Vigilância das meningites na Região Metropolitana de Belo Horizonte, MG, 1999: o uso dos sistemas de informação em saúde e o método da captura-recaptura na estimação da incidência e da subnotificação

Maria da Conceição Juste Werneck Côrtes

Vigilância das meningites na Região Metropolitana de Belo

Horizonte, MG, 1999: o uso dos sistemas de informação em

saúde e o método da captura-recaptura na estimação

da incidência e da subnotificação

Universidade Federal de Minas Gerais

Belo Horizonte

Maria da Conceição Juste Werneck Côrtes

Vigilância das meningites na Região Metropolitana de Belo

Horizonte, MG, 1999: o uso dos sistemas de informação em

saúde e o método da captura-recaptura na estimação

da incidência e da subnotificação

! "# $ % & ' ""

Universidade Federal de Minas Gerais

Belo Horizonte

Côrtes, Maria da Conceição Juste Werneck

C828v Vigilância das meningites na Região Metropolitana de

Belo Horizonte, MG, 1999: o uso dos sistemas de informação

em saúde e o método da captura-recaptura na estimação da

incidência e da subnotificação. /Maria da Conceição Juste

Werneck Côrtes. Belo Horizonte, 2002.

219p.

Tese(Doutorado)Medicina Tropical. Faculdade de

Medicina da UFMG.

1.Meningite. 2.Vigilância epidemiológica.3.Notificação

de doenças/métodos.4.Sistemas de informação. I.Título.

NLM: WA 105

UNIVERSIDADE FEDERAL DE MINAS GERAIS

()* (+!

"

+

,-

+

..

Pró-Reitoria de Pós-Graduação

(/ ()* (+!

"

0

FACULDADE DE MEDICINA

*() (!

"

1

2

Centro de Pós-Graduação

'

!

"

3

4

Programa de Pós-Graduação em Medicina Tropical

'

!

"#

5

'

(

2 6'

7

"#

1

"# 3

4 (

,

"# '

8

+

Ao Fernando, Bruno, Bernardo e Marcelo, meus amores, aos meus queridos pais e irmãos,

Sei da impossibilidade de agradecer a todas mas, quero nomear algumas pessoas que foram fundamentais neste processo trabalhoso e

também fecundo para o meu crescimento.Trilharam comigo os

caminhos tornando-se os verdadeiros responsáveis pela alegria e pela realização que agora vivo.

À

Professora

Waleska,

muito

mais

que

orientadora,

por

sua

disponibilidade, competência e principalmente pelo apoio e confiança, essenciais

na realização deste trabalho.

À Professora Suzana, amiga, companheira, orientadora, incentivadora em

todos os momentos e que tornou possível o término deste trabalho;...” e, se não

houver flores, nem frutos”..., valeu pela amizade!

À Renata Fabiana, pelo trabalho inestimável na preparação dos dados e

elaboração das tabelas; por tantas horas, por tantos sacrifícios, por tanta

paciência...

À Professora Sueli Mingoti, pelas valiosas contribuições nos cálculos e

orientações no método de captura-recaptura.

Ao Professor Manoel Otávio da Costa Rocha, Coordenador do Programa de

Pós-Graduação em Medicina Tropical e aos demais membros do Colegiado, pela

oportunidade de adquirir conhecimentos, pelo apoio e compreensão.

Ao Professor Geraldo Guedes, Chefe do Departamento de Medicina

Preventiva e Social, pelo empenho para a minha liberação de encargos docentes.

À Dra. Valéria de Melo Rodrigues de Oliveira, Superindentente de

Epidemiologia da Secretaria de Estado da Saúde, e Kelly Nogueira Guerra,

Soteres Marques que facilitaram a obtenção dos dados do SINAN.

À equipe da divisão de estatística da DMS, em especial Rômulo Morato,

Terezinha Rios e Gisele, pela boa vontade e presteza no fornecimento dos dados

do SINAN e SIM.

À Elsie, do CGP, pelas informações valiosas sobre as AIH.

À Patrícia Botelho, pela disponibilidade, boa vontade e informações

valiosas sobre as meningites e o SINAN;

À Diretoria da Faculdade de Medicina, representada pelo Professor Geraldo

Brasileiro, pelo suporte financeiro.

Aos colegas professores do DMPS que sempre se dispuseram a ajudar-me:

Horácio, Délcio, Mark, Bernadete, Paulinho, Itamar, Proietti.

Aos funcionários, amigos, sempre disponíveis: Maurílio, Olivier, Roberta,

Elisa...

Ao Sérgio, Marcelo, Fernanda e à Cláudia di Lorenzo, pelo apoio técnico.

Ao Fernando, companheiro que se superou para que eu não esmorecesse.

Aos meus filhos, Bruno, Bernardo e Marcelo, de quem tanto me orgulho,

pela aceitação de minhas ausências e crises de desânimo.

Aos meus pais e irmãos, cunhados e cunhadas exemplos de trabalho,

Raquel, pelo sacrifício!).

Aos meus amigos pela paciência em agüentar-me falando da tese o tempo

todo.

Às amigas Tereza Costa Oliveira e Elisa de Souza e Silva, incentivadoras

deste trabalho.

“O que é científico?

É aquilo que caiu nas redes reconhecidas pela confraria dos cientistas. Cientistas são aqueles que pescam no grande rio... Mas há também os céus e as matas que se enchem de cantos de sabiás...

Lá as redes dos cientistas ficam sempre vazias.”

SUMÁRIO

: *;+

< *; ( => ####################################################################################################################### <?

