inhabitants) and mortality data estimated by sex and age were accessed at the Institut National de la Statistique et des Etudes Economiques - France. Age adjusted mortality rates were calculated also in Reunion, Indian Ocean for comparison. Epidemiological data on CHIKV (cases, hospitalizations, and deaths) were obtained in the official epidemiological reports of the Cellule de Institut de Veille Sanitaire - France. The excess of deaths for each month in 2014 and 2015 was the difference between the expected and observed deaths for all age groups, considering the 99% confidence interval threshold. Pearson coefficient of correlation between monthly excess of deaths and reported cases of chikungunya show a strong correlation (R = 0.81, p <0.005), also with a 1-month lag (R = 0.87, p <0.001), and between monthly rates of hospitalization for CHIKV and the excess of deaths with a delay of 1 month (R = 0.87, p <0.0005).The peak of the epidemic occurred in the month with the highest mortality, returning to normal soon after the end of the CHIKV epidemic. The overall mortality estimated by this method (639 deaths) was about 4 times greater than that obtained through death declarations (160 deaths). Excess mortality increased with age. Although etiological diagnosis of all deaths associated with CHIKV infection is not possible, already well-known statistical tools can contribute to an evaluation of the impact of this virus on the mortality and morbidity in the different age groups.

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Excess mortality in Guadeloupe and Martinique, islands of the French West Indies, during the chikungunya epidemic of 2014

Epidemiology and Infection ◽

10.1017/s0950268818002315 ◽

2018 ◽

Vol 146 (16) ◽

pp. 2059-2065 ◽

Cited By ~ 10

Author(s):

A. R. R. Freitas ◽

P. M. Alarcón-Elbal ◽

M. R. Donalisio

Keyword(s):

Strong Correlation ◽

Excess Mortality ◽

Pearson Correlation ◽

Age Groups ◽

Epidemiological Data ◽

Mortality Data ◽

Surveillance Systems ◽

Mortality And Morbidity ◽

The Impact ◽

Excess Deaths

AbstractIn some chikungunya epidemics, deaths are not completely captured by traditional surveillance systems, which record case and death reports. We evaluated excess deaths associated with the 2014 chikungunya virus (CHIKV) epidemic in Guadeloupe and Martinique, Antilles. Population (784 097 inhabitants) and mortality data, estimated by sex and age, were accessed from the Institut National de la Statistique et des Études Économiques in France. Epidemiological data, cases, hospitalisations and deaths on CHIKV were obtained from the official epidemiological reports of the Cellule de Institut de Veille Sanitaire in France. Excess deaths were calculated as the difference between the expected and observed deaths for all age groups for each month in 2014 and 2015, considering the upper limit of 99% confidence interval. The Pearson correlation coefficient showed a strong correlation between monthly excess deaths and reported cases of chikungunya (R= 0.81,p< 0.005) and with a 1-month lag (R= 0.87,p< 0.001); and a strong correlation was also observed between monthly rates of hospitalisation for CHIKV and excess deaths with a delay of 1 month (R= 0.87,p< 0.0005). The peak of the epidemic occurred in the month with the highest mortality, returning to normal soon after the end of the CHIKV epidemic. There were excess deaths in almost all age groups, and excess mortality rate was higher among the elderly but was similar between male and female individuals. The overall mortality estimated in the current study (639 deaths) was about four times greater than that obtained through death declarations (160 deaths). Although the aetiological diagnosis of all deaths associated with CHIKV infection is not always possible, already well-known statistical tools can contribute to the evaluation of the impact of CHIKV on mortality and morbidity in the different age groups.

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Robust and Timely Estimation of Excess Mortality: Statistical Analysis of Cremation Data During the COVID-19 Pandemic (Preprint)

10.2196/preprints.32426 ◽

2021 ◽

Author(s):

Gemma Postill ◽

Regan Murray ◽

Andrew S Wilton ◽

Richard A Wells ◽

Renee Sirbu ◽

...

