Subnotificação da comorbidade tuberculose e aids: uma aplicação do método de linkage

Abstract

OBJECTIVE:To analyze the underreporting of the tuberculosis (TB) and AIDS comorbidity. METHODS:Surveillance study using records from the Notifi able Diseases Information System -Tuberculosis and AIDS in Brazil from 2000 to 2005. Records of TB without information on the presence of Aids were considered to be underreporting of the comorbidity when paired off with AIDS records in which the year of diagnosis of AIDS was the same or previous to the year of reporting of TB, as well as records from the same patient whose previous records had this information. An indicator was created: recognized TB-AIDS comorbidity, based on the TB records that had information on the presence of AIDS. RESULTS:The underreporting of TB-AIDS was 17.7%. This percentage varied between states. The incorporation of the underreported records into the previously recognized ones increased the proportion of TB-AIDS in Brazil from 6.9% to 8.4%. The highest proportions of underreporting were noted in Acre (Northern), Alagoas, Maranhão and Piauí (Northeastern) (more than 35% each) and the lowest in São Paulo (Southeastern) and Goiás (Central-western) (around 10% each). CONCLUSIONS:The underreporting of the TB-AIDS comorbidity found in Brazil will probably trigger modifi cations in the surveillance system in order to provide information for the national programs.

Progress toward eliminating TB and HIV deaths in Brazil, 2001–2015: a spatial assessment

“…The GBD mortality redistribution method attempts to correct for these biases. Other correction methods include linkage analysis of HIV and TB surveillance systems [27], or linkage of diagnoses made at health facility encounters with information recorded on death certificates. These could be pursued as additional methods to improve ascertainment of TB and HIV deaths.…”

“…A modelling approach that draws strength from neighbouring groups across space and time could stabilise these estimates. Second, TB and HIV deaths may be misclassified due to failure to recognise the cause of death as HIV or TB or stigma associated with reporting these conditions [27–29]. Furthermore, the International Statistical Classification of Diseases (ICD) convention is for TB deaths in persons living with HIV infection (PLHIV) to be assigned to HIV as the underlying cause, which can hide the contribution of TB to these deaths if only a single cause of death is reported in vital registration [30].…”

The burden of disease due to tuberculosis in the state of Santa Catarina, Brazil

“…For the purpose of compensating for occasional underreporting of the tuberculosis/HIV co-infection and of tuberculosis alone, a rate of 17.7% ( 11 ) and of 60% was respectively added to the data. ( 12 ) These rates were added following the same parameters for the distribution of tuberculosis according to sex, age group, and health macroregions obtained from the National Case Registry Database in 2009.…”

“…Para compensar a eventual subnotificação de casos de coinfecção tuberculose/HIV e de tuberculose apenas, foram adicionadas aos dados taxas de 17,7% ( 11 ) e 60%, respectivamente. ( 12 ) Essas taxas foram adicionadas seguindo os mesmos parâmetros do Sistema de Informação de Agravos de Notificação em 2009 para a distribuição da tuberculose de acordo com o sexo, a faixa etária e as macrorregiões de saúde.…”

<b>Mortalidade por tuberculose no interior de São Paulo – brasil (2006-2008)/Mortality from tuberculosis in the countryside of São Paulo - Brazil (2006-2008)<b>

“…A identificação dos casos de óbito por TB sem notificação no Sistema de Informação de Agravos de Notificação (SINAN) sugere que estes pacientes foram diagnosticados apenas na forma avançada da doença, devido à qualidade e acessibilidade aos serviços de saúde que, por sua vez, influenciam na cadeia de transmissão da TB (2) . A não notificação de um agravo no sistema de vigilância ou a realização desta fora do período estabelecido enunciam estimativas equivocadas que prejudicam o planejamento de estratégias de prevenção, podendo acarretar sublocação de ações e recursos (6) . Nesse sentido, esta pesquisa se justifica pela articulação dos casos de óbito por TB com a cartografia da rede de serviços, colocando em destaque as fragilidades desses sistemas de saúde.…”