@ ,* )(+ (+ ######################################################################################################################## @<

@#< + 0* +=> +0 );*; * )0 ############################################################################################## @@

@#@ + A* *,B;'*+ ) * ) * ,/ *'+ ) 0 + +A+,*+=> ################################################################### @C

@#@#< + A* *,B;'*+ ;+0 );*; * )0####################################################################################### DE

@#@#@ +0 );*; * )0 ) + 0 1; * *'+=> ############################################################################## DD

@#D 0 0*0 ) +0 ) *; ( +=> ! ) + (+A 0 ) ; * *'+=> 60*;+;7F G 0 * +,+()0

60*G 0 07 ) ) ( +,* + ) 60* 7 ##################################################################################### DH @#D#< 0*0 ) + ) *; ( +=> ) + (+A 0 ) ; * *'+=> 60*;+;7 ################################## IE

@#D#@ 0*0 ) + ) *; ( +=J)0 G 0 * +,+()0 0*0 ) + K;*' ) 0+K ) 60*G 0 07########## I<

@#D#D 0*0 ) + ) *; ( +=J)0 ) ( +,* + ) 60* 7######################################################## IC

@#I 0 ), 0 ) '+ (+ ()'+ (+ ################################################################################## IL

D 13) *A 0 ########################################################################################################################## C?

D#< )(+, ############################################################################################################################### CM

D#@ )0 )'N *' 0 ###################################################################################################################### CM

I ) , *+##################################################################################################################### CH

I#< +0 ; )0 ) + 0########################################################################################################## L@

I#<#< 0*0 ) + ) *; ( +=> ) + (+A 0 ) ; * *'+=> 60*;+;7####################################### L@

I#<#@ 0*0 ) + ) *; ( +=J)0 G 0 * +,+()0 0*0 ) + K;*' ) 0+K ) 60*G 0 07############# LD

I#<#D 0*0 ) + ) *; ( +=> ) ( +,* + ) 60* 7########################################################## LC

I#@ + ,*'* + ) ) + 0 ################################################################################################### LL

I#D ':,' , 0 ' ) *'*); )0 ) *;'* 9;'*+####################################################################### L?

I#I O + '+ (+ ()'+ (+###################################################################################### LM

I#C ':,' , + 0 1; * *'+=> ########################################################################################## LH

I#L + +;:,*0) 0 + 0 ######################################################################################################## LH

I#? + + ( A+=> O *'+############################################################################################################ ?E

I#M ,)A+; + ); + ,* )(+ (+######################################################################################### ?<

I#H + () +=> + )0)############################################################################################################ ?<

C ()0 , + 0 ####################################################################################################################### ?@

C#< 0*0 ) + ) *; ( +=> ) + (+A 0 ) ; * *'+=> 60*;+;7 ######################################### ?D

C#<#< + *; ( +=> *0 ;NA),############################################################################################ ?I

C#<#@ 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+;############################################################# ?M

C#<#D 0 ' ) *'*); )0 ) *;'* 9;'*+ ) );*; * ) ( ()0* 9;'*+ ) ) )( *;+=>

) * ,/ *'+################################################################################################################ M?

C#@ '+0 0 ) );*; * ) * ); * *'+ 0 ; 0*G 0 0 ################################################################# H<

C#D '+0 0 ) );*; * ) * ); * *'+ 0 ; 0* ######################################################################## HI

C#I + ' +(+=> ) '+(+' )(N0 *'+0 ',N;*' ) (: *'+0 0 '+0 0 0*;+;F

0*G 0 0 ) 0* ########################################################################################################## HC

C#C 0 '+0 0 ) );*; * ) ) *+ (+ + ) A);; ################################################################## H?

C#C#< 0 '+0 0 ;> ; * *'+ 0 + 0*;+;########################################################################## HH

C#C#@ 0 '+0 0 ; * *'+ 0 + 0*;+; ) + 0); )0 0*G 0 0 ############################################ <E@

C#C#D + ' +(+=> ); () 0 '+0 0 ; * *'+ 0 + 0*;+; ) 0 ()0); )0 ;

0*G 0 0 ; 0* #################################################################################################### <EM

C#L + *;'* 9;'*+ ' 1*;+ + ) + 0 1; * *'+=> 10)(A+ + ################################################# <<L

C#? + 0);0*1*,* + ) ) A+, ( () * *A 0* *A 0*0 ) + ) A* *,B;'*+######################### <<?

L *0' 00> ######################################################################################################################## <@<

L#< 0*0 ) + ) *; ( +=> ) + (+A 0 ) ; * *'+=> 60*;+;7 ######################################## <@D

L#<#< + *; ( +=> *0 ;NA), 0 1() );*; * )############################################################ <@D

L#<#@ ( ;*'N * ) ()0* 9;'*+F ) + ); * ); ) ) G 0 * +,*P+=> ########################### <@?

L#@ + ' +(+=> ) '+(+' )(N0 *'+0 ',N;*' ) (: *'+0 0 '+0 0 0*;+;F

0*G 0 0 ) 0* ######################################################################################################### <DM

L#D +0 *; )(0)=J)0 ); () +0 ; )0! *+ (+ + ) A);; #################################################### <IE

L#D#< 0 '+0 0 ;> ; * *'+ 0 + 0*;+;########################################################################## <I@

L#D#@ 0 '+0 0 ; * *'+ 0 + 0*;+; ) + 0); )0 0*G 0 0 ############################################# <I?

L#D#D + ' +(+=> +0 ; )0 ) *; ( +=> ############################################################## <IH

L#D#I 0 '+0 0 ' ;0 Q 0*;+; ) 0*G 0 0 ########################################################################### <CE

L#I + *;'* 9;'*+ ' 1*;+ + ) + 0 1; * *'+=> 10)(A+ + ################################################# <C@

L#I#< + 0);0*1*,* + ) ) A+, ( () * *A 0* *A 0*0 ) + ) A* *,B;'*+#################### <CD

L#C 0 '+0 0 ()0 , +; )0 + '+ (+ ()'+ (+ ################################################################# <CC

L#C#< + )0' ,G+ ), ################################################################################################# <C?

L#L 0 +0 )' 0 ) ,/ *' 0########################################################################################### <LD

? ' ;', 0> ()' ); +=J)0 ########################################################################################## <L?

