{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:21:05Z","timestamp":1787016065840,"version":"build-2736575974"},"reference-count":55,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyse mortality, hospitalisations and in\u2010hospital mortality related to paracoccidioidomycosis (PCM) in Brazil, 2000\u20132024, from a spatio\u2010temporal and social inequalities perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a mixed ecological study using death certificates from the Mortality Information System and hospital admissions from the Hospital Information System of the Brazilian Unified Health System, including admissions that resulted in death. Records with PCM (ICD\u201010 B40\u2013B41) as the underlying or associated cause of death, or as the primary or secondary diagnosis, were included. Sex\u2010 and age\u2010standardised rates (per 1,000,000 inhabitants) were estimated for Brazil and macro\u2010regions. Time trends were assessed using Joinpoint regression and spatial distribution was evaluated by health region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 4904 deaths mentioning PCM over the 25\u2010year period (2980 [60.8%] as the underlying cause and 1924 [39.2%] as an associated cause) corresponding to a standardised mortality rate of 1.00\/1,000,000 inhabitants. Deaths occurred predominantly among men of working age. Mortality declined nationally (average annual percent change [AAPC] \u22123.85%). There were 18,239 hospital admissions (standardised hospitalisation rate 3.71\/1,000,000), which also decreased over time (AAPC \u22122.83%). In total, 1136 admissions resulted in death (standardised in\u2010hospital mortality rate 0.23\/1,000,000), with no significant overall trend. The highest mortality, hospitalisation and in\u2010hospital mortality rates clustered in Rond\u00f4nia, northern Mato Grosso and health regions in the Southeast and Central\u2010West.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite declining national rates, PCM remains concentrated in specific endemic territories, disproportionately affecting socially vulnerable populations and reinforcing its status as a neglected systemic mycosis in Brazil. Making PCM a nationally notifiable disease is essential to reduce its burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70135","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T07:26:38Z","timestamp":1774337198000},"page":"875-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Paracoccidioidomycosis in Brazil: 25\u2010Year Nationwide Trends in Mortality, Hospitalisations and In\u2010Hospital Deaths of a Neglected Systemic Mycosis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1816-9459","authenticated-orcid":false,"given":"Anderson Fuentes","family":"Ferreira","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Sa\u00fade P\u00fablica, Faculdade de Medicina Universidade Federal do Cear\u00e1  Fortaleza 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