Introduction: Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy that affects the peripheral nervous system. The study aimed to describe the incidence of GBS in the world up to the year 2020. Methods: A systematic review was conducted. Searches were done in four databases, PUBMED, EMBASE, EBSCO and Biblioteca virtual em Saude (BVS), and in grey literature and manual search in the reference lists of eligible studies. nbsp;Results: A total of 72 studies were included. The incidence of GBS among the cohort studies varied from 0.30 to 6.08 cases per 100.000 habitants and 0.42 to 6.58 cases per 100.000 person-years. Among the self-controlled studies, the risk incidence ranged from 0.072 to 1 case per 100.000 habitants and 1.73 to 4.30 cases per 100.000 person-years. Conclusions: The reported incidence of GBS in the world among the studies included in the review is slightly higher than that reported in previous studies. The highest incidence rates were associated with public health events of international concern.

Self-Controlled Case Series (SCCS) and Self-Controlled Risk Interval (SCRI) study designs are types of studies where cases act as their controls. They are commonly used  by pharmacovigilance to study rare events. There is no existing tool for the assessment of the methodological quality of such studies. Critical appraisal in primary and secondary studies is crucial as it enables the reader to evaluate how the study was elaborated and take this into consideration while analyzing the evidence presented. This paper presents a proposal of an instrument that has been adapted from an already existing tool used for cohort studies and it combines the elements of this tool and the premises of the SCCS and SCRI study designs. It is expected that the tool will help researchers and readers in critically appraising SCCS and SCRI study designs.

ABSTRACT Background: Snakebites are a major problem in developing countries owing to their high morbidity rates, severity, and sequelae. In Brazil, most cases of envenomation are caused by Bothrops and Lachesis snakes. The present study aimed to evaluate variables associated with death, systemic complications, and amputations in victims of envenomation due to Bothrops or Lachesis snake. Methods: An analytical epidemiological study was performed with data from the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação [SINAN]) relating to the Brazilian Amazon for the period 2010-2015. A hierarchical Poisson regression analysis was performed with three aspects, namely, individual characteristics, sociodemographic characteristics, and clinical conditions. Results: The following associations were observed: i) advanced age (>65 years), sepsis, renal failure, and hemorrhagic manifestations were related to two outcomes - death due to snakebite and death from all causes; ii) more advanced age (≥46 years), time to health care longer than 6 hours, renal and hemorrhagic manifestations, and region of occurrence being rural areas were associated with systemic complications; and iii) children (up to 12 years old) were associated with amputations. Conclusions: Knowledge of the characteristics associated with severe outcomes in snakebites may help identify patients who will require more intensive care or longer follow-up and may provide the physician with counseling rationale for their possible prognosis.

RESUMO: Introdução: A comorbidade tuberculose e diabetes ainda continua um desafio para a saúde pública mundial. Objetivo: Analisar o perfil sociodemográfico e as características do diagnóstico e tratamento dos casos de tuberculose com e sem diabetes no Brasil. Métodos: Estudo transversal, com dados do Sistema de Informação de Agravos de Notificação e do Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica, no período de 2007 a 2011. Modelo de regressão de Poisson com variância robusta foi utilizado para estimar a razão de prevalência (RP) e seus respectivos intervalos de confiança. Resultados: A comorbidade estudada foi encontrada em 7,2% dos casos. Modelo hierárquico mostrou maior RP entre indivíduos do sexo feminino (RP = 1,31; intervalo de confiança de 95% - IC95% 1,27 - 1,35); maior associação nas faixas etárias 40-59 anos e ≥ 60 anos (RP = 11,70; IC95% 10,21 - 13,39 e RP = 17,49; IC95% 15,26-20,05) e com resultado positivo da baciloscopia - primeira amostra (RP = 1,40; IC95% 1,35 - 1,47). Reingresso após abandono e abandono foram inversamente associados na comorbidade (RP = 0,66; IC95% 0,57 - 0,76 e RP = 0,79; IC95% 0,72 - 0,87). Conclusão: Os achados, como a relação inversa do abandono ao tratamento da tuberculose no grupo das pessoas com comorbidade, reforçam a importância de ações integradas nos serviços para mudar o cenário dessa desafiadora comorbidade.

