Causes of morbidity and mortality in Guatemalan Adults

As part of the medical program here we get lectures from the Guatemalan doctors (who by the way are young and hip and really cool) once or twice a week on really interesting topics.  One lecture we had was an overview of morbidity and mortality in the different age groups and genders including pregnant women.   I made note of the major players in adults given my interest in internal medicine.

The top causes of morbidity here are:
1. Respiratory infections
2. Gastritis
3. Intestinal infections
4. Hypertension
5. Diabetes
6. Urinary infections
7. Dermatologic infections
8. Renal insufficiency

The top causes of mortality are:
1. Respiratory infections
2. Peptic ulcers ( or GI bleeds that are presumed to be from peptic ulcers)
3. Renal insufficiency (presumably from hypertension and diabetes)

These causes of morbidity seem very in line with what I’ve seen in the clinic, although we did discuss that there is likely underdiagnosis of hypertension and diabetes and thus these are probably greater contributors to morbidity.  The mortality list, on the other hand, seems pretty strange to me.  I would think that heart disease would still be the number one killer here, and that cancer would still be a major player.  Even with high rates of gastritis I wouldn’t expect GI bleeds to be so high on the list.  I also would think that if hypertension and diabetes were causing high rates of renal insufficiency,  they would certainly also be causing even higher rates of heart disease.  Perhaps the deaths that are recorded only come from hospitals and as such are a skewed sample, and the majority of deaths that occur from heart attacks out in rural communities are not reported or recorded.

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