ABSTRACT
BACKGROUND: Infectious diseases are a leading threat to public health. Accurate and timely monitoring of disease risk and progress can reduce their impact. Mentioning a disease in social networks is correlated with physician visits by patients, and can be used to estimate disease activity. Dengue is the fastest growing mosquito-borne viral disease, with an estimated annual incidence of 390 million infections, of which 96 million manifest clinically. Dengue burden is likely to increase in the future owing to trends toward increased urbanization, scarce water supplies and, possibly, environmental change. The epidemiological dynamic of Dengue is complex and difficult to predict, partly due to costly and slow surveillance systems. METHODOLOGY / PRINCIPAL FINDINGS: In this study, we aimed to quantitatively assess the usefulness of data acquired by Twitter for the early detection and monitoring of Dengue epidemics, both at country and city level at a weekly basis. Here, we evaluated and demonstrated the potential of tweets modeling for Dengue estimation and forecast, in comparison with other available web-based data, Google Trends and Wikipedia access logs. Also, we studied the factors that might influence the goodness-of-fit of the model. We built a simple model based on tweets that was able to 'nowcast', i.e. estimate disease numbers in the same week, but also 'forecast' disease in future weeks. At the country level, tweets are strongly associated with Dengue cases, and can estimate present and future Dengue cases until 8 weeks in advance. At city level, tweets are also useful for estimating Dengue activity. Our model can be applied successfully to small and less developed cities, suggesting a robust construction, even though it may be influenced by the incidence of the disease, the activity of Twitter locally, and social factors, including human development index and internet access. CONCLUSIONS: Tweets association with Dengue cases is valuable to assist traditional Dengue surveillance at real-time and low-cost. Tweets are able to successfully nowcast, i.e. estimate Dengue in the present week, but also forecast, i.e. predict Dengue at until 8 weeks in the future, both at country and city level with high estimation capacity.
Subject(s)
Dengue/epidemiology , Epidemiologic Methods , Internet , Social Media , Dengue/transmission , Forecasting , Humans , Models, StatisticalABSTRACT
Este trabalho avaliou a qualidade da assistência hospitalar prestada aos casos graves de dengue em duas capitais brasileiras, São Luís-MA e Manaus-AM, em 2007. O manejo clínico adequado e o diagnóstico precoce dos casos graves de dengue seriam suficientes para reduzir a letalidade aos níveis considerados aceitáveis (1por cento de letalidade) pela Organização Mundial de Saúde OMS. Os objetivos específicos do estudo foram descrever as ações de assistência hospitalar para os casos graves de dengue; analisar a interferência do contexto interno das Secretarias Municipais de Saúde nas ações de assistência hospitalar para os casos graves de dengue; verificar o grau de implementação das ações de assistência hospitalar para os casos graves de dengue; construir indicadores para o monitoramento da qualidade da assistência hospitalar para os casos graves de dengue. A área do estudo foi selecionada a partir da identificação dos Estados com maior proporção de casos graves em relação ao total de casos de dengue; em seguida selecionou-se os municípios com maior número de casos graves hospitalizados. Foi realizado estudo de casos múltiplos, e a estratégia utilizada foi análise de implantação das ações de assistência hospitalar aos casos graves de dengue. Utilizou-se a abordagem formativa e normativa com foco no processo. Foram desenvolvidos indicadores de acesso relacionados a disponibilidade e adequação. Os critérios e parâmetros foram desenvolvidos por intermédio de um consenso entre especialistas, totalizando 11 critérios. As fontes de dados utilizadas foram entrevistas com os responsáveis pelo programa municipal de controle da dengue, análise de documentos, e roteiro para revisão de prontuários. Foram revisados os prontuários de pacientes de dengue hospitalizados em 2007 nos hospitais públicos. Foi construída uma matriz de julgamento para os critérios, considerando os padrões propostos por Cosendey (2003)...
This study evaluated the quality of hospital care provided to serious cases of dengue in two Brazilian cities, São Luís-MA, Brazil and Manaus-AM, 2007. The appropriate clinical management and early diagnosis of severe cases of dengue were sufficient to reduce fatality rates to levels considered acceptable (1% fatality rate) by theWorld Health Organization - WHO. The specific objectives of the study were todescribe the actions of hospital care for severe cases of dengue; analyze the interference in the internal context of the Municipal Health Department in the actions of hospital care for severe cases of dengue and check the level of implementation of actions hospital care for severe cases of dengue; construct indicators for monitoring the qualityof hospital care for severe cases of dengue. The study area was selected based on the identification of states with the highest proportion of severe cases in relation to the total dengue cases, and then selected the municipalities with the most severe cases hospitalized. Study was conducted in multiple cases, and the strategy used was analysis of the implementation of the actions of hospital care for severe cases of dengue. We used the formative and normative approach with a focus on process. We developed indicators of access related to availability and adequacy. The criteria and parameterswere developed through a consensus among experts, a total of 11 criteria. Data sources used were interviews with those responsible for municipal program for dengue control, document analysis and review of medical records. Medical records of patients hospitalized with dengue in 2007 in public hospitals. We built a matrix of criteria for the trial, considering the standards proposed by Cosendey (2003)...
Subject(s)
Humans , Dengue , Health Services Accessibility , Hospital Care , Quality Indicators, Health Care , Program Evaluation , Quality of Health CareABSTRACT
Trabalho apresentado por Lívia Vinhal (PNCD/SVS/MS) com o título Experiências Nacionais em Monitoramento e Avaliação Dengue. Arquivos disponíveis para leitura/audição e/ou download nos ícones ao lado.
