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      Avaliação da qualidade dos dados, valor preditivo positivo, oportunidade e representatividade do sistema de vigilância epidemiológica da dengue no Brasil, 2005 a 2009 Translated title: Evaluation of the Dengue Epidemiological Surveillance System data quality, positive predictive value, timeliness and representativeness, Brazil, 2005-2009 Translated title: Evaluación de calidad de datos, valor predictivo positivo, oportunidad y representatividad del sistema de vigilancia epidemiológica del dengue en Brasil, 2005 a 2009

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          Abstract

          OBJETIVO: avaliar a qualidade dos dados, o valor preditivo positivo (VPP), a oportunidade e a representatividade do sistema de vigilância epidemiológica da dengue no Brasil entre 2005 e 2009. MÉTODOS: estudo de avaliação, com análise dos dados de dengue do Sistema de Informação de Agravos de Notificação (Sinan) conforme atributos selecionados da metodologia do Centers for Disease Control and Prevention (Atlanta/GA, Estados Unidos da América). RESULTADOS: houve melhora na qualidade dos dados quanto a sua consistência; o VPP dos casos de dengue variou de 34 a 65%; o sistema apresentou uma mediana de oportunidade para notificação dos casos de 3 dias e revelou-se representativo, permitindo conhecer a situação da doença no país. CONCLUSÃO: o sistema de vigilância da dengue no Brasil mostrou-se consistente, com valor preditivo positivo expressivo, oportuno para notificação de casos e representativo, capaz de detectar tendência de mudança no perfil epidemiológico da doença.

          Translated abstract

          OBJECTIVE: to evaluate the dengue surveillance system data quality, positive predictive value (PPV), timeliness and representativeness in Brazil from 2005 to 2009. METHODS: this was an observational, descriptive and cross-sectional study with analysis of data on dengue held on the Notifiable Diseases Information System (Sinan), based on the methodology proposed by the Centers for Disease Control and Prevention. RESULTS: improvement in the quality of the data with regard to consistency; dengue case PPV ranged from 34% to 65%; the system showed a median time of three days for case notification and was found to be representative, providing knowledge of the disease's status in the country. CONCLUSION: the dengue surveillance system in Brazil proved to be consistent, with significant positive predictive value, timely case reporting, as well as being representative and able to detect trends of change in the disease's epidemiological profile.

          Translated abstract

          OBJETIVO: evaluar la calidad de los datos, el valor predictivo positivo (VPP), la oportunidad y la representatividad del sistema de vigilancia epidemiológica del dengue en Brasil entre 2005 y 2009. MÉTODOS: estudio descriptivo transversal, con análisis de los datos del dengue del Sistema de Información de Agravamientos de Notificación (Sinan) conforme atributos seleccionados de la metodología del Centers for Disease Control and Prevention (Atlanta/GA, Estados Unidos de América). RESULTADOS: hubo mejoría en la calidad de los datos con relación a su consistencia; el VPP de los casos de dengue varió de 34 a 65%; el sistema presentó una mediana de oportunidad para notificación de los casos de 3 días y se reveló representativo, permitiendo conocer la situación de la enfermedad en el país. CONCLUSIÓN: el sistema de vigilancia del dengue en Brasil se mostró consistente, con valor predictivo positivo expresivo, oportuno para notificación de casos y representativo, capaz de detectar tendencia de cambio en el perfil epidemiológico de la enfermedad.

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            Recent Shift in Age Pattern of Dengue Hemorrhagic Fever, Brazil

            To the Editor: Brazil is responsible for >60% of reported cases of dengue fever (DF) in the American region (a designation of the Pan American Health Organization, which includes all of North, Central and South America) ( 1 ). The epidemiologic characteristics of dengue diseases in Brazil differ from those described in Southeast Asia. In Brazil, the incidence of DF and dengue hemorrhagic fever (DHF) is highest in adults. By contrast, in Southeast Asia, DHF cases predominate and occur more often in children than in adults ( 2 , 3 ). We describe a preliminary report of a shift in age group predominance that was observed during the 2007 countrywide dengue epidemic in Brazil. The Hospital Information System is the source of data describing the distribution of DHF cases from January 1998 through December 2007 ( 4 ). In Brazil almost all patients with a diagnosis of DHF are hospitalized. This country has promulgated the use of the World Health Organization’s DHF case definitions (International Classification of Diseases, 10th revision – A91). In the 2007 epidemic, a larger than normal proportion of cases were DHF (2,706), more than twice the largest number of such cases reported in previous years. Moreover, in 2007 >53% of cases were in children <15 years of age; during 1998–2006, the predominance of DHF cases were in the 20- to 40-year age group (Appendix Figure). During 1998–2006, the percentage of DHF cases in children varied from 9.5% (in 1998) to 22.6% (in 2001). Of the 2,706 DHF cases in 2007, 1,710 (63.2%) were reported from the northeast region; 1,119 (65.4%) of these were in children <15 years of age. The southeast region had the next largest number (558), accounting for 20.6% of all reported cases; however, only 26.2% were in children. Other regions with cases, central-west and northern, reported no substantial change in age distribution compared with earlier years. Among the 9 states in northeastern Brazil, DHF predominance in children was observed in Maranhao (609 cases; 92.0% in children), Rio Grande do Norte (97 cases and 77.6%), Pernambuco (316 cases and 67.0%), and Ceara (197 cases and 48.0%). The change in age distribution of cases in 2007 is unique in the modern history of dengue in Brazil and requires an explanation. Dengue 1 and 2 viruses, which were introduced in the 1990s, generated epidemics of DF characterized by a low incidence of DHF, predominantly in adults. With the introduction of dengue 3 virus in 2000–2001, DF epidemics of greater magnitude were observed, with a slightly larger fraction of DHF cases. Differences in the epidemiologic patterns in Southeast Asia and the American region have been attributed to genetic resistance in black populations and to underreporting of DHF cases, among other factors ( 2 ). These factors seem insufficient to explain the sudden change observed; should it persist—as it has in Venezuela, Colombia, Central America, and Cuba—this change may bring dengue in Brazil to a pattern closer to that of Southeast Asia ( 2 ). This change in epidemiologic pattern of dengue cases supports calls for improvement in design of dengue surveillance studies to include, where possible, population-based serologic studies. These epidemiologic changes also serve as an alert to health authorities in the American region to update their healthcare services to provide agile, opportune, and good quality care for patients, particularly children, with DHF, to reduce deaths. Supplementary Material Appendix Figure Number of hospitalizations for dengue hemorrhagic fever by age group and year of occurrence, Brazil, 1998-2007.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ress
                Epidemiologia e Serviços de Saúde
                Epidemiol. Serv. Saúde
                Ministério da Saúde do Brasil (Brasília )
                1679-4974
                March 2015
                : 24
                : 1
                : 49-58
                Affiliations
                [1 ] Universidade Federal de Goiás Brazil
                [2 ] Secretaria Municipal da Saúde de Belo Horizonte Brazil
                Article
                S2237-96222015000100049
                10.5123/S1679-49742015000100006
                2737c96a-e4d1-46e8-9072-e18b0d5cb7bc

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=2237-9622&lng=en
                Categories
                Health Care Sciences & Services
                Health Policy & Services

                Health & Social care,Public health
                Dengue,Epidemiological Surveillance,Information Systems,Vigilancia Epidemiológica,Sistemas de Información,Vigilância Epidemiológica,Sistemas de Informação

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