Introduction: Stroke is a significant cause of death worldwide. Temporal studies show a downward trend in mortality rates in recent decades, with variability between countries. The State of Pará, in northern Brazil, has a low human development index and high mortality from stroke; however, little research is reported. Objective: This study aims to analyze the trend in stroke mortality in the adult population of Pará, between 2000 and 2021. Method: This is an ecological, time series study based on official secondary population data. Joinpoint regression models were used to identify the trend of each coefficient segment of the mortality rate and years of potential life lost. Results: There were 49,259 deaths in this period, with an absolute increase in fatalities during the time series and an increase in the age group. The mortality coefficient showed a stationary mortality trend of 0.4% between 2000 and 2021 (p=0.576); however, after 2008, the trend decreased -1.0% (p=0.003). In the stratified analysis, a decreasing mortality trend was detected: -2.3% between 30 and 39 years old (p<0.001), -2.8% between 40 and 49 years old (p<0.001), -2.1% between 50 and 59 years old (p<0.001) and -1.4% between 60 and 69 years old (p<0.001), between the year 2000 and 2021. In the other age groups, the trend decreased -2.5% between 20 and 29 years old after 2006 (p= 0.003), -1.8% between 70 and 79 years old after 2008 (p=0.001), and -5.1% among 80 years old and over after 2016 (p=0.010). Conclusion: The mortality trend attributed to stroke among adults in Pará State remained stable from 2000 to 2021. Despite this stability, the absolute number of deaths remained consistently high, underscoring the critical need to mitigate risk factors and enhance the care and management of affected individuals.

Stroke is the second leading cause of death and disability in Latin America; however, few epidemiological studies have been conducted in South America. An observational study was conducted to analyze trends in stroke mortality in South American (SA) countries. Age-standardized mortality rates and proportional mortality due to stroke in the populations of SA countries between 1990 and 2019 were assessed by extracting data from the Global Burden of Disease 2019 study. Joinpoint regression models were employed to identify trends in the annual percentage change in mortality rates for each segment. Considering the data collected over the 30 years that were studied, the age-standardized stroke mortality trend decreased in Argentina (−1.6%), Uruguay (−0.6%), Brazil (−0.5%), Guyana (−0.5%), and Bolivia (−0.4%), while Venezuela (+1.6%) and Suriname (+1.0%) showed an increasing trend. The proportional stroke mortality trend decreased in Argentina (−1.7%), Paraguay (−0.9%), Uruguay (−0.7%), Guyana (−0.7%), Brazil (−0.5%), and Chile (−0.5%), whereas Bolivia (+1.0%), Suriname (+0.6%), and Peru (+0.4%) exhibited an increasing trend. The trends in stroke mortality between 1990 and 2019 demonstrated considerable variability. While most SA countries experienced significant decreases in stroke mortality trends, Venezuela and Suriname showed increases in age-standardized mortality rates, and Bolivia, Suriname, and Peru exhibited increases in proportional mortality rates. No decreasing stroke mortality trend was observed in the segment after the last joinpoint, highlighting the need for improvement in prevention and treatment.

The disparity between the sexes in stroke mortality has been demonstrated in people from different locations. The objective of this study was to analyze the disparity between sexes in stroke mortality in adults in the metropolitan area of Greater Vitoria between 2000 and 2021. Ecological time series design was conducted with a database of the Brazilian Health System Informatics Department. The annual percentage change and average annual percentage change were calculated through joinpoint regression. Pairwise comparisons using parallelism and coincidence tests were applied to compare temporal trends between men and women. Men had higher mortality rates in most years between 2000 and 2021. In contrast, women had higher proportional mortality values in all years evaluated from 2000 to 2021. The paired comparison revealed a disparity between the sexes in the proportional mortality time series (parallelism test: p = 0.003; coincidence test: p < 0.001). However, the time series of the mortality rates showed no disparity between the sexes (parallelism test: p = 0.114; coincidence test: p = 0.093). From 2000 to 2021, there was a disparity in proportional mortality from stroke between the sexes of the population in the metropolitan area of Greater Vitoria, Brazil. However, the time series of mortality rates between the sexes did not reveal any disparity in the study period.

