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1.
RECIIS (Online) ; 17(4): 909-923, out.-dez. 2023.
Artículo en Portugués | LILACS, Coleciona SUS | ID: biblio-1532334

RESUMEN

O objetivo deste artigo é avaliar, segundo alguns atributos, o sistema de vigilância dos acidentes de trabalho antes e após a implantação do software Sentinela (2018-2021), com base em uma pesquisa descritiva de dados secundários, e efetuar recomendações. Foram analisadas variáveis da ficha de investigação, de acordo com os atributos qualidade dos dados (completitude e consistência), oportunidade e representatividade. Os resultados mostraram que, após o Sentinela, houve aumento da notificação de acidentes (66,16%), maior completitude das variáveis, com importante alteração na 'atividade econômica' (98,9%) e 'evolução' (96,3%), diminuição dos campos ignorados/em branco, com destaque para o campo 'evolução' (3,7%), e melhora na oportunidade de controle dos acidentes fatais (79 dias). Concluímos que a vigilância dos acidentes de trabalho tem excelente qualidade dos dados, é representativa, mas inoportuna. O Sentinela melhorou o sistema, tornando-o mais sensível na captação dos acidentes e permitindo-lhe ter informações de melhor qualidade. É necessária a avaliação rotineira dos atributos, para aprimoramento constante do sistema, assim como rever as rotinas das equipes de saúde, melhorando a oportunidade de controle por meio de suas ações


This article aims to evaluate the occupational health surveillance system before and after the implementa-tion of the Sentinela software (2018-2021), according to some attributes and based on descriptive research using secondary data, and to make recommendations. Variables of the accident investigation report were analysed, according to the attributes of data quality (completeness and consistency), opportunity and rep-resentativeness. The results have revealed that after Sentinela, there was an increase in the notification of accidents (66.16%), greater completeness of the variables, with an important change in 'economic activity' (98.9%) and 'evolution' (96.3%), a decreased in blank fields/information missing, with emphasis on the 'evolution' field (3.7%), and an improvement in the opportunity to control fatal accidents (79 days). We have concluded that the surveillance of the occupational accidents has excellent data quality, is representative, but inopportune. The Sentinela has improved the system, making it more sensitive in capturing accidents, allowing it to provide better quality of information. An evaluation of the attributes is routinely necessary to constantly improve the system, as well as reviewing the routines of health professionals, improving the opportunity to control by their actions


El objetivo de este artículo es evaluar, según algunos atributos, el sistema de vigilancia de los accidentes de trabajo antes y después de la implementación del software Sentinela (2018-2021), por medio de una investigación descriptiva de datos secundarios, y hacer recomendaciones. Fueron analizadas variables de la ficha de investigación de accidentes, de acuerdo con los atributos de calidad de los datos (completitud y consistencia), oportunidad y representatividad. Los resultados demostraron que, después del Sentinela, ha habido un aumento de la notificación de accidentes (66,16 %), una mayor completitud de las variables, con un cambio importante en 'actividad económica' (98,9 %) y 'evolución' (96,3 %), una disminución de campos ignorados/en blanco, con énfasis en el campo 'evolución' (3,7%), y mejora en la probabilidad de control de los accidentes mortales (79 días). Concluimos que la vigilancia de los accidentes de trabajo tiene excelente calidad de datos, es representativa, pero inoportuna. El Sentinela ha mejorado el sistema, haciéndolo más sensible en la captación de los accidentes y permitiéndole tener informaciones de mejor calidad. La evaluación de los atributos con regularidad es necesaria para el perfeccionamiento constante del sistema, así como la revisión de las rutinas de los equipos de salud, mejorando la oportunidad de control a través de sus acciones


Asunto(s)
Humanos , Accidentes de Trabajo , Salud Laboral , Servicios de Salud del Trabajador , Tecnología , Vigilancia en Salud Pública , Análisis de Datos , Prevención de Accidentes
2.
Eur J Epidemiol ; 37(12): 1215-1224, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36333542

