Deaths caused by leprosy in Brazil, 2004-2009: use of database linkage

INTRODUCTION: Leprosy is rarely a direct cause of death. However, in Brazil, each year approximately 200 deaths are recorded with leprosy as underlying cause. The study aimed to describe the characteristics of deaths with underlying cause leprosy recorded in the Mortality Information System (SIM) and compare these characteristics between the groups of cases whose deaths were reported and not reported in the Information System for Communicable Diseases (Sinan). 

METHODS: Descriptive study that included deaths with underlying cause leprosy occurred in Brazil in the period 2004-2009, and the leprosy cases in the period 1975-2019. Probabilistic linkage between SIM and Sinan was carried out. 

RESULTS: Of the 1,463 deaths from leprosy in SIM, 44.2 % were not found in Sinan. Of all deaths, the majority were men (72.5%), with 60 or more years of age (56.6 %), occurring in hospitals (65.3%) and with medical assistance (45.8%). Of the 820 deaths identified in Sinan, 92 % were multibacillary, 45.2% were discharged as cured in Sinan and 38.9% died. 

CONCLUSIONS: The present study revealed the existence of deaths from leprosy who are registered on the SIM, but were not in Sinan, and raised the possibility of deaths from other causes were recorded as being by leprosy, and therefore are not reported in Sinan. The comparison between the reported and underreported deaths at Sinan revealed that among the ten variables studied, only three showed statistically significant differences between groups reported and underreported (sex, color or race, and primary cause). This fact suggests that the people of the two groups have similar profiles. Thus, deaths underreported at Sinan may represent cases of leprosy, although the deaths recorded as the underlying cause leprosy does not necessarily have a direct relationship with the disease.