ABSTRACT: Introduction: Tuberculosis and diabetes comorbidity remains a challenge for global public health. Objective: To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. Methods: This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. Results: We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). Conclusion: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.

RESUMO: Introdução: A comorbidade tuberculose e diabetes ainda continua um desafio para a saúde pública mundial. Objetivo: Analisar o perfil sociodemográfico e as características do diagnóstico e tratamento dos casos de tuberculose com e sem diabetes no Brasil. Métodos: Estudo transversal, com dados do Sistema de Informação de Agravos de Notificação e do Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica, no período de 2007 a 2011. Modelo de regressão de Poisson com variância robusta foi utilizado para estimar a razão de prevalência (RP) e seus respectivos intervalos de confiança. Resultados: A comorbidade estudada foi encontrada em 7,2% dos casos. Modelo hierárquico mostrou maior RP entre indivíduos do sexo feminino (RP = 1,31; intervalo de confiança de 95% - IC95% 1,27 - 1,35); maior associação nas faixas etárias 40-59 anos e ≥ 60 anos (RP = 11,70; IC95% 10,21 - 13,39 e RP = 17,49; IC95% 15,26-20,05) e com resultado positivo da baciloscopia - primeira amostra (RP = 1,40; IC95% 1,35 - 1,47). Reingresso após abandono e abandono foram inversamente associados na comorbidade (RP = 0,66; IC95% 0,57 - 0,76 e RP = 0,79; IC95% 0,72 - 0,87). Conclusão: Os achados, como a relação inversa do abandono ao tratamento da tuberculose no grupo das pessoas com comorbidade, reforçam a importância de ações integradas nos serviços para mudar o cenário dessa desafiadora comorbidade. RESUMO Introdução mundial Objetivo Brasil Métodos transversal Básica 200 2011 Resultados 72 7 2 7,2 1,31 131 1 31 95 IC95 IC 127 27 1,2 135 35 1,35) 4059 40 59 40-5 6 11,70 1170 11 70 1021 10 21 10,2 1339 13 39 13,3 17,49 1749 17 49 15,2620,05 15262005 15,26 20,05 15 26 20 05 15,26-20,05 1,40 140 1,3 1,47. 147 1,47 . 47 1,47) 0,66 066 0 66 057 57 0,5 076 76 0,7 0,79 079 79 072 0,87. 087 0,87 87 0,87) Conclusão achados 201 7, 3 9 IC9 12 1, 405 4 5 40- 11,7 117 102 10, 133 13, 17,4 174 2620 15,2620,0 1526200 1526 15,2 2005 20,0 15,26-20,0 1,4 14 0,6 06 0, 07 08 0,8 8 11, 17, 262 15,2620, 152620 152 15, 20, 15,26-20, 15,2620 15262 15,26-20 15,262 15,26-2 15,26-

