Investigation of underreporting of death monitoring in Xi’an city, 2018-2020 / 西安交通大学学报(医学版)

【Objective】 To evaluate the underreporting of death cases and related factors in disease surveillance system of Xi’an. 【Methods】 Multi-stage cluster random sampling was used, and 733 villages (neighborhood committees) were selected from 44 townships or streets in Xi’an. All the death cases of the residents in the sampled areas from 2018 to 2020 were collected through a variety of channels and checked with those registered in the Disease Surveillance System. Then the missing cases were investigated and verified. The underreporting rate was calculated, the Excel software was applied for statistical processing and Chi square analysis, and the related factors of underreporting were analyzed by using Logistic regression method. 【Results】 A total of 37650 death cases were investigated from 2018 to 2020; the average mortality was 650.59/105, and 2 901 cases were underreported. From 2018 to 2020, the underreporting rate was 9.89%, 6.95%, and 6.24%, respectively (χ2=133.525, P<0.001), with the average underreporting rate of 7.71%. The underreporting rate in the 44 sampled areas ranged from 0.90% to 42.07%. Multivariate Logistic regression analysis showed that compared with that in rural areas (9.87%), the underreporting rate was lower in urban areas (5.91%, OR=0.567, 95% CI:0.525-0.613), and higher in children under 5 years old (31.20%, OR=5.494, 95% CI:3.732-8.090) and people aged 15-44 years old (11.85%, OR=1.541, 95% CI:1.284-1.846) compared to people over 65 years old (7.44%), and higher in 2018 (9.89%, OR=1.702, 95% CI:1.551-1.869) and 2019 (6.95%, OR=1.148, 95% CI:1.038-1.271) compared to the year 2020 (6.24%). There were 2901 cases reported missing, and the proportion of those who died at home was the highest (81.39%). Underreporting of death more easily occurred in heart diseases (36.80%) and cerebrovascular diseases (27.08%) than others. 【Conclusion】 The reporting completeness of disease surveillance system increased in Xi’an. The overall underreporting rate of death causes decreased with year from 2018 to 2020. The underreporting rates in age group under 5 years old and in rural population were still high. Therefore, the reporting and management of death information should still be strengthened to minimize the underreporting rate.

Under-reporting of mortality surveillance in Hainan, 2018-2020 / 中国热带医学

@#Objective　To understand the overall under-reporting of cause of death monitoring in Hainan Province, and to provide a scientific basis for evaluating the data from death registration report and health planning in Hainan. Methods　Multi-stage cluster random sampling was used, all towns/streets in cities and counties of the province were ranked from highest to lowest in terms of crude death rate, divided into high, medium and low levels (the number of each level was basically the same), and one was randomly selected from each level. A total of three towns/streets were used as survey areas, and all households in the area were survey households. Death information of resident population during 2018-2020 was collected and compared with routine surveillance data for the same period. The under-reporting rate was calculated, and comparison between groups was performed by chi-square. Results　A total of 12 583 death cases were investigated from 2018 to 2020, and the average mortality was 621.48/105. 4 809 cases were missed with the total under-reporting rate of 38.22%. The under-reporting rate from 2018 to 2020 were 39.75%, 39.99% and 34.77% (χ2=30.404, P<0.01) respectively. The under-reporting rate in eastern and central and western areas were 30.33%, 30.10% and 60.15% (χ2=931.901, P<0.01) respectively. The negative rate were different in different years old group (χ2=14.834, P<0.05). Of the 4 809 under-reported cases, as many as 93.49% died at home, and the composition of deaths in hospitals was about 10 times higher in the center than in the east and west, and the proportion of those who died in hospital in central areas was about 10 times higher than in eastern and central areas. Conclusions　More than half of the cities and counties in Hainan Province have improved the completeness of cause of death surveillance data. The under-reporting rate in age group <5 years are still high, and regular under-reporting investigations are still needed to strengthen the reporting and management of death information.

Notificações de tuberculose no período pré- pandêmico e pandêmico da Covid-19 no Estado do Paraná / Tuberculosis notifications in the pre-pandemic and pandemic period of Covid-19 in Paraná state / Notificaciones de tuberculosis en el período prepandémico y pandémico de la Covid-19 en el estado de Paraná

Introdução: A tuberculose (TB) é considerada uma doença bem desafiadora para o sistema de saúde no Brasil, devido ao número elevado de casos nas últimas décadas. Contudo, com a pandemia da COVID-19, foi observada uma redução significativa de casos de TB. Objetivo: O objetivo desse trabalho foi avaliar o comportamento da TB nas macrorregionais de saúde do estado do Paraná, bem como nas populações vulneráveis nos anos de 2011 a 2021, e sua associação com a ocorrências de casos de COVID-19 a partir de 2020. Metodologia: Trata-se de um estudo ecológico, com dados secundários de TB do Sistema de Informação de Agravos de Notificação (SINAN) e de COVID-19 no banco de dados público oficial da Secretaria de Estado da Saúde do Paraná (SESA) para o coronavírus. Principais resultados: Foi observada diferenças significativas de ocorrência de casos de TB entre as macrorregionais relacionadas à faixa etária da população e entre os períodos pré-pandêmico e pandêmico no Paraná. Os dados obtidos apontam também para uma associação significativa de casos de TB em populações em situação de rua, privadas de liberdade e portadores do vírus da imunodeficiência humana (HIV) no estado ao longo dos anos observados. Conclusão: As notificações de TB no estado do Paraná foram afetadas pela pandemia da COVID-19.

