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. 2018:52:43.
doi: 10.11606/s1518-8787.2018052017439. Epub 2018 Apr 12.

Reporting of HIV-infected pregnant women: estimates from a Brazilian study

[Article in Portuguese, English]
Rosa Maria Soares Madeira Domingues  1 , Valéria Saraceni  2 , Maria do Carmo Leal  3
Affiliations

Reporting of HIV-infected pregnant women: estimates from a Brazilian study

[Article in Portuguese, English]
Rosa Maria Soares Madeira Domingues et al. Rev Saude Publica. 2018.

Abstract
in English, Portuguese

Objective: To estimate the coverage of the reporting of cases of HIV-infected pregnant women, to estimate the increase in the coverage of the reporting with the routine search of data in other Brazilian health information systems, and to identify missed opportunities for identification of HIV-infected pregnant women in Brazilian maternity hospitals.

Methods: This is a descriptive study on the linkage of Brazilian databases with primary data from the "Nascer no Brasil" study and secondary database collection from national health information systems. The "Nascer no Brasil" is a national-based study carried out in 2011-2012 with 23,894 pregnant women, which identified HIV-infected pregnant women using prenatal and medical records. We searched for cases of HIV-infected pregnant women identified in the "Nascer no Brasil" study in the Information System of Notifiable Diseases, the Control System for Laboratory Tests of the National CD4+/CD8+ Lymphocyte Count and HIV Viral Load Network, and the Logistics Control System for Medications. We used the OpenRecLink software for the linkage of databases. We estimated the notification coverage, with the respective confidence interval, of the evaluated Brazilian health information systems.

Results: We estimated the coverage of the reporting of HIV-infected pregnant women in the Information System of Notifiable Diseases as 57.1% (95%CI 42.9-70.2), and we located 89.3% of the HIV-infected pregnant women (95%CI 81.2-94.2) in some of the Brazilian health information systems researched. The search in other national health information systems would result in an increase of 57.1% of the reported cases. We identified no missed opportunities for the diagnosis of HIV+ in pregnant women in the maternity hospitals evaluated by the "Nascer no Brasil" study.

Conclusions: The routine search for information in other Brazilian health information systems, a procedure carried out by the Ministry of Health for cases of AIDS in adults and children, should be adopted for cases of HIV in pregnancy.

OBJETIVO:: Estimar a cobertura de notificação de casos de infecção pelo HIV em gestantes, o aumento na cobertura de notificação a ser obtido pela busca rotineira de dados em outros sistemas de informação nacionais, e identificar oportunidades perdidas de identificação de gestantes HIV+ em maternidades brasileiras.

MÉTODOS:: Estudo descritivo, de relacionamento de base de dados de estudo nacional com coleta primária de dados (estudo “Nascer no Brasil”), e de base de dados secundários de sistemas de informação nacionais. O estudo “Nascer no Brasil” é um estudo de base nacional, realizado em 2011–2012, com 23.894 puérperas, que identificou gestantes infectadas pelo HIV, utilizando registros em cartão de pré-natal e prontuário. Casos de gestantes com infecção pelo HIV identificadas no estudo “Nascer no Brasil” foram pesquisadas no Sistema de Informação de Agravos de Notificação, Sistema de Controle de Exames Laboratoriais da Rede Nacional de Contagem de Linfócitos CD4+/CD8+ e Carga Viral, e Sistema de Controle Logístico de Medicamentos. Utilizou-se o software OpenRecLink para relacionamento das bases de dados. Foi estimada a cobertura de notificação, com respectivo intervalo de confiança, dos sistemas de informação nacionais avaliados.

RESULTADOS:: A cobertura de notificação de HIV em gestantes no Sistema de Informação de Agravos de Notificação foi estimada em 57,1% (IC95% 42,9–70,2), e 89,3% das gestantes HIV+ (IC95% 81,2–94,2) foram localizadas em algum dos sistemas de informação nacionais pesquisados. A busca em outros sistemas de informação nacionais resultaria em aumento de 57,1% dos casos notificados. Não foram identificadas oportunidades perdidas de diagnóstico de gestantes HIV+ nas maternidades avaliadas pelo estudo “Nascer no Brasil”.

CONCLUSÕES:: A busca rotineira de informação em outros sistemas de informação nacionais, procedimento utilizado pelo Ministério da Saúde para casos de Aids em adultos e em crianças, deve ser adotado para os casos de infecção pelo HIV na gestação.

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Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1. Number of HIV-infected pregnant women identified in the “Nascer no Brasil” study and in Brazilian Health Information Systems. Brazil, 2011 to 2012.
HIS: Health Information System; SINAN Preg: Information System of Notifiable Diseases for HIV+ Pregnant women; SINAN AIDS: Information System of Notifiable Diseases for AIDS; SIM: Mortality Information System; SISCEL CD4: Control System for Laboratory Tests of the National CD4+/CD8+ Lymphocyte Count Network; SISCEL VL Control System for Laboratory Tests of the National HIV Viral Load Network; SICLOM: Logistics Control System for Medications
Figure 2
Figure 2. Cases reported in the SINAN for HIV in pregnancy and cases that would be added with the search in other Brazilian Health Information System. Brazil, 2011 to 2012.
HIS: Health Information System; SINAN AIDS: Information System of Notifiable Diseases for AIDS; SIM: Mortality Information System; SISCEL CD4: Control System for Laboratory Tests of the National CD4+/CD8+ Lymphocyte Count Network; SISCEL VL Control System for Laboratory Tests of the National HIV Viral Load Network; SICLOM: Logistics Control System for Medications
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