M# () )(9;'*+0 1*1,* (: *'+0 ############################################################################################# <?<

H# + 9; *')0######################################################################################################################### <MM

+ 9; *') + *0 (*1 *=> + ()RS9;'*+ ) ());'G* ); 0 '+ 0 0*;+; ; 0

?<L '+0 0 ; * *'+ 0F ( 1GF <HHH ##################################################################### <MH

+ 9; *') 1 '+(+' )(N0 *'+0 ',N;*' ) (: *'+0 0 '+0 0 0*;+;############################# <H<

+ 9; *') ' '+0 0 0*G 0 0 ############################################################################################### <HM

+ 9; *') '+0 0 0* ###################################################################################################### <HH

+ 9; *') ) '+0 0 ;> ; * *'+ 0 + 0*;+ ####################################################################### @EE

+ 9; *') '+0 0 ; * *'+ 0 + );+0 + 0*;+ ################################################################### @EI

+ 9; *') )0 * + *A+0 ( '+ (+ ()'+ (+ ################################################################## @EC

<E# +;)T 0 ############################################################################################################################# @E?

+;)T + ()0 , => 0)0 U CME ( +(*+ U <HID ################################################################ @EM

+;)T 1 ) *;*=> ) '+0 ) );*; * ) 61(+0*,F <HHM7####################################################### @<E

+;)T ' ,+=> ) :()+ + () *> ) ( ,* +;+ ) 1), G (*P ; )F <HHH##################### @<<

+;)T *'G+ *; *A* +, ) *;A)0 * +=> ########################################################################## @<@

+;)T ) (),+=> 0 ;*'N * 0 + *() (*+ ) ( ,* +;+ ) 0+K ) V1G )

'/ * 0 ) G 0 * +*0 + (0 ) 1), G (*P ; ) ################################################## @<I

+;)T + (*P+=> ) *; )(;+=> G 0 * +,+( ################################################################# @<?

LISTA DE TABELAS

+1),+ < 0);0*1*,* + ) ) A+, ( () * *A 0* *A ) 0*0 ) + ) A* *,B;'*+ # @H

+1),+ @ ':,' , + ' 1)( (+ ) () *0 ( 0 ) '+0 0 ) +0 ; )0 ), O ) '+ (+ ()'+ (+ ####################################################################### LH

+1),+ D *0 (*1 *=> + ()RS9;'*+ ) ());'G* ); ) +, ;0 '+ 0 0*;+; ; 0 ?<L '+0 0 ; * *'+ 0F ( 1GF <HHH############################################# ?C

+1),+ I 0);0*1*,* + )F )0 )'* *'* + ) ) A+, ()0 () * *A 0 0 0*;+*0 ) 0*; +0 0+ 0 ;+ ) *;*=> ) '+0 ) );*; * )F 0*;+;F ( 1GF <HHH##################################################################################################################### ??

+1),+ C *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; (

;*'N * ) ()0* 9;'*+ ) ) + ); * ); F ( 1GF <HHH ############################# ?M

+1),+ L *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; (

;*'N * ) + ); * ); ) ) G 0 * +,*P+=> F ( 1GF <HHH ##################### ?H

+1),+ ? *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; ( *+ ;/0 *' *;+,F ( 1GF <HHH ####################################################################### ME

+1),+ M *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; (

G 0 * +,*P+=> F ;*'N * ) *+ ;/0 *' *;+,F ( 1GF <HHH##################### ME

+1),+ H *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; ( G 0 * +, ) *+ ;/0 *' *;+,F ( 1GF <HHH#################################################### M<

+1),+ <E *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; (

)0 + N0 *'+0 + (+=> + G 0 * +,*P+=> F ( 1GF <HHH########################## M@

+1),+ << *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; ( )0 + N0 *'+0 ) )' ((* ); () + G 0 * +,*P+=> ) + ; * *'+=> F ( 1GF <HHH ################################################################################## MD

+1),+ <@ *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; ( ) )( *;+=> ) * ,/ *'+F ( 1GF <HHH########################################################### MI

+1),+ <D *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; (

'(* O(* 0+ +(+ *+ ;/0 *' ) ) * , *+F ( 1GF <HHH ####################### MC

+1),+ <I *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; ( )A , => ) *+ ;/0 *' *;+,F ( 1GF <HHH################################################### ML

+1),+ <C *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; ( ) * , *+ ) )A , => F ( 1GF <HHH################################################################## M?

+1),+ <L ()RS9;'*+0 ) ' ) *' *); )0 ) '+0 0 ) '+0 0 ' ; *( + 0 )

);*; * )F ( ;*'N * ) ()0* 9;'*+F ( 1GF <HHH################################## MM

+1),+ <? ' ) *'*); ) ) *;'* 9;'*+ ) );*; * ) ( ;*'N * ) ()0* 9;'*+ ) ) * , *+F ( 1GF <HHH ###################################################################################### HE

+1),+ <M *0 (*1 *=> 0 '+0 0 ) );*; * ) () *0 (+ 0 ; 0*G 0 0 (

;*'N * ) ()0* 9;'*+ ) ) * , *+F ( 1GF <HHH####################################### H@

+1),+ <H *0 (*1 *=> 0 '+0 0 ) );*; * ) () *0 (+ 0 ; 0*G 0 0 (

;*'N * G 0 * +,F G 0 * +, ) ) * , *+F ( 1GF <HHH########################## HD

+1),+ @E *0 (*1 *=> 0 '+0 0 ) );*; * ) () *0 (+ 0 ; 0*G 0 0 ( )A , => ) ) * , *+F ( 1GF <HHH################################################################## HI

+1),+ @< *0 (*1 *=> 0 /1* 0 ( );*; * ) () *0 (+ 0 ; 0* (

;*'N * ) ()0* 9;'*+ ) ) ' ((9;'*+F ( 1GF <HHH ############################### HI

+1),+ @@ *0 (*1 *=> 0 /1* 0 ( );*; * ) () *0 (+ 0 ; 0* ( G 0 * +,F ( 1GF <HHH ######################################################################################## HC