RESUMEN

Linked administrative data offer a rich source of information that can be harnessed to describe patterns of disease, understand their causes and evaluate interventions. However, administrative data are primarily collected for operational reasons such as recording vital events for legal purposes, and planning, provision and monitoring of services. The processes involved in generating and linking administrative datasets may generate sources of bias that are often not adequately considered by researchers. We provide a framework describing these biases, drawing on our experiences of using the 100 Million Brazilian Cohort (100MCohort) which contains records of more than 131 million people whose families applied for social assistance between 2001 and 2018. Datasets for epidemiological research were derived by linking the 100MCohort to health-related databases such as the Mortality Information System and the Hospital Information System. Using the framework, we demonstrate how selection and misclassification biases may be introduced in three different stages: registering and recording of people's life events and use of services, linkage across administrative databases, and cleaning and coding of variables from derived datasets. Finally, we suggest eight recommendations which may reduce biases when analysing data from administrative sources.


Asunto(s)
Registro Médico Coordinado , Humanos , Sesgo , Estudios Epidemiológicos , Bases de Datos Factuales , Brasil/epidemiología
3.
Malar J ; 21(1): 232, 2022 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-35915484

RESUMEN

BACKGROUND: Data integration and visualisation techniques have been widely used in scientific research to allow the exploitation of large volumes of data and support highly complex or long-lasting research questions. Integration allows data from different sources to be aggregated into a single database comprising variables of interest for different types of studies. Visualisation allows large and complex data sets to be manipulated and interpreted in a more intuitive way. METHODS: Integration and visualisation techniques were applied in a malaria surveillance ecosystem to build an integrated database comprising notifications, deaths, vector control and climate data. This database is accessed through Malaria-VisAnalytics, a visual mining platform for descriptive and predictive analysis supporting decision and policy-making by governmental and health agents. RESULTS: Experimental and validation results have proved that the visual exploration and interaction mechanisms allow effective surveillance for rapid action in suspected outbreaks, as well as support a set of different research questions over integrated malaria electronic health records. CONCLUSION: The integrated database and the visual mining platform (Malaria-VisAnalytics) allow different types of users to explore malaria-related data in a user-friendly interface. Summary data and key insights can be obtained through different techniques and dimensions. The case study on Manaus can serve as a reference for future replication in other municipalities. Finally, both the database and the visual mining platform can be extended with new data sources and functionalities to accommodate more complex scenarios (such as real-time data capture and analysis).


Asunto(s)
Ecosistema , Malaria , Brasil/epidemiología , Bases de Datos Factuales , Técnicas de Apoyo para la Decisión , Humanos , Malaria/epidemiología
4.
Int J Epidemiol ; 51(5): 1502-1510, 2022 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-34849953

RESUMEN

BACKGROUND: In infancy, males are at higher risk of dying than females. Birthweight and gestational age are potential confounders or mediators but are also familial and correlated, posing epidemiological challenges that can be addressed by studying male-female twin pairs. METHODS: We studied 28 558 male-female twin pairs born in Brazil between 2012 and 2016, by linking their birth and death records. Using a co-twin control study matched for gestational age and familial factors, we applied logistic regression with random effects (to account for paired data) to study the association between male sex and infant death, adjusting for: birthweight, within- and between-pair effects of birthweight, birth order and gestational age, including interactions. The main outcome was infant mortality (0-365 days) stratified by neonatal (early and late) and postneonatal deaths. RESULTS: Males were 100 g heavier and more at risk of infant death than their female co-twins before [odds ratio (OR) = 1.28, 95% confidence interval (CI): 1.11-1.49, P = 0.001] and after (OR = 1.60, 95% CI: 1.39-1.83, P <0.001) adjusting for birthweight and birth order. When adjusting for birthweight within-pair difference and mean separately, the OR attenuated to 1.40 (95% CI: 1.21-1.61, P <0.001), with evidence of familial confounding (likelihood ratio test, P <0.001). We found evidence of interaction (P = 0.001) between male sex and gestational age for early neonatal death. CONCLUSIONS: After matching for gestational age and familial factors by design and controlling for birthweight and birth order, males remain at greater risk of infant death than their female co-twins. Birthweight's role as a confounder can be partially explained by familial factors.