ABSTRACT: Introduction: Tuberculosis and diabetes comorbidity remains a challenge for global public health. Objective: To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. Methods: This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. Results: We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). Conclusion: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity. ABSTRACT Introduction Objective Brazil Methods crosssectional cross sectional 200 2011 (PR intervals Results 72 7 2 7.2 PR=1.31 PR131 1 31 (PR=1.31 95 95CI CI 1.271.35 127135 1.27 1.35 27 35 1.27-1.35) 4059 40 59 40-5 6 PR=11.70 PR1170 11 70 (PR=11.70 10.2113.39, 10211339 10.21 13.39, 10 21 13 39 10.21-13.39 PR=17.49 PR1749 17 49 15.2620.05, 15262005 15.26 20.05 , 15 26 20 05 15.26-20.05) st PR=1.40 PR140 (PR=1.40 1.351.47. 135147 1.47 . 47 1.35-1.47) PR=0.66 PR066 0 66 (PR=0.66 0.570.76 057076 0.57 0.76 57 76 0.57-0.7 PR=0.79 PR079 79 0.720.87. 072087 0.72 0.87 87 0.72-0.87) Conclusion findings 201 7. PR=1.3 PR13 3 (PR=1.3 9 271 1.271.3 12713 127 1.2 135 1.3 1.27-1.35 405 4 5 40- PR=11.7 PR117 (PR=11.7 2113 10.2113.39 1021133 1021 10.2 1339 13.39 10.21-13.3 PR=17.4 PR174 2620 15.2620.05 1526200 1526 15.2 2005 20.0 15.26-20.05 PR=1.4 PR14 (PR=1.4 351 1.351.47 13514 147 1.4 1.35-1.47 PR=0.6 PR06 (PR=0.6 570 0.570.7 05707 057 0.5 076 0.7 0.57-0. PR=0.7 PR07 720 0.720.87 07208 072 087 0.8 8 0.72-0.87 PR=1. PR1 (PR=1. 1.271. 1271 12 1. 1.27-1.3 PR=11. PR11 (PR=11. 211 10.2113.3 102113 102 10. 133 13.3 10.21-13. PR=17. PR17 262 15.2620.0 152620 152 15. 20. 15.26-20.0 1.351.4 1351 14 1.35-1.4 PR=0. PR0 (PR=0. 0.570. 0570 0. 07 0.57-0 0.720.8 0720 08 0.72-0.8 PR=1 (PR=1 1.271 1.27-1. PR=11 (PR=11 10.2113. 10211 13. 10.21-13 PR=17 15.2620. 15262 15.26-20. 1.351. 1.35-1. PR=0 (PR=0 0.570 0.57- 0.720. 0.72-0. PR= (PR= 1.27-1 10.2113 10.21-1 15.2620 15.26-20 1.351 1.35-1 0.720 0.72-0 1.27- 10.211 10.21- 15.262 15.26-2 1.35- 0.72- 15.26-

BACKGROUND Schistosomiasis mansoni is a poverty-related parasitic infection that has a variety of clinical manifestations. We consider the disability and deaths caused by schistosomiasis unacceptable for a tool-ready disease. Its condition in Brazil warrants an analysis that will enable better understanding of the local health losses and contribute to the complex decision-making process. OBJECTIVE This study estimates the cost of schistosomiasis in Brazil in 2015. METHODS We conducted a cost of illness study of schistosomiasis mansoni in Brazil in 2015 based on a prevalence approach and from a societal perspective. The study included 26,499 schistosomiasis carriers, 397 hepatosplenic cases, 48 cases with the neurological form, 284 hospitalisations, and 11,368.26 years of life lost (YLL) of which 5,187 years are attributable to economically active age groups. RESULTS The total cost of schistosomiasis mansoni in Brazil was estimated to be US$ 41,7million in 2015 with 94.61% of this being indirect costs. CONCLUSIONS The economic burden of schistosomiasis mansoni in Brazil is high and results in the loss of productivity. Its persistence in Brazil is a challenge to public health and requires inter-sectorial interventions in areas such as indoor water supply, basic sanitation, and education.

Abstract INTRODUCTION Chagas disease is a major public health problem that is endemic in Brazil and Latin America. This study aimed to determine the socioeconomic, demographic, and clinical characteristics of 171 patients (mean age, 45 years; female, 65%) with Chagas disease at Hospital Universitário de Brasília, Federal District, Brazil. METHODS We implemented this cross-sectional study using a clinical epidemiological questionnaire, electrocardiography, echocardiography, and quantitative detection of Trypanosoma cruzi DNA in blood using qRT-PCR. RESULTS Among the patients, 26.3% had a full elementary education, and 13.2% were illiterate. Most (63.6%) were economically classified as class C, and 51.5% were born in Bahia state. A total of 62.0% participants reported previous contact with the triatomine bug. The clinical forms of the disease were indeterminate (69.51%), cardiac (15.24%), digestive (10.37%), and mixed (4.88%). The most common electrocardiographic abnormality was complete right bundle branch block in association with a divisional anterosuperior block. Only 14.6% of the patients complied with benznidazole medication for at least 60 days, and 164 of them were assessed by echocardiography. The parasite load was positive in 56% of the patients. CONCLUSIONS: Chagas disease affected mostly women, with the indeterminate chronic form of the disease.