+1),+ @D ' +(+=> ) A+(*:A)*0 ',N;*' ) (: *'+0 0 '+0 0 )

);*; * ) );' ; (+ 0 ; 0*;+;F 0*G 0 0 ) 0* F ( 1GF <HHH#################### HL

+1),+ @C *0 (*1 *=> 0 '+0 0 ) );*; * ) () *0 (+ 0 ; 0*;+; )

+ 0); )0 ; 0*G 0 0F ( 1GF <HHH ################################################################# <ED

+1),+ @L *0 (*1 *=> 0 '+0 0 ) );*; * ) () *0 (+ 0 ; 0*;+; )

+ 0); )0 ; 0*G 0 0 ( ;*'N * ) ()0* 9;'*+ ) G 0 * +,F ( 1GF <HHH####################################################################################################### <EI

+1),+ @? *0 (*1 *=> 0 '+0 0 ) );*; * ) () *0 (+ 0 ; 0*;+; ) + 0); )0 ; 0*G 0 0F ( 1GF <HHH ################################################################# <EC

+1),+ @M *0 (*1 *=> 0 '+0 0 ) );*; * ) () *0 (+ 0 ; 0*;+; )

+ 0); )0 ; 0*G 0 0 ( ;*'N * ) G 0 * +,*P+=> ) ) * , *+F ( 1GF <HHH######################################################################################################## <EL

+1),+ @H *0 (*1 *=> 0 '+0 0 ) );*; * ) () *0 (+ 0 ; 0*;+; )

+ 0); )0 ; 0*G 0 0 ( G 0 * +, ) ) * , *+F ( 1GF <HHH##################### <EL

+1),+ DE *0 (*1 *=> 0 '+0 0 ) );*; * ) () *0 (+ 0 ; 0*;+; ) + 0); )0 ; 0*G 0 0 ( '(* O(* 0+ +(+ *+ ;/0 *' ) ) * , *+F ( 1GF <HHH #################################################################################### <E?

+1),+ D< ' +(+=> ) +, +0 A+(*:A)*0 ) '+0 0 );' ; (+ 0 + );+0 ;

0* F ; 0*G 0 0 ) ; 0* F ) ; 0*;+; ) 0* F ( 1GF <HHH############################# <EH

+1),+ D@ (+=> + G 0 * +,*P+=> 0 '+0 0 ) );*; * ) () *0 (+ 0 + );+0 ; 0*G 0 0 ) ; 0*;+;F ( 1GF <HHH################################################## <<E

+1),+ DD *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; ) () *0 (+ 0 ; 0*G 0 0 ( A+(*:A)*0F 1+;' 0 ) )('); +, ) ' ;' ( B;'*+F ( 1GF <HHH ############################################################################ <<@

+1),+ DI *0 (*1 *=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; )

() *0 (+ 0 ; 0*G 0 0 ( ) * , *+F ( 1GF <HHH################################## <<D

+1),+ DC *0 (*1 *=> 0 '+0 0 ) );*; * ) )0'+( + 0 ) 0) *; ( +=> 0*;+; ) () *0 (+ 0 ; 0*G 0 0 ( +*T+ ) :(*+ ) ) * , *+F ( 1GF <HHH####################################################################################################### <<I

+1),+ DL *0 (*1 *=> 0 '+0 0 ) );*; * ) )0'+( + 0 ) 0) *; ( +=> 0*;+; ) () *0 (+ 0 ; 0*G 0 0 ( G 0 * +, ) ) * , *+F ( 1GF <HHH################################################################################################################### <<I

+1),+ D? (+=> + G 0 * +,*P+=> 0 '+0 0 ) );*; * ) ; * *'+ 0 + 0*;+; ) () *0 (+ 0 ; 0*G 0 0F ( 1GF <HHH ############################################# <<C

+1),+ DM ()R 9;'*+0 ) ' ) *'*); )0 ) '+0 0 ) );*; * ) 0*;+;F 0 * ); * *'+ 0 (+ 0*;+; ) + ( (=> ) 0 1; * *'+=> F ( 1GF <HHH################################################################################################################### <<L

+1),+ DH 0);0*1*,* + ) ) A+, ( () * *A 0* *A 0*0 ) + ) A* *,B;'*+F ( 1GF <HHH######################################################################################################## <<?

+1),+ IE )0 * + *A+ ) '+0 0 ) );*; * ) 0+; ), 0 ( 1+1*,N0 *' 0 ) +0 ; )0 0*;+;F 0*G 0 0 ) 0* F ( 1GF <HHH################################################ <<H

+1),+ I< )0 * + *A+ ) '+0 0 ) );*; * ) 0+; ), 0 ( 1+1*,N0 *' 0 ) +0 ; )0 0*;+;V0*G 0 0 ) 0*;+;V0*G 0 0V0* F ( 1GF <HHH####################### <<H +1),+ I@ ' ) *'*); ) ) *;'* 9;'*+ ) 0);0*1*,* + ) +0 ; )0 ) *; ( +=>

LISTA DE FIGURAS

* (+ < Q *; )(0)=> +0 ; )0 +(+ )0 * + *A+ ) ;K )( ) '+0 0 ) +

,+=> ( '+ (+ ()'+ (+######################################################################## IH

* (+ @ Q () *> ) ( ,* +;+ ) 1), G (*P ; )F <HHH 6@L ;*'N * 07######################### L<

* (+ D Q +, (* +(+ +;:,*0) ) ,*'+=J)0 ) '+0 ; 0*;+;##################################### LL

* (+ I Q ' ) *'*); ) ) *;'* 9;'*+ ) );*; * ) ; * *'+ + + 0*;+;F (

;*'N * ) ()0* 9;'*+F ( 1GF <HHH############################################################### MH

* (+ C Q ;K )( ) '+0 0 Q +,F ' ; *( + 0 6 7F )0'+( + 0 6 7 ) 0)

