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Objective: To estimate the national and provincial number of excess deaths due to diabetes across Cuba in 2019. Study design: Cross-sectional design with secondary data. Methods: We used DISMODII, a computerized generic disease model, to assess disease burden by modelling the relationships between incidence, prevalence, and disease-specific mortality. Baseline input data included population structure, total mortality, and age- and sex-specific estimates for diabetes prevalence from the Cuban National Health Survey 2019, and available published estimates of the relative risk of death for people with diabetes compared to people without diabetes. The results were internally validated with DISMODII output for duration of diabetes (years). Results: In 2019, we estimated an excess of mortality attributable to diabetes of 7.5 times the diabetes mortality reported by the National Death Registry, which is equivalent to 16.4 % of all deaths in Cuba. The percentages of all-cause mortality among provinces varied between 10.7 % in Villa Clara and 24.5 % in Ciego de Avila. Conclusions: These are the first estimates of mortality attributable to diabetes in Cuba and its provinces. Diabetes is likely to be a much more prominent leading cause of death than the 9th ranking reported by the Cuban National Death Registry 2019. Disease models similar to DISMODII are important tools to validate the epidemiologic indicators used in the burden of disease calculations.

Background: Excessive Mortality is considered an especially useful indicator to assess the health impact of COVID-19 at the international level; its employment has been increasing throughout 2021, but in the national scientific literature its presence is, as far as we know, null. Objectives: to define and discuss the characteristics and computation requirements. To illustrate the use of the indicator through calculation of Excessive Mortality for Cuba, and compare results with other countries. Methods: Illustrative study of the use and interpretation of an indicator of COVID-19 impact. Results: Excessive Mortality in Cuba compares favorably with that of other countries, in particular in the Latin American region. Conclusions: The incidence of the disease, together with the Non-Pharmaceutical Interventions implemented by Governments, among other factors, influence Excessive Mortality. In the case of Cuba, it is necessary to calculate the Excessive Mortality for 2021, given that in that year the highest incidence rates were observed, and thus contribute to the evaluation of the global resilience of our Health System in the face of the pandemic. [ABSTRACT FROM AUTHOR]

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Copyright of MediSur is the property of Centro Provincial de Informacion de Ciencias Medicas de Cinfuegos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Una forma de cuantificar la mortalidad prematura es mediante el indicador conocido como años de vida potencial perdidos, el cual ha sido ampliamente utilizado para estimar el estado de salud de las poblaciones. El objetivo del presente trabajo es comparar los años de vida potencial perdidos por mortalidad prematura de algunas afecciones de la esfera reproductiva en los años 1990, 1995 y 2000. Las afecciones analizadas fueron: síndrome de inmunodeficiencia adquirida, otras infecciones de transmisión sexual, condiciones maternas y cáncer del aparato reproductivo. Se calcularon los años de vida potencial perdidos utilizando la esperanza de vida para el período 94-95. Se determinaron los porcentajes y las tasas por 100 000 habitantes de años de vida potencial perdidos. La tasa total de años de vida potencial perdidos aumentó en el período estudiado en ambos sexos: en el femenino de 512,4 en el año 90 a 679,9 en el 2000, mientras que en el hombre se quintuplicaron las cifras de 27,2 a 145,9. Hubo un mayor aporte a la mortalidad prematura del sexo femenino, y resultó siempre superior al 80 % de la carga total. En ambos sexos se observó un incremento del peso relativo de la mortalidad por síndrome de inmunodeficiencia adquirida. En las mujeres el cáncer de mama y los de cuello y cuerpo de útero resultaron las causas más importantes de mortalidad prematura con ascenso en el período. El peso relativo de las condiciones maternas descendió de 10,7 % en el año 90 a 2,6 en el 2000. Las afecciones estudiadas, consideradas en su conjunto, muestran una carga por mortalidad prematura ascendente en el período estudiado, y resultaron los principales contribuyentes el cáncer de mama y los de cuello y cuerpo de útero en la mujer, y el síndrome de inmunodeficiencia adquirida en ambos sexos.A procedure for quantifying premature mortality is based on potential years of life lost, a well-known indicator, which is widely used to estimate the health status of the population. The objective of the present paper is to compare the potential years of life lost due to premature mortality from some diseases in the reproductive field during 1990, 1995 and 2000. The analyzed diseases were: acquired immunodeficiency syndrome; other sexually transmitted infections, maternal conditions and reproductive apparatus cancer. Potential years of life lost were calculated by using life expectancy rates for the period 1994-1995. Percentages and rates of potential years of life lost per 100 000 inhabitants were determined. The total rate of potential years of life lost increased for both sexes in the studied period: in females, it increased from 521,4 in the year 1990 to 679,9 in the year 2000 whereas in males, the rate values went up five times from 27,2 to 145,9. Females contributed more to premature mortality rates, representing over 80% of the total burden. It was observed that the relative burden of mortality from AIDS rose in both sexes. As to females, breast and uterine cancers were the most important causes of premature mortality, with an increasing tendency in the period. The relative burden of maternal conditions decreased from 10,7 in 1990 to 2,6 in 2000. The studied diseases as a whole showed rising burden of premature mortality in the studied period, being breast and cervical uterine cancers in women and acquired immunodeficiency syndrome in both sexes the main contributors.