Keyword(s):

Real Time ◽

Excess Mortality ◽

Age Groups ◽

Time Estimation ◽

Vital Statistics ◽

Accurate Estimation ◽

Mortality Data ◽

Mortality Estimation ◽

Statistics Canada ◽

The Impact

BACKGROUND Early estimates of excess mortality are crucial for understanding the impact of COVID-19. However, there is a lag of several months in the reporting of vital statistics mortality data for many jurisdictions. In Ontario, a Canadian province, certification by a coroner is required before cremation can occur, creating timely mortality data that encompasses the majority of deaths within the province. OBJECTIVE Our objectives were to (1) validate the ability of cremation data in permitting real-time estimation of excess all-cause mortality, interim of vital statistics data, and (2) describe the patterns of excess mortality. METHODS Cremation records from January 2020 until April 2021 were compared to the historical records from 2017-2019, grouped according to week, age, sex, and COVID-19 status. Cremation data were compared to Ontario’s provisional vital statistics mortality data released by Statistics Canada. The 2020 and 2021 records were then compared to previous years to determine whether there was excess mortality and if so, which age groups had the greatest number of excess deaths during the COVID Pandemic, and whether deaths attributed to COVID-19 account for the entirety of the excess mortality. RESULTS Between 2017-2019, cremations were performed for 67.4% (95% CI: 67.3–67.5%) of deaths; the proportion of cremated deaths remained stable throughout 2020, establishing that the COVID-19 pandemic did not significantly alter cremation practices, even within age and sex categories. During the first wave (from April to June 2020), cremation records detected a 16.9% increase (95% CI: 14.6–19.3%) in mortality. The accuracy of this excess mortality estimation was later confirmed by vital statistics data. CONCLUSIONS The stability in the percent of Ontarians cremated and the completion of cremation data several months before vital statistics data, enables accurate estimation of all-causes mortality in near real-time with cremation data. These findings demonstrate the utility of cremation data to provide timely mortality information during public health emergencies.

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The Impact of Heat Waves on Mortality in Nanjing Area from 2004 to 2010

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.726-731.931 ◽

2013 ◽

Vol 726-731 ◽

pp. 931-935

Author(s):

Yuan Shu Jing ◽

Di Zhang ◽

Min Fei Yan ◽

Jian Guo Tan

Keyword(s):

Heat Wave ◽

Excess Mortality ◽

Heat Waves ◽

Residual Disease ◽

Meteorological Data ◽

Age Groups ◽

Maximum Temperature ◽

Mortality Data ◽

Average Maximum ◽

The Impact

This paper analyzed the excess mortality change in nine districts of Nanjing city, based on mortality data and meteorological data from 2004 to 2010. Taken a typical heat waves process in summer of 2006 as an example, it was discussed of the effect of the heat process on different gender, different age groups , and various disease death toll and excess mortality changes. The excess mortality was associated with the average maximum temperature and average minimum temperature during the heat waves. Excess mortality occurred in the middle of June heat wave when excess mortality was much higher than in other time periods. In late June, early July to early August, the excess mortality is relatively small. The average daily deaths are increasing with increasing age for male and female, and every age death numbers is higher than that with no heat waves during the heat wave period. In addition to the respiratory system diseases, diseases of the genitourinary system, other diseases, residual disease in the heat waves has increased, and diseases of the nervous system and the endocrine system diseases of excess mortality rate reached a staggering 342.93% and 119.63%, accounting for almost half of the total heat excess mortality. The heat waves effect is very obvious. The conclusion is of great significance for prevention of high temperature heat harm.

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The decomposition of life expectancy for age and cause of death in Tuscany, Italy

European Journal of Public Health ◽

10.1093/eurpub/ckz185.638 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

N Nante ◽

L Kundisova ◽

F Gori ◽

A Martini ◽

F Battisti ◽

...

Keyword(s):