Asunto(s)
Mortalidad Infantil , Caracteres Sexuales , Peso al Nacer , Brasil/epidemiología , Femenino , Edad Gestacional , Humanos , Lactante , Muerte del Lactante , Recién Nacido , Almacenamiento y Recuperación de la Información , Masculino , Factores de Riesgo
5.
Rev. baiana saúde pública ; 45(1, n.esp): 204-217, 01 jan. 2021.
Artículo en Portugués | LILACS | ID: biblio-1178386

RESUMEN

Na pandemia da Covid-19, a transparência dos dados e das informações em saúde são fundamentais para subsidiar o processo decisório na adoção de medidas de prevenção e controle, bem como estabelecer mecanismos de comunicação mais efetivos com a imprensa, organismos de controle e sociedade. Contudo, os registros dos casos de Covid-19 são derivados de três sistemas de informação do Ministério da Saúde (e-SUS Notifica, GAL e Sivep-Gripe), sem que haja interoperabilidade entre eles, o que favorece a duplicidade de dados e a inconsistência das informações. Diante desse problema, a Secretaria da Saúde do Estado da Bahia, por meio da Diretoria de Vigilância Epidemiológica, desenvolveu uma solução computacional própria. Nesse sentido, este trabalho objetiva descrever o processo de criação da metodologia aplicada para a geração de uma base única de dados voltada à emissão de informações mais qualificadas para subsidiar o processo decisório e a elaboração do Boletim Epidemiológico do estado da Bahia sobre a Covid-19. Trata-se de uma pesquisa processual, cujas soluções tecnológicas foram se desenvolvendo no decorrer das atividades, num movimento dinâmico e contínuo, na tentativa de resolver a falta de interoperabilidade entre os sistemas de informação envolvidos. A interconexão das bases de saúde propiciou a criação de soluções para operacionalização integrada, incluindo provas de conceito realizadas por meio de diferentes chaves de ligação, o que possibilitou mudanças incrementais nos processos de trabalho da vigilância epidemiológica. Conclui-se que a interconexão de dados possibilitou um processo mais ágil e eficiente para a análise dos dados e tomada de decisão por parte da gestão.


In the Covid-19 pandemic, transparency of health data and information is fundamental to support the decision-making process in the adoption of prevention and control measures and in the establishment of more effective communication mechanisms with the press, control bodies and society. However, Covid-19 case records are derived from three Ministry of Health information systems (e-SUS Notifica, GAL and SIVEP-Gripe), without interoperability, which favors data duplicity and information inconsistency. To face this problem, the Health Department of the State of Bahia, by the Epidemiological Surveillance Directorate, developed its own computational solution. In this sense, this study aims at describing the process of creating the methodology applied to generate a single database for issuing more qualified information to support the decision-making process and preparation of the State of Bahia Epidemiological Bulletin on Covid-19. It is a procedural research, whose technological solutions were developed during the activities, in a dynamic and continuous movement, in an attempt to resolve the lack of interoperability among the information systems involved. The interconnection of the health bases led to the creation of solutions for integrated operation, including proofs of concept performed using different connection keys, which enabled incremental changes in the epidemiological surveillance work processes. It is concluded that, the data interconnection enabled a more agile and efficient process for the analysis of the data and decision making by the management.


En la pandemia del covid-19, la transparencia de los datos e información de salud es fundamental para apoyar el proceso de toma de decisiones en la adopción de medidas de prevención y control, así como establecer mecanismos de comunicación más efectivos con la prensa, los órganos de control y la sociedad. Sin embargo, los registros de casos del covid-19 se derivan de tres sistemas de información del Ministerio de Salud (e-SUS Notifica, GAL y Sivep-Gripe), sin interoperabilidad entre ellos, lo que favorece la duplicidad e inconsistencia de datos. Ante este problema, la Secretaría de Salud del Estado de Bahía, por medio de la Dirección de Vigilancia Epidemiológica, desarrolló su propia solución computacional. Este trabajo tiene como objetivo describir el proceso de creación de la metodología aplicada para generar una base de datos única para emitir información más calificada para sustentar el proceso de toma de decisiones y elaboración del Boletín Epidemiológico del Estado de Bahía sobre Covid-19. Esta es una investigación procedimental, cuyas soluciones tecnológicas se desarrollaron durante las actividades, en un movimiento dinámico y continuo, en un intento por resolver la falta de interoperabilidad entre los sistemas de información involucrados. La interconexión de las bases de salud condujo a la creación de soluciones para la operación integrada, incluidas pruebas de concepto realizadas mediante diferentes claves de conexión, que permitieron cambios incrementales en los procesos de trabajo de vigilancia epidemiológica. Se concluye que la interconexión de datos permitió un proceso más ágil y eficiente para el análisis de los datos y la toma de decisiones por parte de la gerencia.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Monitoreo Epidemiológico , Análisis de Datos
6.
BMC Med Inform Decis Mak ; 20(1): 289, 2020 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-33167998

