Tendência temporal da prevalência e mortalidade infantil das anomalias congênitas no Brasil, de 2001 a 2018 / Temporal trends in prevalence and infant mortality of birth defects in Brazil, from 2001 to 2018

Resumo As anomalias congênitas (AC) configuram um relevante problema para a saúde pública global, afetando em média de 3% a 6% dos recém-nascidos em todo o mundo. No Brasil, ocupam a segunda posição entre os principais grupos de causas de óbito infantil. Assim, estudos amplos são necessários para mostrar o impacto das AC na saúde infantil. O presente estudo descreve a tendência temporal da prevalência e da mortalidade infantil por AC entre nascidos vivos (NV) no Brasil e em suas cinco regiões de 2001 a 2018, utilizando dados vinculados entre as bases de dados do Sistema de Informações sobre Nascidos Vivos (SINASC) e do Sistema de Informações sobre Mortalidade (SIM). A prevalência e mortalidade infantil por AC mostrou-se crescente no Brasil na maioria das regiões, principalmente no Norte e no Nordeste. Aquelas do aparelho osteomuscular foram as mais prevalentes ao nascimento (29,8/10.000 NV); as do aparelho circulatório passaram para a segunda posição (12,7/10.000 NV) após a vinculação das bases e representam a primeira causa de morte desse grupo. A técnica de vinculação de dados aplicada corrigiu a prevalência nacional das AC em 17,9% no período analisado, após serem recuperadas as AC notificadas no SIM, mostrando ser uma boa ferramenta para melhorar a qualidade das informações das AC.

Abstract Congenital anomalies (CA) are a relevant problem for global public health, affecting about 3% to 6% of newborns worldwide. In Brazil, these are the second main cause of infant mortality. Thus, extensive studies are needed to demonstrate the impact of these anomalies on births and deaths. The present study describes the temporal trends of prevalence and infant mortality due to CA among live births in Brazil and regions, from 2001 to 2018, using the related data between the Live Birth Information System (SINASC, acronym in Portuguese) and the Mortality Information System (SIM, acronym in Portuguese). The prevalence and infant mortality due to CA has increased in Brazil and in most regions, especially in the Northeast and North. CAs in the musculoskeletal system were the most frequent at birth (29.8/10,000 live births), followed by those in the circulatory system (12.7/10,000 live births), which represented the primary cause of death in this group. The applied linkage technique made it possible to correct the national prevalence of CA by 17.9% during the analyzed period, after retrieving the anomalies reported in SIM, thereby proving to be a good tool to improve the quality of information on anomalies in Brazil.

A completeness indicator of gestational and congenital syphilis information in Brazil

ABSTRACT OBJECTIVE To evaluate the quality of information on gestational syphilis (GS) and congenital syphilis (CS) on the Sistema de Informação de Agravos de Notificação (SINAN-Syphilis Brazil - Notifiable Diseases Information System) by compiling and validating completeness indicators between 2007 and 2018. METHODS Overall, care, and socioeconomic completeness scores were compiled based on selected variables, by using ad hoc weights assigned by experts. The completeness scores were analysed, considering the region and area of residence, the pregnant woman's race/colour, and the year of case notification. Pearson's correlation coefficients were used to validate the scores obtained by the weighted average method, compared with the values obtained by principal component analysis (PCA). RESULTS Most selected variables presented a good or excellent degree of completeness for GS and CS, except for clinical classification, pregnant woman's level of education, partner's treatment, and child's race/colour, which were classified as poor or very poor. The overall (89.93% versus 89.69%) and socioeconomic (88.71% versus 88.24%) completeness scores for GS and CS, respectively, were classified as regular, whereas the care score (GS-90.88%, and CS-90.72%) was good, despite improvements over time. Differences in the overall, care and socioeconomic completeness scores according to region, area of residence, and ethnic-racial groups were reported for syphilis notifications. The completeness scores estimated by the weighted average method and PCA showed a strong linear correlation (> 0.90). CONCLUSION The completeness of GS and CS notifications has been improving in recent years, highlighting the variables that form the care score, compared with the socioeconomic scores, despite differences between regions, area of residence, and ethnic-racial groups. The weighted average was a viable methodological alternative easily operationalised to estimate data completeness scores, allowing routine monitoring of the completeness of gestational and congenital syphilis records.

Repercussões da emergência do vírus Zika na saúde da população do estado do Tocantins, 2015 e 2016: estudo descritivo / Repercusiones de la aparición del virus Zika en la salud de la población de Tocantins, Brasil, 2015 e 2016: estudio descriptivo / Repercussions of Zika virus emergency on the health of the population of Tocantins state, Brazil, 2015 and 2016: a descriptive study

Objetivo: Descrever a ocorrência da febre pelo vírus Zika (ZIKV) e suas complicações no estado do Tocantins e em sua capital, Palmas. Métodos: Estudo descritivo, utilizando dados dos sistemas de informações em saúde. Resultados: A incidência de casos notificados de febre pelo ZIKV, em 2015 e 2016, foi de 295,2/100 mil e 411,1/100 mil habitantes na população geral, e de 5,9/mil e 27,8/mil nascidos vivos em gestantes, respectivamente. Maiores riscos ocorreram em mulheres, nas idades de 20-39 anos, nos municípios das regiões central e noroeste do estado, durante os meses mais quentes (fevereiro e março). A incidência de microcefalia relacionada à infecção pelo ZIKV na gestação foi de 0,06/mil nascidos vivos. Foi confirmado um caso de síndrome de Guillain-Barré decorrente da infecção pelo ZIKV. Conclusão: A febre pelo ZIKV atingiu o Tocantins intensamente, embora seus desfechos adversos tenham sido menos frequentes que em outros estados.

Objetivo: Describir la aparición de la fiebre del virus del Zika y sus complicaciones, en el estado de Tocantins y en la ciudad de Palmas, su capital. Métodos: Estudio descriptivo utilizando datos de los Sistemas Oficiales de Información. Resultados: La incidencia de casos informados de fiebre por ZIKV en 2015 y 2016 fue 295,2/100.000 y 411,1/100.000 habitantes, respectivamente y 5,9/1000 y 27,8/1000 de nacidos vivos en gestantes, respectivamente. Los riesgos mayores estuvieron en mujeres, entre los 20-39 años de edad, en los municipios de las regiones central y noroeste y en los meses más calurosos (febrero y marzo). La incidencia de microcefalia relacionada con el ZIKV en la gestación fue 0,06/1000 nacidos vivos. Se confirmó un caso de Síndrome de Guillain- Barré debido al ZIKV. Conclusión: La fiebre por el ZIKV afectó intensamente a Tocantins. Pero, sus desenlaces adversos han sido menos frecuentes que en otros estados.

Objective: To describe the occurrence of Zika virus disease and its complications in the state of Tocantins and in its capital, the city of Palmas. Methods: This was a descriptive study using data from health information systems. Results: Incidence of reported Zika virus disease cases in 2015 and 2016 was 295.2/100,000 inhabitants and 411.1/100,000 inhab. in the general population, and 5.9/1,000 and 27.8/1,000 live births, respectively. Higher risks occurred in women, the 20-39 year age group, municipalities in the central and northwestern regions of the state and in hotter months (February and March). Incidence of Zika-related microcephaly during pregnancy was 0.06/1,000 live births. One case of Guillain-Barré Syndrome resulting from Zika virus infection was confirmed. Conclusion: Zika virus disease hit Tocantins intensely, although its adverse outcomes were less frequent than in other states.