OBJECTIVES: To characterise geographical distribution and time trends of @entity740 ( @entity740 ) mortality in the context of the epidemic of Mesoamerican @entity8 ( @entity1 ), likely related to occupational heat stress and other, unknown, factors. METHOD: Vital statistics (1970-2012) provided deaths from @entity740 and unspecified @entity177 . Data of four censuses were extrapolated to derive @entity1 -years by sex and 10-year age groups for the seven provinces and 81 counties. SMRs were compared for three time periods between provinces and between counties, with national rates as reference. To assess time trends, age-specific and age-standardised mortality rates were computed for 5-year periods. RESULTS: During 1970-2012, 3843 @entity1 and 2452 @entity1 died from @entity740 . In the Guanacaste province, the SMR for 1997-2012 was four-fold in @entity1 and two-fold in @entity1 . In Guanacaste, @entity740 mortality increased from the mid-1970s in @entity1 , and mid-1980s in @entity1 . Age-standardised rates per 100.000 in @entity1 aged >= 30 increased from 5.8 in the early seventies to 75.0 in 2007-2012, compared to 5.9 to 16.2 in the rest of Costa Rica. For @entity1 , rates increased from 4.5 to 20.7 in Guanacaste versus 4.2 to 9.7 in the rest of the country. Within Guanacaste, there was marked spatial variation in mortality between counties, with patterns being consistent between time periods but different for @entity1 and @entity1 . CONCLUSIONS: Guanacaste is a heterogeneous @entity740 "hot spot," affecting mostly @entity1 , but to lesser extent also @entity1 . @entity740 seemed high already four decades ago in the province. These findings are pertinent for etiologic research.

0204   Mesoamerican @entity8 in Costa Rica: Geographical distribution and time trends of XXXX mortality between 1970 and 2012.

@entity1 :: ('9606', 'Species') :: ['women', 'person', 'MeN', 'men'] @entity8 :: ('MESH:D007674', 'Disease') :: ['nephropathy'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity740 :: ('MESH:D051436', 'Disease') :: ['CKD', 'chronic kidney disease']
@entity740 :: (MESH:D051436,Disease) :: ['chronic kidney disease']
