What was spains disease

An estimated 8 million people worldwide are infected, the country with the highest disease burden being Bolivia. Chagas disease has overcome borders, and it is no longer restricted to endemic countries. Nowadays, it can be found in the Unites States, Canada, Europe, Japan, and Australia, mainly due to mobility of population.

Spain ranks second only to the United States in the list of countries receiving migrants from Latin America, and it is the European country with the highest prevalence of Chagas disease, therefore posing a challenge in terms of public health [1]. The main nonvectorial routes are congenital transmission, blood transfusion, and solid organ transplant.

In fact, in Europe as well as in other nonendemic areas, there have been several cases of vertical transmission of T. Many nonendemic countries have not yet established official guidelines to avoid these routes [1] , [2].

Mandatory screening of blood donors at risk for T. Although not included in the Royal Decree, many blood banks also screen individuals who have resided in endemic areas for more than 2 months.

In Spain, there is a national law that regulates the activity of tissue banks; moreover, the Spanish Society of Tropical Medicine and International Health has published a document in order to establish the guidelines to be followed in case a potential donor or a tissue or organ recipient could be affected by Chagas disease [4]. According to the recommendations of the WHO experts on the control and management of congenital Chagas disease, screening should be carried out during pregnancy to detect mothers who carry the infection and are at risk of transmitting the infection to their offspring.

Furthermore, the WHO states that cases of congenital T. In Spain, systematic detection of congenital infection is not performed at the national level [1] ; only two regions Autonomous Community of Valencia and Catalonia have a specific protocol.

Currently, several scientific groups have drafted a clinical guide, which will be published shortly, about diagnosis, follow-up, and treatment of pregnant women and children with Chagas disease. Regarding treatment of infected newborns, the WHO recommendations are followed [5] , using benznidazole as the first-line treatment option for Chagas disease in children and adults in Spain. Stocks of this drug ran out at the end of last year, which will result in Chagas disease becoming a NTD also in developed countries [6].

Benznidazole is available in Spain for all patients from the second half of November Estimating the burden of Chagas disease in nonendemic countries is crucial in order to plan preventive measures and to determine the resources for screening and treatment.

Estimates are normally calculated according to the number of Latin Americans registered in each country and to the infection rates in their countries of origin. Thus, it is assumed that the prevalence of the infection in the host country is the same as that in the country of origin, this being the main limitation for achieving accurate estimations.

In the past recent years, estimates on the expected number of migrants with T. The last one yields a figure of 48,—86, cases, based on the Bolivians' infection rates of three studies performed only in two regions of Spain [7]. This standard simulation method was repeated 1, times to be able to capture uncertainty in the prevalence of all sequelae and disability weights [ 10 ].

The population of older adults in Spain presented the highest increase among all age groups. Table 2 illustrates the main causes of mortality and YLLs by gender and age group for the Spanish population. Cardiovascular and circulatory diseases were the main cause of mortality among the non-communicable diseases The third category, injuries, accounted for 4. Age-specific analysis revealed that non-communicable diseases remained the major cause of mortality except for children below 1 year of age.

On the contrary, the main cause of mortality in newborns was communicable diseases, which accounted for On the other hand, the main cause of female mortality were cardiovascular diseases Spanish deaths in for males , total deaths and females , total deaths at all ages. In , regardless of gender, the leading specific cause for YLLs was neoplasms followed by cardiovascular and circulatory diseases.

Spanish years of life lost YLLs ranks for the top 20 main causes in and , and the percentage change between and Solid line for increase or equal position. Continuous line represents an ascending order in rank and the broken line represents a descending order. Transport injuries were the seventh cause third in , and the chronic respiratory diseases were the third cause fourth in The burden of YLLs in , attributable to cirrhosis of the liver as well as diarrhea, lower respiratory infections, meningitis, and other common infectious diseases, decreased compared with seventh to sixth cause and eight to ninth position, respectively.

In the broader classification terms between and , musculoskeletal disorders, mental and behavioral disorders, and diabetes, urogenital, blood, and endocrine diseases were the three main contributors to the years lived with disability in Spain.

Putting premature mortality and disability together in terms of DALYs provides an overall picture of the leading health problems in Spain. Between and , there was a slight increase 5. There was only a slight change in numerical order between the first two causes. Between the sixth and the eleventh positions the causes for DALYs changed only slightly. Finally, the last four causes among the 20 top ranking of DALYs in Spain remained completely stable between and , despite the changes in disability Figure 3.

