Evaluation of the Tuberculosis Surveillance System in Manaus, Amazonas, Brazil, 2005-2007

Introduction. Tuberculosis (TB) is a chronic infectious disease and Manaus reports the 4th highest incidence among Brazilian capitals. Objective. Evaluate the surveillance system for TB of Manaus (SVTB) between 2005-2007. Method. We used the CDC Guidelines for Surveillance System Evaluation to describe the system and evaluate its attributes and utility. The analysis used the Notifiable Diseases Information System (SINAN), Mortality Information System and Respiratory Symptoms Registry (LSR) of 78 health units (HU), and a questionnaire applied to SVTB managers and staff in 71 HU. Results. The SVTB aims to identify barriers to treatment and cure and reduce abandonment. It registers laboratory-confirmed cases; 4,485 new cases were recorded during the study period. Data analysis is centralized at the City Health Department; non-standard laboratory flow makes SVTB complex. For data quality, most variables showed consistency and completeness of >90%. For acceptability, 88% of cases were detected by secondary or tertiary level treatment facilities and 94% did not use the LSR correctly. SVTB sensitivity for deceased cases was 58%. The inclusion of new cases in <7 days and 180-210 days to closure was appropriate (>90%) but 12% of cases did not start treatment in timely fashion (<2 days). For stability, we found 5% variability between the notification of SINAN by city vs. state. The SVTB can potentially identify / quantify barriers to treatment of risk groups, but in 65% of cases, comorbidities were missing. Conclusion. The SVTB is stable and has good data quality. Standardizing laboratory flow and training HU staff may strengthen acceptability, sensitivity, timeliness, usefulness and minimize complexity. Keywords: Epidemiology, Surveillance, Systems Evaluation, TB For more information, email the presenter at: amanda.cabral@saude.gov.br

Year: 
2009
Author (s): 

Amanda Priscila de Santana Cabral*, Gisele Oliveira**, Stefano Codenotti**, Jair dos Santos Pinheiro***, Agla?r Alves da N_brega*. *Brazilian Field Epidemiology Training Program (Episus)/ Center for Strategic Information and Response in Health Surveil

Presenter (s): 
Ms. Amanda Cabral
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