Information system on tuberculosis: data completeness spatial analysis in the state of Paraná, Brazil

Silva, Marcelle Saldanha da; Arcoverde, Marcos Augusto Moraes; Andrade, Rubia Laine de Paula; Zilly, Adriana; Villa, Tereza Cristina Scatena; Silva-Sobrinho, Reinaldo Antonio

doi:10.1590/1980-220X-REEUSP-2020-0538

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Revista da Escola de Enfermagem da USP

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 55 • 2021 • https://doi.org/10.1590/1980-220X-REEUSP-2020-0538 copy

Information system on tuberculosis: data completeness spatial analysis in the state of Paraná, Brazil

Sistema de información sobre tuberculosis: análisis espacial de la completitud de los datos en el estado de Paraná, Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the spatiality of completeness of the Information System on Diseases of Compulsory Declaration of tuberculosis in Paraná state, focusing on the border region.

Method:

A study composed by the notified cases of the disease treated in Paraná between 2008 and 2017. The variable completeness was classified as excellent (<5% of incompleteness), good (5 to <10%), regular (10 to <20%), poor (20% to 50%), and very poor (>50%). Moran global was used for the spatial correlation and local association was analyzed. Logistic regression was employed to assess the spatial association of the variables with the border and, for the significant variables, multiple logistic regression was used. The study abides by the resolution 510/2016 of the National Health Council.

Results:

There was a “high-high” correlation for education level, 2- and 6-month sputum smear in the Eastern health macroregional and “high-high” correlation in the Northwestern macroregional for 2-month sputum smear and antibiotic sensitivity testing. There was no spatial association with the border.

Conclusion:

Unsatisfactory completeness was identified in the database and conglomerates, indicating spatial association of incompleteness of some variables, but with no relation with the border. There was no worsening of completeness nor of the case outcomes related to these regions.

DESCRIPTORS
Tuberculosis; Health Information Systems; Public Health Surveillance; Disease Notification; Border Areas; Public Health Nursing

Variable	Excellent	Good	Regular	Poor	VP^* VP: Very poor; WR: Without record; AST: Antibiotic Sensitivity Testing; **DOTS: directly observed treatment, short-course.	WR^** VP: Very poor; WR: Without record; AST: Antibiotic Sensitivity Testing; **DOTS: directly observed treatment, short-course.	Total	p value
Sociodemographic and behavioral
Residency zone	85.46	7.77	4.26	1.75	0.50	0.25	100	<0.001
Education level	20.55	9.27	25.56	38.60	5.76	0.25	100	<0.001
Race/skin color	91.73	4.26	3.26	0.50	0.00	0.25	100	<0.001
Receiving government support	57.14	5.01	7.02	3.51	3.51	13.78	100	<0.001
Immigrants	75.82	2.02	2.77	4.53	1.01	13.85	100	<0.001
People living on the streets	75.94	1.75	2.51	4.76	1.25	13.78	100	<0.001
People deprived of freedom	75.44	2.51	2.76	4.76	0.75	13.78	100	<0.001
Alcoholism	81.20	10.53	5.76	1.75	0.50	0.25	100	<0.001
Smoking	3.77	0.75	1.00	17.29	76.94	0.25	100	<0.001
Illicit drugs	4.51	0.00	1.00	16.79	77.44	0.25	100	<0.001
Clinical
Aids	64.41	14.79	11.03	9.02	0.50	0.25	100	<0.001
Diabetes	81.20	10.53	5.01	2.26	0.75	0.25	100	<0.001
Mental disease	82.71	8.27	5.51	2.51	0.75	0.25	100	<0.001
Other comorbidities	56.89	14.04	16.79	10.28	1.75	0.25	100	<0.001
Pregnancy	97.49	0.75	0.75	0.75	0.00	0.25	100	<0.001
2-month sputum smear	31.08	15.29	22.06	25.81	5.51	0.25	100	<0.001
6-month sputum smear	20.55	8.02	22.81	41.60	6.77	0.25	100	<0.001
Thorax x-ray	93.73	4.26	1.25	0.50	0.00	0.25	100	<0.001
AST^*** VP: Very poor; WR: Without record; AST: Antibiotic Sensitivity Testing; **DOTS: directly observed treatment, short-course.	7.52	0.00	0.75	18.80	59.15	13.78	100	<0.001
DOTS performed^**** VP: Very poor; WR: Without record; AST: Antibiotic Sensitivity Testing; **DOTS: directly observed treatment, short-course.	80.20	8.02	5.26	6.02	0.25	0.25	100	<0.001
Closing situation	88.72	4.01	3.51	3.26	0.25	0.25	100	<0.001