Introduction: Tuberculosis (TB) is considered a very challenging disease for the health system in Brazil, due to the high number of cases in recent decades. However, with the COVID-19 pandemic, a significant reduction in TB cases was observed. Objective: The objective of this study was to evaluate the behavior of TB in the macro-regional health regions of the state of Paraná, as well as in vulnerable populations in the years 2011 to 2021 and the association with the occurrence of COVID-19 cases from 2020. Methodology: Its an ecological study with secondary tuberculosis data from SINAN and data COVID-19 in the official public database of the Paraná State Health Department (SESA). Results: Results show significant differences of TB cases among the macro-regions related to the age group of the population and between the pre-pandemic and pandemic periods. A significant association of TB cases was also observed for the homeless, deprived of liberty and HIV-positive populations in the state over the years observed. Conclusion: TB notifications in the state of Paraná were affected by the COVID-19 pandemic.

Introducción: La tuberculosis (TB) es considerada una enfermedad muy desafiadora para el sistema de salud en Brasil, debido al elevado número de casos en las últimas décadas. Sin embargo, con la pandemia de COVID-19, se observó una reducción significativa de los casos de TB. Objetivo: El objetivo de este estudio fue evaluar el comportamiento de la TB en las macro regiones sanitarias del estado de Paraná, así como en poblaciones vulnerables en los años 2011 a 2021 y la asociación con la ocurrencia de casos de COVID-19 a partir de 2020. Metodología: Es un estudio ecológico con datos secundarios de tuberculosis del SINAN y datos COVID-19 en la base de datos pública oficial de la Secretaría de Salud del Estado de Paraná (SESA). Resultados: Los resultados muestran diferencias significativas de casos de TB entre las macrorregiones relacionadas con el grupo de edad de la población y entre los períodos prepandémico y pandémico. También se observó una asociación significativa de casos de TB para la población sin hogar, privada de libertad y seropositiva al VIH en el estado a lo largo de los años observados. Conclusiones: Las notificaciones de TB en el estado de Paraná fueron afectadas por la pandemia de COVID-19.

Obesity and diet contents of protein and fat are associated with underreport of energy at pregnancy / Obesidade e conteúdo de proteína e gordura na dieta estão associados ao sub-relato do consumo energético na gravidez

Abstract Objectives: to evaluate the association of pre-pregnancy and current body mass index and the density of dietary macronutrients on underreporting of energy intake at pregnancy. Methods: cross-sectional analysis of 327 postpartum women from the city of Mesquita, in Rio de Janeiro. A food frequency questionnaire was administered at maternity ward having the last six months of the pregnancy as the time frame. Energy balance was considered as the outcome, and it was calculated as the division of energy intake by basal metabolic rate (underreport <1.35). Multivariate logistic regression was applied to test the associations between body mass index (pre-gestational and postpartum) on energy balance (underreport or not). Dietary density of protein (4th quartile), carbohydrate (1st quartile) and fat intake (1st quartile) were tested. Results: mean energy intake was 2,894 kcal and near of 25% of the women were considered as underreported during pregnancy. Obese women had higher chance (OR=1.90; CI95%=1.09-3.33) of being underreported at pregnancy. Underreported women presented greater chance of report dietary intake with higher contents of protein (OR=2.37; CI95%=1.37-4.09) and lower density of fat (OR= .81; CI95%=1.04-3.15). Conclusion: underreported pregnant women had higher chance of report great and lower amounts of protein and fat dietary densities.

Resumo Objetivos: avaliar a associação entre o índice de massa corporal pré-gestacional e pós-parto e a densidade de macronutrientes da dieta com o sub-relato de energia da dieta na gestação. Métodos: análise transversal com 327 puérperas da cidade de Mesquita, no Rio de Janeiro. Aplicou-se o questionário de frequência alimentar na primeira semana após o parto tendo como base o consumo dos dois últimos trimestres gestacionais. O balanço energético foi calculado a partir da divisão da ingestão de energia pela taxa metabólica basal (sub-relato<1,35). Adotou-se a regressão logística multivariada para analisar as associações entre os índices de massa corporal e a densidade dos macronutrientes da dieta (proteína, carboidratos e lipídios) com o balanço energético (sub-relato ou não). Resultados: a ingestão média de energia foi de 2.894 kcal e 25% das mulheres foram classificadas com sub-relato. Mulheres obesas no pós-parto tiveram maiores chances (OR=1,90; IC95%=1,09-3,33) de sub-relato de energia na gravidez e gestantes com balanço energético <1,35 apresentaram dieta com maior densidade de proteína (OR=2,37; IC95%=1,37-4,09) e menor densidade de gordura (OR=1,81; IC95%=1,04-3,15). Conclusão: a obesidade no pós-parto foi associada ao sub-relato de energia na gravidez e o balanço energético associou-se a densidade dos macronutrientes da dieta

Investigation and analysis of late reporting and under-reporting of occupational diseases from 2018 to 2020 in China / 中华劳动卫生职业病杂志

