Non-COVID-19 respiratory tract infection mortality among children under 5 years old: a time series, Brazil, 2002-2022

Abstract Objectives To describe and analyze the temporal trend of non-COVID-19 respiratory tract infection deaths among children under 5 years of age in Brazil from 2002 to 2022. Methods This is a descriptive study of respiratory tract infection deaths and time series analysis of mortality rates using data from the Mortality Information System. Trend analysis used the Trigonometric seasonality, Box-Cox transformation, ARMA errors, Trend and Seasonal components model for interrupted time series, examining monthly mortality rates. Annual percentage change (APC) for the period was estimated in order to present the time series trend and its 95% confidence interval (95%CI). Results A total of 52,015 respiratory tract infection deaths were recorded among children under 5 years old during the period, with a higher incidence among males (54.2%), Black children (46.0%), and those under 1 year of age (66.9%). The respiratory tract infection mortality rate among children under 5 years old in Brazil in 2002 was 1.22 deaths/1,000 live births, and in 2022 it was 0.87 deaths/1,000 live births. The proportional mortality rate in children aged 28 days to 5 years varied around 13.0%. There was a decreasing mortality rate trend from 2002 to 2019 (APC -0.37%; 95%CI -0.43; -0.31). In the post-pandemic period, there was no significant variation in the mortality rate analyzed (APC -1.41%; 95%CI -8.74; 6.52). Conclusion Despite the reduction in respiratory infection mortality rates along the time series, there was no reduction in proportional mortality. New strategies are needed to prevent and reduce respiratory tract infection deaths in the Brazilian health system.