*; ( +=> 6 7 ) );*; * ) ( 1+;' ) + 0######################################### HM

* (+ L Q '+0 0 ' ; *( + 0 ) );*; * ) ( 1+;' ) + 0 ########################################## HH

* (+ ? Q '+0 0 ;> ; * *'+ 0 + 0*;+;############################################################################ HH

* (+ M Q '+0 0 () *0 (+ 0 + );+0 ; 0* ######################################################################## <EE

* (+ H Q '+0 0 () *0 (+ 0 ; 0*G 0 0 ) ; 0* ################################################################ <E<

* (+ <E Q '+0 0 ; * *'+ 0 + 0*;+; ) + 0); )0 ; 0*G 0 0 ############################################ <E@

LISTA DE SIGLAS E ABREVIATURAS

+*G + . * G

' ' ' " '

' ( Q ' F ( W W

')A Q ' ) A 8

' ' Q ' ' 6 '; 3 Q ' ; 3 8 7

' '

') Q ' )

'*<EE ' " X <EE#EEE 2

'* ' " *

'* <E Q ' " * Q <EY

'*) Q ' "

'* <EE ' " 4 X <EE#EEE 2

' ) Q ' X O

+ +0 0 * " 5 0 K 0

-0 0 - 1 G .

;+ : & 4

Q /

(0 Q ( 0

-0 0 5 1 G .

),*0+ ) . % W

) + ) + 4

G) * G )

* #

*G Q * G

(+ # 5"

G+1# G

G) G ) .

G*Q G "

G*A A8 * " X G

*1 ) * 1 " ) 8

*;+ 0 Q * ; + X 4 X

,'( ,8 4"

,*,+'0 Q , , + ' ' X 0

-1;) Q 1 ; ) "

) ,*;) Q 1 1 ; )

;) Q ; ) "

) Q )

1 ) 1

A ) A

;1 ; .

0 Q . + 0

'( (

;) Q

( +1), Q ) 1 G .

( 1G ( 1 G .

(;+ : ( 4

0+ G 0 Q 0 + X 4 G X 0

0+ G 0V+*G Q 0 + X 4 G X 0 V+ . *

G

0)0V 0 ) 0 - )

0* Q 0 * "

0*G 0 0 0 * " Z G 0 K 0

-0* 0 * "

0*;+; 0 * " + ; "

0*; +0 Q 0 ; + X 0

0 0+ 1G Q 0 0 - 1 G .

0;' 'G Q 0 ; ' ' G

0;A) Q 0 ; A [

0 0 0 K 0

-+1# Q

1' Q

0 Q 0

RESUMO

) [ ( 1

G

.

F

F

<HHHF

.

0*;+;F

0*G 0 0

0* F

F

"

"

" 8 5 X "

#

"

<#D@E

F

?<L 6CIF@\7

0*;+; ]CM? " 6M@FE\7F ?L 6<EFL\7 CD "

6?FI\7^_ CC< 6I<FM\7

0*G 0 0

CD

0*

6IFE\7# '

H<M

F <? 6<FH\7 X " F DIL 6D?F?\7 0*G 0 0

0*;+;_ <I 6<FC\7

0*;+;

0* _ M 6EFH\7

0*G 0 0

0* _ DDH

6DLFH\7

0*;+;F <ME 6<HFL\7

0*G 0 0

<I 6<FE\7

0* # ;

0*;+;F " F @CI 6IDFH\7

]H? 6<LFL\7 F D? 6LFD\7 F @I 6IF<\7

2 " ^_ M? 6<IF?\7F " _ @EH 6DCF?\7 _

CH 6<EF<\7 " # ) " " # 0*;+;

<EE\

2

Q

"

X Q <E\

2 # + 4 8 F

<#EM? 6*' HC\! <EDD_<<LL7

" 60*;+; 0*G 0 07 Q , Q <#EMC 6*'

HC\! <#EIL_<#<D?7 <#<EE 6*' HC\! <#EL<_<#<CE7 X

"

C<\F

F

"

F

LC\

CE\

X "

# +

X

"

<?F?

<EE#EEEF

<IFC

"

#

"

X

" @? <EE#EEE 2 # + " Z " DI\

DC\ 0*;+; IH\ CE\ 0*G 0 0F F F

X " # ' !

" " 8 F F "

"

_ 0*G 0 0 [ F F

. ` " _

"

2

[

_

" X _ "

Z

F a #

2 ! _ [ _ " _

ABSTRACT

2 " 2 W b " 2

+ " 1 G . F F 1 . F <HHHF 2 "

2 W ! 2 W "

W Q 0*;+;_ 2 2 Q 0*G 0 0 2

W W Q 0* # ) " " 2 b F

" 2

W " 2

"

b

# 2

2 " 2 W b

2

W# +

" <FD@E b

F

H<M

F b 2 <#H\ "

W

# * 0*;+;F

" CM?

"

F @CI

b ]H? 6<L#L\7 W

N. meningitidis

F D? 6L#D\7 W

S. pneumoniae

@I 6I#<\7 W

H. Influenzae

^F M?

F @EH

CH 2

"

" 2

W# 2

"

" 0*;+; " <EE\ 6 " "

7

2

<E\ 6 &

&

F 2

2W & F

F 7# +" W c

F " 2 F " b

2

"

# 2 ,

6 b ! 0*;+; 0*G 0 07 W <F<M? 6HC\ '*! <FEDD

<F<LL7

'*! <FEL< <F<CE7 2 2 # 2 W " 0*;+; 0*G 0 0

b

LL\

C<\F

WF

b

LC\

CE\ b 2 2 # 2 " b <?F?V<EEFEEE

6<IFCV<EEFEEE " " 7F 2 2 @?#@V<EEFEEE#

*

"

F

F

F 2 " " 0*;+; " "

_ 2 2

"

"

W ` 2 " W 2

# + b 2 W "

W

_ 2

2

W

"

" " 2 " # 2 " 2

b

W

W

2

2

F " W #

d Wb

!