Objective: To understand the late reporting and the under-reporting of occupational disease from 2018 to 2020 in China and analyze the causes, so as to provide scientific evidence for improving the quality of occupational disease reports in China, timely acquiring the incidence of occupational disease, and assessing the occupational hazards. Methods: From May to December 2021, A total of 320 occupational disease diagnostic institutions were selected for investigation. The original documents of occupational disease diagnosis cases from 2018 to 2020 were compared with the online reported cases, and late reported and under-reported cases of occupational disease were analyzed. Results: A total of 32207 diagnosed cases from 2018 to 2020 were investigated, including 28934 confirmed cases and 3273 cases without occupational disease. The overall late reported rate and under-reported rate of confirmed cases were 20.2% and 2.1%, respectively. There were significant differences in the rate of late reporting and under-reporting of occupational diseases in different regions and different types of diagnostic institutions (P<0.001). The southwest region had the highest rates of late reporting and under-reporting, 61.6% and 7.9% respectively. The late reported rate of all kinds of occupational diseases was about 15.0%, and the under-reported rate was from 1.5.0% to 5.0%. Conclusion: At present, the phenomenon of late reporting and under-reporting occupational diseases is still obvious. It is necessary to strengthen the inspection of occupational disease reporting, improve the quality of occupational disease reporting, and provide scientific basis for the formulation of occupational disease prevention and control policies.

Leptospirose em uma cidade do sul do Brasil / Leptospirosis in a municipality of southern Brazil

Introdução: Leptospirose é uma zoonose transmitida principalmente por roedores e está relacionada com a situação socioambiental de uma população. A transmissão ocorre especialmente pela eliminação de urina do roedor, por exemplo, nas enchentes que aumentam o risco de contaminação. O artigo analisa a presença de leptospirose na cidade de Pelotas/RS, visando identificar fatores de risco para realizar de forma mais adequada o diagnóstico precoce e evitar possíveis consequências da doença. Objetivos: O estudo tem por objetivo analisar o perfil das pessoas que contraíram leptospirose e seu desfecho no município de Pelotas/RS no período de 2007 a 2017. Métodos: Estudo transversal em que foram analisados dados de prevalência de Leptospirose em Pelotas/RS, comparando zona de residência, sexo, raça, escolaridade, faixa etária e evolução da doença. Resultados: Foi possível observar que a prevalência da doença foi maior em indivíduos com baixa escolaridade, do sexo masculino, brancos e residentes de zona urbana. Metade dos casos evoluiu para a cura, e 2,34% evoluíram para óbito devido ao agravo da doença. Contudo, 53,9% não tiveram a evolução notificada, tendo seus resultados registrados como em branco/ignorado. Conclusão: A leptospirose é uma patologia potencialmente fatal, e ainda subdiagnosticada, e consequentemente subnotificada, tendo grande prevalência em locais com as características de Pelotas/RS. É de fundamental importância que haja uma reestruturação do registro da notificação compulsória com uma abrangência maior sobre dados epidemiológicos para haver um melhor planejamento de meios de prevenção, alcançando uma redução da incidência e melhorando o desfecho desses pacientes.

Introduction: Leptospirosis is a zoonosis transmitted mainly by rodents and is related with the socioenvironmental conditions of a population. Transmission occurs especially through rodents' urine, for example, risk for contamination increases in floods. The article analyzes the presence of leptospirosis in the municipality of Pelotas, Brazil, in order to identify risk factors so as to perform a more appropriate early diagnosis and to prevent possible disease consequences. Objectives: The study aimed to assess the profile of people who contracted leptospirosis and its outcome in the municipality of Pelotas, Brazil, from 2007 to 2017. Methods: Cross-sectional study that analyzed data on the prevalence of leptospirosis in Pelotas, Brazil, comparing area of residence, sex, race, schooling, age, and disease outcome. Results: It was observed that the prevalence of the disease was higher in individuals with little education, male, white, and living in the urban area. Half of the cases evolved to cure, and 2.34% evolved to death due to disease worsening. However, 53.9% of the cases did not have their outcome informed, being reported as blank/unknown. Conclusion: Leptospirosis a potentially lethal disease and is still underdiagnosed, and consequently underreported, being highly prevalent in place with the characteristics of Pelotas, Brazil. It is extremely importance to promote a restructuring in disease notification reporting, with a greater coverage on epidemiological data, in order to improve the planning of prevention strategies, achieving a reduction in disease incidence and improving patient outcomes.

Subnotificação de óbitos por AIDS no Brasil: linkage dos registros hospitalares com dados de declaração de óbito / Underreporting of AIDS deaths in Brazil: linkage of hospital records with death certificate data

Resumo Este estudo investigou a subnotificação de óbitos por Síndrome da Imunodeficiência Adquirida (AIDS) no Brasil, utilizando o produto do pareamento entre o Sistema de Informação sobre Mortalidade (SIM) e o Sistema de Informação Hospitalar (SIH) para os anos de 2008 a 2012. A hipótese era de que houvesse óbitos registrados no SIM que deveriam ter a AIDS como causa básica da morte, mas que tinham causas mal classificadas. Muitos desses falecidos tiveram internações anteriores devido à doença. Os óbitos por AIDS subnotificados foram definidos levando-se em consideração as regras de codificação da Classificação Internacional de Doenças 10ª Revisão, com vistas a discriminar os óbitos por AIDS daqueles devido a outras causas em pessoas vivendo com HIV/AIDS. Nesse período, 60.362 falecidos tiveram a AIDS como causa básica, e encontramos outros 2.671 (4,2%) como causas subnotificadas. Os óbitos subnotificados aumentaram a taxa média de mortalidade por AIDS no período de 6,3/100.000 para 6,6/100.000. Em conclusão, este estudo demonstrou que, através do pareamento entre o SIH e o SIM, é possível encontrar subnotificação de óbitos por AIDS no Brasil. Esses resultados servem de alerta para a necessidade de ações que promovam uma melhor certificação das causas de óbitos entre os pacientes com AIDS.

