Mortalidade em indígenas do Distrito Sanitário Especial Indígena Ceará, no período de 2013 a 2018

Abstract

The study aims to characterize the indigenous mortality (general and infantile) of the Special Indigenous Health District Ceará (DSEI-CE) and to evaluate the quality of the variables in the Indigenous Health Care Information System (SIASI). Methods: Descriptive study of general and infantile indigenous mortality in the 2013-2015 and 2016-2018 trienniums in Ceará. The data sources were the SIASI, Live Birth Information Systems (SINASC) and Mortality (SIM) banks. The degree of incompleteness in SIASI and the reliability and coverage of indigenous deaths in SIM were evaluated; crude and standardized general mortality rates (TM) were calculated; proportional mortality, by age group, sex and basic cause of death, estimating rate ratios between indigenous and general populations of the state and municipalities in DSEI-CE territory and three-year periods. Results: SIASI does not record socioeconomic variables, Apgar scores in the 1st and 5th minutes and description of congenital anomalies; it does not allow the extraction through the report of variables on pregnancy and childbirth in the data of birth and death. There was an improvement in 40% of the birth variables, 40% of those of infant death and 54.5% of those of general death. The reliability in the records of indigenous deaths in SIASI compared to SIM was 45.5% (328) in total deaths and 37.5% (15) in infant deaths; and coverage of 93.6% (674) for total deaths and 95% (38) for indigenous infant deaths. Among indigenous people, there was a predominance of deaths in the post-neonatal period (53%) in the first three years, a situation that was reversed in the second three years, in which the concentration of deaths was observed in the early neonatal period (68%), starting to resemble the standard of the state and municipalities in DSEI-CE territory. The indigenous population had an age structure and basic causes of death similar to the general population of the state and municipalities in the DSEI-CE territory. Indigenous people had a higher ratio of TM among children under five 1.48 (1.1-1.9) compared to municipalities; due to ill-defined causes [1.36(1.3-1.4)] and diseases of the circulatory system and in women, respectively 1.26(1.2-1.2) and 1.25(1.2-1.2) compared to the population of the state. Lower ratio between MT in men due to infectious and parasitic diseases [0.52(0.4-0.5)], circulatory system diseases [0.79(0.7-0.8)], genitourinary system [0 .51(0.4-0.5)] and external causes [0.81(0.8-0.8)] compared to the state. There was a reduction of approximately 83% in the ratio of specific mortality rates due to ill-defined causes between indigenous peoples of the DSEI-CE and general populations when comparing the first and second trienniums. Conclusion: SIASI has limitations for socioeconomic and maternal child analyzes of births and deaths. The SIM showed weakness in identifying indigenous deaths, even though almost all deaths were registered. The demographic profile and the health situation of the indigenous people were similar to that of the general population of the study; and improved in the second half.