Intoxicações exógenas por medicamentos em crianças: perfil clínico-epidemiológico e qualidade dos dados do Sistema de Informação de Agravos de Notificação (Sinan) e do Sistema Nacional de Vigilância Sanitária (Sinavisa), em Goiânia, Goiás, 2012-2016
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2018-11-24
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Universidade Federal de Goiás
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Introduction: Exogenous drug intoxications are considered a serious public health problem in Brazil and in the world, especially in children. Objective: To describe the clinical and epidemiological profile of the reported cases of exogenous poisoning by drugs in children and the quality of the information systems in Goiânia, Goiás. Methods: This is a descriptive study, using secondary data from children from zero to 12 years of age, obtained from the Notification of Injury Information System (Sinan) and National Sanitary Surveillance Information System (Sinavisa) between 2012 and 2016. We analyzed general, individual data, epidemiological history, exposure, care, conclusion of the case and risk factors for hospitalization. Regarding data quality, the incompleteness and inconsistencies of the variables were evaluated. The agreement between the data was made by calculating the Kappa index and the Intraclass Correlation Coefficient (p <0.05). After extracting the data using Tabwin®, the analysis was performed in the IBM® SPSS Statistics®, version 22 program. Results: A total of 389 cases of drug intoxication were reported in children in Sinan and 680 cases in Sinavisa, with 243 cases common to both systems. The prevalence of cases in the two systems was divergent between 2012 and 2013, and from 2014, there was a progressive increase in the number of cases after convergence. The drug poisoning at Sinan and Sinavisa was predominant, consecutively, in the age range of one to four years (53.1%; 72.0%), at home (88.4%, 95.4%), through the digestive route (88.3%, 96.1%), due to accidental causes (60.7%, 77.2%) and the single acute type (92.0%, 99.6%). In both systems, the highest frequency was hospital (82.0%, 53.8%), in the public sector (96.9%, 80.4%) and without hospitalization (55.0%, 71% 9%). A wide variety of medications led to intoxications, most frequently central nervous system depressants in both systems (25.7%, 22.9%). In Sinan, hospitalizations were more likely to occur in children aged one to eight years. In Sinavisa, hospitalizations were more likely to occur in cases treated in the public sector and involving drugs controlled by Portaria n. 344/98. There were inconsistencies in both systems. In both systems, the completeness of the variables was greater than 91.0%, but four variables were not fulfilled. Between the two systems, only the variables gender, date of birth and age had excellent agreement. Conclusions: Medication poisonings occur more frequently in infancy, by accidental circumstance, orally, in the residences, in a unique acute form and present cure without sequelae. The drugs most involved are the central nervous system depressants. The greatest chance of hospitalization occurs among children aged one to eight years, in public units and involving controlled medications. The quality of the data and the agreement between the Sinan and Sinavisa systems are unsatisfactory.
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CARDOSO, H. A. Intoxicações exógenas por medicamentos em crianças: perfil clínico-epidemiológico e qualidade dos dados do Sistema de Informação de Agravos de Notificação (Sinan) e do Sistema Nacional de Vigilância Sanitária (Sinavisa), em Goiânia, Goiás, 2012-2016. 2018. 91 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2018.