Life Expectancy ◽

Causes Of Death ◽

National Level ◽

Age Groups ◽

Resistant Bacteria ◽

Mortality Data ◽

Life Expectancy At Birth ◽

Icd 10 ◽

Reduction Of Mortality ◽

The Impact

Abstract Introduction Changing of life expectancy at birth (LE) over time reflects variations of mortality rates of a certain population. Italy is amongst the countries with the highest LE, Tuscany ranks fifth at the national level. The aim of the present work was to evaluate the impact of various causes of death in different age groups on the change in LE in the Tuscany region (Italy) during period 1987-2015. Material and methods Mortality data relative to residents that died during the period between 1987/1989 and 2013/2015 were provided by the Tuscan Regional Mortality Registry. The causes of death taken into consideration were cardiovascular (CVS), respiratory (RESP) and infective (INF) diseases and cancer (TUM). The decomposition of LE gain was realized with software Epidat, using the Pollard’s method. Results The overall LE gain during the period between two three-years periods was 6.7 years for males, with a major gain between 65-89, and 4.5 years for females, mainly improved between 75-89, <1 year for both sexes. The major gain (2.6 years) was attributable to the reduction of mortality for CVS, followed by TUM (1.76 in males and 0.83 in females) and RESP (0.4 in males; 0.1 in females). The major loss of years of LE was attributable to INF (-0.15 in females; -0.07 in males) and lung cancer in females (-0.13), for which the opposite result was observed for males (gain of 0.62 years of LE). Conclusions During the study period (1987-2015) the gain in LE was major for males. To the reduction of mortality for CVS have contributed to the tempestuous treatment of acute CVS events and secondary CVS prevention. For TUM the result is attributable to the adherence of population to oncologic screening programmes. The excess of mortality for INF that lead to the loss of LE can be attributed to the passage from ICD-9 to ICD-10 in 2003 (higher sensibility of ICD-10) and to the diffusion of multi-drug resistant bacteria, which lead to elevated mortality in these years. Key messages The gain in LE during the period the 1987-2015 was higher in males. The major contribution to gain in LE was due to a reduction of mortality for CVS diseases.

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Real-time estimation of the influenza-associated excess mortality in Hong Kong

Epidemiology and Infection ◽

10.1017/s0950268819001067 ◽

2019 ◽

Vol 147 ◽

Cited By ~ 1

Author(s):

Jessica Y. Wong ◽

Edward Goldstein ◽

Vicky J. Fang ◽

Benjamin J. Cowling ◽

Peng Wu

Keyword(s):

Hong Kong ◽

Real Time ◽

Excess Mortality ◽

Time Estimation ◽

Surveillance Data ◽

Control Measures ◽

Influenza Surveillance ◽

Mortality Data ◽

Real Time Estimation ◽

The Impact

Abstract Statistical models are commonly employed in the estimation of influenza-associated excess mortality that, due to various reasons, is often underestimated by laboratory-confirmed influenza deaths reported by healthcare facilities. However, methodology for timely and reliable estimation of that impact remains limited because of the delay in mortality data reporting. We explored real-time estimation of influenza-associated excess mortality by types/subtypes in each year between 2012 and 2018 in Hong Kong using linear regression models fitted to historical mortality and influenza surveillance data. We could predict that during the winter of 2017/2018, there were ~634 (95% confidence interval (CI): (190, 1033)) influenza-associated excess all-cause deaths in Hong Kong in population ⩾18 years, compared to 259 reported laboratory-confirmed deaths. We estimated that influenza was associated with substantial excess deaths in older adults, suggesting the implementation of control measures, such as administration of antivirals and vaccination, in that age group. The approach that we developed appears to provide robust real-time estimates of the impact of influenza circulation and complement surveillance data on laboratory-confirmed deaths. These results improve our understanding of the impact of influenza epidemics and provide a practical approach for a timely estimation of the mortality burden of influenza circulation during an ongoing epidemic.

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Epidemiology of Childhood Hyperthyroidism in France: A Nationwide Population-Based Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-00273 ◽

2018 ◽

Vol 103 (8) ◽

pp. 2980-2987 ◽

Cited By ~ 3

Author(s):

Marie Simon ◽

Annabel Rigou ◽

Joëlle Le Moal ◽

Abdelkrim Zeghnoun ◽

Alain Le Tertre ◽

...

Keyword(s):