RESUMEN

BACKGROUND: Record linkage is the process of identifying and combining records about the same individual from two or more different datasets. While there are many open source and commercial data linkage tools, the volume and complexity of currently available datasets for linkage pose a huge challenge; hence, designing an efficient linkage tool with reasonable accuracy and scalability is required. METHODS: We developed CIDACS-RL (Centre for Data and Knowledge Integration for Health - Record Linkage), a novel iterative deterministic record linkage algorithm based on a combination of indexing search and scoring algorithms (provided by Apache Lucene). We described how the algorithm works and compared its performance with four open source linkage tools (AtyImo, Febrl, FRIL and RecLink) in terms of sensitivity and positive predictive value using gold standard dataset. We also evaluated its accuracy and scalability using a case-study and its scalability and execution time using a simulated cohort in serial (single core) and multi-core (eight core) computation settings. RESULTS: Overall, CIDACS-RL algorithm had a superior performance: positive predictive value (99.93% versus AtyImo 99.30%, RecLink 99.5%, Febrl 98.86%, and FRIL 96.17%) and sensitivity (99.87% versus AtyImo 98.91%, RecLink 73.75%, Febrl 90.58%, and FRIL 74.66%). In the case study, using a ROC curve to choose the most appropriate cut-off value (0.896), the obtained metrics were: sensitivity = 92.5% (95% CI 92.07-92.99), specificity = 93.5% (95% CI 93.08-93.8) and area under the curve (AUC) = 97% (95% CI 96.97-97.35). The multi-core computation was about four times faster (150 seconds) than the serial setting (550 seconds) when using a dataset of 20 million records. CONCLUSION: CIDACS-RL algorithm is an innovative linkage tool for huge datasets, with higher accuracy, improved scalability, and substantially shorter execution time compared to other existing linkage tools. In addition, CIDACS-RL can be deployed on standard computers without the need for high-speed processors and distributed infrastructures.


Asunto(s)
Conjuntos de Datos como Asunto , Almacenamiento y Recuperación de la Información , Registro Médico Coordinado , Algoritmos , Estudios de Cohortes , Humanos , Sistemas de Registros Médicos Computarizados
7.
Front Pharmacol ; 10: 984, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31607900

RESUMEN

Health technology assessment (HTA) is the systematic evaluation of the properties and impacts of health technologies and interventions. In this article, we presented a discussion of HTA and its evolution in Brazil, as well as a description of secondary data sources available in Brazil with potential applications to generate evidence for HTA and policy decisions. Furthermore, we highlighted record linkage, ongoing record linkage initiatives in Brazil, and the main linkage tools developed and/or used in Brazilian data. Finally, we discussed the challenges and opportunities of using secondary data for research in the Brazilian context. In conclusion, we emphasized the availability of high quality data and an open, modern attitude toward the use of data for research and policy. This is supported by a rigorous but enabling legal framework that will allow the conduct of large-scale observational studies to evaluate clinical, economical, and social impacts of health technologies and social policies.

