Sistema de informaçöes hospitalares - fonte complementar na vigiläncia e monitoramento de doenças transmitidas entre pessoas / Hospital information system - complementary source for surveillance and monitoring of person-to-person transmitted diseases

RESUMO

Analisaram-se as doenças de notificaçäo compulsória (DNC) cuja característica é a tranmissäo de pessoa a pessoa AIDS, meningite(meingocócica, tuberculosa), tuberculose pulmonar, hanseníase, síifilis congênita e hepatites(A e B). As fontes de dados foram Sistemas de Internaçöes Hospitalares (SIH/-SUS) (internaçöes) e Centro Nacional de Epidemiologia-CENEPI (notificaçöes) analisadas por regiöes e estados. Observou-se coerência entre os dados do CENEPI e SIH para Aids, com um sobre-internamento provavelmente mais por reinternaçöes que por subnotificaçöes. A sífilis congênita apresentou razäo de internaçäo maior que 1 no período analisado, havendo mudança em 1997. Os dados de tuberculose pulmonar e hanseníase foram analisados mais detalhadamente, tendo-se observado o total de pacientes cronificados. A exclusäo definiu os casos novos. Destacou-se o peso da prática de dispensarizaçäo no país. As meningites apresentaram resultados diferentes, conforme sua etiologia meningite menigocócica com comportamento semelhante para internaçäo e notificaçäo, a meningite tuberulosa apresentando internaçöes inferiores às notificaçöes sugerindo imprecisäo da informaçäo gerada. A análise das hepatites a partir do SIH/SUS apresentou dificuldades. Concluiu-se pela potencialidade do SIH/SUS como sistema complementar na Vigilância e Monitoramento das DNC de transmissäo entre pessoas, particularmente se adotadas as proposiçöes apontadas no estudo

ABSTRACT

Notifiable Diseases characterized by person-to-person transmission such as Aids, meningitis (meningococcal, tuberculous), pulmonary tuberculosis, leprosy, congenital syphilis and hepatitis (A and B), were analyzed. Data from the Hospital Information System - SIH/SUS (admittances) and National Center of Epidemiology-CENEPI (case reports), were used as sources of information and were analyzed by regions and states. Coherence was observed between the data of CENEPI and SIH for AIDS, however, over-admittances were detected, probably due to re-admittances rather than underreporting. Congenital syphilis presented a ratio of admittances greater than one in the analyzed period, changing in 1997. Data for pulmonary tuberculosis and leprosy were analyzed in more detail, by determining the total number of admittances of chronical patients. Their exclusion, defined new cases. It was detached the weight of the practices of hospital for chronic patients in the country. For meningitis, different results were obtained, according to the etiology Similar patterns for admittances and reporting were observed for meningococcal meningitis while discordant results were detected for tuberculous meningitis, wich showed inferior number of admittances compared to cases reports, suggesting imprecision of the generated information. Difficulties for the analysis of hepatitis using data from SIH/SUS were identified. SIH/SUS has potenciality as a complementary source for surveillance and monitoring of notifiable person-to-person transmitted diseases, particularly if the proposed suggestions pointed out in the study are considered.