F

W

F

F

"

<M

;

2

F

- Z "

5 F 8 .

8

-

F

)

2 F

*

F

) +F # F 4 F 8 4 F

[ ; e %

6+'d +;F 1*(dG)+ F ,e;;F <HHL7F . Q

! Q F F

Z 8 #

2 " 2

[ 6' 'F @EE<7F [

4 F 2 #

+ -

-F " a 8"

6 ), ,+F <HMD_ 1(+0*,F <HHL_ ' 'F <HH?_ 1+(( 0

#F <HHM_ *+PF <HHH_ ),1+( F <HHH_ 1 ),G F @EE<7# )

" 8 F . 4

8

F

. - - # !

F

F

&

X

"

._

+* 0F F

6( ) F @EEE_ 1)()P*; #F @EE@_ ()*()F @EE@7#

" X " F

1 6 )('G:; G+ +;;F <HH?_ 0*,A+ 3K;* ( #F @EEE_ 1 ),G F @EE<7

6$); )(

#F <HHE_ G+(A)eF d+ ,F ) )(0F <HH@_ 1+(R )

#F <HHH_

, F <HHH_ + 0 *;*

#F @EEE7

" [ #

"

"

4

.5

F

8

Z 61+(( 0 #F <HHM_ ,)00+

#F @EEE_ ); )0 #F @EEE_ )('G:; G+ +;; f ,+ +( *+F @EEE7#

'

F

F

<H

8 F ` " "5

" " #

; F F 4 "

F

F

8

<HHE @EEEF "

@#C?L

# +

4

Z 2 8 <HHD @EEEF " D#DHI# 1 2 6@EE<7

"

#

F 0

3-

# 6@EEE7F

Z " Z

1 F F F

" Z Z F 2 Z

8 #

" . Z !

7 &

-

5

"

_

7

-25

F

F

"

8

F

F

.

5

Z #

)

"

F

F X " " #

"

.

"

Z

" 5 + . * G 6+*G7

Z

2

-

6 + G*+0 f

0 1 ,,F <HHM_ '+

0

#F @EEE7#

[

"

&

2 -

-6+R *;

#F <HH?_ '+(A+,G F <HH?_ '

+ *1*,*P+=> <HH? _

' + *1*,*P+=> <HH? _ +, )* + f +,);'+(F @EEE_ ' ),*F A)(+0F

' *;G F @EEE_ ,)00+ #F @EEE_ ); )0 #F @EEE7#

+

[

"

"

[

-

#

"

" . [ F "

@E

F " F

-

5

4

6,+ ( )F ''+( eF ,,F <HH@_ ,+ ( )F <HHI_ +'d +;F 1*(dG)+ F

,e;;F <HHL_ G d f () +,F @EEE7#

F X ( 1GF

" #

+

4

F

F

Z

8"

5

#

F

a

61(+0*,F <HHM7# )

2

"

"

F

4

&

2.1

A SITUAÇÃO DAS MENINGITES

@@

+ 6()0); )F

<HHM_

),1+( F <HHH_ $*;

*), F <HHH_ +,A)0F @EE<_ 0+; 0F @EE<7F

6 ()*() f ()*()F @EEE7# )

F $

"

6<HHH7

2

"

# )

F a F F

6'+( $(* G F <HH?F

$*;

*), F <HHH7# +

F F F

" . F F F Z

6'+ 1),,F <HHH7#

; * [

F 0

6<HH?7

@E

X

F F F

4

F

F #

)

F

8

` G

+

2 F '

5F '2

F

F ) +F

[

F

F

[

F

1

2 F G

F * [

F ;

F 0 4

# +

2

"

?EE#EEE

.

a

4 IE\F

(-

F

8"

60'G 'G+

.

F <HH?_

,e;)+ T

#F <HHM_

* *;+

.

F <HHH_

),1+( F <HHH_ , F <HHH_ ,+; +A)( )

.

.

F <HHH7#

+ "

aX

*

8

L@?

F

<HH@F @H <HH@#

; ) + 2 HI\ X <HML <HHC 60'G 'G+

.

F <HH?7#

; 1

F

<HHE

@EEEF "

"

@H?#EEE

"

F

&

<L#EEE 6CFI\7

Haemophilus influenzae

# +

<?\F

@E\

<@\ < I 61(+0*,F

<HHL_ 1(+0*,F @EEE7# ; ( 1G "

"

II<

8

@D

5

F

<HHH#

`5

F 4 <CIM F " 4

HE "

8

<EL

1

@EEE 6( +;),,*

#F

@EE@7#

' " 6<HD?7 6<HII7

61+(R ) .F <HHH7F

6$*0)F <HHH7F

2 8 #

) F F

" F X X "

"

.

1# ) 5

Z

[ V 6G+((*0 ;F <HHC_

3+'d0 ;

.

+ " 4

8" 6 " & 7F

# '

"

<D

! +F 1F 'F

F TF eF PF

$<DCF @H)F GF *F d ,F . X & F

8 F

.

&

F

+F

1F

'

5 HE\ F 1

F +

63+'d0 ;

.,

<HHC_ 1+, (

.

F <HHH_ +(G+ f

+(R )0F

@EEE7#

8

8"

.

"

*

*

# +

N.

meningitidis

8

F

F

8" 6 +(G+ f +(R )0F @EEE7# + 8

+F ' 6

7 F

F

+F 1F $<DCF eF

61(+0*,F <HHM_ +(G+ f

+(R )0F @EEE7# +

1F X

" 5 `5 . 5

6()R )3 F <HH?_ ), ,+F <HHH_ +(G+ f +(R )0F @EEE7#

+

"

&

"

-@I

6' 'F <HH?_ ), ,+F <HHH7

5

8

2

`

!

