Braga José Ueleres
Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Rev Saude Publica. 2007 Sep;41 Suppl 1:77-88. doi: 10.1590/s0034-89102007000800011.
To assess the quality of tuberculosis surveillance in Brazil.
Local data from 2001 to 2003 were assessed according to the quality of detection and follow-up of the cases in the region, the quality of the information produced by the notification system, and the load of morbidity of tuberculosis. Cities were classified into four groups, according to tuberculosis epidemiologic stage and the quality of tuberculosis surveillance.
In the study period, about 8% of the Brazilian cities presented over 10% of the cases of tuberculosis notified by the health care services of another city. In about 950 cities, the frequency of patients with pulmonary tuberculosis undergoing sputum examination was lower than 90%. In the North region, Amazonas, Pará and Amapá presented more cities classified in the groups of poor tuberculosis surveillance. In the Northeast, Pernambuco, Ceará and Bahia presented the poorest surveillance. The South and Midwest regions presented greater number of cities with better tuberculosis surveillance.
One third of the Brazilian cities present poor tuberculosis surveillance. This picture is not homogeneous in Brazil, and the regions with highest tuberculosis incidence have a great number of cities with apparently insufficient control measures.
评估巴西结核病监测的质量。
根据该地区病例的检测和随访质量、报告系统所产生信息的质量以及结核病发病率,对2001年至2003年的本地数据进行评估。根据结核病流行阶段和结核病监测质量,将城市分为四组。
在研究期间,约8%的巴西城市上报了其他城市医疗服务机构通报的10%以上的结核病病例。在约950个城市中,肺结核患者进行痰检的频率低于90%。在北部地区,亚马孙州、帕拉州和阿马帕州有更多城市被归类为结核病监测较差的组。在东北部,伯南布哥州、塞阿拉州和巴伊亚州的监测最差。南部和中西部地区有更多城市的结核病监测较好。
三分之一的巴西城市结核病监测较差。这种情况在巴西并不统一,结核病发病率最高的地区有大量城市的控制措施明显不足。