Notifiable Diseases Information System Research Articles

ESTUDO CLÍNICO-EPIDEMIOLÓGICO DE CASOS NOTIFICADOS POR HANSENÍASE ENTRE OS ANOS DE 2019 A 2023 EM UM MUNICÍPIO DO TOCANTINS

INTRODUCTION: Leprosy is an infectious disease with a chronic evolution caused by the bacillus Mycobacterium leprae, which, although curable, is still endemic in several parts of the world, and among these countries we have Brazil, it is associated with social inequalities and a lack of basic structure. This study aimed to analyze the incidence and epidemiological profile of Leprosy cases in Porto Nacional, Tocantins, between 2019 and 2023. METHODOLOGY: A quantitative approach was used, based on retrospective data collected from the Notifiable Diseases Information System (SINAN). Sex, Operational Classification, Initial Therapeutic Scheme and Bacilloscopy. Notification forms in ignored and blank fields above 70% unfilled or that do not provide conclusive data will be excluded. The incidence calculation was carried out based on population estimates provided by IBGE. RESULTS: The data reveal that there was an increase in the total number of reported cases of Leprosy in the Municipality of Porto Nacional during the period analyzed. The majority of cases affected men (52.15%). DISCUSSION: The discussion of the results highlights the need for more effective public policies to control the spread of the disease, especially in endemic regions such as Porto Nacional – TO. FINAL CONSIDERATIONS: The clinical-epidemiological analysis of Leprosy cases in Porto Nacional highlights the urgent need for more effective interventions to control the disease and prevent new cases, breaking the transmission chain.

Leprosy-related disability in children and adolescents under 15 years old in Brazil: evaluation of macro-regional disparities from 2001 to 2022

Objectives: to investigate macro-regional disparities in the incidence of leprosy in children and adolescents under 15 years old in Brazil from 2001 to 2022, with a focus on leprosy-related disabilities. Methods: an ecological study was carried out with data from the Brazilian Notifiable Diseases Information System (SINAN). The annual number of leprosy cases was normalized to every 100,000 residents in each macro-region (incidence), stratified by leprosy-related disability (grade 0, 1 and 2). The significance level was set at 5%, and Poisson regression adjusted for a robust dispersion was used to estimate the incidence ratio. Results: approximately 14% (7,694) of all leprosy cases in this age group were notified with grade 1 (78.9%) or 2 (21.1%) disability. Moreover, in grade 1 and 2, the incidence of leprosy was significantly higher in the North, Northeast and Central-West macro-regions when compared to the national estimate, as well as significantly lower in the Southeast and South (p-value <0.05). Conclusion: macro-regional disparities were observed in the incidence of leprosy in children and adolescents under 15 years old with grade 1 or 2 disability in Brazil from 2001 to 2022.

Environmental Education and Health Promotion: Diagnosis of the Epidemiological Profile of Dengue Cases in the City of Anápolis, Goiás, From 2014 to 2017

Objective: The aim of this study is to investigate the epidemiological profile of dengue cases reported in the city of Anápolis - Goiás, during the years 2014 to 2017, with the aim of providing an overview to support control and prevention actions. Theoretical Framework: Considered a Public Health problem in Brazil, dengue is a disease transmitted by the main arbovirus vector, the Aedes aegypti mosquito, through the bite of an infected female, which causes morbidity in the country and it is re-emerging. In the case of dengue fever in the urban environment, it is necessary to monitor the epidemiology, due to the probability of epidemics due to the conditions that facilitate the formation of the transmission chain. Method: The methodology adopted for this research was an exploratory study, in order to understand the subject to be addressed, and a documentary research to present the data, which were obtained from the Notifiable Diseases Information System – Goiás (SINAN), and in the IT Department of the Brazilian Unified Health System / Health Information System (DATASUS). Results and Discussion: During the period evaluated, 22,592 cases were reported. Data for the years 2014 to 2017 showed that the number of cases of dengue fluctuated over the period studied and the need for more investment in information as a disease prevention strategy. Research Implications: The practical and theoretical implications of this research are discussed below, providing insights into how the results can be applied or influence practices in the field of Epidemiology and Environmental Sciences. These implications can cover the Surveillance and Health Care sectors, as well as directly impact the management sector. Originality/Value: This study contributes to the democratization of information and is relevant for identifying the epidemiological reality of certain geographic areas, identifying certain weaknesses and providing data for managers in light of scientific evidence.