Foundation: Maternal mortality in the world is unacceptably high. Complications in pregnancy, childbirth and the puerperium are the leading cause of death in women of childbearing age. In recent years the number of maternal deaths in Cuba, is one of the lowest in Latin America, but it is still far from the results of more developed countries. The most evident achievements are made in reducing infant mortality. Objective: to describe the behavior of deaths that occurs during pregnancy, childbirth and the puerperium in Cuba, in the period 2005-2018. Methods: an annual cross-sections descriptive study was carried out. The universe was the total deaths registered during pregnancy, childbirth and the puerperium in the period 2005-2018, in Cuba (N = 829). The mortality ratio, percentages, the trend and the average were calculated. Results: the death ratio during pregnancy, childbirth and the puerperium averaged 48.6 per 100,000 live births, as well as the average maternal mortality was 41.6. Direct obstetric deaths contributed 463, indirect 247; and for other deaths, there were 119. Conclusion: in the studied period, the behavior between the number of deaths and the ratio has been very similar, which indicates that the last one was determined mainly by the number of deaths and not by the number of live births. Direct obstetric deaths predominated, followed by indirect deaths, and then by the others. Indirect obstetric deaths were the only ones that showed a tendency to increase over time. [ABSTRACT FROM AUTHOR]

INTRODUCTION Mortality analysis based on a single cause of death is not, in most cases, fully informative. There are several more illuminating procedures using a multiple cause of death approach; these are little known and rarely used in Cuba. The simplest of these methods, while methodologically limited, consists of summing all deaths from a specific cause mentioned on death certificates, regardless of whether the cause is listed as underlying or contributing. OBJECTIVE Using Cuban data, critically assess and implement two of the most recognized approaches to analyzing multiple causes of death. METHODS Multiple causes of death in Cuba were assessed for the years 2005, 2010 and 2015, employing death records from the National Medical Records and Health Statistics Bureau of Cuba's Ministry of Public Health. With the example of diabetes mellitus as underlying cause, we explored connections between underlying and associated (antecedent and contributing) causes on death certificates using two approaches from the international literature: the simple method and the cause-of-death association indicator. RESULTS The study identified main trends in multiple causes of death identified in 2005, 2010 and 2015, overall and by age group and sex. We observed a trend to increasing mean number of causes of death per death certificate between 2005 and 2015. The number of causes reported showed no substantial differences by age group or sex. Diseases of the arteries, arterioles and capillaries were by far the most frequently associated with diabetes mellitus as underlying cause. CONCLUSIONS The multiple causes of death approach affords more nuanced understanding of patterns of disease, comorbidity and death in the Cuban population. The indicators used fulfill different roles: the simple method brings to light the full range of ways in which a given cause contributes to mortality, and the cause-of-death association indicator enables exploration of links between different causes of death, not possible with the simple method. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. To describe the burden of disease, using morbidity and mortality in Cuba from 1990-2002, by cancer type and location. Methods. A descriptive study of the disease burden in the years 1990, 1995, 2000, and 2002, by Cuba's most frequently associated cancer types and locations. Official Cuban sources were used to calculate years of potential life lost (YPLL) due to mortality (based on life expectancy) and morbidity (based on the incidence, average duration, and severity of the disease), as well as years of potential life lost per death (YPLL/D) and the disability-adjusted life years (DALY), for each cancer type and location, by sex and age group. Results. The locations with higher YPLL were also those with the greatest total burden: lung, breast, prostate, colon and rectum, and cervix, and showed an upward trend for all cancer types and locations, except leukemia. The morbidity-related YPLL were concentrated in: breast, lung, prostate, colon and rectum, and cervix. In men, the highest mortality-related YPLL values were in the oral cavity and oropharynx, esophagus, stomach, lung, bladder, melanoma, lymphoma, and leukemia; women were more affected by cancer of the colon and rectum. The highest YPLL/D values were observed for cervix, breast, ovaries, leukemia, and lymphoma. The cancer types and locations with more DALYs were: lung, breast, prostate, colon and rectum, cervix, and endometrium. Conclusions. The burden of disease from cancer increased in Cuba from 1990-2002, mostly due to a rise in the mortality burden. [ABSTRACT FROM AUTHOR]

