Mecanismo de controle para qualificar informações relevantes no SIH / SUS: a aplicação da Portaria SAS/SVS 20 de 2005 / Control mechanism to qualify relevant information in SIH / SUS: the execution of the SAS / SVS ordinance 20 / 2005

O Sistema de Informação Hospitalar (SIH) em uso desde 1990 vem sendo de forma crescente utilizado para a obtenção de informações para a produção de indicadores com a finalidade de avaliar a morbidade da população assistida no SUS assim como a assistência hospitalar prestada. A qualidade dos indicadores irá depender dos componentes utilizados na sua formulação. Assim, compreende-se que se os registros do SIH não forem precisos irão gerar indicadores sem qualidade. Ao longo dos anos foram incluídos neste sistema regras e funcionalidades, de forma a possibilitar que as informações tivessem a qualidade necessária ao monitoramento da situação de morbimortalidade no âmbito do SUS. Em 2005 o Ministério da Saúde publicou uma portaria que incluísse mecanismo capaz de qualificar as informações sobre agravos de notificação compulsória imediata. O objetivo deste trabalho é analisar o mecanismo de bloqueio instituído pela Portaria Conjunta SAS / SVS nº 20 de 25 de maio de 2005 na Autorização de Internação Hospitalar (AIH) com os agravos de notificação compulsória imediata (ANCi) Poliomielite, Carbúnculo, Tularemia, Febre Amarela Urbana, Síndrome Respiratória Aguda Grave, Varíola e Peste Pneumônica, no período de 2005 a 2009. Os resultados obtidos com o relacionamento dos bancos de dados do SIH / SUS e do Sistema Nacional de Agravos de Notificação (SINAN) mostraram que o mecanismo incluído pela Portaria 20 não foi capaz de favorecer o conhecimento pela Vigilância Epidemiológica dos casos internados com diagnósticos possíveis pelos agravos selecionados. Recomenda-se que se invista na formação dos profissionais responsáveis pelos SIS, no sentido de entenderem o valor de uma informação de qualidade, valorizando seu uso na gestão e no planejamento de ações em prol da população. Também é necessário o monitoramento das informações advindas desses sistemas para identificar possíveis falhas.

Seroepidemiological study of herpes simplex virus type 2 in patients with the acquired immunodeficiency syndrome in the city of Niterói, Rio de Janeiro, Brazil

This study was designed to determine the seroprevalence of herpes simplex virus type 2 (HSV-2) and to evaluate its association with age, sex as well as other demographic and behavioural factors in 150 human immunodeficiency virus (HIV) positive adults patients attending the general medical outpatient ward for routine care of Niterói, state of Rio de Janeiro, Brazil. Serum samples were screened for HSV-2 antibodies using an indirect ELISA. Eighty-three patients were men (mean age: 38.8) and 67 were women (mean age: 35.4). The estimated prevalence of HSV-2 was 52 percent (95 percent CI: 44-60 percent) and it was higher among men (53 percent) than among women (50.7 percent). Overall, the age of first sexual intercourse and past history of genital herpes were associated with HSV-2 seropositivity. Analysis by gender disclosed significant association of number of lifetime sex partners only among men. Although HSV-2 antibodies were frequent in the study group, genital herpes was reported by 21.8 percent of the HSV-2 positive subjects, indicating low awareness of the HSV-2 infection. These results may have public health importance for Brazil as the high rate of HSV-2 infection may act as a cofactor of HIV transmission.

Clinical and epidemiological aspects of human parvovirus B19 infection in an urban area in Brazil (Niterói city area, State of Rio de Janeiro, Brazil)

This study was designed to analyse the clinical and epidemiological data from human parvovirus B19 cases in a six-year study of rash diseases conduct in an urban area in Brazil (Niterói city area, State of Rio de Janeiro). A total of 673 patients with acute rash diseases were seen at two primary health care units and at a general hospital. A clotted blood sample was collected from all subjects at the time of consultation. Forty-nine per cent (330 cases) of the patients were negative for dengue, rubella and measles IgM or for low avidity IgG to HHV-6. Of these 330, 105 (31.8 percent) were identified as IgM positive to parvovirus B19 by using an antibody capture EIA. During the study period, three distinct peaks of parvovirus infection were detected, suggesting that the disease appears to cycle in approximately 4-5 years. B19 infection was characterized by variable combinations of fever, flu-like symptoms, arthropathy, and gastrointestinal symptoms. Frequency of fever and arthropathy was substantially higher in adults, 75 percent [chi2 (1 D.F.) = 11.39, p = 0.0007] and 62.5 percent [chi2 (1 D.F.) = 29.89, p = 0.0000], respectively. "Slapped-cheek" appearance and reticular or lace-like rash were seen in only 30.1 percent of the children. No adult presented this typical rash. The lack of the typical rash pattern in a large proportion of parvovirus B19 and the similarity of clinical manifestations to other rash diseases, specially to rubella, highlight the difficulty of diagnosing B19 infection on clinical grounds alone