Spatio-temporal trends of mortality by aggression in a central-western state of Venezuela

Background: Mortality by aggression is a public health problem worldwide. In Venezuela, it has been between the third and the fourth cause of death in the last 10 years. It has been observed increasing trends in small areas where this was not a public health concern. However, this situation has not been studied in spatiotemporal context.

Study objective: Analyzing the spatio-temporal trends of mortality by aggression at parish level in a central-western state of Venezuela from 2000 to 2011.

Methods: We conducted a space-time analysis of mortality by aggression using mortality data recorded by the Health Ministry in Lara state. 7061 deaths by aggression, according to the ICD-10, in 58 parishes from 2000 to 2011 were studied. We used the spatial variation in temporal trends statistic for the detection of clusters with a trend that is higher or lower than the trend outside the cluster using the Discrete Poisson model. The identified clusters were analyzed for age, sex and other socioeconomic features.

Results: The analysis showed statistically significant clusters with more increasing mortality rates (p-value <0.01). The most likely cluster was localized in Bolívar parish within Morán municipality with 34.16% annual increase inside. Six secondary clusters were identified in other different parishes (9 parishes). A temporal cluster occurred from 2003 to 2004 in all parishes. Different points in time within parishes at which significant changes occurred in rates were detected.

Conclusion: Our findings highlight the increasing trend of mortality by aggression in a few parishes of Lara state. Most of them with rates in years prior to the study period, well below the currently existing. It clearly shows the need to intervention strategies aimed at reducing these preventable deaths.