Notifiable Diseases Information System Research Articles

Factors associated with unsuccessful tuberculosis treatment in Manaus, Amazonas, from 2011 to 2021.

To identify vulnerability factors associated with unsuccessful tuberculosis treatment outcomes between 2011 and 2021 in Manaus, Amazonas. Ecological study using tuberculosis case notification data from the Notifiable Diseases Information System, from 2011 to 2021, of residents in Manaus. The variables refer to treatment outcomes and patient vulnerability, according to the theoretical model: individual, programmatic and social. The analysis tested the association between vulnerability and tuberculosis treatment non-success, measured by the occurrence of death, loss to follow-up or treatment default. The Odds Ratio estimate with confidence interval was obtained by logistic regression, according to a hierarchical model. The following factors were more likely to lead to unsuccessful tuberculosis treatment: individual vulnerability (age group 20 to 29 years and over 60 years, indigenous race, HIV+, drug use); programmatic vulnerability (not having an HIV test), social vulnerability (special population). Individual vulnerability was more strongly associated with non-success. Intervention is needed to explore the points of greatest individual vulnerability, enabling effective action to prevent unsuccessful tuberculosis treatment.

HIV and AIDS in the state of Paraná, Brazil, 2007-2022: trends and spatiotemporal distribution.

The aim of this study was to analyze the spatiotemporal evolution of the incidence rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in the state of Paraná, Brazil. An ecological study with an analytical component of time series analysis was conducted in the state of Paraná from 2007 to 2022. The data source was the Notifiable Diseases Information System. To study the trend, the Prais-Winsten generalized linear regression model was used by decomposing the time series, and for spatial analysis, the Moran's index was applied. The total sample consisted of 50,676 HIV/AIDS records. The incidence rate showed an increasing trend, with an average growth of 2.14% [95% confidence interval - 95%CI 1.16-3.13] per month. From 2007 to 2014 and from 2015 to 2022, the average number of cases in the state was 105.64 and 159.20 per 100,000 inhabitants, respectively, with significant variation among municipalities. Spatial clusters of high risk persisted in the metropolitan region, the capital, and coastal areas, and a new cluster was observed in the northern region of the state. The incidence rates of HIV/AIDS showed an upward trend over time. The number of cases varied considerably in some municipalities, especially in the coastal region. Spatial analysis revealed geospatial patterns of high risk in the main metropolitan areas of Paraná: Curitiba (including the coastal area), Londrina, and Maringá, which share characteristics such as a high degree of urbanization and ongoing economic development.

Time until tuberculosis recurrence and associated factors in Brazil: a populationbased retrospective cohort study using a linked database.

To calculate the rate of tuberculosis recurrence, estimate its average time until recurrence, and identify factors associated with recurrence in Brazil. Retrospective cohort study with a linked database from the Notifiable Diseases Information System. The study included individuals diagnosed with tuberculosis in 2015, focusing on those who experienced their first recurrence within 6.5 years. We estimated the relative risk (RR) and its 95% confidence interval (95%CI), as well as the population attributable fraction (PAF) or the population preventable fraction (PPF) of associated factors. Within a 6.5-year period, 3,253 individuals (6.5%) experienced tuberculosis recurrence, with a median time of 2.2 years. Positively associated factors included: male sex (RR: 1.4; 95%CI 1.3-1.5; PAF: 22.9%), age 30 to 59 years (RR: 3.0; 95%CI 1.6-5.7; PAF: 36.0%), black race (RR: 1.3; 95%CI 1.2-1.5; PAF: 3.5%), mixed race (RR: 1.3; 95%CI 1.2-1.4; PAF: 10.6%), deprivation of liberty (RR: 1.9; 95%CI 1.7-2.1; PAF: 9.1%), pulmonary/mixed clinical form (RR: 1.7; 95%CI 1.4-1.9; PAF: 37.1%), acquired immunodeficiency syndrome diagnosis (RR: 1.8; 95%CI 1.5-1.9; PAF: 4.3%), and alcohol use (RR: 1.2; 95%CI 1.1-1.3; PAF: 2.9%). Negatively associated factors were: 12 or more years of schooling (RR: 0.5; 95%CI 0.4-0.6; PPF: 3.3%) and supervised treatment (RR: 0.9; 95%CI 0.8-0.9; PPF: 4.4%). This study revealed high tuberculosis recurrence rates in Brazil, influenced by sociodemographic, compartmental, and social factors, both positively and negatively impacting disease recurrence.

Human anti-rabies care in the State of São Paulo: evaluating prophylaxis conduct in individuals attacked by dogs and cats.

Rabies is a zoonosis usually transmitted to mammals via contact between the saliva of infected animals and either the skin or mucosa of the attacked individual, and post-exposure prophylaxis (PEP) is the only way to avoid the disease. This study aimed to perform a descriptive analysis of PEP after attacks by dogs and cats in the state of São Paulo. We analyzed the disease compulsory notification forms Human Anti-Rabies Care (CID10: W64), available in the Notifiable Diseases Information System (SINAN), from 2013 to 2017. Treatment adequacy was analyzed according to the parameters established by the Brazilian Health Ministry. A total of 572,889 notifications were reported during the study period, 94.1% (538,975) of which corresponded to dog or cat attacks, with an occurrence of 26.9 cases per 10,000 inhabitants. Among the recommended procedures, the most frequent was the observation of the animals for 10 days (44.4%), which was adopted inappropriately at a lower frequency. Prophylactic conduct was adequate in 68.8% of the cases, but only 55.5% of the individuals received adequate treatment. More than 112 thousand individuals (31,4%) received a correct recommendation for PEP but did not receive adequate treatment, leading to 246,787 doses of the vaccine and 8,888 doses of rabies immunoglobulin administered without following the recommendations of the Ministry of Health. The use of immunobiologicals is excessive, indicating the need for investment in training health professionals to follow the recommendations of the Ministry of Health.

Fatores associados aos desfechos desfavoráveis de tratamento da tuberculose em idosos no Brasil: uma análise multinomial

Abstract Objective To identify, within the three axes of vulnerabilities (individual, social, and programmatic), the factors associated with unfavorable treatment outcomes of tuberculosis (TB) among older adults in Brazil between 2015 and 2019. Method This is a cross-sectional study utilizing secondary data from the Notifiable Diseases Information System (SINAN) regarding reported TB cases in Brazil, among individuals aged 60 years or older. The covariates associated with the outcome of interest (p≤0.20) were included in a multinomial logistic regression model using the cure category as the reference. Results Older adults self-identified as black or mixed-race, experiencing homelessness, with mental health disorders, living with the human immunodeficiency virus (HIV), and engaging in the use of licit and illicit drugs had higher odds of loss to follow-up. Furthermore, older adults experiencing homelessness, with mental health disorders, engaging in the use of licit and illicit drugs, and who did not undergo bacilloscopy, presented higher odds of death due to TB. For the outcome of death due to other causes, individuals living with diabetes mellitus and HIV, engaging in the use of licit and illicit drugs, also had higher odds of experiencing this outcome Conclusion The results highlighted the influence of factors on TB treatment outcomes in older adults, encompassing the individual, social, and programmatic axes. Aspects such as advanced age, race, female sex, comorbidities, and homelessness were identified as relevant determinants, emphasizing the need for integrated approaches to improve outcomes and promote a favorable treatment outcome for TB in older adults.

Quality of healthcare services to reduce leprosy in Brazil: a trend analysis from 2001 to 2020.

To analyze the temporal trend of healthcare services quality indicators to reduce leprosy in Brazil, over a 20-year period. This is an epidemiological study with a temporal trend, whose data were extracted from the Notifiable Diseases Information System. Indicators were constructed from the Ministry of Health Technical-Operational Manual that presents the Guidelines for Surveillance, Care and Elimination of Leprosy as a Public Health Problem. For trend analysis of the selected indicators, the Prais-Winsten model was used and the Average Annual Growth Rate (AAGR) was also calculated. In the 20-year time series investigated here, 732,959 cases of leprosy were reported in Brazil. The trend was stationary for: new leprosy cases cure rate (β=-0.000; p=0.196; AAGR=-0.2), new leprosy cases drop out rate (β=-0.001; p=0.147; AAGR=-0.4), new leprosy cases contact tracing rate (β=-0.001; p=0.112; AAGR=1.6), new cases of leprosy with degree physical disability assessment rate among new cases (β=-0.000; p=0.196; AAGR=-0.2) and cases cured in the year with the degree of physical disability assessed (β=0.002; p=0.265; AAGR=0.5); while the indicator of recurrence rate among cases reported in the year (β=0.019; p<0.001; AAGR=0.5) showed an increasing trend. Based on the evaluation of indicators to assess the quality of healthcare services to reduce leprosy, it was evident that Brazil has major challenges for its full implementation, with improvements being necessary in the quality of care service offered to the population.

Temporal Pattern and Spatial Distribution of Tuberculosis Prevalence Associated with Multimorbidity in Brazil.

Four main chronic conditions may be involved in the tuberculosis pathogenic process and/or clinical evolution: HIV/AIDS, diabetes mellitus, mental illness, and Chronic Obstructive Pulmonary Disease. This study aimed to determine the spatiotemporal pattern of tuberculosis (TB) associated with multimorbidity in Brazil. Ecological study use data from the Notifiable Diseases Information System (SINAN), collected from the electronic portal of the Department of Informatics of the SUS (DATASUS). These data included TB cases that were reported between 2007 and 2021 and were associated with two or more chronic clinical health conditions (multimorbidity). A total of 7,795 cases of TB associated with multimorbidity were recorded, with an average growth trend of 4.6% per year (95% Confidence Interval (CI): 3.3-5.9; p<0.001) and higher growth in the first temporal segment (2007 to 2011) (8.9%; 95%CI: 4.2-13.9; p=0.002). The spatial analysis, after Bayesian smoothing, highlighted the main municipalities states of the study, namely: São Paulo (19.8%; n = 297), Porto Alegre (23.6%; n = 354), and Rio de Janeiro (44.8%; n = 672). The proportion of extremely poor (β=-0.002), the bolsa família program (β=0.002), the average per-person income (β=0.001), and the percentage of the population living in households with a density of more than 2 people per bedroom (β=0.001) were related to chronic health conditions. These findings will stimulate public action to manage this situation. However, as this is still a recent topic in the literature, we encourage the development of studies on the synergistic characteristics of TB and other clinical conditions.

Rape and the "minute-after" law in Minas Gerais, Brazil: socio-demographic factors associated with emergency prophylaxis

This research project investigated the relationship between sociodemographic characteristics of girls and women who were the victims of rape of in Minas Gerais between 2013 and 2021, and the likelihood of receiving emergency treatment as stipulated in Law No. 12,845/2013, known as the "Minute-After" (Minuto Seguinte) Law. Data from the Notifiable Diseases Information System (SINAN) for rape cases were used to estimate binary choice models. The results indicate that the sociodemographic factors of the victims, aligned with the theory and practice of intersectionality (race, age, place of residence within health regions, relationship with the perpetrator, and year of crime registration), negatively influence the probability of receiving emergency treatment. Specifically, indigenous victims, minors, those raped by acquaintances, and residents in certain health regions, were found to have a lower probability of receiving immediate medical care after rape. Furthermore, it was found that the implementation of public policy did not result in an improvement, as there has been a decrease in the number of medical appointments since the enactment of the law in 2013 through to the year 2021.

Proteção social em áreas vulneráveis à tuberculose: um estudo misto em São Luís, Maranhão

ABSTRACT Objectives: to analyze the risk areas for tuberculosis and the influences of social protection on the development of treatment for the disease in the municipality of São Luís, Maranhão. Methods: this is explanatory sequential mixed method research. In the quantitative phase, the data were obtained from the Notifiable Diseases Information System from 2010 to 2019, with georeferencing being carried out to identify areas vulnerable to tuberculosis. In the qualitative phase, semi-structured interviews were carried out with individuals who received social benefits. Results: 7,381 cases were geocoded, and, from the purely spatial scanning analysis, it was possible to identify 13 spatial clusters of risk. As for the interviews, there was a positive relationship between patient improvement and receiving benefits. Conclusions: geographic space and social determinants are relevant for reorienting monitoring actions for the conditions that generate the health-disease process.

A brief research report of suicide rates in the Brazilian elderly over a 12-year period: the lack of association of the "Setembro Amarelo" campaign for suicide prevention.

Aiming to disseminate information related to suicide prevention in Brazil, the "Setembro Amarelo" campaign has been conducted since 2015. The objective of this study is to assess the association between this campaign and elderly suicide rates over a 12-year period. Data were gathered from the Mortality Information System and the Notifiable Diseases Information System, established by public institutions in Brazil. An interrupted time-series framework was applied to assess the association between the "Setembro Amarelo" campaign and suicide mortality rates in the elderly population (60 et plus) in the southeastern region of Brazil. We consider three monthly outcomes: all suicides, suicides in males and suicide in females. We operationalize the campaign assuming three effects: short-term, declining and sustained. The period of analysis was from 2011-2022. The suicide-mortality rate over time has remained stable; the average rate in the pre-campaign period was 0.028 and increased slightly to 0.035. Regardless of the campaign's operationalization and the outcome used, results show no significant associations between the campaign and elderly suicide rates. The campaign was associated with non-significant decreased effects of 15% (P=0.532) in the short term, and 16% (P=0.446) assuming the campaign was sustained. There is a lack of association between the campaign and suicide rates, among the elderly in Brazil's southeastern region. As suicide is complex and multifactorial, more research is needed. The campaign, while raising awareness and reducing stigma, may not reduce suicides. To reduce the suicide rate in the elderly requires addressing social, economic and cultural factors, multisectoral interventions, and upholding basic human rights.

Space-time dispersion of dengue occurrence in epidemic and non-epidemic years in a municipality in the metropolitan region of Belo Horizonte, MG, 2011 to 2017.

To analyze the transmission dynamics of dengue, a public health problem in Brazil and the Metropolitan Region of Belo Horizonte (MRBH). The spatiotemporal evolution of the occurrence of dengue in the municipality of Contagem, state of Minas Gerais, a region with high arbovirus transmission, was analyzed. Furthermore, epidemic and non-epidemic periods were analyzed, based on probable cases of dengue. This is an ecological study that used the Notifiable Diseases Information System (SINAN) national database. The analyses were carried out considering the period from epidemiological week (EW) 40 of 2011 to 39 of 2017. Spatial analysis tools (crude and smoothed incidence rate, directional distribution ellipse, global Moran index and local Moran index, and spatial scanning time with definition of epidemiological risk) were used. The 2012 to 2013 and 2015 to 2016 epidemic cycles presented high incidence rates. The disease was concentrated in more urbanized areas, with a small increase in cases throughout the municipality. Seven statistically significant local clusters and areas with a high rate of cases and accentuated transmission in epidemic cycles were observed throughout the municipality. Spatial autocorrelation of the incidence rate was observed in all periods. The results of the present study highlight a significant and heterogeneous increase in dengue notifications in Contagem over the years, revealing distinct spatial patterns during epidemic and non-epidemic periods. Geoprocessing analysis identified high-risk areas, a piece of knowledge that can optimize the allocation of resources in the prevention and treatment of the disease for that municipality.

Trend and spatial pattern of intimate partner rape notifications against women in Northeast Brazil (2013-2022).

To analyze the trend and spatial pattern of intimate partner rape reports against women in Northeast Brazil. Ecological time-series study and spatial analysis with secondary data from the Notifiable Diseases Information System between 2013 and 2022. Gross rape rates were calculated by type of intimate partner and by age group of the victim. Prais-Winsten regression was used to calculate the trend, and the global and local Moran indices were used for spatial analysis. A total of 5,542 cases of intimate partner rape were reported. Spousal rates ranged from 0.34/100,000 women in 2013 to 0.51/100,000 in 2017, with greater increases between 2018 (1.04/100 thousand) and 2022 (1.28/100 thousand). There was an upward trend in the Northeast as a whole (APC=19.47; 95%CI 15.88-23.22) and in almost all states, except Paraíba and Sergipe. Cases perpetrated by boyfriends (APC=23.90; 95%CI 12.80-36.09) and among women aged 15 to 19 years (APC=22.63; 95%CI 4.18-44.35) showed the highest annual variation. A concentration of high rates was observed in several municipalities in the northwest of Ceará and southeast of Pernambuco. The trend in intimate partner rape rates against women increased in the Northeast, especially among younger women and by boyfriends, with a greater agglomeration of notifications in Ceará and Pernambuco.

Análise dos casos de violência por parceiro íntimo contra mulheres indígenas notificados na macrorregião de Dourados-MS, Brasil

Abstract The present study aimed to analyze notifications of intimate partner violence (IPV) against indigenous women in the macro-region of Dourados-MS, Brazil, from 2009 to 2020. This is a cross-sectional study with secondary data from registered reports in the Notifiable Diseases Information System (SINAN) of indigenous women who suffered violence. Descriptive statistics of the variables and Poisson regression were performed to determine the prevalence ratio (PR). IPV represented 56.6% of reports. The most reported types of violence were physical violence (93.3%) and psychological violence (27%). In the adjusted analysis, IPV was associated with women with partners (PR 1.32, 95%CI 1.19; 1.46), and women in situations of repeated violence (PR 1.15, 95%CI 1.05; 1.25) and at home as the place of occurrence (PR 1.13, 95%CI 1.01; 1.29). The majority of reports of violence against indigenous women registered in the Dourados health macro-region were perpetrated by an intimate partner. Knowledge of the profile of violence that arrives at health services, combined with associated factors, should enable the implementation of strategies aimed at reducing the number of cases.

Subnotificação de violência contra as mulheres: uma análise de duas fontes de dados

Abstract 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.

Hanseníase em menores de quinze anos no município mais hiperendêmico do Brasil

ABSTRACT Objective: To describe leprosy involvement and physical disability profiles in children and adolescents under 15 years old. Methods: Ecological time series study, based on data from the Brazilian Notifiable Diseases Information System, including new cases of leprosy residing in Palmas (TO), from 2001 to 2020. Results: A total of 471 notified cases in children and adolescents under 15 years of age were evaluated, resulting in a detection coefficient of 26.5 per 100,000 inhabitants. Of these, 52% (n=243) were women, 5% (n=24) corresponded to grade two disability, and 36% (n=168) were diagnosed through spontaneous demand. The temporal trend analysis showed a 0.5% reduction in the detection coefficient. There was a significant decrease in the diagnosis of the undetermined and tuberculoid clinical forms and a significant increase in the dimorphous form. Diagnosis through contact examination increased significantly by 13.1% and that through spontaneous demand decreased by 4.9%. The detection coefficient of cases with grade two disability reduced significantly by 7.4% while those with grade one increased by 16.8%. Conclusions: Despite the downward trend in the detection coefficient in children and adolescents under 15 years of age and in cases with grade two disability, other factors indicate failure in the adequate management of leprosy in Palmas.

Perfil da violência contra o idoso no Brasil segundo as capitais brasileiras

Introduction: Violence against older adults is a public health problem, being camouflaged in society due to the relationship between aggressors and victims. Objective: To analyze the profile of violence against older person in Brazil according to data from Brazilian capitals between 2011 and 2019, emphasizing the characteristics of the victims, the aggressors and the violence. Materials and Methods: This is a temporal ecological epidemiological research, collecting information from the DATASUS database of the Ministry of Health, and consulting the Notifiable Diseases Information System (SINAN). The population was made up of older adults with reported cases of violence between 2011 and 2019. Results: The majority of cases were female, with schooling corresponding to incomplete 1st-4th grade, white, with physical violence being the most recurrent, with repetition, within the residence, and the main aggressors were the children. Discussion: The predominance of females is justified by gender/sociocultural, the majority of victims are white, consistent with Brazilian self-declaration, level of education and greater distribution of uneducated older adults. Physical violence is the most prevalent, as it is more visible, favoring its identification. Older adults spend more time at home, triggering risk factors related to the aggressors, with children being more prevalent due to family structural changes. Conclusion: The study made it possible to profile violence against the old person, exposing the characteristics of this population and identifying possible risk/protective factors; the study also made it possible to identify the importance of correctly filling out the report form and the need to readjust the physical form and the information system

Effect of environmental variables on the incidence of Visceral Leishmaniasis in Brazil and Colombia

Effect of environmental variables on the incidence of Visceral Leishmaniasis in Brazil and Colombia

Geography and public health: analysis of the epidemiological dynamics of meningitis in Brazil, between 2010 and 2019.

To analyze the spatiotemporal epidemiological dynamics of meningitis in Brazil, between 2010 and 2019. Descriptive ecological study with cases and deaths due to meningitis in Brazil (2010-2019) in the National Notifiable Diseases Information System (Sistema de Informações de Agravos de Notificação - SINAN). The following analyses were performed: (I) frequency analyses of cases and deaths, prevalence rates, mortality, lethality, Fisher's exact test, and chi-square test; (II) Prais-Winstein regression; and (III) Global, Local Moran's index, and Kernel density. 182,126 cases of meningitis were reported in Brazil, of which 16,866 (9.26%) resulted in death, with prevalence rates of 9.03/100,000 inhabitants, mortality of 0.84/100,000 inhabitants, and lethality of 9.26%. There was a noted trend of decreasing prevalence rates (-9.5%, 95% confidence interval - 95%CI -13.92; -4.96, p<0.01) and mortality (-11.74%, 95%CI -13.92; -9.48, p<0.01), while lethality remained stable (-2.08%, 95%CI -4.9; 0.8; p<0.1941). The majority of cases were viral meningitis (45.7%), among 1-9 years old (32.2%), while the highest proportion of deaths was due to bacterial meningitis (68%), among 40-59 years old (26.3%). In the Moran and Kernel maps of prevalence and mortality rates, municipalities in the South, Southeast, and the capital of Pernambuco in the Northeast stood out with high rates; as for lethality, the North, Northeast, and Southeast coastal areas were highlighted. A decrease in meningitis cases and deaths was found in this study; however, the lethality rate was higher in areas with lower prevalence, emphasizing the need to enhance actions for identifying, monitoring, and providing health care for cases, as well as expanding vaccination coverage.

Hospitalization of elderly people due to COVID-19 in the State of Paraná, Brazil: analysis of associated factors

Abstract Objective To analyze the prevalence and factors associated with hospitalization of elderly people with COVID-19 in the State of Paraná, PR, Brazil. Methods A cross-sectional study linked to the cohort “Longitudinal Monitoring of adults and elderly people who were discharged from hospital admission due to COVID-19”, was carried out using information contained in the compulsory notification forms of the Notifiable Diseases Information System. Analyzes were carried out using relative and absolute frequencies, applying the chi-square test adopted in the logistic regression model. The study population included people aged 60 years or over and residing in the State of Paraná, who were hospitalized for COVID-19 from March 2020 to September 2021. Results A higher hospitalization prevalence was identified among elderly people with eight years of education or more. Individuals not vaccinated against COVID-19 had a greater chance of hospitalization. Males had a greater chance of admission to the Intensive Care Unit compared to females. Cardiovascular diseases, lung disease, and obesity have increased the prevalence of the severe form of the disease. Conclusion Factors such as education and non-adherence to vaccination against COVID-19 can increase the risk of hospitalization due to the disease. Elderly people of the male sex have a greater chance of hospitalization in the ICU compared to the female sex. Furthermore, not using antivirals can contribute to worsening health status.

Assessment of the Prevalence of Suicide in Joinville (SC) from 2019 to 2020

The data were collected using the information contained in the Violence Prevention Center base regarding the notifications from the Notifiable Diseases Information System (SINAN), information about the deaths was selected and divided in age, sex, marital status, schooling, neighborhood, place of death and code of the International Disease Classification applied. The variables were analyzed and detailed through the article.