Sensibilidade do sistema de vigilância da dengue na detecção de casos hospitalizados pela doença, 2008-2013
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Data
2014-10-27
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Universidade Federal de Goiás
Resumo
In Brazil, dengue has emerged as a major public health problem, and despite the
investments and efforts of health authorities, the disease still remains a high incidence.
Currently the four dengue virus serotypes circulating in all regions of the country, and
this simultaneous movement features a scenario hyperendemicity disease, responsible
for the increase of severe cases and deaths in the last decade.
The first article is a descriptive study based on data collected for surveillance of dengue
in the country, covering the main aspects of epidemiology and disease trends in Brazil
during October 2001 until August 2014.
During the analyzed period, there were approximately 6.9 million probable cases with
more than two million in the years 2010 and 2013. The second half of the 2000s marked
a period of more cases of dengue with complications (DCC) and Fever Dengue
hemorrhagic (DHF), accompanied by an increase in the number of deaths from the
disease. The results showed different patterns of incidence and hospitalization for the
disease in regions throughout the study period.
An analysis of clinical cases that were classified as DCC for the period 2011 to 2013
features was made, according to age group. Among the clinical characteristics
considered more severe, there is the group that was classified as DCC not met the
criteria for DHF which represented in 2011 and 2012, about 50% of the total cases in all
age groups.
The second article is an assessment of the sensitivity of the surveillance system to detect
dengue cases hospitalized in the Unified Health System (SUS). For this study, a
probabilistic linkage data from SINAN and SIH and the municipalities of Rio de
Janeiro (RJ), Belo Horizonte (MG), Fortaleza (CE), Natal (RN), São Luis (MA),
Teresina (PI), Goiânia (GO), Campo Grande (MS), Manaus (AM) and Boa Vista (RR)
was performed , for the period 2008-2013.
The combination of the two systems allowed us to identify 69,935 hospitalizations
representing increases of 50.3% and 31.1% in hospitalizations compared with SINAN
(34,756 hospitalizations) and SIH / SUS (48,174 hospitalizations). The sensitivity of detection SINAN in hospitalized cases with hospitalization variable
filled, was 26.7% ranging from 8.3% in 2009, 41.9% in 2013. The calculation of
sensitivity including all records was almost twice as compared with the use of
hospitalization variable filled. With this approach the cumulative sensitivity was 49.8%
ranging from 41.2% in 2009, 76.5% in 2013.
The study results represent a robust assessment of the epidemiology of dengue in Brazil.
It was possible to estimate the burden of disease in order stratified by region and
estimate the sensitivity of the surveillance system in ten major urban areas endemic and
representative of their regions.
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COELHO, G. E. Sensibilidade do sistema de vigilância da dengue na detecção de casos hospitalizados pela doença, 2008-2013. 2014. 92 f. Tese (Doutorado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2014.