Evaluación de la completitud y oportunidad de datos en el Sistema de Información sobre Enfermedades de Notificación Obligatoria (Sinan) por fiebre manchada en el estado de São Paulo, Brasil, 2007-2017

Xavier, Daniele Rosa; Albuquerque, Michellin Pereira de; Sousa-Carmo, Sílvia Von Tiesenhausen de; Pinter, Adriano

Daniele Rosa Xavier

concept and design

data analysis and interpretation

drafting and approving

approved and integrity

Universidade de São Paulo, Programa de Pós-Graduação em Saúde Pública, São Paulo, SP, Brazil

http://orcid.org/0000-0003-0398-7667

Michellin Pereira de Albuquerque

data analysis and interpretation

approved and integrity

Universidade de São Paulo, Programa de Pós-Graduação em Saúde Pública, São Paulo, SP, Brazil

http://orcid.org/0000-0003-1676-0488

Sílvia Von Tiesenhausen de Sousa-Carmo

data analysis and interpretation

reviewing

approved and integrity

Secretaria de Estado da Saúde, Centro de Informações de Vigilância Epidemiológica, São Paulo, SP, Brazil

http://orcid.org/0000-0002-0334-6926

Adriano Pinter

concept and design

data analysis and interpretation

drafting and approving

approved and integrity

Superintendência de Controle de Endemias, São Paulo, SP, Brazil

http://orcid.org/0000-0003-4596-3268

Correspondence
: Daniele Rosa Xavier.
E-mail
:danni_vet@alumni.usp.br

AUTHOR CONTRIBUTIONS

Xavier DR and Pinter A contributed to the study concept and design, data analysis and interpretation, drafting and approving the final version of the article. Albuquerque MP contributed to data analysis and interpretation. Sousa-Carmo SVT contributed to data analysis and interpretation and with relevant critical reviewing of the intellectual content of the manuscript and approving the final version of the article. All the authors have approved the final version of the article and are responsible for all aspects thereof, including the guarantee of its accuracy and integrity.

CONFLICTS OF INTEREST

The authors declare that they have no conflicts of interest.

Figuras (3)
Tablas (3)

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Figure 1
- Distribution of the time lapses (in days) of the timeliness parameters of confirmed spotted fever cases by year of notification, São Paulo State, 2007-2017

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Figure 2
Percentage timeliness of notification in relation to onset of first symptoms, data input, investigation, closure and serological sample collection, São Paulo State, 2007-2017

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Figure 3
Evaluation of percentage timeliness per Epidemiological Surveillance Group for the “A - Notification”, “B - Data input”, “C - Investigation”, and “D - Closure” variables of the spotted fever investigation forms, São Paulo State, 2007-2017

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Study contributions Main results In São Paulo state the majority of the spotted fever variables had good completeness; closure and investigation had good timeliness; and laboratory investigation timeliness was inadequate. Implications for services The study can contribute to better resource allocation in areas such as surveillance, health worker training, as well as adoption of regionalized health policies. Perspectives The situation analyses provide more information for public health authorities, including for the re-evaluation of activities commonly considered bureaucratic, with subsequent reflection in health indicators.

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Table 1
Statistical description of the time lapses (in days) of the timeliness analyses of confirmed spotted fever cases by year of notification, São Paulo State, 2007-2017

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Table 2
Time trend analysis of completeness and timeliness of 12 fields of the spotted fever investigation form, São Paulo State, 2007-2017