Abstract INTRODUCTION: We aimed to evaluate the frequency and associated factors of acute respiratory infection and death among home care patients in Sobradinho/DF, Brazil. METHODS: Data were obtained from patients’ medical records. Bivariate and multivariate analyses were performed. Odds ratio and 95% confidence interval were estimated. RESULTS: Factors associated with respiratory infection were ages <40 and >80 years and accommodation. Female sex was a protective factor. Age >30 years and dependency for daily activities were associated with death. CONCLUSIONS: These factors can improve clinical results in this specific home care and open new opportunities and questions for future research.

Resumo OBJETIVO: descrever o perfil dos casos de comorbidade tuberculose-diabetes no Brasil. MÉTODOS: estudo descritivo com dados do Sistema de Informação de Agravos de Notificação - tuberculose (Sinan-tuberculose) e do Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica (Hiperdia), de 2007 a 2011; o relacionamento probabilístico foi realizado com auxílio do software Reclink. RESULTADOS: foram encontrados 24.443 casos de comorbidade, incluindo 3.181 não registrados no Sinan-tuberculose; do total de casos recuperados, predominaram indivíduos do sexo masculino (57,2%), faixa etária de 40 a 59 anos (52,3%), raça/cor da pele preta/parda (68,4%), cinco a oito anos de estudo (78,4%), uso não regular de álcool (86,5%) e sorologia negativa para o vírus da imunodeficiência humana - HIV (91,8%). CONCLUSÃO: os casos captados tiveram perfil semelhante àqueles registrados no Sinan-tuberculose e o relacionamento dos dados de diferentes sistemas de informações possibilitou a detecção de casos não captados pela vigilância.

Abstract OBJECTIVE: to describe the profile of cases of tuberculosis and diabetes comorbidity in Brazil. METHODS: this is a descriptive study with data from the Brazilian Information System for Notifiable Diseases - tuberculosis (Sinan-TB) and from the System of Registration and Monitoring of Hypertension and Diabetes Mellitus (Hiperdia), from 2007 to 2011; probabilistic linkage was carried out with Reclink software. RESULTS: 24,443 cases of comorbidity were found, including 3,181 cases not registered on Sinan-TB; of the total number of recovered cases, mostly were males (57.2%), aged 40-59 years (52.3%), black/brown-skinned (68.4%), with five to eight years of schooling (78.4%), with no regular use of alcohol (86.5%) and negative serology for the HIV virus (91.8%). CONCLUSION: the cases found had similar profile to those registered on Sinan-TB and the probabilistic linkage of data from different information systems enabled the detection of cases not captured by surveillance.

Resumen OBJETIVO: describir el perfil de comorbilidad de casos entre tuberculosis y diabetes en Brasil. MÉTODOS: estudio descriptivo con datos del sistema de información de casos de notificación obligatoria - tuberculosis (Sinan-tuberculosis) y el Sistema de Gestión Clínica de Hipertensión y Diabetes Mellitus de Atención Primaria (Hiperdia), 2007-2011; la relación probabilística se realizó con el software Reclink. RESULTADOS: encontramos 24.443 casos de comorbilidad, incluyendo 3.181 casos no registrado en Sinan-tuberculosis; del número total de casos recuperados predominaron varones (57,2%), edades entre 40-59 años (52,3%), negro/mulato (68,4%), cinco a ocho años de estudio (78,4%), no uso alcohol (86,5%) y serología negativa para el virus de inmunodeficiencia humana HIV (91,8%). CONCLUSIÓN: los casos captados tuvieron un perfil similar a los del Sinan-tuberculosis y el relacionamiento de datos entre diferentes sistemas de información ayudó a la detección de casos no captador por la vigilancia.

