Avaliação do sistema de vigilância epidemiológica da dengue no Brasil, 2005 - 2009
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2011-02-18
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Universidade Federal de Goiás
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Introduction: Dengue fever is one of the most important public health challenges in Brazil nowadays. Despite all the efforts and activities to prevent and control the disease in the country, the impact of dengue has grown in the last decade. In this scenario, it is of utmost importance to evaluate the national dengue surveillance system to address its preparedness to face the changing epidemiology of the disease. Objective: To evaluate the national dengue fever surveillance system from 2005 to 2009. Methods: We analyzed data available from the dengue surveillance system in Brazil, using two versions of the information system: 1. Sinan-Windows for 2005 and 2006; and 2. Sinan-Net from 2007 to 2009. The evaluation was conducted according to the guidelines for evaluating public health surveillance systems proposed by Centers for Disease Control and Prevention (CDC-Atlanta). Results: A total of 2,813,417 dengue cases were reported from January 2005 to December 2009, with a marked seasonal pattern from January to June. The national dengue fever surveillance system was considered representative, allowing to characterize the epidemiology of dengue in different regions of the country. The timeliness of case reporting was adequate (median interval between the onset of symptoms and case notification: 3 days), but data entry into the information system was delayed (median interval between the onset of symptoms and data entry: 14 days in 2009). The positive predictive value (PPV) of reported cases from January to May ranged from 34% to 65%, and by the end of 2009, PPV was higher than 60% in November and December. The surveillance system was considered flexible regarding routine activities during the epidemic periods and adoption of new case report forms and diagnostic tests. However, it was not flexible in the correction of problems in the information system. Inadequate completion of data was still observed after the adoption of a simpler report form in the new information system (Sinan-Net). However, data quality improved and only a small percentage of the cases presented inconsistencies considering the essential fields of the reporting form. Conclusions: Despite the observed limitations, the surveillance system was useful to monitor dengue cases and trends, to guide prevention and control measures and to support changes in routine activities and clinical management of the cases. It also allowed to estimate the dengue fever morbidity and mortality in the country, alerting the health system to shifts in disease epidemiology.
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BARBOSA, J. R. Avaliação do sistema de vigilância epidemiológica da dengue no Brasil, 2005 - 2009. 2011. 93 f. Dissertação (Mestrado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2011.