Gerência de Pneumologia Sanitária, Superintendência de Vigilância Epidemiológica e Ambiental, Secretaria de Estado de Saúde e Defesa Civil do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Rev Saude Publica. 2010 Dec;44(6):1072-8. doi: 10.1590/s0034-89102010000600012.
To propose a tuberculosis-related death surveillance strategy based on the Brazilian Mortality Information System.
Data on 55 tuberculosis-related deaths, which occurred in two large hospitals in Rio de Janeiro, Southeastern Brazil, between September 2005 and August 2006, were obtained from the SIM. These cases were searched and compared with cases in the National Notification System (Sinan). The increment in the number of notifications and completeness of data were evaluated, as well as entry type and outcome in Sinan.
Of the 55 deaths, 28 were registered in Sinan. Comparison between systems allowed for the following corrections: 27 new cases were notified, 14 new notifications performed by the hospitals where death occurred and ten outcomes corrected. This represented an increment of 41/144 (28%) notifications by these two hospitals in 2006. Nine cases, previously classified as unconfirmed tuberculosis were reclassified as bacteriologically confirmed, and another five cases were reclassified from tuberculosis to AIDS as the primary cause of death.
The proposed surveillance system for tuberculosis-related death was useful to increase data completeness, decrease under-notification and cases with unknown outcome, to evaluate epidemiological surveillance and death certificate quality and to trace previously unidentified contacts.
基于巴西死亡信息系统,提出肺结核相关死亡监测策略。
从 SIM 中获取了 2005 年 9 月至 2006 年 8 月间,巴西东南部里约热内卢的两家大型医院发生的 55 例肺结核相关死亡病例的数据。对这些病例进行了检索,并与国家通报系统(Sinan)中的病例进行了比较。评估了通报数量的增加和数据的完整性,以及 Sinan 中的录入类型和结果。
55 例死亡病例中,有 28 例在 Sinan 中登记。两个系统之间的比较允许进行以下更正:新通报了 27 例病例,死亡发生的两家医院新通报了 14 例,结果更正了 10 例。这代表这两家医院在 2006 年的通报数量增加了 41/144(28%)。9 例先前被归类为未确诊肺结核的病例被重新归类为细菌学确诊,另有 5 例从肺结核重新归类为艾滋病,作为死亡的主要原因。
所提出的肺结核相关死亡监测系统有助于提高数据的完整性,减少漏报和不明结果的病例,评估流行病学监测和死亡证明的质量,并追踪以前未识别的接触者。