Resumo OBJETIVO: descrever o perfil dos casos de comorbidade tuberculose-diabetes no Brasil. MÉTODOS: estudo descritivo com dados do Sistema de Informação de Agravos de Notificação - tuberculose (Sinan-tuberculose) e do Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica (Hiperdia), de 2007 a 2011; o relacionamento probabilístico foi realizado com auxílio do software Reclink. RESULTADOS: foram encontrados 24.443 casos de comorbidade, incluindo 3.181 não registrados no Sinan-tuberculose; do total de casos recuperados, predominaram indivíduos do sexo masculino (57,2%), faixa etária de 40 a 59 anos (52,3%), raça/cor da pele preta/parda (68,4%), cinco a oito anos de estudo (78,4%), uso não regular de álcool (86,5%) e sorologia negativa para o vírus da imunodeficiência humana - HIV (91,8%). CONCLUSÃO: os casos captados tiveram perfil semelhante àqueles registrados no Sinan-tuberculose e o relacionamento dos dados de diferentes sistemas de informações possibilitou a detecção de casos não captados pela vigilância.

Abstract OBJECTIVE: to describe the profile of cases of tuberculosis and diabetes comorbidity in Brazil. METHODS: this is a descriptive study with data from the Brazilian Information System for Notifiable Diseases - tuberculosis (Sinan-TB) and from the System of Registration and Monitoring of Hypertension and Diabetes Mellitus (Hiperdia), from 2007 to 2011; probabilistic linkage was carried out with Reclink software. RESULTS: 24,443 cases of comorbidity were found, including 3,181 cases not registered on Sinan-TB; of the total number of recovered cases, mostly were males (57.2%), aged 40-59 years (52.3%), black/brown-skinned (68.4%), with five to eight years of schooling (78.4%), with no regular use of alcohol (86.5%) and negative serology for the HIV virus (91.8%). CONCLUSION: the cases found had similar profile to those registered on Sinan-TB and the probabilistic linkage of data from different information systems enabled the detection of cases not captured by surveillance.

Resumen OBJETIVO: describir el perfil de comorbilidad de casos entre tuberculosis y diabetes en Brasil. MÉTODOS: estudio descriptivo con datos del sistema de información de casos de notificación obligatoria - tuberculosis (Sinan-tuberculosis) y el Sistema de Gestión Clínica de Hipertensión y Diabetes Mellitus de Atención Primaria (Hiperdia), 2007-2011; la relación probabilística se realizó con el software Reclink. RESULTADOS: encontramos 24.443 casos de comorbilidad, incluyendo 3.181 casos no registrado en Sinan-tuberculosis; del número total de casos recuperados predominaron varones (57,2%), edades entre 40-59 años (52,3%), negro/mulato (68,4%), cinco a ocho años de estudio (78,4%), no uso alcohol (86,5%) y serología negativa para el virus de inmunodeficiencia humana HIV (91,8%). CONCLUSIÓN: los casos captados tuvieron un perfil similar a los del Sinan-tuberculosis y el relacionamiento de datos entre diferentes sistemas de información ayudó a la detección de casos no captador por la vigilancia.

RESUMO A pesquisa teve por objetivo estudar se o macrocusteio, baseado no valor médio identificado no Sistema de Internação Hospitalar (SIH/SUS), constitui um bom estimador do custo de profissionais de saúde por paciente, tendo como comparação o método de microcusteio. O estudo foi desenvolvido no contexto da assistência hospitalar oferecida ao portador da deficiência de glicose-6-fosfato desidrogenase (dG6PD) do sexo masculino com evento adverso grave devido ao uso da primaquina, na Amazônia Brasileira. O macrocusteio baseado no gasto em serviços profissionais do SIH/SUS, como proxy desse custo, correspondeu a R$60,71, e o microcusteio, baseado nos salários do médico (R$30,43), do enfermeiro (R$16,33) e do técnico de enfermagem (R$5,93), estimou um custo total de R$52,68. A diferença foi de apenas R$8,03, mostrando que os valores pagos pela Autorização de Internação Hospitalar (AIH) são estimadores próximos daqueles obtidos por técnica de microcusteio para os profissionais envolvidos diretamente no cuidado.

