Completitude do sistema de informação sobre tuberculose no Município de Parnamirim/RN

Abstract

Introduction: The Primary Health Care services are the gateway to a possible suspected case of tuberculosis and after confirmation, the case notification must be carried out and inserted in the Information System for Notifiable Diseases for tuberculosis. Objective: This study aimed to evaluate the completeness and incompleteness of the tuberculosis data in the Notifiable Diseases Information System in the municipality of Parnamirim / RN in the period from 2009 to 2019. Method: This is a descriptive, retrospective study of historical series based on secondary data. The population was composed by the database of the Information System of Notifiable Diseases, with information from the notification forms for tuberculosis in the municipality of Parnamirim / RN, totaling 891 cases. Data collection took place in the second half of 2020. The selected variables are represented by the sociodemographic, clinical, laboratory variables and the outcome of the case. The database was analyzed in Excel format, version 2017, for the realization of descriptive tables and graphs. For the application of statistical tests, the free statistical software R, version 3.6.1, was used. In the qualitative variables, a descriptive analysis was carried out by means of distributions of absolute and relative frequencies (%). In the comparison of completeness with the time under study, the Spearman’s non-parametric statistical test was applied with a significance level of 5%. After the conclusion of the descriptive analysis, the evaluation of variables was started according to the completeness criterion. The completeness analysis was based on the classification of the Notifiable Diseases Information System for qualitative assessment, establishing the following division: category 1 (bad), when there is 0 to 25% of completeness; category 2 (regular), between 25.1% and 50%; category 3 (good), between 50.1% and 75%, and category 4 (excellent), for completeness between 75.1% and 100%. The study followed the ethical precepts in research with human beings described in Resolution 466/2012 of the National Health Council. Approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, through the report 4,009,967 and Certificate of Presentation for Ethical Consideration 30793920.1.0000.5537. Results: 891 cases were analyzed in the period from 2009 to 2019. It was found that the predominance of reported cases was male (70.93%); between 20 to 29 years (31.09%); as for the level of education, (25.34%) had between the 1st to the 4th grade incomplete elementary school. The situation of the user entering the Health Unit, a new case predominated with (78.56%); clinical form was pulmonary (86.76%); (60.20%) underwent chest radiography with a suspicious result (91.15%); (75.59%) performed sputum smear microscopy in a sample for diagnosis, of these (71.90%) had a positive result; only (37.50%) performed the rapid test, with (87.04%) detectable sensitive to rifampicin and (1.23%) detectable resistant to rifampicin; (17.96%) underwent sputum culture, of these (35%) had a negative result. For the situation of closure of the notified case (77.63%) they obtained a cure for tuberculosis. While 8.20% abandoned the treatment. Regarding completeness, he was classified as regular: illicit drug, smoking and rapid test, as good schooling and other conditions and as excellent sex, age, type of entry, clinical form, chest X-ray, AIDS, alcoholism, diabetes, disease mental, sputum smear microscopy, sputum culture and outcome of the case. Evidence of a statistically significant correlation was obtained between the time under analysis and the completeness of education level, chest X-ray and the outcome of the case (drop in completeness); illicit drug, smoking and rapid test (increase in completeness). Conclusion: Considering the completeness of the fields of the notification / investigation form for tuberculosis, it was found that out of the 17 variables analyzed, 18% were classified as regular, 12% as good and 70% as excellent between the years 2009 to 2019 In the mandatory field variables, a behavior was verified, with the fields being completely filled out. As for the quality of the essential fields, there was a variability in completeness. Thus, it is necessary to establish strategies for the importance of the quality of the registration of notifications.