Epidemiological Profile of Deaths Among Brazilians Due to Paracoccidioidomycosis Between 2013 and 2023

Paracoccidioidomycosis is an endemic systemic mycosis and is among the ten leading causes of death from chronic and infectious diseases in Brazil. Its incidence ranges from 0.71 to 3.10 cases per 100,000 inhabitants per year in Brazil. In this context, this study aimed to analyze the epidemiological profile of deaths among Brazilians due to this disease between 2013 and 2023. Ecological study analyzing secondary data obtained from the Brazilian public health informatics platform (DATASUS), using the Mortality Information System (SIM). Data were included for paracoccidioidomycosis across Brazilian regions, considering the variables: sex, age group, ethnicity, and year of death from 2013 to 2023. Between 2013 and 2023, 774 deaths due to paracoccidioidomycosis were recorded in Brazil, distributed as follows: 105 in the North (13.5%), 367 in the Southeast (47.4%), 171 in the South (22.0%), 95 in the Central-West (12.2%), and 36 in the Northeast (4.6%). This indicates endemicity in the Southeast, which concentrated 47.4% (n = 367) of records. Regarding age group, there was predominance among individuals aged 50–59 years, with 226 deaths (29.2% of the total). Males were the most affected, accounting for 85.6% (n = 663) of confirmed cases. Regarding ethnicity, whites predominated with 51.0% (n = 395), followed by mixed race (“pardo”) with 35.1% (n = 272), Black with 10.3% (n = 80), Indigenous with 0.77% (n = 6), Asian with 0.38% (n = 3), and unknown with 2.3% (n = 18). In addition, the largest percentage increases in deaths were observed in almost all regions between 2018 and 2019 (15%) and between 2020 and 2021 (28%). These data reinforce that paracoccidioidomycosis is an important cause of mortality in Brazil, with endemicity in the Southeast and predominance among males, whites, and individuals aged 50–59 years. These findings indicate that prevention measures focused mainly on men and active screening in risk groups—considering both acute outbreaks and environmental exposure history—are essential. Understanding risk factors, exposure patterns, and immune response may help reduce disease burden, especially alongside improved reporting observed between 2020 and 2021.