ABSTRACT The aim of this study has been to study whether the top-down method, based on the average value identified in the Brazilian Hospitalization System (SIH/SUS), is a good estimator of the cost of health professionals per patient, using the bottom-up method for comparison. The study has been developed from the context of hospital care offered to the patient carrier of glucose-6-phosphate dehydrogenase (G6PD) deficiency with severe adverse effect because of the use of primaquine, in the Brazilian Amazon. The top-down method based on the spending with SIH/SUS professional services, as a proxy for this cost, corresponded to R$60.71, and the bottom-up, based on the salaries of the physician (R$30.43), nurse (R$16.33), and nursing technician (R$5.93), estimated a total cost of R$52.68. The difference was only R$8.03, which shows that the amounts paid by the Hospital Inpatient Authorization (AIH) are estimates close to those obtained by the bottom-up technique for the professionals directly involved in the care.

RESUMO A pesquisa teve por objetivo estudar se o macrocusteio, baseado no valor médio identificado no Sistema de Internação Hospitalar (SIH/SUS), constitui um bom estimador do custo de profissionais de saúde por paciente, tendo como comparação o método de microcusteio. O estudo foi desenvolvido no contexto da assistência hospitalar oferecida ao portador da deficiência de glicose-6-fosfato desidrogenase (dG6PD) do sexo masculino com evento adverso grave devido ao uso da primaquina, na Amazônia Brasileira. O macrocusteio baseado no gasto em serviços profissionais do SIH/SUS, como proxy desse custo, correspondeu a R$60,71, e o microcusteio, baseado nos salários do médico (R$30,43), do enfermeiro (R$16,33) e do técnico de enfermagem (R$5,93), estimou um custo total de R$52,68. A diferença foi de apenas R$8,03, mostrando que os valores pagos pela Autorização de Internação Hospitalar (AIH) são estimadores próximos daqueles obtidos por técnica de microcusteio para os profissionais envolvidos diretamente no cuidado.

ABSTRACT The aim of this study has been to study whether the top-down method, based on the average value identified in the Brazilian Hospitalization System (SIH/SUS), is a good estimator of the cost of health professionals per patient, using the bottom-up method for comparison. The study has been developed from the context of hospital care offered to the patient carrier of glucose-6-phosphate dehydrogenase (G6PD) deficiency with severe adverse effect because of the use of primaquine, in the Brazilian Amazon. The top-down method based on the spending with SIH/SUS professional services, as a proxy for this cost, corresponded to R$60.71, and the bottom-up, based on the salaries of the physician (R$30.43), nurse (R$16.33), and nursing technician (R$5.93), estimated a total cost of R$52.68. The difference was only R$8.03, which shows that the amounts paid by the Hospital Inpatient Authorization (AIH) are estimates close to those obtained by the bottom-up technique for the professionals directly involved in the care.

Abstract: INTRODUCTION: In the Brazilian Amazon, malaria infections are primarily caused by Plasmodium vivax. The only drug that kills the hypnozoite form of P. vivax is primaquine, thereby preventing relapse. However, treating glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals with primaquine can lead to severe hemolysis. G6PD deficiency (G6PDd) affects approximately 400 million people worldwide, most of whom live in malaria-endemic areas. Therefore, clinicians need tools that can easily and reliably identify individuals with G6PDd. This study estimated the accuracy of the Carestart(tm) G6PD rapid test (Access Bio) in the diagnosis of G6PDd in male participants with and without P. vivax acute malaria. METHODS: Male participants were recruited in Manaus. Malaria diagnosis was determined by thick blood smear. G6PD quantitative analysis was performed spectro photometrically at a wave length of 340nm. The Carestart(tm) G6PD test was performed using venous blood. Genotyping was performed for individuals whose samples had an enzyme activity less than 70% of the normal value. RESULTS: Six hundred and seventy-four male participants were included in this study, of whom 320 had a diagnosis of P. vivax malaria. In individuals with enzyme activity lower than 30% (n=13), the sensitivity, specificity, positive predictive value, and negative predictive value of the Carestart(tm) G6PD test were as follows: 61.5% (95%CI: 35.5%-82.3%), 98.3% (95%CI: 97.0%-99.1%), 42.1% (95%CI: 23.1%-63.7%), and 99.2% (95%CI: 98.2%-82.3%), 98.3% (95%CI: 97.0%-99.1%), 42.1% (95%CI: 23.1%-63.7%), and 99.2% (95%CI: 98.2%-99.7%), respectively. Increases in sensitivity were observed when increasing the cut-off value. CONCLUSIONS: Despite low sensitivity, Carestart(tm) G6PD remains a good alternative for rapid diagnosis of G6PDd in malaria-endemic regions.