Congenital syphilis (CS) is an important infectious cause of miscarriage, stillbirth, and neonatal morbidity and mortality. Despite the advances in diagnosis and treatment, CS continues to challenge health systems with increasing incidence and mortality rates in recent years worldwide. Given this, the present study aims to comparatively analyze the temporal trends in CS incidence and mortality in Brazil’s Southeast Region from 2008 to 2022. This is an ecological time-series study using secondary data on congenital syphilis from the states of Espírito Santo, Minas Gerais, Rio de Janeiro, and São Paulo. The data was extracted from the Brazilian Health System Informatics Department. Incidence and mortality rates were calculated per 100,000 live births. Joinpoint regression models were employed to identify trends in annual percentage change and average annual percentage change with 95% confidence intervals. The temporal trend of CS incidence in Brazil’s Southeast Region increased 12.8% between 2008 and 2022. Minas Gerais, São Paulo, Espírito Santo, and Rio de Janeiro showed increasing temporal trends of 21.4%, 14.1%, 14.0%, and 10.9%, respectively. The temporal trend of CS mortality in Brazil’s Southeast Region rose 11.9% between 2008 and 2022. Minas Gerais, São Paulo, and Rio de Janeiro exhibited increasing mortality temporal trends of 21.9%, 20.8%, and 10.1%, respectively. In contrast, Espírito Santo showed reduced mortality, with no deaths in 2021 and 2022. The temporal trend of CS incidence increased in all states of Brazil’s Southeast Region between 2008 and 2022, highlighting the need to reassess control measures. The temporal trend of CS mortality also increased during the same period, except in Espírito Santo. Considering that CS is preventable with adequate prenatal care and low-cost measures, these findings can serve as instruments to support strengthening public health policies.

Background/Objectives: While the descriptive trajectory of COVID-19 is well-documented, there is a methodological gap in quantifying the precise magnitude of risk reduction across multi-year pandemic phases in Brazilian subnational units. This study aimed to fill this gap by applying Generalized Linear Models (GLMs) to quantify the temporal transition of epidemiological risks (Incidence, Mortality, and Case Fatality) in Ceará (2020–2023), using the first year of the pandemic as a statistical baseline. Methods: Ecological time-series study was conducted using official surveillance data. We employed GLMs with Poisson distribution to calculate Rate Ratios (RRs) and 95% Confidence Intervals, allowing for a robust comparative risk modeling between 2020 (reference) and subsequent years (2021–2023). Results: Modeling revealed a significant epidemiological dissociation between transmission and severity. While the risk of incidence remained high through 2022 (RR = 1.42), the mortality risk showed an earlier and more drastic decline, with a 68% reduction as early as 2022 (RR = 0.32) and 99% in 2023 (RR = 0.01). The Case Fatality Rate (CFR) risk decreased consistently from 2021 onwards, reaching its lowest point in 2023 (RR = 0.09; 91% reduction). Conclusions: Between 2020 and 2023, Ceará transitioned to reduced COVID-19 severity. Despite ecological design and data limitations, these findings underscore the importance of resilient health systems and equitable immunization.

Background/Objectives: COVID-19 placed substantial pressure on health systems and showed marked spatial and temporal heterogeneity in Brazil. We analyzed monthly and annual patterns of incidence, mortality, and period-specific case fatality in Pernambuco from 2020 to 2023. Methods: This ecological time-series study used 48 monthly surveillance observations. Monthly case and death counts were modeled with calendar year as a categorical predictor. Negative binomial generalized linear models with log offsets were selected as the primary models because Poisson models showed marked overdispersion; heteroscedasticity—and autocorrelation-consistent (HAC) standard errors were used to reduce sensitivity to serial dependence. A log-linear model estimated Monthly Percent Change (MPC) using a four-month moving-block bootstrap. A quasi-Poisson generalized additive model (GAM) with k = 10 was examined as an exploratory description of non-linearity. Results: Annual incidence increased from 2310.85 per 100,000 in 2020 to 4905.65 per 100,000 in 2022 and decreased to 908.18 per 100,000 in 2023. Mortality peaked in 2021 and period-specific CFR declined markedly thereafter. In the primary negative binomial models with HAC inference, incidence was lower in 2023 than in 2020 (RR = 0.39; 95% CI: 0.17–0.89; p = 0.0247). Mortality in 2021 did not differ from 2020 (RR = 1.11; 95% CI: 0.43–2.89; p = 0.8270), whereas mortality was lower in 2022 (RR = 0.22; 95% CI: 0.09–0.52; p = 0.0006) and 2023 (RR = 0.06; 95% CI: 0.03–0.14; p < 0.0001). The global MPC was +2.52% (moving-block bootstrap 95% CI: −5.42% to 11.00%; p = 0.5152), providing no evidence of a consistent global log-linear trend. The exploratory GAM suggested a non-linear trajectory, but its basis-dimension check indicated that k = 10 was insufficient (k-index = 0.469; p < 0.001); therefore, no inferential conclusion was based on the GAM. Conclusions: Pernambuco surveillance data show an epidemiological divergence between reported incidence and severe outcomes, particularly from 2022 onward. Because vaccination, hybrid immunity, circulating variants, testing practices, and clinical management were not directly modeled, these findings support epidemiological decoupling but do not by themselves establish its biological mechanisms.