Infectious diseases transmitted by animals beyond symptoms, how socioeconomic and environmental conditions can influence them

Vector-borne diseases, such as dengue, chikungunya, zika, and leishmaniasis, represent a global public health challenge. This study aimed to understand the impact of socioeconomic, environmental, and healthcare access variables on the incidence of infectious diseases from 2012 to 2021, investigating patterns and correlations. Variables analyzed included the number of healthcare facilities, average income, population size, Gross Domestic Product (GDP), and accumulated deforestation. Multiple linear regression and correlations were used, with data from the Notifiable Diseases Information System (SINAN) and the National Institute for Space Research (INPE). Dengue showed a strong correlation with GDP, the number of healthcare facilities, and deforestation. Chikungunya was associated with population, GDP, and deforestation. Zika showed correlations with population growth and deforestation. Leptospirosis was negatively influenced by healthcare facilities and GDP, while hantavirus infection was inversely related to population growth and healthcare facilities. Leishmaniasis had positive correlations with GDP, healthcare facilities, and deforestation. This study reveals complex interactions between socioeconomic, environmental, and health variables in the incidence of infectious diseases. Understanding these patterns is crucial for formulating effective public policies, highlighting the need for integrated and holistic strategies in the control and prevention of these diseases.

Towards malaria elimination: a case–control study to assess associated factors to malaria relapses in the extra-Amazon Region of Brazil from 2008 to 2019

BackgroundMalaria is an infectious disease caused by the Plasmodium species and is a global burden. When not treated correctly, it can reemerge as a relapse or recrudescence. Malaria relapse cases can contribute to maintaining active transmission chains and can influence the patient to develop severe malaria, potentially leading to hospitalization or death. The objective of this study is to estimate the number of malaria relapse cases in the extra-Amazon region of Brazil and to investigate the associated factors.MethodsThis is a case–control study that analyses malaria infections caused by Plasmodium vivax, as reported in Notifiable Diseases Information System (Sinan) for the Brazilian extra-Amazon region (an area not endemic for the disease) from 2008 to 2019. For the identification of relapse cases, deduplication record linkage processes in R software were used. Malaria relapses were defined as the case group, and new malaria infections were defined as the control group. Logistic regression models were used to assess associated factors.ResultsOf the 711 malaria relapses, 589 (82.8%) were first relapses. Most relapses (71.6%) occurred between 30 and 120 days after the previous infection. Malaria relapses are spread throughout the extra-Amazon region, with a higher concentration near big cities. Driver occupation was found to be a common risk factor compared to other occupations, along with asymptomatic individuals. Other associated factors were: being infected in the Brazilian Amazon region, having follow-ups for malaria relapses, and having parasite density of the previous infection higher than 10,000 parasites per mm3.ConclusionsThis study provides evidence that allows malaria health surveillance services to direct their efforts to monitor cases of malaria in the highest risk segments identified in this study, particularly in the period between 30 and 120 days after being infected and treated. Relapses were associated to driver occupation, absence of symptoms, infection in endemic areas of Brazil, being detected through active surveillance or routine follow-up actions, and with parasitaemia greater than 10,000 parasites per mm3 in the previous infection. Improving cases follow-up is essential for preventing relapses.