8.
J Pediatr ; 202: 291-299.e1, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30029862

RESUMEN

OBJECTIVE: To examine the incidence and trend of child maltreatment and its associated health problems in Hong Kong by linking healthcare and social service databases. STUDY DESIGN: Data on 4816 children under the age of 18 years registered with the Child Protection Registry and matching health records in public hospitals in Hong Kong from 2003 to 2010 were extracted. Associations were examined between different types of child maltreatment and child's medical diagnosis according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes including suicidal attempt (X60-X84), nonchild maltreatment related injuries (S00-S99; T00-T98, excluding T74 and T76 that are maltreatment related injuries), mental health problems (F00-F99), and congenital malformations/chromosomal abnormalities (Q00-Q99). RESULTS: Significant rising trends were found for child physical abuse, neglect, and sexual abuse during the period from 2003 to 2010. Psychological abuse remained stable. Risk of suicide attempt was higher among children suffering from sexual abuse, psychological abuse, and children experiencing multiple abuses; mental health diagnoses were more common in victims of psychological and multiple abuses. Congenital malformations and chromosomal abnormalities were more commonly found among neglected children. CONCLUSIONS: In contrast to the decreasing trend observed in the West during the study period, there has been an escalating trend in child maltreatment in Hong Kong and child maltreatment is strongly associated with major health problems. This is one of the first studies to demonstrate the power of linking healthcare and social service databases, which allows for both a better understanding of the impact of child maltreatment and as a guide future policy and service planning.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Salud Infantil/estadística & datos numéricos , Trastornos Mentales/epidemiología , Servicio Social/estadística & datos numéricos , Heridas y Lesiones/epidemiología , Adolescente , Distribución por Edad , Niño , Maltrato a los Niños/psicología , Preescolar , Estudios de Cohortes , Bases de Datos Factuales , Femenino , Hong Kong/epidemiología , Humanos , Masculino , Trastornos Mentales/diagnóstico , Evaluación de Necesidades , Prevalencia , Estudios Retrospectivos , Distribución por Sexo , Estrés Psicológico/epidemiología , Intento de Suicidio/estadística & datos numéricos , Heridas y Lesiones/fisiopatología
9.
Int J Popul Data Sci ; 3(1): 446, 2018 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-34095519

RESUMEN

INTRODUCTION: In Brazil, the National Health System (SUS) provides healthcare to the public. The system has multiple administrative databases; the major databases record hospital (SIH) and outpatient (SIA) procedures. Epidemiological information is collected for all populations in subsystems, such as mortality (SIM), live births (SINASC) and diseases of compulsory declaration (SINAN). Each subsystem has its own information system, which is able to provide information about consultations, clinical information and medicines dispensed. However, these systems are not linked, thereby preventing individual-centred analysis. OBJECTIVE: To describe the methods and results of parameter setting that are needed to execute the probabilistic deduplication of large administrative and epidemiological databases in Brazil and to create a National Health Database Centred on the individual. METHODS: This paper shows the results of a record linkage model to integrate data from SIH, SIA, SIM, and SINAN, which have different formats and attributes between them and over time. These data consist of 1.3 billion records from 2000-2015. Probabilistic and deterministic record linkages were used to deduplicate these data. The Kappa statistic and clerical review were used to ensure the quality of the linkage. The graph algorithm and depth-first search were used to generate the identifiers. RESULTS: The deterministic deduplication process resulted in a database with 403,113,527 possible unique individuals. After the probabilistic deduplication process of the former database was performed, 159,703,805 unique individuals were identified. This result had an estimated a false positive error rate of 3.3%, and the false negative error was estimated at 12.3%. CONCLUSIONS: The National Health Database centred on the individual was generated and will allow researchers to use real-world evidence to conduct clinical, epidemiological, economic and other studies. This database represents a significant cohort, spanning 15 years of historical data and preserving patient privacy. The success of the process described will allow repeating and appending the data for future years and enable important studies to promote SUS efficiency and provide better treatments for patients.

10.
BMC Med Inform Decis Mak ; 17(1): 108, 2017 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-28716074

RESUMEN

BACKGROUND: Due to the increasing availability of individual-level information across different electronic datasets, record linkage has become an efficient and important research tool. High quality linkage is essential for producing robust results. The objective of this study was to describe the process of preparing and linking national Brazilian datasets, and to compare the accuracy of different linkage methods for assessing the risk of stillbirth due to dengue in pregnancy. METHODS: We linked mothers and stillbirths in two routinely collected datasets from Brazil for 2009-2010: for dengue in pregnancy, notifications of infectious diseases (SINAN); for stillbirths, mortality (SIM). Since there was no unique identifier, we used probabilistic linkage based on maternal name, age and municipality. We compared two probabilistic approaches, each with two thresholds: 1) a bespoke linkage algorithm; 2) a standard linkage software widely used in Brazil (ReclinkIII), and used manual review to identify further links. Sensitivity and positive predictive value (PPV) were estimated using a subset of gold-standard data created through manual review. We examined the characteristics of false-matches and missed-matches to identify any sources of bias. RESULTS: From records of 678,999 dengue cases and 62,373 stillbirths, the gold-standard linkage identified 191 cases. The bespoke linkage algorithm with a conservative threshold produced 131 links, with sensitivity = 64.4% (68 missed-matches) and PPV = 92.5% (8 false-matches). Manual review of uncertain links identified an additional 37 links, increasing sensitivity to 83.7%. The bespoke algorithm with a relaxed threshold identified 132 true matches (sensitivity = 69.1%), but introduced 61 false-matches (PPV = 68.4%). ReclinkIII produced lower sensitivity and PPV than the bespoke linkage algorithm. Linkage error was not associated with any recorded study variables. CONCLUSION: Despite a lack of unique identifiers for linking mothers and stillbirths, we demonstrate a high standard of linkage of large routine databases from a middle income country. Probabilistic linkage and manual review were essential for accurately identifying cases for a case-control study, but this approach may not be feasible for larger databases or for linkage of more common outcomes.


Asunto(s)
Dengue , Registros Electrónicos de Salud , Registro Médico Coordinado , Complicaciones Infecciosas del Embarazo , Mortinato , Brasil/epidemiología , Dengue/epidemiología , Registros Electrónicos de Salud/normas , Femenino , Humanos , Registro Médico Coordinado/normas , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Riesgo , Mortinato/epidemiología
11.
Vaccine ; 35(16): 2025-2033, 2017 04 11.
Artículo en Inglés | MEDLINE | ID: mdl-28318769

RESUMEN

BACKGROUND: Routine infant immunization with meningococcal C conjugate (MCC) vaccination started in Brazil in November 2010, scheduled at three and five months plus a booster at 12-15months of age. No catch-up was implemented. We assessed the impact of vaccination on meningococcal C disease (MenC) four years after vaccination start in the National Immunization Program. METHODS: We performed an ecological quasi-experimental design from 2008 to 2014 using a deterministic linkage between the National Notification and the National Reference Laboratory databases for meningitis. We conducted an interrupted time-series analysis considering Brazil except for Salvador municipality, because an epidemic of serogroup C disease occurred in this city, which prompted a mass vaccination campaign with catch-up for adolescents in 2010. Observed MenC rates in the post-vaccination period were compared to expected rates calculated from the pre-vaccination years. Results for Salvador were presented as descriptive data. An additional time-series analysis was performed for the state of São Paulo. RESULTS: A total of 18,136 MenC cases were analyzed. The highest incidence rates were observed for infants aged <12months and no second incident peak was observed for adolescents. For Brazil, MenC rates were reduced by 67.2% (95%CI 43.0-91.4%) for infants <12months of age, 92.0% (77.3-106.8%) for the age-group 12-23months, and 64.6% (24.6-104.5%) for children aged 2-4years. For children 5-9years old, MenC rates reduced 19.2% (9.5-28.9%). Overall, 955 MenC cases were averted in Brazil in individuals aged <40years after MCC vaccination. Results from São Paulo State, mirror the patterns seen in Brazil. CONCLUSION: After four years of infants and toddlers vaccination start, MenC invasive disease reduced in the target population. This investigation provide a robust baseline to ascertain how much the upcoming catch-up dose in 12-13years of age will accelerate the decrease in MenC incidence rates among youths in Brazil.