4 F

"

F

F

2

F

F

"

8

F

4F @C 2

X

8

- #

+ " & F 2 " F 5

2 F

# ) 2 F ` " " &

2 @ F F `

8 & @I 2 6 ()*() f ()*()F @EEE7#

+

F

"

(

4

F

# +

F

F 5 # )

<HMH <HHIF X 5 F F <HHHF

F 1 6CE\7

' 6DC\7#

'

[

F

"

2

F

6;)+,

.

F <HHH_ $*0)F

<HHH7#

1F

&

C

F

( # + " C\ H\

8

<HMH <HHC

@E\

# +

"

@@\

6'+( $(* G F <HHM ),1+( F <HHH7# + 1 2 " 8

' <HHHF

. ` 5 F

4

6$*0)F <HHH7#

;

) +F

4

N. meningitidis

4

` 6' 'F <HH?_

0'G 'G+

.

F <HH?_

*+PF <HHH7

5

@LEE

# )

5

F

5

5

6 *+PF <HHH7# +

&

F

F

EFC

@FE

<EE#EEE

# ) F 8 " F F 2

@C

@C

<EE#EEE

&

CEE

<EE#EEE

# F <HHCF DD#EI? F <HHLF <CD#LCC

<HH?F LE#E<E

61 A*)(F $e00F + F <HHH_ '+

+ ;)

.

F <HHH_

+(G+ f +(R )0F @EEE7#

"

X

<EE#EEE 2

<HH@ " ! , @FE_ ; e % EFDM_

$ 2 EFIH_ 1 IF?M 6 [ 7 CF?E

6 7 61+(R )

.

F <HHH7#

) F 4 X

- F F F

F

"

# ; 1

F

f 2 F 6<HHH7 X

5 @E\F &

6

@\7

# +

"

X X X

" 61)()P*;

#F @EE@_ ( +;),,*

#F @EE@7#

"

` F

F

8

F

.

4 6( +;),,* #F @EE@7#

2.2

A VIGILÂNCIA EPIDEMIOLÓGICA E SUA AVALIAÇÃO

h W 2 % " 2

F 2 2 " b #i<

+ [ " X " X 6

surveillence

7

8

2

;

1

# 0

;

6<HHM7F

4

Z

#

.

F

F

`

h

i

8

5

. F X F " 5

6 G+'d)( f 1)(d), +;F <HH@7#

+ " <D??F

" 6 )*T)*(+

.

@L

5 [ j

<DIMF

5

F

( - A . F

6 G+'d)( f 1)(d), +;F <HH@7# ) <MC<F 4

A . F ' " X 0 5 * F

" 8 5&

"

F

8

F

4 # ) 8 F " "

(

0

5

*

<HC<F

4 2 `

#

"

"

5

4

!

F

F "

F

8

F "

"

# )

<HLHF "

"

"

" F <HM<F 8 " & 8 #

0

2

%

f 1

%

6<HH@7

2

-

-

F "

2

,

02

%

$

# ' 0 5 2 02 %

<MCEF " X "

" Z # 8 5

[ " " $ 6<ME? <MMD7 F

8 ' (

*

8

F

<MDH

<M?HF

F

8 F F - #

; ) +F 5 8 <M?IF

-

2

"

5

.

F

4 # ' F " " F

* 5 <MM< F 1 2 <MHH#

+

2

8

F

&

X

5

4

CEF

& 4 [

8

# +

X

2

5

F

@?

[ 8

6 +(() F <HHC7#

; 1

F

A

[

)

4

0 - 61(+0*,F <HHM7F 4 4 CEF

vigilância epidemiológica

5 "

8 F

# ;

8

LEF

F

`

" 5 2 F F

2

F

Z

"

6'+(A+,G F <HH?_ 1(+0*,F <HHM7#

)

<H?CF

0

;

A

[

)

Q 0;A)F

,

L@CHVHC

?M#@D<V?LF "

F

4

Z

.

.

8

2

8

Q ')A 6<HLL ?D7 61(+0*,F <HHM7F

`

F

[

5

8 F ` !

7

`

(

0

5

*

!

8

F "

F _

7

;

*

.

!

F

F 4

F

"

F

2 F

F "

"

_

7

4 0 - ! 5 F 2 8 _ F

7

) F " " 8 "

2 F , F 4

"

# )

"

Z

"

F

4

1

0

;

"

F

0 0 - F .F F

@M

+ , MEME 61(+0*,F <HHE7 0 K

0 -

Q 0 0

5

F

.

-

1

8

- Z - #

vigilância

epidemiológica

<HMH

"

vigilância em saúde públicaF

"

Z

6$+, +;F <HHM7#

[

-

-

4

--

8

-- 6' 'F @EE<7# 8 4

2

6+'d +;F 1*(dG)+ F ,e;;F <HHL7#

[ - - 4

[

-

`

#

2

"

a

.

!

F " &

F

F

F

F

F

#

`

[

`

F 4

5

"

F

"

F 2

"

F

# 0

" Z " ! - F &

5

5"

F

&

F

F

" F

6 ), ,+F <HHH7# +

"

Z

&

F

F

"

5

"

Z

.

6 7#

)

#

5"

" &

"

Z

@H

"

5

-

Z

"

.

[

F

` F & #

+

[

-

-

4 "

6' 'F @EE<7!

7

7

Z ` " _

7

"

F

aX

2

4

6 " 7_

7

+ X "

5

"

`

"

Q 4

- [ F

F +V6+ k'7 +1#<#

6A

7 4

"

X

[

F

` F

"

F

+V6+k17 +1#<#

TABELA 1- SENSIBILIDADE E VALOR PREDITIVO POSITIVO DE UM SISTEMA DE VIGILÂNCIA

Detectado pelo sistema Sim

Doença

Não Total

0

; Total

! ' 'F @EE<#

Verdadeiro positivo + Falso negativo

' + k '

Falso positivo 1 Verdadeiro negativo

1 k

+ k 1

' k

+ k 1 k 'k

+ A " "

"

# A

"

" - # ; 8 F

[

A

& F

` F

"

F

5

&

# )

8 - - F " "

5

.