Age Groups ◽

Poisson Model ◽

Epidemiological Data ◽

Epidemiological Survey ◽

Population Based ◽

Antithyroid Drugs ◽

Childhood And Adolescence ◽

Age Group ◽

Cross Sectional ◽

The Impact

Abstract Context Hyperthyroidism affects all age groups, but epidemiological data for children are scarce. Objective To perform a nationwide epidemiological survey of hyperthyroidism in children and adolescents. Design A cross-sectional descriptive study. Setting Identification of entries corresponding to reimbursements for antithyroid drugs in the French national insurance database. Participants All cases of childhood hyperthyroidism (6 months to 17 years of age) in 2015. Main Outcome Measures National incidence rate estimated with a nonlinear Poisson model and spatial distribution of cases. Results A total of 670 cases of childhood hyperthyroidism were identified. Twenty patients (3%) had associated autoimmune or genetic disease, with type 1 diabetes and Down syndrome the most frequent. The annual incidence for 2015 was 4.58/100,000 person-years (95% CI 3.00 to 6.99/100,000). Incidence increased with age, in both sexes. This increase accelerated after the age of 8 in girls and 10 in boys and was stronger in girls. About 10% of patients were affected before the age of 5 years (sex ratio 1.43). There was an interaction between age and sex, the effect of being female increasing with age: girls were 3.2 times more likely to be affected than boys in the 10 to 14 years age group and 5.7 times more likely to be affected in the 15 to 17 years age group. No conclusions about spatial pattern emerged. Conclusion These findings shed light on the incidence of hyperthyroidism and the impact of sex on this incidence during childhood and adolescence. The observed incidence was higher than expected from the results published for earlier studies in Northern European countries.

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Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset

eLife ◽

10.7554/elife.69336 ◽

2021 ◽

Vol 10 ◽

Author(s):

Ariel Karlinsky ◽

Dmitry Kobak

Keyword(s):

New Zealand ◽

Excess Mortality ◽

Mortality Data ◽

Objective Indicator ◽

Death Toll ◽

The World ◽

All Cause Mortality ◽

Expected Mortality ◽

The Impact ◽

Annual Mortality

Comparing the impact of the COVID-19 pandemic between countries or across time is difficult because the reported numbers of cases and deaths can be strongly affected by testing capacity and reporting policy. Excess mortality, defined as the increase in all-cause mortality relative to the expected mortality, is widely considered as a more objective indicator of the COVID-19 death toll. However, there has been no global, frequently-updated repository of the all-cause mortality data across countries. To fill this gap, we have collected weekly, monthly, or quarterly all-cause mortality data from 94 countries and territories, openly available as the regularly-updated World Mortality Dataset. We used this dataset to compute the excess mortality in each country during the COVID-19 pandemic. We found that in several worst-affected countries (Peru, Ecuador, Bolivia, Mexico) the excess mortality was above 50% of the expected annual mortality. At the same time, in several other countries (Australia, New Zealand) mortality during the pandemic was below the usual level, presumably due to social distancing measures decreasing the non-COVID infectious mortality. Furthermore, we found that while many countries have been reporting the COVID-19 deaths very accurately, some countries have been substantially underreporting their COVID-19 deaths (e.g. Nicaragua, Russia, Uzbekistan), sometimes by two orders of magnitude (Tajikistan). Our results highlight the importance of open and rapid all-cause mortality reporting for pandemic monitoring.

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Neurological diseases in Peru: a systematic analysis of the global burden disease study

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20200018 ◽

2020 ◽

Vol 78 (5) ◽

pp. 282-289

Author(s):

Carlos ALVA-DÍAZ ◽

Andrely HUERTA-ROSARIO ◽

Kevin PACHECO-BARRIOS ◽

Roberto A. MOLINA ◽

Alba NAVARRO-FLORES ◽

...

Keyword(s):

Disease Burden ◽

Neurological Diseases ◽

Age Groups ◽

Epidemiological Data ◽

Global Burden ◽

Years Of Life Lost ◽

Systematic Analysis ◽

Life Years ◽

Disease Study ◽

The Impact

ABSTRACT Background: Disease burden indicators assess the impact of disease on a population. They integrate mortality and disability in a single indicator. This allows setting priorities for health services and focusing resources. Objective: To analyze the burden of neurological diseases in Peru from 1990-2015. Methods: A descriptive study that used the epidemiological data published by the Institute for Health Metrics and Evaluation of Global Burden of Diseases from 1990 to 2015. Disease burden was measured using disability-adjusted life years (DALY) and their corresponding 95% uncertainty intervals (UIs), which results from the addition of the years of life lost (YLL) and years lived with disability (YLD). Results: The burden of neurological diseases in Peru were 9.06 and 10.65%, in 1990 and 2015, respectively. In 2015, the main causes were migraine, cerebrovascular disease (CVD), neonatal encephalopathy (NE), and Alzheimer’s disease and other dementias (ADD). This last group and nervous system cancer (NSC) increased 157 and 183% of DALY compared to 1990, respectively. Young population (25 to 44 years old) and older (>85 years old) were the age groups with the highest DALY. The neurological diseases produced 11.06 and 10.02% of the national YLL (CVD as the leading cause) and YLD (migraine as the main cause), respectively. Conclusion: The burden of disease (BD) increased by 1.6% from 1990 to 2015. The main causes were migraine, CVD, and NE. ADD and NSC doubled the DALY in this period. These diseases represent a significant cause of disability attributable to the increase in the life expectancy of our population among other factors. Priority actions should be taken to prevent and treat these causes.