Asunto(s)
Meningitis Meningocócica/epidemiología , Meningitis Meningocócica/prevención & control , Vacunas Meningococicas/administración & dosificación , Vacunas Meningococicas/inmunología , Neisseria meningitidis Serogrupo C/inmunología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Masculino , Persona de Mediana Edad , Neisseria meningitidis Serogrupo C/aislamiento & purificación , Ensayos Clínicos Controlados no Aleatorios como Asunto , Adulto Joven
12.
Hum Vaccin Immunother ; 12(2): 285-92, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26905679

RESUMEN

Routine infant immunization with 10-valent pneumococcal conjugate vaccine (PCV-10) began in Brazil in 2010. The impact of the PCV-10 on rates of invasive pneumococcal disease (IPD) at the population level was not yet evaluated. Serotype-specific IPD changes after PCV-10 introduction is still to be determined. Data from national surveillance system for notifiable diseases (SINAN) and national reference laboratory for S. pneumoniae in Brazil (IAL) were linked to enhance case ascertainment of IPD. An interrupted time-series analysis was conducted to predict trends in the postvaccination IPD rates in the absence of PCV-10 vaccination, taking into consideration seasonality and secular trends. PCVs serotype-specific distribution were assessed before (2008-2009) and after (2011-2013) the introduction of PCV-10 in the immunization program. A total of 9,827 IPD cases were identified from 2008-2013 when combining SINAN and IAL databases. Overall, PCV-10 types decreased by 41.3% after PCV-10 vaccination period, mostly in children aged 2-23 months, while additional PCV-13 serotypes increased by 62.8% mainly in children under 5-year of age. For children aged 2-23 months, targeted by the immunization program, we observed a 44.2% (95%CI, 15.8-72.5%) reduction in IPD rates. In contrast, significant increase in IPD rates were observed for adults aged 18-39 y (18.9%, 95%CI 1.1-36.7%), 40-64 y (52.5%, 95%CI 24.8-80.3%), and elderly ≥ 65 y (79.3%, 95%CI 62.1-96.5%). This is the first report of a time-series analysis for PCV impact in IPD conducted at national level data in a developing country. We were able to show significant impact of PCV-10 on IPD for age groups targeted by vaccination in Brazil, 3 y after its introduction. No impact on other age groups was demonstrated.


Asunto(s)
Programas de Inmunización , Síndromes de Inmunodeficiencia/epidemiología , Meningitis Neumocócica/epidemiología , Infecciones Neumocócicas/epidemiología , Vacunas Neumococicas/inmunología , Vacunas Conjugadas/inmunología , Adolescente , Adulto , Brasil/epidemiología , Niño , Preescolar , Humanos , Síndromes de Inmunodeficiencia/microbiología , Síndromes de Inmunodeficiencia/prevención & control , Lactante , Quinasas Asociadas a Receptores de Interleucina-1 , Meningitis Neumocócica/microbiología , Meningitis Neumocócica/prevención & control , Persona de Mediana Edad , Infecciones Neumocócicas/microbiología , Infecciones Neumocócicas/prevención & control , Enfermedades de Inmunodeficiencia Primaria , Serogrupo , Streptococcus pneumoniae/inmunología , Vacunación , Adulto Joven
13.
Inf. epidemiol. SUS ; 9(1): 51-58, jan.-mar. 2000. tab
Artículo en Portugués | LILACS, Sec. Est. Saúde SP | ID: lil-278050

RESUMEN

Nesta nota técnica apresenta-se um método para a criação de banco de dados gerado dos arquivos do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS), colocados à disposição em CD-ROM pelo Ministério da Saúde. O banco de dados resultante deste processo contém dados que estão dispersos em vários arquivos com estrutura e objetivos diversos. Neste exemplo específico utilizaram-se os seguintes arquivos mensais: Movimento de AIH (MA); Movimento de Prestadores (MT) e Procedimentos Autorizados (PA)


Presented in this technical report is a method to develop a database originating from files of the Ministry of Health Hospital Admission Information System (SIH-SUS - Sistema de Informações Hospitalares do Sistema Único de Saúde), which are available to the public on CD-ROM. This database contains data from different files, each with a different structure and objective. In this example, three files were utilized on a monthly basis: Hospital Admission Authorizations( AIH -MA); information of health services covenant to SUS (MT) and Authorized Proceedures (PA)


Asunto(s)
Sistema Único de Salud , Bases de Datos Factuales , Hospitales Públicos , Sistemas de Registros Médicos Computarizados , Sistemas de Información en Hospital , Brasil , CD-ROM
14.
Estud Migr Latinoam ; 11(33): 249-68, 1996 Aug.
Artículo en Español | MEDLINE | ID: mdl-12348148

