Domingues Rosa Maria Soares Madeira, Saraceni Valéria, Leal Maria do Carmo
Laboratório de Pesquisa Clínica em DST/Aids, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Rev Saude Publica. 2018;52:43. doi: 10.11606/s1518-8787.2018052017439. Epub 2018 Apr 12.
To estimate the coverage of the reporting of cases of HIV-infected pregnant women, to estimate the increase in the coverage of the reporting with the routine search of data in other Brazilian health information systems, and to identify missed opportunities for identification of HIV-infected pregnant women in Brazilian maternity hospitals.
This is a descriptive study on the linkage of Brazilian databases with primary data from the "Nascer no Brasil" study and secondary database collection from national health information systems. The "Nascer no Brasil" is a national-based study carried out in 2011-2012 with 23,894 pregnant women, which identified HIV-infected pregnant women using prenatal and medical records. We searched for cases of HIV-infected pregnant women identified in the "Nascer no Brasil" study in the Information System of Notifiable Diseases, the Control System for Laboratory Tests of the National CD4+/CD8+ Lymphocyte Count and HIV Viral Load Network, and the Logistics Control System for Medications. We used the OpenRecLink software for the linkage of databases. We estimated the notification coverage, with the respective confidence interval, of the evaluated Brazilian health information systems.
We estimated the coverage of the reporting of HIV-infected pregnant women in the Information System of Notifiable Diseases as 57.1% (95%CI 42.9-70.2), and we located 89.3% of the HIV-infected pregnant women (95%CI 81.2-94.2) in some of the Brazilian health information systems researched. The search in other national health information systems would result in an increase of 57.1% of the reported cases. We identified no missed opportunities for the diagnosis of HIV+ in pregnant women in the maternity hospitals evaluated by the "Nascer no Brasil" study.
The routine search for information in other Brazilian health information systems, a procedure carried out by the Ministry of Health for cases of AIDS in adults and children, should be adopted for cases of HIV in pregnancy.
评估艾滋病毒感染孕妇病例报告的覆盖率,估计通过在巴西其他卫生信息系统中常规检索数据使报告覆盖率的增加情况,并确定巴西妇产医院中识别艾滋病毒感染孕妇的错失机会。
这是一项关于巴西数据库与“巴西出生”研究的原始数据以及国家卫生信息系统的二级数据库收集进行关联的描述性研究。“巴西出生”是一项在2011 - 2012年开展的全国性研究,涉及23,894名孕妇,通过产前和医疗记录识别艾滋病毒感染孕妇。我们在法定传染病信息系统、国家CD4+/CD8+淋巴细胞计数和艾滋病毒病毒载量网络实验室检测控制系统以及药品物流控制系统中搜索“巴西出生”研究中识别出的艾滋病毒感染孕妇病例。我们使用OpenRecLink软件进行数据库关联。我们估计了所评估的巴西卫生信息系统的报告覆盖率及其相应的置信区间。
我们估计法定传染病信息系统中艾滋病毒感染孕妇报告的覆盖率为57.1%(95%置信区间42.9 - 70.2),并且在一些所研究的巴西卫生信息系统中找到了89.3%的艾滋病毒感染孕妇(95%置信区间81.2 - 94.2)。在其他国家卫生信息系统中的搜索将使报告病例增加57.1%。我们在“巴西出生”研究评估的妇产医院中未发现孕妇艾滋病毒阳性诊断的错失机会。
对于孕期艾滋病毒病例,应采用卫生部针对成人和儿童艾滋病病例所开展的在巴西其他卫生信息系统中常规检索信息的程序。