Abstract This study investigated the underreporting of deaths due to Acquired Immunodeficiency Syndrome (AIDS) in Brazil, using the product of the linkage between the Mortality Information System (SIM) and the Hospital Information System (SIH) for the years 2008 to 2012. The hypothesis was that there were deaths recorded in the SIM that should have AIDS as the underlying cause of death, but that had been poorly classified. Many of the decedents had previous hospitalizations due to the illness. Underreported AIDS deaths were defined taking into account the coding rules of the International Classification of Diseases 10th Revision, in order to discriminate AIDS deaths from those due to other causes in people living with HIV / AIDS. In this period, 60,362 deceased had AIDS as the underlying cause, and we found another 2,671 (4.2%) as underreported causes. Underreported deaths increased the average AIDS mortality rate from 6.3/100,000 to 6.6/100,000. In conclusion, this study demonstrated that, through linkage in between SIH and SIM, it is possible to find underreporting of AIDS deaths in Brazil. These results serve as a warning for the need for actions that would promote a better certification of the causes of death among AIDS patients.

Underreporting deaths in public health surveillance areas of Zhejiang Province / 预防医学

Objective@#To understand the underreporting rate of death among residents in Zhejiang Province from 2016 to 2018, so as to provide a basis for improvement of death surveillance measures. @*Methods@#Multi-stage random cluster sampling was used to select residents in 30 public health surveillance areas of Zhejiang Province and all the residents were investigated the general information and death conditions that occurred during the period 2016-2018 by door to door visit. The underreporting rate of death was calculated and descriptive methods were used to analyze the causes of underreporting deaths.@*Results@#A total of 358 992 residents were investigated in 30 public health surveillance areas of Zhejiang Province. There were 63 underreporting deaths among 5 896 deaths, with an underreporting rate of 1.07%. The underreporting rate in men was 1.30%, which was higher than 0.75% in women ( P<0.05 ). The underreporting rate of residents aged 20 to <40 years was 6.74%, the highest among all the age groups ( P<0.05 ). The underreporting rate was 4.46% on the way to the hospital, the highest among all the places of death ( P<0.05 ). The underreporting rate in Wuxing District of Huzhou was 5.80%, the highest among all the surveillance areas. There were 25 cases of "late report or untimely review", accounting for 39.68%; 38 cases of "not report", accounting for 60.32%, of which 14 cases were caused by doctors forgetting to report, accounting for 22.22%. @*Conclusion@#The underreporting rate of death in Zhejiang Province from 2016 to 2018 is generally low. In response to underreporting deaths, multi-departmental collaboration should be promoted to effectively strengthen the reporting and management of routine death surveillance.

Reducing the under-reporting rate of adverse transfusion reactions: Application of 5W+ 1H method combined with ECRS analysis principle / 中国输血杂志

【Objective】 To investigate the application of 5W+ 1H combined with ECRS analysis principle in reducing the under-reporting rate of adverse reactions to blood transfusion (ARBT). 【Methods】 The causes of under-reporting rate of ARBT were analyzed using 5W+ 1H combined with ECRS analysis principle in Department of Hematology, and the countermeasures and intervention measures were carried out. The under-reporting rate of ARBTs before(January 2018 to December 2019, control) and after(January 2016 to December 2017, test) the interventions was compared. 【Results】 After the application of 5W+ 1H combined ECRS analysis principle, the under-reporting rate of ARBTs decreased significantly(17.39% test vs 37.67% control) (P<0.05). 【Conclusion】 The application of 5W+ 1H combined ECRS analysis principle can effectively reduce the under-reporting rate of ARBT, improve the report management of it, and improve the safety of the blood products.

Prevalence study on self-declared work accidents in areas covered by family health strategies: a cross-sectional study

ABSTRACT BACKGROUND: Occupational accidents are a complex phenomenon and a major public health problem. Occupational health surveillance actions are essential for prevention of injuries of this nature. OBJECTIVE: To ascertain the prevalence of and the variables associated with occupational accidents in the city of Itajubá (MG). DESIGN AND SETTING: A cross-sectional study with a quantitative approach, based on a household survey with random sampling, was conducted in areas covered by the Family Health Strategy (FHS) in Itajubá (MG). METHODS: Questionnaires were applied to 292 people. The data were analyzed by means of logistic regression. RESULTS: The prevalence of occupational accidents was 8.6%. The underreporting rate was 60.0%. The scenario for these accidents, according to the model established through the regression analysis, was most likely to involve males who declared their skin color as white and who did not have a formal employment contract. CONCLUSION: This study makes a contribution towards unveiling the relationship between healthcare and work, and thus serve as support for the development of strategies to prevent underreporting. Lastly, the results provide the basis for future public health intervention actions and for future studies.