ESTUDO EPIDEMIOLÓGICO DE CASOS NOTIFICADOS POR CHIKUNGUNYA ENTRE OS ANOS DE 2019 A 2023 EM UM MUNICÍPIO DO TOCANTINS

INTRODUCTION: The Chikungunya virus is transmitted by Aedes aegypti and Aedes albopictus, causing fever and joint pain, with potential serious complications. This study aimed to analyze the incidence and epidemiological profile of Chikungunya cases in Porto Nacional, Tocantins, between 2019 and 2023. METHODOLOGY: A quantitative approach was used, based on retrospective data found in the Notifiable Diseases Information System (SINAN). The variables tested included sex, age group, education and disease progression. The incidence calculation was carried out based on population estimates provided by IBGE. RESULTS: The results indicated a significant increase in cases in 2022, representing 58% of the total, followed by a drop in 2023. The majority of cases affected women (65%) and people between 20 and 39 years old. Laboratory classification was the main diagnostic method, responsible for 60% of confirmed cases. DISCUSSION: The discussion of the results highlights the need for more effective public policies to control the spread of the virus, especially in vulnerable regions. FINAL CONSIDERATIONS: Therefore, although there was a reduction in cases in 2023, it is crucial to maintain continuous epidemiological surveillance and vector control actions to prevent future outbreaks and mitigate the impacts of Chikungunya on the population.

A sífilis congênita nas regiões de saúde no estado de Alagoas (2009-2018)

Introduction: Syphilis is a sexually transmitted infection caused by Treponema pallidum. When transmission occurs from mother to child during pregnancy, it is called congenital syphilis (CS). Alagoas is among the Brazilian states with one of the highest mortality rates for CS in children under one year old. Given this scenario, this article aims to analyze the temporal trend of congenital syphilis in the Health Regions (HR) of Alagoas from 2009 to 2018. Methods: This is an ecological time series study. Sociodemographic variables and clinical aspects were analyzed. Data were obtained from the Information System for Notifiable Diseases and the Information System for Live Births. Trend analysis was conducted using the joinpoint regression model. Results: A total of 3,342 cases of CS were registered in Alagoas, with the 1st HR being the most affected (83.57%). The 8th HR had the lowest number of cases (0.18%). In terms of incidence, the 10th HR had the highest rate (14.51/1,000 inhabitants), while the 8th HR had the lowest (0.24/1,000 inhabitants). Regarding neonatal outcomes, most newborns survived (92.40%), and the majority were of mixed race (74.78%). Among maternal characteristics, there was a predominance of incomplete primary education (32.92%) and mixed race (75.08%). Conclusion: The State of Alagoas had a high incidence of CS between 2009 and 2018. The CS rate increased in almost all HRs, except for the 5th HR.

Internações hospitalares por desnutrição infantil no Brasil: um panorama epidemiológico dos últimos 10 anos

Objective: To describe the number of hospital admissions due to child malnutrition in Brazil. Methods: This is an epidemiological, descriptive, observational study with a quantitative approach, focusing on hospitalizations of children aged 1 to 9 years due to malnutrition across Brazilian regions. Data were collected from the Notifiable Diseases Information System (SINAN) between January 2012 and December 2022. Results: A total of 20,855 cases of child malnutrition were reported in Brazil. The years with the highest incidence within the analyzed period were 2012, with 13.0% of cases, followed by 2014, with 12.4%. The Northeast region showed the highest number of hospitalizations, accounting for 34.2% of the total cases. Reports of malnutrition were more common among males (50.9%), children aged 1 to 4 years (70.9%), and those self-identified as brown (40.8%). Regarding the number of deaths, 286 cases were reported, with the highest incidence in 2012 (12.9%). Conclusion: Although there has been a significant decrease in hospitalizations due to malnutrition over the study period, child malnutrition remains a public health issue, driven by fac- tors related to socioeconomic inequalities and disparities in health services across the country.

