Evaluation of the Drug-Resistant Tuberculosis Surveillance System, Brazil, 2013-2017Abstract
Objective: to evaluate the Brazilian Drug-Resistant Tuberculosis Surveillance System (DRTB-SS).
Methods: this was an evaluative study, following Centers for Disease Control and Prevention guidelines, using national data from the Special Tuberculosis Treatment Information System (SITETB), and the Notifiable Diseases Information System (SINAN), from 2013 to 2017.
Results: average data completeness was 95% (schooling [89.1%; 5,417/6,078], nationality [94.7%; 5,754/6,078], race/skin color [99.1%; 6,023/6,078], type of resistance [98.6%; 5,995/6,078], clinical form [100%; 6,078/6,078], and HIV test [87%; 5,289/6,078]); average proportion of cases with sputum cultures performed was 65.7% (culture 1 [94.8%; 5,764/6,078], culture 2 [69.8%; 4,241/6,078], culture 3 [54.7%, 3,324/6,078], and culture 4 [43.6%; 2,652/6,078]); DRTB-SS reported 52% (1,197/2,300) of multi-resistant cases estimated by the World Health Organization in 2015, 41.3% (990/2,400) in 2016, and 45.8% (1,100/2,400) in 2017.
Conclusion: low DRTB-SS sensitivity suggests the need for improved access to DRTB diagnosis.
Keywords:
Tuberculosis, Multidrug-Resistant; Information Systems; Epidemiological Monitoring; Public Health Surveillance
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a) RMT: rapid molecular test.b) SITETB: Special Tuberculosis Treatment Information System.c) HIV: human immunodeficiency virus.
a) DRTB: drug-resistant tuberculosis.b) Indicators calculated for each key variable (schooling, nationality, race/skin color, resistance type, clinical form, HIV test date).c) HIV: human immunodeficiency virus. d) Indicators calculated per year of diagnosis (2013-2017).e) Indicators calculated per sputum culture performed (cultures 1 to 4).f) SITETB: Special Tuberculosis Treatment Information System.g) Indicators calculated per year of diagnosis (2015-2017).h) MDR-TB: multi-drug-resistant tuberculosis.i) DRTB-SS: Drug-Resistant Tuberculosis Surveillance System.j) WHO: World Health Organization.k) Cases that had no treatment start date were removed.l) Extensively resistant cases were removed.m) RMT: rapid molecular test.