La Farmacovigilancia en Cuba y la Infranotificaciones de Reacciones Adversas a los Medicamentos / Pharmacovigilance in Cuba and Adverse Reactions to Drugs Underreporting / Farmacovigilância em Cuba e Subnotificações de Reções Adversas a Medicamentos / Pharmacovigilance à Cuba et Sous-déclaration des Réactions Indésirables aux Médicaments

Resumen Objetivo: Efectuar una revisión de los conocimientos sobre la Farmacovigilancia, el suministro de información sobre sospechas de RAM, que es tanto un deber moral para el médico y otros profesionales de salud como un aspecto de la atención al paciente y la infranotificación de estos reportes. Material y métodos: La revisión fue realizada en las bases de datos LILACS, PAHO, SciELO, EMBASE, PubMed e Infomed, los motores de búsqueda Google y Google Scholar donde se colocaron palabras claves para la búsqueda de la información en artículos originales, tesis, otros artículos de revisión bibliográfica y revistas de elevado índice de citación publicados desde 1937 a 2017, en los idiomas español o inglés. Resultados: Se identificaron 100 artículos, de los cuales 30 fueron seleccionados como útiles verificados para actualizar los conceptos relacionados con las disciplinas de Farmacovigilancia. En la práctica clínica existen varios factores que pueden dificultar la detección de las RAM y como consecuencia contribuir a la infranotificación. Conclusiones: La infranotificación en Farmacovigilancia es una realidad mundial, observándose que la mayoría de las publicaciones analizadas que proceden de Europa (Alemania, España y Reino Unido) y en países de América Latina como Colombia, reconocen bajos índices de notificación.

Abstract Object: The article proposes a pharmacovigilance knowledge review, the provisión of information on suspicion of AMR, which is both a moral duty for the doctor and other health professionals and an aspect of patient care and the underreporting of them. Materials and methods: The review was carried out in the databases LILACS, PAHO, SciELO, EMBASE, PubMed and Infomed, the Google search engines and Google Scholar where keywords were placed for the search of the information in original articles, theses, other articles of bibliographic review and high citation index journals published from 1937 to 2017, in Spanish or English. Results: Consequently 100 articles were identified, 30 of which were selected as verified tools to update the concepts related to Pharmacovigilance discipline. There are several factors in clinical practice that can hinder the detection of ADR and it could contribute to under-reporting. Conclusión: In pharmacovigilance the under-reporting is a global reality, noting that most of the analyzed publications come from Europe (Germany, Spain and the United Kingdom) and in Latin American countries such as Colombia, recognize low reporting rates.

Resumo Objetivo: O artigo propõe uma revisao de literatura sobre farmacovigilancia, fornecendo informações sobre suspeitas de RAM, que é um dever moral para os médicos e outros profissionais de saúde como um aspecto da assistencia ao doente e subnotificação desses relatórios. Materiais e métodos: A pesquisa foi realizada nas bases de dados LILACS, PAHO, SciELO, EMBASE, PubMed e Infomed, nos motores de busca Google e Google Scholar, onde foram colocadas as palavras-chave para encontrar as informações em artigos originais, teses, outros artigos de revisão bibliográfica e de revistas de alto índice de citação publicados de 1937 a 2017, em espanhol ou inglês. Resultados: Foram identificados 100 artigos, dos quais 30 foram selecionados como instrumentos importantes para atualização dos conceitos relacionados á disciplina de farmacovigilancia. Na prática clínica, existem vários fatores que podem dificultar a detecção de RAM e, consequentemente, contribuir para uma subnotificação Conclusão: Na farmacovigilãncia, a subnotificação é uma realidade mundial, observando que a maioria das publicações analisadas provenientes da Europa (Alemanha, Espanha e Reino Unido) e dos países latino-americanos como a Colõmbia, reconhecem baixos índices de notificação.

Résumé Objectif: Procéder á une revue de littérature des connaissances sur la pharmacovigilance et la fourniture d'informations sur la suspicion de Réactions Indésirables aux Médicaments (RIM), qui est autant un devoir moral pour le médecin et pour d'autres professionnels de la santé qu'un aspect des soins aux patients, ainsi que sur la sous-déclaration. Matériaux et méthodes: La revue a été réalisée á l'aide des bases de données LILACS, PAHO, SciELO, EMBASE, PubMed et INFOMED, et des moteurs de recherche Google et Google Scholar, en utilisant des mots clés pour chercher des informations dans des articles originaux, théses, articles de revue de littérature et revues ayant des indices de citations élevés, publiés entre 1937 et 2017, en espagnol ou en anglais. Résultats: 100 articles ont été identifiés, dont 30 ont été sélectionnés comme utiles pour actualiser les concepts en relation avec les disciplines impliquées dans la pharmacovigilance. Dans la pratique clinique, plusieurs facteurs peuvent entraver la détection des RIM et, par conséquent, contribuer á la sous-déclaration. Conclusions: La sous-déclaration en pharmacovigilance est une réalité mondiale. Dans la plupart des publications analysées provenant d'Europe (Allemagne, Espagne et Royaume-Uni) et des pays d'Amérique latine comme la Colombie, on a pu observer la reconnaissance d'un faible taux de déclaration.