Descrevem-se as internações por condições sensíveis à atenção primária com foco nas doenças infecciosas e parasitárias (DIP) e valida-se o Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS), para o registro das internações por condições sensíveis à atenção primária, em hospital do Distrito Federal, Brasil, em 2012. Estimaram-se sensibilidade (S), especificidade (E), valor preditivo positivo (VPP) e valor preditivo negativo (VPN) do SIH/SUS para registro de internações por condições sensíveis à atenção primária, tendo o prontuário como padrão-ouro. Houve 1.604 (19,6%; IC95%: 18,7-20,5) internações por condições sensíveis à atenção primária, e as principais DIP foram: infecção do rim e trato urinário; infecção da pele e tecido subcutâneo; gastroenterites infecciosas. As DIP foram causa principal de internações na faixa etária de 20 a 29 anos, tendo causado 28 óbitos. Estimou-se S = 70,1% (IC95%: 60,5-79,7), E = 88,4% (IC95%: 85,6-91,2), VPP = 51,7% (IC95%: 42,7-60,7) e VPN = 94,3% (IC95%: 92,2-96,4). Os achados de internações por condições sensíveis à atenção primária no hospital em questão foram similares aos de outros estudos, com destaque para as internações por DIP. O SIH/SUS foi mais específico do que sensível.

This study analyzes hospitalizations due to ambulatory care-sensitive conditions with a focus on infectious and parasitic diseases (IPDs) and validates the Hospital Information System, Brazilian Unified National Health System (SIH/SUS) for recording hospitalizations due to ambulatory care-sensitive conditions in a hospital in the Federal District, Brazil, in 2012. The study estimates the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the SIH for recording hospitalizations due to ambulatory care-sensitive conditions, with the patient's medical file as the gold standard. There were 1,604 hospitalizations for hospitalizations due to ambulatory care-sensitive conditions (19.6%, 95%CI: 18.7-20.5), and the leading IPDs were renal and urinary tract infection, infection of the skin and subcutaneous tissue, and infectious gastroenteritis. IPDs were the leading cause of hospitalization in the 20 to 29-year age bracket and caused 28 deaths. Sensitivity was 70.1% (95%CI: 60.5-79.7), specificity 88.4% (95%CI: 85.6-91.2), PPV = 51.7% (95%CI: 42.7-60.7), and NPV = 94.3% (95%CI: 92.2-96.4). The findings for admissions due to ACSCs in this hospital were similar to those of other studies, featuring admissions for IPDs. The SIH/SUS database was more specific than sensitive.

Se describen los internaciones por condiciones sensibles a la atención primaria, centrándose en las enfermedades infecciosas y parasitarias (DIP), y se valida el Sistema de Información Hospitalaria del Sistema Único de Salud (SIH/SUS) para el registro de las internaciones por condiciones sensibles a la atención primaria, en un hospital del Distrito Federal, en 2012. Estimadas sensibilidad (S), especificidad (E), valor predictivo positivo (VPP) y valor predictivo negativo (VPN) del SIH/SUS para el registro de internaciones por condiciones sensibles a la atención primaria, teniendo el historial como padrón-oro. Hubo 1.604 (19,6%; IC95%: 18,7-20,5) internaciones por condiciones sensibles a la atención primaria y las principales DIP fueron: infección del riñón y tracto urinario, infección de la piel y tejido subcutáneo y gastroenteritis infecciosas. Las DIP fueron la causa principal de las hospitalizaciones en la franja de edad de 20 a 29 años y causaron 28 óbitos. Se estimó S = 70,1% (IC95%: 60,5-79,7), E = 88,4% (IC95%: 85,6-91,2), VPP = 51,7% (IC95%: 42,7-60,7) y VPN = 94,3% (IC95%: 92,2-96,4). Los hallazgos de internaciones por condiciones sensibles a la atención primaria en este hospital fueron similares a otros estudios, destacando los internamientos por DIP. El SIH/SUS fue más específico que sensible.