Year	Notification-Symptoms		Notification-Serology		Data input		Investigation		Closure		1^st serological sample collection (hospitalized cases)		1^st serological sample collection (non-hospitalized cases)		2^nd serological sample collection
Year	Mean ± sd	Median (Min-Max)	Mean ± sd	Median (Min-Max)	Mean ± sd	Median (Min-Max)	Mean ± sd	Median (Min-Max)	Mean ± sd	Median (Min-Max)	Mean ± sd	Median (Min-Max)	Mean ± sd	Median (Min-Max)	Mean ± sd	Median (Min-Max)
2007	9.9 ± 10.5	7 (0;49)	1.2 ± 3.6	0 (0;16)	28.7 ± 54.9	6 (0;245)	0.6 ± 2.3	0 (0;11)	9.9 ± 10.5	42.5 (11;238)	1.2 ± 3.6	7 (0;18)	28.7 ± 54.9	7 (0;18)	0.6 ± 2.3	19.5 (0;18)
2008	9.2 ± 10.4	7 (1;63)	1.8 ± 4.3	0 (0;18)	22.7 ± 28.1	9.5 (0;119)	9.8 ± 55.4	0 (0;363)	9.2 ± 10.4	49.5 (0;228)	1.8 ± 4.3	6 (0;22)	22.7 ± 28.1	3 (0;22)	9.8 ± 55.4	15 (0;22)
2009	12.0 ± 25.4	6 (0;164)	7.9 ± 29.7	0 (0;157)	67.2±101	9 (0;353)	0.1±0.4	0 (0; 2)	12.0 ± 25.4	47 (0;224)	7.9 ± 29.7	5,5 (1;23)	67.2 ± 101	5 (1;23)	0.1 ± 0.4	16 (1;23)
2010	9.9 ± 16.4	6 (0;89)	5.0 ± 14.3	0 (0;78)	61.9 ± 80.5	35 (0;348)	0.0 ± 0.3	0 (0;2)	9.9 ± 16.4	41 (0;275)	5.0 ± 14.3	5 (1;37)	61.9 ± 80.5	6 (1;37)	0.0 ± 0.3	15 (1;37)
2011	9.9 ± 42.6	6 (1;362)	9.3 ± 52.6	0 (0;354)	14.7 ± 21.9	6 (0;98)	0.3 ± 2.1	0 (0;18)	9.9 ± 42.6	27 (0;152)	9.3 ± 52.6	5 (1;29)	14.7 ± 21.9	6 (1;29)	0.3 ± 2.1	15 (1;29)
2012	9.9 ± 12.2	5 (0;86)	2.2 ± 5.5	0 (0;24)	13.7 ± 29.6	3 (0;144)	0.5 ± 3.6	0 (0;32)	9.9 ± 12.2	24.5 (0;274)	2.2 ± 5.5	5 (0;37)	13.7±29.6	14 (0;37)	0.5 ± 3.6	16 (0;37)
2013	9.9 ± 5.7	5 (0;31)	2.0 ± 4.8	0 (0;27)	17.0 ± 40.9	6 (0;294)	1.5 ± 8.0	0 (0;58)	9.9 ± 5.7	31 (0;293)	2.0 ± 4.8	5 (1;24)	17.0 ± 40.9	4 (1;24)	1.5 ± 8.0	15 (1;24)
2014	9.9 ± 8.9	6 (0;57)	1.9 ± 4.4	0 (0;22)	14.5 ± 33.7	4 (0;278)	0.0 ± 0.3	0 (0;3)	9.9 ± 8.9	22.5 (0;142)	1.9 ± 4.4	5 (1;50)	14.5 ± 33.7	4 (1;50)	0.0 ± 0.3	15 (1;50)
2015	9.9 ± 5.8	6 (0;42)	11.5 ± 75.1	0 (0;577)	12.5 ± 20.9	5 (0;111)	0.8 ± 4.5	0 (0;39)	9.9 ± 5.8	33 (0;262)	11.5 ± 75.1	5 (0;26)	12.5 ± 20.9	4 (0;26)	0.8 ± 4.5	17 (0;26)
2016	9.9 ± 5.7	6 (0;42)	1.5 ± 5.9	0 (0;37)	12.3 ± 16.6	6 (0;80)	0.0 ± 0.2	0 (0;2)	9.9 ± 5.7	34 (1;83)	1.5 ± 5.9	6 (1;18)	12.3 ± 16.6	4 (1;18)	0.0 ± 0.2	16 (1;18)
2017	9.9 ± 13.6	5 (0;108)	1.2 ± 3.7	0 (0;22)	24.8 ± 40.6	12 (0;256)	0.3 ± 2.6	0 (0;22)	9.9 ± 13.6	37 (0;256)	1.2 ± 3.7	5 (1;15)	24.8 ± 40.6	5 (1;15)	0.3 ± 2.6	17 (1;15)

Study variables	APC^a	95%CI^b	p-value	Trend
Completeness
Date of hospital admission	0.07	-1.02;1.17	0.903	Stable
Date of discharge	5.59	1.19;10.19	0.034	Rising
Date of 1^st serological sample	0.04	-1.02;1.11	0.947	Stable
Date of 2^nd serological sample	5.35	3.37;7.36	< 0.001	Rising
Timeliness
From first symptoms up until notification	3.07	0.17;6.05	0.767	Stable
From notification to 1^st serological sample	-1.22	-8.71;6.88	0.067	Stable
From notification to data input	2.43	-3.65;8.90	0.461	Stable
From notification to investigation	0.80	-0.30;1.90	0.189	Stable
From notification to closure	4.84	2.46;7.28	0.003	Rising
From first symptoms to 1^st serological sample - hospitalized cases	3.47	-2.67;10.00	0.302	Stable
From first symptoms to 1^st serological sample - non-hospitalized cases	2.91	-0.63;6.58	0.143	Stable
From 1^st serological sample to 2^nd serological sample	1.51	-2.62;5.81	0.498	Stable

[1] Correspondence
: Daniele Rosa Xavier.
E-mail
:danni_vet@alumni.usp.br

Brasil

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Evaluación de la completitud y oportunidad de datos en el Sistema de Información sobre Enfermedades de Notificación Obligatoria (Sinan) por fiebre manchada en el estado de São Paulo, Brasil, 2007-2017

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