Knowledge, attitude and practices towards pharmacovigilance among health care professionals in a teaching and general hospital of South India

Background: Pharmacovigilance is the science and activities relating to detection, monitoring, assessment, understanding and prevention of adverse effects or any other drug related problem from any pharmaceutical products. The core purpose of pharmacovigilance is to enhance patient care and generate the evidence based information on safety of medicines. The objective of present study was to evaluate the knowledge, attitude and practices of the healthcare professionals about pharmacovigilance and to assess the reasons for underreporting of ADRs.Methods: A cross-sectional study was conducted by administering KAP questionnaire to the healthcare professionals. There were 22 multiple choice questions. Ten related to knowledge, 5 related to attitude, and 6 related to practice. One question was asked to determine the reasons for underreporting of ADRs. The performance in each category was graded as good, average and poor if the number of participants giving correct/positive responses were >70%, 50-69%, <50% respectively. Question no 22 was assessed independently to find out reasons for underreporting of ADRs. Data was compiled and analyzed by descriptive statistics, Chi-square and ANOVA test.Results: The response rate in this study was 62.5%. The study included professors (11%), associate professors (6%), assistant professors (20%), postgraduates (26%) and interns (37%). That there was statistically very highly significant difference of mean score of knowledge, attitude and practice among health care professionals (P<0.001). The performance score with respect to attitude of health care professionals towards pharmacovigilance was good as compared to knowledge which was average followed by practice which showed poor performance (72.5% >51.6% >36.8%) (p <0.001).Conclusions: Awareness campaigns, CMEs, workshops on pharmacovigilance should be conducted regularly such that good knowledge about pharmacovigilance can be imparted which can be moulded into good practice.

Acidentes de trabalho fatais em Palmas, Tocantins, Brasil: oportunidades perdidas de informação / Fatal work accidents in Palmas, Tocantins, Brazil: missed opportunities of information

Resumo Objetivo: estimar o sub-registro de acidentes de trabalho fatais (ATF) nos sistemas de informação do Ministério da Saúde, Secretaria Estadual de Segurança Pública (SSP), Ministério do Trabalho e Secretaria da Previdência Social, de 2007 a 2015, em Palmas, Tocantins. Métodos: para identificação dos casos de ATF, as fontes de dados foram o Sistema de Informação sobre Mortalidade (SIM), o Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS), o Sistema de Informações de Agravos de Notificação (SINAN), a Relação Anual de Informações Sociais (RAIS), o Sistema de Informação de Comunicação de Acidentes de Trabalho (SISCAT), os boletins de ocorrência (BO), Guias de Encaminhamento Cadavérico (GEC) e Laudo de Exame Cadavérico (LEC). Para calcular a subnotificação de cada sistema, uma base de dados única foi criada com os registros de todas as fontes, eliminando-se repetições. Resultados: foram identificados 114 casos. Os sub-registros encontrados foram: SIM, 28,9%; SINAN, 44,7%; SSP, 55,3%; RAIS, 73,1%; SISCAT, 65,4%, para trabalhadores segurados. Conclusão: o melhor desempenho de registro é o do SIM. Observou-se extenso sub-registro em todas as demais fontes. Registros de mortalidade por ATF são subestimados. Ações de melhoria dos registros, especialmente no SIH-SUS, RAIS, SISCAT, SSP, seguidos pelo SINAN e SIM, são necessárias.

Abstract Objective: to estimate the underreporting of fatal work accidents (FWA) in information systems of the Ministry of Health, State Secretariat of Public Security (SSP), Ministry of Labor and Social Security Secretariat, from 2007 to 2015, in Palmas, Tocantins. Methods: the data sources of the FWA cases were the Mortality Information System (SIM), the Hospital Information System of the Unified Health System (SIH-SUS), the Information System on Diseases of Compulsory Declaration (SINAN), the Annual Social Information Report (RAIS), the Information System of Communication of Work Accidents (SISCAT), police reports (PR), Cadaver Referrals (GEC) and Cadaveric Examination Reports (LEC). To calculate underreporting within each system, a single database was created with the records of all sources, eliminating repetitions. Results: 114 cases were identified. Under-reports identified were: SIM, 28.9%; SINAN, 44.7%; SSP, 55.3%; RAIS, 73.1%; SISCAT, 65.4%, for insured workers. Conclusion: the best performance in registry is from SIM. Extensive underreporting was observed in all other sources. Mortality records due to FWA are underestimated. Action to improve recording, especially at SIH-SUS, RAIS, SISCAT, and SSP, followed by SINAN and SIM, are required.

Under-reporting of energy and nutrient intake is a persistent issue in the Malaysian Adult Nutrition Surveys

@# Introduction: Under-reporting of energy intake is a common cause of bias in nutritional studies. This study was aimed at examining the extent of under- reporting of energy intake and its related characteristics among respondents in the Malaysian Adult Nutrition Survey (MANS) 2003 and MANS 2014. Methods: The present study analysed energy intakes of 9,624 adults aged 18-59 years from the MANS in year 2014 (2,890 respondents) and 2003 (6,734 respondents) using a single 24-hour diet recall. Basal metabolic rates (BMR) were calculated from the age- and gender-specific equations of Schofield. Under-reporting was defined as an energy intake:BMR ratio of <1.2 as proposed by Goldberg. Results: Under-reporting was found to have increased significantly from 53% in 2003 to 61% in 2014. In both surveys, under-reporting increased with higher body mass index (BMI) and older age groups. It was higher among women than men, lowest among those with primary schooling or below, and those living in Peninsular Malaysia. It was higher among rural respondents in 2014 but higher among urban respondents in 2003. The intake of energy and micronutrients increased when under-reporters were excluded. Conclusion: Under-reporting was prevalent in both the nationwide MANS, and is associated with BMI, age, gender, education level, location strata, zone. It is important to take this factor into account when assessing dietary intake in population-based studies.