Descrevem-se as internações por condições sensíveis à atenção primária com foco nas doenças infecciosas e parasitárias (DIP) e valida-se o Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS), para o registro das internações por condições sensíveis à atenção primária, em hospital do Distrito Federal, Brasil, em 2012. Estimaram-se sensibilidade (S), especificidade (E), valor preditivo positivo (VPP) e valor preditivo negativo (VPN) do SIH/SUS para registro de internações por condições sensíveis à atenção primária, tendo o prontuário como padrão-ouro. Houve 1.604 (19,6%; IC95%: 18,7-20,5) internações por condições sensíveis à atenção primária, e as principais DIP foram: infecção do rim e trato urinário; infecção da pele e tecido subcutâneo; gastroenterites infecciosas. As DIP foram causa principal de internações na faixa etária de 20 a 29 anos, tendo causado 28 óbitos. Estimou-se S = 70,1% (IC95%: 60,5-79,7), E = 88,4% (IC95%: 85,6-91,2), VPP = 51,7% (IC95%: 42,7-60,7) e VPN = 94,3% (IC95%: 92,2-96,4). Os achados de internações por condições sensíveis à atenção primária no hospital em questão foram similares aos de outros estudos, com destaque para as internações por DIP. O SIH/SUS foi mais específico do que sensível.

This study analyzes hospitalizations due to ambulatory care-sensitive conditions with a focus on infectious and parasitic diseases (IPDs) and validates the Hospital Information System, Brazilian Unified National Health System (SIH/SUS) for recording hospitalizations due to ambulatory care-sensitive conditions in a hospital in the Federal District, Brazil, in 2012. The study estimates the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the SIH for recording hospitalizations due to ambulatory care-sensitive conditions, with the patient's medical file as the gold standard. There were 1,604 hospitalizations for hospitalizations due to ambulatory care-sensitive conditions (19.6%, 95%CI: 18.7-20.5), and the leading IPDs were renal and urinary tract infection, infection of the skin and subcutaneous tissue, and infectious gastroenteritis. IPDs were the leading cause of hospitalization in the 20 to 29-year age bracket and caused 28 deaths. Sensitivity was 70.1% (95%CI: 60.5-79.7), specificity 88.4% (95%CI: 85.6-91.2), PPV = 51.7% (95%CI: 42.7-60.7), and NPV = 94.3% (95%CI: 92.2-96.4). The findings for admissions due to ACSCs in this hospital were similar to those of other studies, featuring admissions for IPDs. The SIH/SUS database was more specific than sensitive.

Se describen los internaciones por condiciones sensibles a la atención primaria, centrándose en las enfermedades infecciosas y parasitarias (DIP), y se valida el Sistema de Información Hospitalaria del Sistema Único de Salud (SIH/SUS) para el registro de las internaciones por condiciones sensibles a la atención primaria, en un hospital del Distrito Federal, en 2012. Estimadas sensibilidad (S), especificidad (E), valor predictivo positivo (VPP) y valor predictivo negativo (VPN) del SIH/SUS para el registro de internaciones por condiciones sensibles a la atención primaria, teniendo el historial como padrón-oro. Hubo 1.604 (19,6%; IC95%: 18,7-20,5) internaciones por condiciones sensibles a la atención primaria y las principales DIP fueron: infección del riñón y tracto urinario, infección de la piel y tejido subcutáneo y gastroenteritis infecciosas. Las DIP fueron la causa principal de las hospitalizaciones en la franja de edad de 20 a 29 años y causaron 28 óbitos. Se estimó S = 70,1% (IC95%: 60,5-79,7), E = 88,4% (IC95%: 85,6-91,2), VPP = 51,7% (IC95%: 42,7-60,7) y VPN = 94,3% (IC95%: 92,2-96,4). Los hallazgos de internaciones por condiciones sensibles a la atención primaria en este hospital fueron similares a otros estudios, destacando los internamientos por DIP. El SIH/SUS fue más específico que sensible.