Evidence map›Paper›PMID 41669934›Full record

ArticleMycoses2026

Neglected Mycoses in Brazil: A Population-Based Study of Mortality and In-Hospital Mortality Over 25 Years.

Anderson Fuentes Ferreira, Jorg Heukelbach, Eliana Amorim de Souza, Maria Aparecida Shikanai-Yasuda, Lisandra Serra Damasceno, Fernanda Dockhorn Costa, Terezinha do Menino Jesus Silva Leitão, Helia Kawa, Alberto Novaes Ramos

Abstract read
In one paragraph

Article in Mycoses, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Anderson Fuentes FerreiraPrograma de Pós-Graduação Em Saúde Pública, Faculdade de Medicina, Universidade Federal Do Ceará, Fortaleza, Ceará, Brazil.ORCID https://orcid.org/0000-0002-1816-9459
Jorg HeukelbachPrograma de Pós-Graduação Em Saúde Pública, Faculdade de Medicina, Universidade Federal Do Ceará, Fortaleza, Ceará, Brazil.ORCID https://orcid.org/0000-0002-7845-5510
Eliana Amorim de SouzaInstituto Multidisciplinar de Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Vitória da Conquista, Bahia, Brazil.ORCID https://orcid.org/0000-0002-9653-3164
Maria Aparecida Shikanai-YasudaDepartamento de Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-3864-041X
Lisandra Serra DamascenoPrograma de Pós-Graduação Em Saúde Pública, Faculdade de Medicina, Universidade Federal Do Ceará, Fortaleza, Ceará, Brazil.ORCID https://orcid.org/0000-0003-1425-5912
Fernanda Dockhorn CostaDepartamento de HIV/Aids, Tuberculose, Hepatite Viral e ISTs, Secretaria de Vigilância Em Saúde e Ambiente, Ministério da Saúde, Brasília, Brazil.ORCID https://orcid.org/0000-0002-1762-9484
Terezinha do Menino Jesus Silva LeitãoPrograma de Pós-Graduação Em Saúde Pública, Faculdade de Medicina, Universidade Federal Do Ceará, Fortaleza, Ceará, Brazil.ORCID https://orcid.org/0000-0002-3301-3057
Helia KawaDepartamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Rio de Janeiro, Brazil.ORCID https://orcid.org/0000-0003-0864-804X
Alberto Novaes RamosPrograma de Pós-Graduação Em Saúde Pública, Faculdade de Medicina, Universidade Federal Do Ceará, Fortaleza, Ceará, Brazil.ORCID https://orcid.org/0000-0001-7982-1757

Funding

Conselho Nacional de Desenvolvimento Científico e TecnológicoCoordenação de Aperfeiçoamento de Pessoal de Nível SuperiorFundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico
6 · The paper itself

Abstract

objectiveTo describe the epidemiology, associated factors, spatial distribution, and temporal trends of mortality and in-hospital mortality related to systemic mycoses in Brazil, 2000-2024.

methodsThis is a nationwide ecological study combining temporal and spatial analyses using death certificates (DC; underlying and/or associated causes) and hospital admissions (HA; primary and/or secondary diagnoses) with in-hospital deaths. We estimated rate ratios (RR) with 95% confidence intervals (CI) interpreted as comparative mortality and in-hospital mortality rates between sociodemographic categories at the aggregate level, stratified by sex and age group; temporal trends were presented with the average annual percent change (AAPC) and 95% CIs; spatial heterogeneity was described across states. Outcomes were expressed as population-based rates (per 100,000 inhabitants).

resultsWe identified 22,230 mycosis-related deaths among a total of 30,488,786 deaths (0.07%), corresponding to an overall mortality rate of 0.46 per 100,000 population. Mortality was higher in males (RR 2.91; 95% CI 2.51-3.38) and peaked at ages 60-69 years (RR 3.47; 95% CI 2.67-4.51). Nationwide mortality declined over time (AAPC -1.12; 95% CI -1.41 to -0.83). Deaths were geographically concentrated in the states of Rondônia, Mato Grosso, Goiás and Mato Grosso do Sul. We recorded a total of 4471 in-hospital deaths among 11,367,369 admissions (0.04%), yielding an in-hospital mortality rate of 0.09 per 100,000 population. In-hospital risk of death was higher in males (RR 2.12; 95% CI 1.55-2.89) and in those aged ≥ 70 years (RR 12.50; 95% CI 7.38-21.17). No significant nationwide trend was observed for in-hospital mortality (AAPC 0.64; 95% CI -1.20 to 2.59). Spatial distribution during the analysis period was heterogeneous, especially in the states of Rondônia, São Paulo, Rio de Janeiro, Paraíba and Paraná.

conclusionOur findings fill an important gap by jointly analysing long-term mortality and in-hospital mortality related to systemic mycoses at a nationwide scale, using two complementary information systems. Neglected mycoses remain an important cause of death in Brazil, including deaths during hospitalisation. Distinct individual-level and spatial patterns support the need for strengthened surveillance, prevention, control, and therapeutic strategies within the Brazilian Unified Health System.

Indexed as

Hospital MortalityMycosesNeglected DiseasesAdolescentAdultAgedAged, 80 and overBrazilChildChild, PreschoolFemaleHospitalizationHumansInfantInfant, NewbornMalehospitalisationin‐hospital mortalitymortalitymycosesneglected tropical diseasesspatiotemporal analysis

Identifiers

PMID41669934
PMCPMC12892236

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.