A cross sectional study of knowledge, practice and attitude of medical professionals regarding pharmacovigilance function

Background: Pharmacovigilance is of core importance for the prevention of adverse effect by signal generation. It developed as a science and Practice. Central database collecting international reports helpful in generating signals, improving safety profile, prevention of future adverse effects, thus provide a key data to national drug regulatory to make regulation. It is not only a science but act as a law and regulation. Underreporting of ADRs by healthcare professionals remains a major problem. Clinician’s collaboration is needed to come up with the challenges of underreporting. Spontaneous reporting plays a cardinal role in Pharmacovigilance practice.Methods: Cross Sectional, questioner-based study, 56- postgraduates, 42- first year,60- Second year, 35- Third year students of Institute of Medical Sciences were included with prior consent and Ethical committee permission. Structured pre-test questioner on, Knowledge-10, Attitude-02, Practice-06 were asked. Seminar was conducted on the ‘Pharmacovigilance in India: current Scenario, Study material were distributed to students. Prior to seminar and one week after conduction of seminar again the questioner was distributed again, and the same study was conducted, the difference in the response and attitude after transformation of knowledge were recorded.Results: After transformation of knowledge 77% JR responded that ADR and medication both should be reported which was earlier only 31%. 80% JR replied that ADR should be reported as early as possible which was earlier 38%. It indicates that transformation of knowledge is a pillar to bring the change in practise. 100% second year students responded that they have seen ADR reporting form which was only 30% before seminar.Conclusions: Up gradation of Knowledge by seminar, research papers, awareness pamphlets, Apps will promote the reporting and will strengthen the signal generation systems.

Knowledge, attitude and practice of haemovigilance amongst healthcare professionals in Nashik, Maharashtra, India

Background: Haemovigilance Programme of India was launched in 2012 with the purpose to identify, analyse and learn the complications related to transfusion and blood donation, in order to avoid such complications in future. Though it is essential to identify the Adverse Transfusion Reactions (ATR) to reduce the incidence and make transfusion easier; there are rare reports available about knowledge, attitude, and practice (KAP) of Healthcare Professionals (HCP) for haemovigilance.Methods: In this cross-sectional study, pre-validated questionnaire designed for assessing the KAP, the possible ways to improve transfusion reaction reporting and causes of underreporting were distributed among 220 Healthcare Professional (HCP) in Nashik, Maharashtra.Results: The response rate of the study was 93%. Amongst them 58% HCP had poor knowledge while only 9% had good knowledge about haemovigilance. According to respondents, training to the HCP, CME’s, making reporting compulsory and launching of a toll-free helpline number will mark a milestone in improving transfusion reaction reporting. Legal liability issue and lack of time & knowledge were the main factors which discouraged them from reporting.Conclusions: Overall, most of HCP in Nashik have a positive attitude towards transfusion reaction reporting but knowledge regarding the haemovigilance concept is poor and the majority of them never reported ATR. Hence, our study demands increased awareness and continued training to strengthen the haemovigilance system, especially ATR reporting.

The under-reporting of energy intake influences the dietary pattern reported by obese women in the waiting list for bariatric surgery / A subnotificação do consumo energético influencia os resultados de padrão alimentar relatado por mulheres obesas na fila de espera para cirurgia bariátrica

ABSTRACT Objective To verify the interference of the energy intake under-reporting in the determination of the dietary patterns and nutrient intakes reported by obese women in the waiting list for bariatric surgery. Methods The study included 412 women aged 20 to 45 years with a body mass index ranging from 35 to 60kg/m2 who were on waiting list for bariatric surgery. Data from three reported food intake and physical activity, body weight, and height were used for estimating the reported energy intake, physical activity level, and resting energy expenditure. Subsequently, it was checked the biological plausibility of the reported energy intakes, classifying all participants as plausible reporters or under-reporters. Exploratory factor analysis was used to determine the participants' dietary patterns. The Mann-Whitney test assessed the reported energy and nutrient intakes between plausible reporters and under-reporters groups. The Z-test assessed the variables of plausible reporters or under-reporters in relation to all participants of the study. Results Six dietary patterns were determined for all participants of study. After excluding information from under-reporting women, only two dietary patterns remained similar to those of all participants, while three other dietary patterns presented different conformations from food subgroups to plausible reporters. The reported energy intake did not present difference for the subgroups of fruits, leaf vegetables and vegetables. However, the energetic value reported for the other food subgroups was higher for the plausible reporters. Conclusion The under-reporting of energy intake influenced the determination of dietary patterns of obese women waiting for bariatric surgery.

RESUMO Objetivo Esta pesquisa buscou verificar a interferência da subnotificação do consumo energético na determinação do padrão alimentar e consumo de nutrientes, relatados por mulheres obesas na fila de espera para cirurgia bariátrica. Métodos Participaram do estudo 412 mulheres com idade entre 20 e 45 anos e índice de massa corporal entre 35 e 60 kg/m2, que aguardavam na fila de espera de cirurgia bariátrica. Foram utilizadas informações de três registros do consumo alimentar, da atividade física de 24 horas e do peso corporal e altura, para estimativa da Ingestão Energética Relatada, Nível de Atividade Física e Gasto Energético de Repouso das participantes e subsequente verificação da plausibilidade biológica do consumo energético. As mulheres foram agrupadas em notificadoras plausíveis e subnotificadoras. A análise fatorial exploratória foi utilizada para classificar os padrões alimentares. Os valores relatados de energia e nutrientes entre os grupos de notificadoras plausíveis e subnotificadoras foram avaliados por meio do teste de Mann-Whitney. O Teste de hipótese Z avaliou as variáveis das notificadoras plausíveis ou subnotificadoras em relação a todas as participantes do estudo. Resultados Seis padrões alimentares foram determinados para todas as participantes do estudo. Após excluir as informações das mulheres subnotificadoras, apenas dois padrões alimentares mantiveram-se similares aos de todas as participantes, ao passo que outros três padrões alimentares apresentaram diferentes conformações de subgrupos alimentares para as notificadoras plausíveis. A ingestão energética relatada não apresentou diferença para os subgrupos das frutas, hortaliças e legumes. Porém, o valor energético relatado para os demais subgrupos alimentares foi maior para as notificadoras plausíveis. Conclusão A subnotificação do consumo energético influenciou a determinação de padrões alimentares de mulheres obesas na lista de espera para cirurgia bariátrica.