Temporal trend and epidemiological profile of accidents involving venomous animals in the State of Rio de Janeiro, Brazil (2012-2021)

Introduction: Accidents involving venomous animals have significant clinical implications. In Brazil, accidents caused by scorpions (59%), spiders (13.6%), and snakes (10.9%) are the mostfrequently reported, although proportions vary by region. This study describes the temporal trends and epidemiological characteristics of accidents involving venomous animals in the State of Rio de Janeiro. Methods: This is an ecological (time series) study of accidents caused by venomous animals over the last 10 years (2012 to 2021) in Rio de Janeiro. Data were collected from the Brazilian Notifiable Diseases Information System. We estimated incidence rates and analyzed time series using Joinpoint regression, according to geographical region, age, and type of animal. Results: From 2012 to 2021, 17,891 accidents involving venomous animals were reported, with rates increasing from 8.4 to 10.7 per 100,000 inhabitants. Snakes were responsible for the highest number of cases (33.4%), followed by scorpions (27.2%) and spiders (27.0%). Snakebite cases remained stable, while cases of arachnidism and scorpion envenomation increased, marking them as the main types of accidents. The regions with the highest rates were Centro-Sul (65.5 per 100,000 inhabitants), Baía da Ilha Grande (62.3), Médio Paraíba (45.3), and Serrana (43.5). Males and the 40 to 59 age group predominated, but all age groups showed an increase, with a more pronounced rise among children and adolescents. Most accidents were classified asmild, although 51 deaths were recorded.Conclusions: Rio de Janeiro has relatively low rates of accidents involving venomous animals,but some regions have values higher than the national average. Snakebite accidents remainedstable, except in the adolescent group. Accidents involving scorpions and spiders showed anupward trend.

The impact of the COVID-19 pandemic on the incidence of sexual violence against children and adolescents in the home environment in Brazil

The scope of this article is to identify the impact of the COVID-19 pandemic on the incidence of sexual violence against children and adolescents in the home environment in Brazil. It involves an ecological time-series study using joinpoint regression based on data from the Notifiable Diseases Information System from 2009 to 2021. The relative frequency and crude incidence rates of sexual violence occurring in the home against the population group aged 0 to 19 years were analyzed, estimating the annual percentage change (APC) and average annual percentage change (AAPC), with a 95% confidence interval. The relative frequency of the problem was higher in 2020 (69.8%) and 2021 (71.7%), with an increase of 3.1% (p = 0.001) in 2017-2021. Girls were more affected, with rates rising in 2009-2012 (APC = 44.4; p = 0.010) and 2015-2019 (APC = 16.6; p=0.017) but falling in 2019-2021 (APC= -17.7; p = 0.042). All age groups showed a significant increase until 2019, and a reduction after this year for 5-9 years (APC = -18.6; p = 0.016), 10-14 years (APC = -14.1; p = 0.040) and 15-19 years (APC = -18.4; p = 0.021). The reduction in the incidence rates of this type of violence may have been influenced by the context of social isolation during the COVID-19 pandemic, which led to the underreporting of cases.

Underreporting of violence against women: an analysis of two data sources.

This article aims to estimate the underreporting of violence against women (VAW) in the Notifiable Diseases Information System (SINAN), based on data from the National Survey of Health (NSH), in Brazil and subnational units (SU). This work was an ecological study using SINAN and NSH, both from 2019. In SINAN, reports of sexual, physical, and psychological VAW, aged 18 years or older, were selected. In the NSH, women of the same age group who reported psychological, physical, or sexual violence, and who had sought health care due to consequences of the violence were selected. SINAN underreporting was calculated in reference to the NSH's estimated population, for Brazil and each SU. Underreporting of VAW in Brazil was 98.5%, 75.9%, and 89.4% for psychological, physical, and sexual violence, respectively. The North and Northeast states presented the lowest reporting rates among the states. VAW in Brazil is highly underreported by the health sector, showing the need for adequate training of health professionals to recognize situations of violence and raise awareness of the importance of reporting.

Mapping dengue in Brazil: an epidemiological, geospatial and climate correlation

Brazil has been suffering for many years from an extensive dengue epidemic. The objective of this study was to map dengue cases in Brazil between 2007 and 2022, correlating their epidemiology, geospatial distribution, and relationship to climatic and social data. An epidemiological survey was conducted based on data available in the Notifiable Diseases Information System, calculating incidence rates (IR), mortality rates (MR), case fatality rates (CFR), and the distribution of epidemiological characteristics, allowing the geolocation of cases and the creation of maps for each year and Brazilian states. Finally, the ecological determinants were correlated with IR and MR. We observed that IR and MR remained high throughout the analyzed period, with a slight decrease in IR in 2017 and 2018. Cases occurring in female individuals were higher, however, with a similar percentage of deaths. A decrease in the average mortality was observed, during the evaluation period, in children and adolescents; however, an increase in the average mortality among elderly was correlated with the presence of comorbidities. The states located in the Midwest region were the most affected, followed by the states in the Northern region. In addition, we observed a significant, but weak, correlation between ecological determinants (maximum temperature and humidity) and IR, GDP per capita and HDI (Human Development Index) with MR. Due to the hyperendemic scenario, it is necessary to take efficient control and constant epidemiological surveillance.

ANÁLISE TEMPORAL DA INCIDÊNCIA DE CASOS NOTIFICADOS DA DOENÇA DE CHAGAS NO BRASIL, NO PERÍODO DE 2010-2019

Chagas disease is caused by Trypanosoma cruzi and remains an important public health concern in Brazil, despite control measures adopted over the last few decades. The objective of this study is to carry out a temporal analysis of the incidence of reported cases of Chagas Disease in Brazil from 2010 to 2019, identifying trends and possible associated factors. Secondary data from the Notifiable Diseases Information System (SINAN) were used to calculate incidence rates by region and year. The statistical analysis included linear regression models to evaluate the temporal variation of notifications. The results indicate an overall reduction in notifications in the country during the period analyzed, with significant regional variations. The North region showed an increase in notifications, suggesting the need for greater surveillance and control strategies. In contrast, the Southeast and South regions maintained a stable downward trend, as a result of continued vector control measures. It is concluded that, although cases of Chagas disease are declining in much of Brazil, the disease still represents a public health challenge in some regions, especially in areas where oral transmission and vector synanthropy are on the rise.

Spatiotemporal relationship between agriculture, livestock, deforestation, and visceral leishmaniasis in Brazilian legal Amazon

Visceral leishmaniasis (VL) is an urgent public health concern in Brazil. We evaluated the spatiotemporal distribution of VL to better understand the effects of economic activities related to agriculture, livestock, and deforestation on its incidence in the Brazilian Legal Amazon (BLA). The data on newly confirmed cases of VL in Brazilian municipalities from 2007 to 2020 were extracted from the Brazilian Notifiable Diseases Information System (SINAN) and analyzed. The data on agricultural production (planted area in hectares) and livestock (total number of cattle) were obtained from the Brazilian Institute of Geography and Statistics (IBGE), whereas deforestation data (in hectares) were obtained from the Amazon Deforestation Estimation Project (PRODES). SatScan and the local indicators of spatial association (LISA) were used to identify the spatial and temporal patterns of VL and its relationships with economic and environmental variables. The cumulative incidence rate was found to be 4.5 cases per 100,000 inhabitants. Based on the LISA results, areas with a high incidence of VL and deforestation were identified in the states of Roraima, Pará, and Maranhão. Strengthening deforestation monitoring programs and environmental enforcement actions can help implement public policies to control illegal deforestation and mitigate the socio-environmental vulnerability in the BLA. Therefore, areas identified in this study should be prioritized for controlling VL.

PANORAMA EPIDEMIOLÓGICO DA TUBERCULOSE EM CRIANÇAS E ADOLESCENTES NO BRASIL: ANÁLISE DE CASOS NOTIFICADOS ENTRE 2003 E 2023.

Tuberculosis (TB) remains a significant public health issue in Brazil, particularly among children and adolescents. This study aims to conduct a retrospective analysis of the epidemiological profile of TB cases reported in the population aged 0 to 19 years between 2003 and 2023, focusing on diagnosis and follow-up. It is a descriptive and analytical study with a quantitative approach, utilizing data extracted from the Notifiable Diseases Information System (SINAN) and the Brazilian Institute of Geography and Statistics (IBGE). A total of 163,262 TB cases were analyzed, of which 55.1% were female and 44.8% were male. The majority of cases were concentrated in the 15 to 19 age group, and the distribution by race/color showed a predominance of mixed-race individuals. A general decline in the number of cases was observed over the years, with a significant reduction between 2020 and 2021. However, the incidence of TB in children under 1 year of age increased gradually. Regarding diagnosis, only 51.87% of cases were confirmed by laboratory tests, with low rates of sputum culture and bacilloscopy. Cure and treatment adherence rates remained stable until 2021 but dropped dramatically in 2023. The study concludes that there are significant challenges in the early diagnosis and management of TB in this population, suggesting the need for more effective public policies to improve health outcomes and reduce TB-related mortality among children and adolescents.

Predictor effect of the Rapid Survey (LIRAa) and priority areas for Dengue surveillance in Maranhão, Brazil

Dengue fever is a serious public health problem in Brazil. However, there are still mechanisms involved in the dynamics of the disease that need to be better elucidated, especially in Maranhão. In this sense, the objective was to evaluate the predictive effect of LIRAa in relation to the incidence of dengue fever in Maranhão in 2022, and to identify priority municipalities for interventions through geospatial analysis. This is a scholastic study, carried out with data obtained from the Zoonosis Surveillance Units - UVZ of the municipalities, in the Notifiable Diseases Information System (SINAN). A simple linear regression with post-hoc analyses and the Local Moran Index (LISA) were performed. A positive effect of LIRAa on the incidence of dengue fever was observed (R2 = 0.0352; p = 0.0062). LISA indicated ten high-risk municipalities and six in a transition situation to high risk of dengue fever in the state. LIRAa has proven to be an efficient entomoepidemiological surveillance tool and the identification of priority areas for surveillance can help health authorities in developing specific strategies to contain future epidemics.

Analysis of the Vulnerability Profile of tuberculosis co-infection in people living with HIV

Introduction: studies that seek to identify and outline the vulnerability profile contribute to directing necessary interventions to be carried out in people with tuberculosis (TB) and HIV (acronym in English for human immunodeficiency virus) co-infection, to achieve the end of TB. Objective: to describe the profile of people with tuberculosis and HIV co-infection, from 2016 to 2018, in Espírito Santo, Brazil. Methods: this is a cross-sectional descriptive study, using secondary data from the Notifiable Diseases Information System (SINAN) for TB and HIV, through a methodological process of database preparation and descriptive data analysis, the information was encoded and stored anonymously in a database in Excel for Windows®; Afterwards, the STATA statistical package, version 16 (Stata Corp LP, College Station, TX, USA) was used to carry out descriptive analyses with identification of relative and absolute values, and tables were generated for data analysis. The study was approved by the Research Ethics Committee of the Health Sciences Center of the Federal University of Espírito Santo (CEP/CCS/UFES) under opinion number 4022892 on 05/12/2020. Results: of a total of 4,428 cases, 325 cases were TB-HIV co-infection, 322 cases were located in the SINAN-TB database and three cases were located after linking with the SINAN-HIV database that presented a record of negative results for the diagnostic test of HIV in the SINAN-TB database. There was a profile with a predominance of men (71%), young people (20 to 39 years old) (52%), mixed race (59%), up to 8 years of schooling (25%), of which 29% reported alcohol consumption, 26% used illicit drugs, and 37% were smokers, who had the pulmonary form of the disease (66%), they reported adherence to antiretroviral therapy (65%) and only 44% had a cure outcome at closure and 20% stopped treatment; the majority of cases (61%) did not undergo directly observed treatment and only 6.9% of cases reported receiving assistance from the government’s income transfer program. Conclusion: in order to ensure greater coverage of tuberculosis control in PLHIV patients, it is necessary to expand the dialogue between health and social support policies; enable access to health services such as antiretroviral treatment for all people diagnosed with HIV, and timely directly observed treatment (DOT) for people who present this vulnerability profile. Carrying out new studies is essential to contribute to technological advancement and planning in health service actions.

Fatores associados ao abandono do tratamento da tuberculose: um estudo transversal entre 2014 e 2019

Introduction: tuberculosis (TB) is a public health problem. Brazil is among the group of 22 countries responsible for 90% of the world’s TB cases. High proportions of abandonment of treatment may contribute to this epidemiological scenario that is difficult to control. Objective: to analyze the factors associated with abandonment of tuberculosis treatment (ATT). Methods: this is a cross-sectional study of individuals diagnosed with tuberculosis in Brazil between 2014 and 2019 whose cases had been reported to the Notifiable Diseases Information System. Poisson regression of robust variance was used according to hierarchical levels. Results: a total of 508,787 cases were reported, and 59,871 patients (16.4%) abandoned treatment. The prevalence of abandonment was higher in homeless individuals (PR 2.75; 95%CI 2.10-3.61), black race/skin color (PR 1.79; 95%CI 1.46-2.20), HIV/AIDS (PR 1.59; 95%CI 1.30-1.93), alcoholics (PR 1.38; 95%CI 1.14-1.68), illicit drug use (PR 1.85; 95%CI 1.49-2.28), and in individuals who resumed treatment after abandonment (PR 1.91; 95%CI 1.54-2.37). Conclusion: social vulnerability is associated with the abandonment of tuberculosis treatment.

Data Descriptor of Snakebites in Brazil from 2007 to 2020

Snakebite envenomations (SBE) are a significant global public health threat due to their morbidity and mortality. This is a neglected public health issue in many tropical and subtropical countries. Brazil is in the top ten countries affected by SBE, with 32,160 cases reported only in 2020, posing a high burden for this population. In this paper, we describe the data structure of snakebite records from 2007 to 2020 in the Notifiable Disease Information System (SINAN), made available by the Brazilian Ministry of Health (MoH). In addition, we also provide R scripts that allow a quick and automatic updating of data from the SINAN according to its availability. The data presented in this work are related to clinical and demographic information on SBE cases. Also, data on outcomes, laboratory results, and treatment are available. The dataset is available and freely accessible; however, preprocessing, adjustments, and standardization are necessary due to incompleteness and inconsistencies. Regardless of these limitations, it provides a solid basis for assessing different aspects and the national burden of envenoming.

Retreatment and Anti-tuberculosis Therapy Outcomes in Brazil Between 2015 and 2022: A Nationwide Study.

Adherence to anti-tuberculosis treatment (ATT) in Brazil remains a challenge in achieving the goals set by the World Health Organization (WHO). Patients who are lost to follow-up during treatment pose a significant public health problem. This study aimed to investigate the factors associated with unfavorable ATT outcomes among those undergoing retreatment in Brazil. We conducted an observational study of patients aged ≥18 years with tuberculosis (TB) reported to the Brazilian National Notifiable Disease Information System between 2015 and 2022. Clinical and epidemiologic variables were compared between the study groups (new cases and retreatment). Regression models identified variables associated with unfavorable outcomes. Among 743 823 reported TB cases in the study period, 555 632 cases were eligible, consisting of 462 061 new cases and 93 571 undergoing retreatments (44 642 recurrent and 48 929 retreatments after loss to follow-up [RLTFU]). RLTFU (odds ratio [OR], 3.96 [95% confidence interval {CI}, 3.83-4.1]) was a significant risk factor for any type of unfavorable ATT. Furthermore, RLTFU (OR, 4.93 [95% CI, 4.76-5.11]) was the main risk factor for subsequent LTFU. For death, aside from advanced age, living with HIV (OR, 6.28 [95% CI, 6.03-6.54]) was the top risk factor. Retreatment is a substantial risk factor for unfavorable ATT outcomes, especially after LTFU. The rates of treatment success in RLTFU are distant from the WHO End TB Strategy targets throughout Brazil. These findings underscore the need for targeted interventions to improve treatment adherence and outcomes in persons who experience RLTFU.