Spanish disability-adjusted life years DALYs ranks for the top 20 main causes in and , and the percentage change between and Summarizing the above data, in , the leading causes for DALYs among newborn children 0—1 years old were neonatal disorders and the other communicable diseases group.

The leading causes for DALYs in the younger group 5 to 44 years old in the Spanish population were mental and behavioral disorders and musculoskeletal disorders, while in the middle aged and older adults groups the leading causes shifted to cardiovascular and circulatory diseases and neoplasms Figure 4.

DALYs in Spain by cause and age in Adopted and modified from GBD data visualizations. In both and , there was a high consistency across European countries regarding the top causes of YLDs being major depressive disorders, musculoskeletal disorders, low back and neck pain, and diabetes, as well as injuries i.

YLDs caused by asthma, anxiety disorders, and chronic obstructive pulmonary disease ranked lower in Spain compared with other southern European countries, in both and Figure 5. Numbers in cells indicate the ranks by country for each cause, with 1 being the disorder with the highest impact.

The presented causes are ordered by the 20 leading causes of YLDs in Spain. From to overall DALYs attributable to non-communicable diseases in Spain increased by , from 8,, to 9,, Changes in DALYs mostly correspond to population increase and are secondary to population ageing.

Moreover, the highest difference was attributed to those 40 years and older. The analysis of changes by age and gender group denoted that DALYs decreased when analyzed as rates per , population. The relevance of neoplasms and cardiovascular and circulatory diseases on population health is mostly driven by mortality.

Accordingly, the cardiovascular and circulatory diseases, neoplasms, and injuries due to transport reasons were the top three leading causes for the burden of YLLs. However, the impact of musculoskeletal disorders and mental disorders is mostly through YLDs, since they are the first and second causes in the ranking.

Additionally, depression, and other mental disorders like anxiety, etc. All these conditions are related to occupational risk, particularly low back pain [ 19 ], and absenteeism. The impact of these disorders and the need for mental health promotion and musculoskeletal health prevention may have been underestimated by public health authorities and policies [ 20 ]. Other studies have previously evaluated the burden of morbidity and mortality in Spain [ 8 ],[ 9 ].

According to these, in , the major causes for mortality in males and females were also cardiovascular diseases and malignant neoplasms [ 8 ].

Furthermore, a recent study in Valencia reported similar results in mortality rates in the local population i. Clear gender differences emerged in the analyses. Specifically, in males, cancer i. Risk factor differences may be causing the increased impact of cancer in males: they still have higher rates of smoking and heavy alcohol consumption [ 21 ],[ 22 ]. The increased mortality of cardiovascular diseases in females is due to cerebro-vascular problems. Further, hormonal factors disappearance of the protective role of estrogens after menopause have been associated to the increased risk of stroke in females [ 23 ].

The top five causes for the burden of YLDs in Spain are similar to those in the other Mediterranean countries except for slight differences with France [ 24 ]-[ 26 ].

Spain, as well as other Mediterranean countries, has to shift the provided health care services from curative to preventive [ 29 ],[ 30 ] and to identify the priority diseases for health research funding and prevention policies development [ 8 ]. When comparing the results among all European countries, some remarkable results have also been found. Country differences may be mostly caused by differences in mortality instead of differences in YLDs. Whether this can be attributed to mortality figures being recorded more systematically in each country than prevalence figures should still be clarified.

In , Spain presented the same leading conditions for YLLs compared to other Mediterranean countries, such as Greece, France, and Italy [ 24 ]-[ 26 ]. In , Spain, France, and Italy showed age-standardized YLL rates for liver cancers significantly higher than the overall mean rate. Spain and Greece showed significantly higher rates of age-standardized YLL rates for bladder cancers [ 7 ].

There are about two million people in the country with COPD but the majority go undiagnosed. A main cause of COPD is smoking. COPD can lead to emphysema and chronic bronchitis. Mental and Behavioral Disorders Mental illnesses are the second most common cause of temporary and permanent leave from work in Spain.

Depression is the most prevalent. About five to 10 percent of Spaniards suffer at least one depressive episode in their lives. Depression and other mental health illnesses have high social impacts because of missed work, costs, morbidity and care. These patients were the incurably ill, the chronically ill and the elderly.

This process is contextualized within the liberal reforms of the Spanish healthcare system in the reign of Isabel 11