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About the Authors:
Ligia Capuani
* E-mail: [email protected]
Affiliation: Department of Infectious Diseases, School of Medicine-University of Sao Paulo-FMUSP, Sao Paulo, Sao Paulo, Brazil
ORCID http://orcid.org/0000-0002-3467-6805
Ana Luiza Bierrenbach
Affiliation: Institute of Education and Research, Hospital Sirio Libanes, Sao Paulo, Sao Paulo, Brazil
Airlane Pereira Alencar
Affiliation: Department of Statistics, Institute of Mathematics and Statistics, University of Sao Paulo-IME-USP, Sao Paulo, Sao Paulo, Brazil
Alfredo Mendrone Jr.
Affiliation: Fundação Pró-Sangue-Hemocenter of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
João Eduardo Ferreira
Affiliation: Department of Computer Science, Institute of Mathematics and Statistics, University of Sao Paulo-IME-USP, Sao Paulo, Sao Paulo, Brazil
Brian Custer
Affiliation: Epidemiology and Health Policy Research, Blood Systems Research Institute-BSRI, San Francisco, California, United States of America
Antonio Luiz P. Ribeiro
Affiliation: Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais-UFMG, Belo Horizonte, Minas Gerais, Brazil
Ester Cerdeira Sabino
Affiliation: Department of Infectious Diseases, School of Medicine and Tropical Medicine Institute-University of Sao Paulo-FMUSP, Sao Paulo, Sao Paulo, BrazilAbstract
Background
Individuals in the indeterminate phase of Chagas disease are considered to have mortality rates similar to those of the overall population. This study compares mortality rates among blood donors seropositive for Chagas disease and negative controls in the city of São Paulo, Brazil.
Methodology/principal findings
This is a retrospective cohort study of blood donors from 1996 to 2000: 2842 seropositive and 5684 seronegative for Chagas disease. Death status was ascertained by performing probabilistic record linkage (RL) with the Brazil national mortality information system (SIM). RL was assessed in a previous validation study. Cox Regression was used to derive hazard ratios (HR), adjusting for confounders. RL identified 159 deaths among the 2842 seropositive blood donors (5.6%) and 103 deaths among the 5684 seronegative (1.8%). Out of the 159 deaths among seropositive donors, 26 had the 10th International Statistical Classification of Diseases and Related Health Problems (ICD-10) indicating Chagas disease as the underlying cause of death (B57.0/B57.5), 23 had ICD-10 codes (I42.0/I42.2/I47.0/I47.2/I49.0/I50.0/I50.1/ I50.9/I51.7) indicating cardiac abnormalities possibly related to Chagas disease listed as an underlying or associated cause of death, with the others having no mention of Chagas disease in part I of the death certificate. Donors seropositive for Chagas disease had a 2.3 times higher risk of death due to all...