Variables		OR (95% CI)
Proportion of incompleteness of sociodemographic and behavioral variables	Residency zone	1.01 (0.99–1.06)
	Education level	1.00 (0.99–1.01)
	Race/skin color	1.03 (0.97–1.13)
	Receiving government support	1.00 (0.99–1.01)
	Immigrants	0.99 (0.97–1.01)
	People living on the streets	0.99 (0.98–1.01)
	People deprived of freedom	0.99 (0.97–1.01)
	Alcoholism	1.06 (1.01–1.13)^* OR: Odds ratio; CI 95% Confidence interval 95%; DOTS: directly observed treatment, short-course; AST: Antibiotic Sensitivity Testing; NA: no possibility of statistical calculation. *Variables which presented significant confidence interval.
	Smoking	1.01 (0.99–1.01)
	Illicit drugs	1.01 (1.00–1.02)^* OR: Odds ratio; CI 95% Confidence interval 95%; DOTS: directly observed treatment, short-course; AST: Antibiotic Sensitivity Testing; NA: no possibility of statistical calculation. *Variables which presented significant confidence interval.
Proportion of incompleteness of clinical variables	Aids	1.02 (1.00–1.05)^* OR: Odds ratio; CI 95% Confidence interval 95%; DOTS: directly observed treatment, short-course; AST: Antibiotic Sensitivity Testing; NA: no possibility of statistical calculation. *Variables which presented significant confidence interval.
	Diabetes	1.06 (1.02–1.12)^* OR: Odds ratio; CI 95% Confidence interval 95%; DOTS: directly observed treatment, short-course; AST: Antibiotic Sensitivity Testing; NA: no possibility of statistical calculation. *Variables which presented significant confidence interval.
	Mental disease	1.06 (1.01–1.12)^* OR: Odds ratio; CI 95% Confidence interval 95%; DOTS: directly observed treatment, short-course; AST: Antibiotic Sensitivity Testing; NA: no possibility of statistical calculation. *Variables which presented significant confidence interval.
	Other comorbidities	1.02 (1.00–1.03)^* OR: Odds ratio; CI 95% Confidence interval 95%; DOTS: directly observed treatment, short-course; AST: Antibiotic Sensitivity Testing; NA: no possibility of statistical calculation. *Variables which presented significant confidence interval.
	Pregnant	0.96 (0.88–1.03)
	2-month sputum smear	0.99 (0.98–1.01)
	6-month sputum smear	0.99 (0.98–1.00)
	Thorax x-ray	1.03 (0.97–1.13)
	AST	1.00 (0.99–1.01)
	DOTS performed	1.00 (0.98–1.03)
	Closing situation	1.00 (0.98–1.04)
Cases outcomes	Cure	0.99 (0.98–1.00)
	Primary abandonment	0.86 (0.46–1.46)
	Secondary abandonment	1.01 (0.98–1.04)
	Death due to TB	1.01 (0.99–1.04)
	Death due to other causes	1.01 (0.99–1.03)
	Scheme change	1.01 (0.88–1.20)
	Treatment failure	1.89 (NA)

Variables		OR (CI 95%)
Variables which presented a significant confidence interval for logistic regression	AIDS	1.01 (0.98–1.04)
	Alcoholism	1.03 (0.94–1.11)
	Diabetes	1.02 (0.97–1.12)
	Mental disease	1.01 (0.96–1.11)
	Illicit drugs	1.00 (0.99–1.01)
	Other comorbidities	1.00 (0.99–1.02)

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Marcelle Saldanha da Silva, Av. Araucária, 5629, Bloco 18, Apto. 101 Residencial Pilar Parque Campestre, 85862-012 – Foz do Iguaçu, PR, Brazil, saldanha.enf@hotmail.com