Maia-Elkhoury Ana Nilce Silveira, Carmo Eduardo Hage, Sousa-Gomes Marcia Leite, Mota Eduardo
Departamento de Vigilância Epidemiológica, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brasil.
Rev Saude Publica. 2007 Dec;41(6):931-7. doi: 10.1590/s0034-89102007000600007.
To analyze the number of cases, deaths, incidence and fatality rate due to visceral leishmaniasis, and to estimate its underreporting, as well as the coverage of the national information systems.
Confirmed cases of visceral leishmaniasis were analyzed, based on the following systems: the Sistema de Informação de Agravos de Notificação (SINAN - Information System on Disease Notification), the Sistema de Informações sobre Mortalidade (SIM - Mortality Information System) and the Sistema de Informações Hospitalares (SIH - Hospital Information System), between 2002 and 2003. The variables utilized in relationship for pair identification were: patient's name, mother's name, date of birth, gender, city of residence, and mailing address. The capture-recapture method was applied to calculate the estimates, by means of the Chapman formula.
The estimated underreporting of visceral leishmaniasis in the SINAN, in relation to the SIH and the SIM, was 42.2% and 45.0% respectively. The estimated underreporting of deaths was 53% and 46.5%, when compared to SINAN-deaths and SIH-deaths respectively. The estimated incidence was 2.9 per 100,000 inhabitants, from the comparison between the SINAN and the SIH, 70.5% higher than the one found when SINAN's data were the only ones utilized. Furthermore, when comparing data from SIM and SINAN-deaths, an estimated fatality rate of 8% was observed, representing an increase in 16% from the one initially registered in the SINAN-deaths.
The results show high estimated underreporting of cases and deaths due to visceral leishmaniasis in Brazil. The relationship between information systems and the capture-recapture method application enabled to know and improve the epidemiological estimates, making its utilization in health services feasible.
分析内脏利什曼病的病例数、死亡数、发病率和死亡率，并估计其漏报情况以及国家信息系统的覆盖范围。
基于以下系统对2002年至2003年期间确诊的内脏利什曼病病例进行分析：疾病通报信息系统（SINAN）、死亡信息系统（SIM）和医院信息系统（SIH）。用于配对识别的相关变量为：患者姓名、母亲姓名、出生日期、性别、居住城市和邮寄地址。采用捕获-再捕获法，通过查普曼公式计算估计值。
与SIH和SIM相比，SINAN中内脏利什曼病的估计漏报率分别为42.2%和45.0%。与SINAN死亡数据和SIH死亡数据相比，死亡估计漏报率分别为53%和46.5%。根据SINAN和SIH的比较，估计发病率为每10万居民2.9例，比仅使用SINAN数据时高出70.5%。此外，比较SIM和SINAN死亡数据时，观察到估计死亡率为8%，比最初在SINAN死亡数据中登记的死亡率增加了16%。
结果显示巴西内脏利什曼病病例和死亡的估计漏报率很高。信息系统与捕获-再捕获法应用之间的关系有助于了解和改进流行病学估计，使其在卫生服务中的应用可行。
