Mortality and Case Fatality From Visceral Leishmaniasis in Brazil From 2014 to 2023

Visceral leishmaniasis (VL) is a severe infectious disease caused by the protozoan Leishmania (Leishmania) infantum, transmitted by sand flies and widely endemic in Brazil. Despite advances in surveillance and treatment, VL still has high case fatality and a strong association with social determinants of health. This study aimed to characterize deaths due to visceral leishmaniasis in Brazil between 2014 and 2023, with emphasis on sociodemographic, regional, and epidemiological aspects of mortality. Descriptive and retrospective study based on secondary data from the Mortality Information System (SIM) and the Notifiable Diseases Information System (SINAN), extracted from the DATASUS platform of the Brazilian Unified Health System. Deaths recorded under ICD-10 code B55.0 during the stated period were included. Variables analyzed included year of death, sex, age group, race/color, education, region of residence, and HIV coinfection. Case fatality rate was calculated as the number of deaths over the number of notified confirmed cases. Data were organized in Excel spreadsheets and analyzed using descriptive statistics. Between 2014 and 2023, 2,974 deaths from VL were recorded in Brazil. Most occurred in males (68.4%), aged 40 to 59 years (29.1%), with low educational attainment (56.8% with up to seven years of schooling). Regarding race/color, the Black population predominated (76%), according to the IBGE classification, which groups “preto” (12.1%) and “pardo” (63.8%) together. The Northeast region concentrated most cases (56.1%) and deaths (55.5%), with a mean case fatality of 10.1%. Despite the low absolute number of cases, the South region had the highest case fatality rate (29.8%), followed by the Central-West (13.2%). The national mean case fatality was 10.01%, with an increasing trend up to 13.48% in 2023. VL-HIV coinfection was present in 8.18% of deaths among coinfected individuals. VL remains a serious public health problem in Brazil, with mortality associated with social inequalities, especially among adult men with low education and belonging to ethnoracially vulnerable groups. High case fatality in less endemic regions highlights the urgency of regional strategies, professional training, active surveillance, and universal access to treatment. HIV coinfection should also be considered a priority in disease control actions.