Sharp injuries: a cross-sectional study among health care workers in a provincial teaching hospital in China

BACKGROUND@#The objectives of this study are to investigate the incidence and reporting behavior of sharp injuries among healthcare workers (HCWs) and identify the risk factors associated with these injuries.@*METHODS@#A cross-sectional survey was conducted in February 2017 in a provincial teaching hospital in China. Data were collected from 901 HCWs using a self-administered questionnaire which included demographic information, experience, and reporting behavior of sharp injuries. Stepwise logistical regression was used to analyze the risk factors.@*RESULTS@#HCWs (248 [27.5%]) had sustained a sharp injury in the previous year. Factors including seniority, job category, title, education, department, and training programs were associated with the occurrence of sharp injuries. According to the stepwise logistical regression, seniority, and training programs were the risk factors associated with the occurrence of sharp injuries. Of 248 sharp injuries, 130 HCWs were exposed to blood. Only 44 (33.9%) HCWs reported their injuries to the concerned body. The main reasons for not reporting the sharp injuries were as follows: perception that the extent of the injury was light (30.2%), having antibodies (27.9%), and unaware of injury (16.3%).@*CONCLUSIONS@#Sharp injuries in the studied hospital were common and were likely to be underreported. Therefore, an effective reporting system and sufficient education on occupational safety should be implemented by the relevant institutions. Moreover, it is important to take effective measures to manage sharp injuries in HCWs and provide guidance for their prevention.

Captação de óbitos não informados ao Ministério da Saúde: pesquisa de busca ativa de óbitos em municípios brasileiros / Capturing deaths not informed to the Ministry of Health: proactive search of deaths in Brazilian municipalities

RESUMO: Introdução: A busca ativa de óbitos é uma estratégia de captação de eventos que não foram informados ao Sistema de Informações sobre Mortalidade (SIM) do Ministério da Saúde (MS). Sua importância na redução do sub-registro de óbitos e na avaliação da operacionalização do sistema de informações é amplamente conhecida. Objetivo: Descrever a metodologia e os principais achados da pesquisa de busca ativa de óbitos realizada em 2013, estabelecendo a contribuição das diferentes fontes de informação. Métodos: A pesquisa foi realizada em 79 municípios brasileiros. Foram investigadas diversas fontes oficiais e não oficiais de informações sobre óbitos de residentes nesses municípios. Todas as fontes de informações investigadas e os casos encontrados foram digitados em um painel on-line. A segunda etapa da pesquisa foi de confirmação dos casos para verificar as informações sobre o ano do óbito e o município de residência, assim como para completar informações faltantes. Resultados: Foram encontrados 2.265 óbitos que não foram informados ao SIM. Desses, 49,3% foram encontrados em fontes não oficiais, cemitérios e funerárias. Em alguns municípios rurais, condições precárias de sepultamento foram encontradas em cemitérios no meio da mata, sem registro do falecido. Os fatores de correção foram inversamente associados ao nível de adequação das informações de mortalidade. Conclusão: Os achados confirmam a associação entre o nível de adequação das informações e a cobertura do registro de óbitos, e indicam que a aplicação de pesquisas de busca ativa é um método efetivo para capturar óbitos não informados ao MS.

ABSTRACT: Introduction: The proactive search of deaths is a strategy for capturing events that were not informed to the Mortality Information System of Ministry of Health. Its importance to reduce underreporting of deaths and to evaluate the operation of the information system is widely known. Objective: To describe the methodology and main findings of the Proactive Search of Deaths, 2013, establishing the contribution of different information sources. Methods: The research was carried out in 79 Brazilian municipalities. We investigated several official and unofficial sources of information about deaths of municipality residents. Every information source investigated and all cases found in each source were typed in an on-line panel. The second stage of the research was the confirmation of cases to verify information of year and residence and to complete missing information. For all confirmed cases, we estimated the completeness of death registration and correction factors according to the adequacy level of mortality information. Results: We found 2,265 deaths that were not informed to the Mortality Information System. From those, 49.3% were found in unofficial sources, cemeteries and funeral homes. In some rural municipalities, precarious burial conditions were found in cemeteries in the middle of the forest and no registration of the deceased. Correction factors were inversely associated to the adequacy level of mortality information. Conclusion: The findings confirm the association between level of information adequacy and completeness of death registration, and indicate that the application of the proactive search is an effective method to capture deaths not informed to the Ministry of Health.

Estimation of the rate and number of underreported deliberate self-poisoning attempts in western Iran in 2015 / 한국역학회지

OBJECTIVES: Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran. METHODS: We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n0, was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level. RESULTS: The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population. CONCLUSIONS: Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides.