Análise ecológica dos dados de óbito por tuberculose no Espírito Santo
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Data
2024-08-16
Autores
Oliveira, Yasmin Gurtler Pinheiro de
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Universidade Federal do Espírito Santo
Resumo
Introduction: Tuberculosis is still a challenge for the world and is the second leading cause of death from infectious diseases. Not unlike the world scenario, Brazil has also been seeking strategies to tackle tuberculosis in order to reduce the number of new cases and deaths from the disease. To this end, ecological studies have been developed in Brazil as a tool for analyzing the points of highest incidence and prevalence of a disease in the territory, as well as a tool used to evaluate the temporal trend of the disease, showing the places that present the greatest risks for the development and worsening of a disease. Objectives: To identify in the scientific literature the methods used for ecological analysis of deaths from tuberculosis in Brazil between 2018 and 2024. To analyze the quality of data on tuberculosis care services in the municipalities of the state of Espírito Santo using information from the forms, especially the completeness of data from the notification forms in the Compulsory Notifiable Diseases Information System with the outcome of deaths from the disease, between 2015 and 2019. Methods: The PICOS search strategy and the PRISMA research protocol were used to carry out a literature review of ecological studies that addressed the topic of tuberculosis deaths and the methods adopted by the scholars. The period analyzed was from 2018 to 2024 and used the Scielo, PubMed and LILACS databases. As for the spatial analysis, this is an ecological, descriptive and exploratory study, which involved secondary data from the compulsory tuberculosis notification forms of the Compulsory Notifiable Diseases Information System made available by the Espírito Santo State Health Department. In order to assess the completeness of the information, the 2003 Centers for Disease Control and Prevention classification was used, classifying completeness as “poor”, “fair” and “excellent”. Maps were created showing the distribution of completeness in the territory of Espírito Santo in order to see which places filled in the notification forms better or worse. Results: Sixteen articles were eligible, addressing the theme of tuberculosis death in the Brazilian territory, published between 2018 and 2024. The authors used secondary data from DATASUS, mostly Mortality Information System data. Among Brazil's macro-regions, the Northeast was the territory with the most publications. The Global and Local Moran's Index was the most used method in the 13 sample, as was the spatial scanning method. Finally, all the studies presented the relationship between the territory and social determinants as an outcome. As for the completeness analysis, the total number of tuberculosis notifications closed as “TB deaths” was 347 cases, of which 271 met the eligibility criteria (not presenting the “post-mortem” entry type). The majority of cases were male, aged between 50 and 60, of brown race/color, with incomplete schooling. The state of Espírito Santo had a fair rating for the completeness of the information on the variables analyzed and the Metropolitan Region of Vitória had a poor and fair rating for the completeness of the data on the tuberculosis notification form. Conclusions: In relation to the findings of the integrative literature review, it was observed that the tools of ecological spatial analysis are reflected in maps that show the scenario of the territory and how it is possible to evaluate the temporal trend of the region of analysis. Therefore, this type of scientific method has been developed in regions where death from tuberculosis is still an alarming factor for public health, contributing to the interpretation and analysis of space in relation to the disease. With the ecological analysis of the completeness of the data from the tuberculosis notification forms that had the outcome “death from tuberculosis”, it was observed that the completeness of the data directly affects the demonstration of death in the municipalities of Espírito Santo, hindering epidemiological analysis of the population. In addition, it was observed that the flow of notifications in the territory is centralized in the state capital, with the municipality of Vitória having more notifications than residents who died from the disease. In view of this, the findings of this study emphasize the need to analyze the collective in order to help devise health strategies for dealing with tuberculosis. To this end, it is suggested that future studies explore ecological methods for analyzing the behavior of tuberculosis deaths in space and that measures and flows be planned and audited
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Palavras-chave
Tuberculose , Análise Espacial , Revisão de Integridade Científica , Mortalidade