RESUMEN

PIP: "The author discusses the fruitful use of nominal lists for a gendered analysis of international migration. [U.S.] studies carried out in the 1970s and 1980s produced interesting information as to female work for wages outside the home, but found the census a flawed source for work done by women within their homes. Combination with other nominal sources [has revealed] the role played by women in the organization and maintenance of kin and neighborhood networks. The approach to the Italian diaspora abroad requires the linkage of different nominal sources at origin and in the different places of destination." (EXCERPT)^ieng


Asunto(s)
Recolección de Datos , Emigración e Inmigración , Empleo , Composición Familiar , Proyectos de Investigación , Características de la Residencia , Derechos de la Mujer , Américas , Demografía , Países Desarrollados , Economía , Europa (Continente) , Geografía , Italia , América del Norte , Población , Dinámica Poblacional , Investigación , Factores Socioeconómicos , Estadística como Asunto , Estados Unidos
15.
Estud Migr Latinoam ; 11(33): 269-85, 1996 Aug.
Artículo en Español | MEDLINE | ID: mdl-12348149

RESUMEN

PIP: "[Based] on research on emigration from Agnone, Italy, to the United States and Argentina, the author analyzes the possibilities of linking different sources available at the countries of origin and destination, classified in three main groups: sources at origin, sources at destination and sources linking origin with destination. The members of an Agnone community in Pueblo, Colorado, are traced by using Agnone Census and Family Files, Agnone Passport Records, U.S. Census, Ships Passenger Lists and Naturalization Records, as well as interviews with members of the community." (EXCERPT)^ieng


Asunto(s)
Recolección de Datos , Emigración e Inmigración , Américas , Argentina , Demografía , Países Desarrollados , Países en Desarrollo , Europa (Continente) , Italia , América Latina , América del Norte , Población , Dinámica Poblacional , Investigación , América del Sur , Estados Unidos
16.
Soc Biol ; 38(3-4): 233-41, 1991.
Artículo en Inglés | MEDLINE | ID: mdl-1801203

RESUMEN

Published infant mortality rates (IMR's) for Mexican-American populations frequently are lower than expected given the socioeconomic status (SES) of these populations. It has been speculated that this is due to bias or incompleteness in Mexican-American vital statistics. In this paper an extensive genealogical data base constructed from Catholic church records and civil records for the border city of Laredo, Texas is used to study this problem. The infant mortality probabilities (IMP's) since 1950 are compared to conventional IMR's, both based strictly on the population at risk defined by baptisms, in which the deaths are a proper subset of the denominator, and these are compared with IMR's calculated in the usual way from aggregate civil records of births and infant deaths for Laredo. We find that when these data are used, the IMR's for the most recent years are about twice the conventional rates computed from registered vital statistics.


PIP: Infant mortality rate (IMR) and infant mortality probability (IMP) were computed for the border city Loredo, Texas, from an extensive set of genealogies generated from baptismal and marriage records of 12 Catholic parishes from 1850-1977, Loredo death records since the beginning of registration through 1988, and hospital morbidity records from 1910-1980. Data were linked by a computer algorithm and verified manually. 254,000 individuals and 83,000 nuclear families were included. IMRs for Mexican American groups are often much lower than expected for their socioeconomic status. Loredo IMRs until 1940 were much too high, ranging from 173 to 465, because of unreported birth sin private dwellings. Later there were more registered births than baptisms, because Mexican nationals giving birth in Loredo in hopes of getting a U.S. Birth certificate. The 1970 IMR was a 42% underestimate, the 1977 IMR a 54% underestimate. IMPs computed from baptism closely resembled those for U.S. non-whites after 1950. This study shows that currently computed IMRs for border Mexican-American populations may be about 50% of the true risks.


Asunto(s)
Mortalidad Infantil , Sesgo , Estudios de Cohortes , Hispánicos o Latinos , Humanos , Recién Nacido , Reproducibilidad de los Resultados , Factores Socioeconómicos , Texas , Estadísticas Vitales
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