Spatial and temporal patterns of stroke mortality in Ceará State, Brazil, between 2009 and 2019

Abstract

OBJECTIVE:

To outline the epidemiological profile and the spatial and temporal distribution of stroke-related deaths in Ceará State, Brazil.

MATERIALS AND METHODS:

This ecological study analyzed stroke-related deaths from 2009 to 2019 among Ceará residents, as reported in the Mortality Information System (DATASUS). Descriptive analysis with univariate statistics, spatial analysis, mortality rate calculations, and preparation of maps using TabWin v4.15, as well as temporal analysis with the Joinpoint Regression Program v4.6.0.0, were conducted.

RESULTS:

There were 24,552 deaths, predominantly among brown individuals, aged 60 and above, and with no schooling. There was a stationary trend between 2009 and 2016 (APC: -1.5%; 95%CI: -3.5 - 0.7; p = 0.1), followed by a significant decrease between 2016 and 2019 (APC: -12.0%; 95%CI: -20.0 - -3.2; p = 0.0). The average crude mortality rate was 25.42 deaths per 100,000 inhabitants, with a linear decreasing trend in deaths over time (R² = 0.7536). The Health Regions with the highest annual mortality rates were the 10th Region Limoeiro do Norte, 11th Region Sobral, 15th Region Crateús, 17th Region Icó, and 18th Region Iguatu.

CONCLUSION:

Despite the linear downward trend in mortality rate, stroke remains highly prevalent, highlighting its status as a public health issue. Therefore, the need for prevention, promotion, and treatment actions for the disease in Brazil is evident.