Summary: Background: The large scale migration currently taking place from Latin-America to the United States has created a new era in public health. A systematic examination of patterns of cardiovascular mortality (CVD) for the major US Hispanic populations was carried out and a direct comparison to their respective countries/regions of origin was conducted to evaluate possible transitions in health with migration. Methods: Vital statistics records from the US, Mexico, Cuba and Puerto Rico compiled by governmental agencies in each country during 2000 were used to estimate CVD age-adjusted mortality. Results: Total age-adjusted CVD mortality for Mexican Americans, Cuban Americans and mainland Puerto Ricans was similar to non-Hispanic whites, and lower than among blacks. CVD rates in Mexico and on the island of Puerto Rico were likewise similar in magnitude, while these mortality rates were 20% higher in Cuba. Death from ischemic heart disease, on the other hand, was higher in non-Hispanic whites than Mexican Americans, Mexicans, Cuban Americans, but lower than Puerto Ricans, Cubans and US blacks. Stroke rates tended to be lower in US whites and all Hispanics and higher in Mexico and Cuba. Conclusions: These data suggest at most a very modest Hispanic advantage in CVD within the US at the present time and a substantial burden of both heart disease and stroke in the countries from which these individuals have immigrated. Further surveillance efforts will be required to determine whether the long-term trends for these populations are following the downward course observed in the US. [Copyright &y& Elsevier]

En este trabajo se presentó un software para el cálculo de los Años de Vida Perdidos, uno de los componentes de los AVAD. Se ilustró la aplicación de este programa a dos tablas del Anuario Estadístico del MINSAP 1997, con la distribución de la mortalidad por grupos de edades y por años (desde 1970 hasta la fecha) en un caso, y por grupos de edades y por provincias en 1997 en el otro. Los cálculos se realizaron para distintas ponderaciones de las edades, y para distintos descuentos en el tiempo del "valor" de un año de vida saludable. Se puso de manifiesto la posibilidad que tienen los AVP de hacer más integral la evaluación de la carga de la mortalidad, su distribución en el espacio y su evolución en el tiempo.In this work a software for the calculation of the Years of Life Lost, one of the components of the AVAD was presented. It was shown the application of this program to two tables of MINSAP's Statistic Yearbook of 1997, with the distribution of mortality by groups of ages and by years (since 1970 up to the present, in a case, and by groups of ages and by provinces in 1997 in the other. The calculations were performed for different determinations of the ages, and for different reductions in the time of the "value" of a healthy year of life. It was evidenced the possibility the YLL have to become more comprehensive the evaluation of the load of mortality, its distribution in space and its evolution in time.

OBJETIVO: describir la carga de la diabetes en Cuba en el período 1990-2005. MÉTODOS: se calcularon las tasas de mortalidad (x 100 000), las tasas de años de vida potencial perdidos por mortalidad prematura (x 1 000), los años de vida potencial perdidos promedio por cada defunción, las tasas de años de vida potencial perdidos por morbilidad (x 1 000), las tasas de años de vida ajustados por discapacidad (x 1 000) y la proporción de la carga total correspondiente a la morbilidad. Los años de vida potencial perdidos por mortalidad prematura se obtuvieron a partir de los estimados de esperanza de vida para intervalos quinquenales de edad, y por morbilidad como el producto de la severidad, la incidencia y la duración promedio de la diabetes. Los años de vida ajustados por discapacidad se calcularon como la suma de los años de vida potencial perdidos por mortalidad y por morbilidad. RESULTADOS: la tasa de años de vida potencial perdidos por mortalidad prematura disminuyó del año 1990 a 2005 (de 2,44 a 1,98 x 1 000 en los hombres y de 4,54 a 3,72 x 1 000 en las mujeres). Los años de vida potencial perdidos promedio por cada defunción mostraron cambios discretos (al ascenso en los hombres y al descenso en las mujeres). La tasa de estos por morbilidad aumentó en el período en ambos sexos. Por su parte, la tasa de años de vida ajustados por discapacidad se incrementó en el período de 5,24 a 6,61 x 1 000 en los hombres y de 8,40 a 11,19 x 1 000 en las mujeres. El sexo femenino resultó notoriamente más afectado. CONCLUSIONES: la carga integral de la diabetes aumentó en Cuba en el período de estudio a expensas de la carga por morbilidad.OBJECTIVE: to describe the burden of diabetes in Cuba from 1990 to 2005. METHODS: the mortality rates (x 100 000), the rates of years of potential life lost due to early mortality (x 1 000), the average years of potential life lost per each death, the rates of years of potential life lost due to morbidity (x 1 000), the rates of years of life adjusted by disability (x 1 000) and the proportion of the total burden corresponding to morbidity were calculated. The years of potential life lost as a result of early mortality were obtained from the estimates of life expectancy for five-year intervals of age, and from morbidity as the product of the severity, the incidence and the average duration of diabetes. The years of life adjusted by disability were calculated as the sum of the years of potential life lost due to mortality and morbidity. RESULTS: the rate of years of potential life lost because of early mortality decreased from 1990 to 2005 (from 2.44 to 1.98 x 1 000 in males and from 4.54 to 3.72 x 1 000 in females). The average years of potential life lost per death showed discreet changes (towards the increase in males and towards the reduction in females). Their rate due to morbidity increased during this period in both sexes. The rate of years of life adjusted by disability rose from 5.24 to 6.61 x 1 000 in males, and from 8.40 to 11.19 x 1 000 in females. Females were significantly affected. CONCLUSIONS: the integral diabetes burden grew in Cuba during the studied period at the expense of the morbidity burden.