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Helminths in South Africa: management of cestode and trematode infections in humans

South African General Practitioner ◽

10.36303/sagp.2020.1.1.0004 ◽

2020 ◽

pp. 33-38

Author(s):

RL van Zyl

Keyword(s):

South Africa ◽

South African ◽

Age Groups ◽

Signs And Symptoms ◽

Epidemiological Data ◽

Sub Saharan Africa ◽

The South ◽

Increased Risk ◽

Sub Saharan ◽

The Impact

Sub-Saharan Africa has to contend with many challenges, including inadequate healthcare systems, lack of optimal sanitation, and clean water and food. All of these contribute to malnutrition and an increased risk of infections, including parasitism by cestodes and trematodes. Schistosomiasis is a category-2 notifiable trematode (fluke) infection, whereas cestode (tapeworm) infections need not be reported to the South African Department of Health. Epidemiological data for helminthiasis in South Africa is scant, with a paucity of publications on the South African scenario. As such, a complete picture of the impact of helminth infections on all age groups in South Africa does not exist. These parasitic diseases not only have an impact on socio economic development of a country, community and families, but also contribute to the chronic and detrimental effects on the health and nutritional status of the host, including the impaired development of children. In order to break the cycle of poverty and disease, a strong education drive is required in schools and communities to provide effective strategies and guidelines on preventative measures that result in avoidance of exposure to infective stages of Schistosoma and Taenia tapeworms. Also, it is imperative that healthcare professionals are able to recognise the signs and symptoms, so that interventions can be promptly initiated. The current anthelmintic treatments available in South Africa are effective against cestodes and trematodes, with no drug resistance having being reported. The need for compliancy when taking anthelmintic drugs must be emphasised.

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Excess mortality during the COVID-19 outbreak in Italy: a two-stage interrupted time series analysis

10.1101/2020.07.22.20159632 ◽

2020 ◽

Cited By ~ 1

Author(s):

Matteo Scortichini ◽

Rochelle Schneider dos Santos ◽

Francesca De' Donato ◽

Manuela De Sario ◽

Paola Michelozzi ◽

...

Keyword(s):

Time Series ◽

Excess Mortality ◽

Temporal Distribution ◽

Interrupted Time Series ◽

Baseline Risk ◽

Mortality Data ◽

Interrupted Time Series Analysis ◽

Two Stage ◽

Smooth Functions ◽

The Impact

Background: Italy was the first country outside China to experience the impact of the COVID-19 pandemic, which resulted in a significant health burden. This study presents an analysis of the excess mortality across the 107 Italian provinces, stratified by sex, age group, and period of the outbreak. Methods: The analysis was performed using a two-stage interrupted time series design using daily mortality data for the period January 2015 - May 2020. In the first stage, we performed province-level quasi-Poisson regression models, with smooth functions to define a baseline risk while accounting for trends and weather conditions and to flexibly estimate the variation in excess risk during the outbreak. Estimates were pooled in the second stage using a mixed-effects multivariate meta-analysis. Results: In the period 15 February - 15 May 2020, we estimated an excess of 47,490 (95% empirical confidence intervals: 43,984 to 50,362) deaths in Italy, corresponding to an increase of 29.5% (95%eCI: 26.8 to 31.9%) from the expected mortality. The analysis indicates a strong geographical pattern, with the majority of excess deaths occurring in northern regions, where few provinces experienced up to 800% increase during the peak in late March. There were differences by sex, age, and area both in the overall impact and in its temporal distribution. Conclusions: This study offers a detailed picture of excess mortality during the first months of the COVID-19 pandemic in Italy. The strong geographical and temporal patterns can be related to implementation of lockdown policies and multiple direct and indirect pathways in mortality risk.

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