DE

"

"

" X [

6d,+ 'd)F <HH@_ ' 'F @EE<7#

[

8

Z

F

"

X

# ;

X

F

4

F & " 6+'d +;F 1*(dG)+ F

,e;;F <HHL_ + 0 *;* #F @EEE7#

;

[

F 4

"

&

8

"

Z

6' 'F <HMM7#

" Z 2 8 $ 2 F

) +F

"

2

1

2

&

&

2

+

1

8

"

# +

[

" F X

F " "

2 6' 'F <HMM7# F

.

F

8

j

4

F

2

F

8

#

F

" 4 F X

[ #

.

[

5

#

.

[

.

"

2

Z

F 4

Z " Z 6' 'F <HMM7#

)

Z 5 2 F " X

Z 6' 'F @EE<7#

2.2.1 A VIGILÂNCIA NAS MENINGITES

'

(

0)0 Y CME

`

@EE< 6+;)T +7

D<

! F

Haemophilus influenzae

#

0 A [ ) 4 0

-61(+0*,F <HHM7F ` [

! 2

X #

+

F

5

"

! " X

5

5 #

5 4 " !

7

5

5"

5 X X _

7

F

6 ), ,+F

d+ +3+F >d),>F <HM@_ A(+;3+'dF <HMM7_

7

X _

7

6 F F

" 7_

7

"

#

. V

8 . Z

_

"7

4 " . _

7

"

F " #

Z

`

"

&

4

"

`

"

F

D@

8

"

Z

6 )()*(+F <HHC_

0F <HHH 7# + 4 F 4 5

2

"

Z

5 #

+ " . 4 "

"

6,+

+( *+ f );;+F

<HHH7# ) 4 F F F 8

8

F

F

8

F " 6 0F <HHH 7#

F

.

"

"

# +

.

"

" 6,+ +( *+ f );+F <HHH7#

4

"

6+;)T 17

61(+0*,F <HHM7

8

F

" Z

5

#

8

F

F

"

" 61(+0*,F <HHM7 "

X F

#

)

"

F

"

" 8 8" F 4 8 8 F

4

.

F

X

Z

8

8

# )

DE\

IE\

2

[

61 ;+ * F <HH@_ 1+

f ,*

+;F @EEE_

;d), f 0'G), F @EEE7#

+

5

8

F & 2 "

F

2

5

F

2

"

"

F

&

4 [ #

"

+* 0F

DD

F & [

" # )

[

.

6 )('G:; G+

+; f ,+

+( *+F

@EEE7#

2.2.2

AS MENINGITES E A SUBNOTIFICAÇÃO

+

2

.

"

F

"

[

#

F

F

2 ` F

[

5

-

-

6 ), ,+F <MMD_

),1+( F <HHH_ G+0G* .F @EEE_ d+;*; + .F @EEE7#

2 8 X

5 F

Z 8 6$G+,); .F <HHC_

;+,*0*

.

.

F @EEE7#

) F " "

[ "

F 8 . F " f

6<H?L7F 0 2

2

.

6<HMC7F 0

`

.

6<HMC7F G

WF

F

6<HMH7F $

.

6<HHE7F ,

.

6<HH<7F ;

`

.

6<HH<7F G

WF d

F

6<HH@7F

.

6<HH@7F

f

6<HHD7F 0W F F G 6<HHI7F 0

.

W 6<HHL7F 0 2 2 . 6<HH?7F 1 . 6<HHH7F ( F 0 F

14 6<HHH7F

.

6@EEE7#

f

6<H?L7 `5

"

F

"

F

# ) F * F 5 "

6(

2

F (

F

'

"

;

"

7

"

"[ 6 <E 7

LDE#EEE

#

"

"

"

F

F

DI

# " MM\ 2

" Q <EE\ F @L\

2 <H\ 2 # ; 8

F

"

"

# ;

2

" " 2 #

0 2

2

.

6<HMC7

"

)

F

8

<H?M

<HM<F

F

5&

F IE\

F

[

#

0

`

.

6<HMC7

X "

G

6;

"

Z

-

F (

2 , " X 7F

8

<H??

<HM@#

"

@@<

5

4

C?

"

5

#

X

EFLV<EE#EEE 2

"

@F<V<EE#EEEF

2

#

<L\

& 8 , " X

<<\ ) 8 2 F

#

F

.

5

"

"

F

Z

&

"

#

G

WF

F

6<HMH7

G

WF d

F

6<HH@7

6<HMD <HMI7F 5

1

2 F

.

5

"

6;

"

Z

-

F (

2

(

2

7#

) 8 LC\ " F

2

CE\

F

F

f

6<H?L7#

+ I@\

"

2

<L\

&

DC

6DC\

Haemophilus influenzae,

<I\

Streptococcus

pneumoniae

F "

5 6 2 7F

F j Z

X

#

"

F

#

$

.

<HMLF

4

ativa

F "

aX

X

. 0 2 2

.

6<HMC7#

,

.

4

F

8

<HMC

<HM?F

CLL

F

0 [ F , " X "

6

2

7

0

8

6

Z

7# *

"

! <#H@@

F

4

4

_ <DM

"

Z

[

_ @?

"

" X

DL

Z

#

"

G

WF

F

6<HMH7!

4

"

"

*

8

#

<CM

F LL\

2

" 0 8 # A " F F

ID F 6@@\ 7F 2

"

#

"

" 4 # ) 6@@\7 4 2 f

6<H?L7! @H\ F "

# 2 <@\

Z ! " . 2 F

5

"

"

0

8

#

;

`

.

6<HH<7

8

'

F )

2 F CDD

DL

2 0 " F

8 <HMD MHF " IL\ 2

"

#

.

6<HH@7F

4

)

2 F

.

5

"

0

[

F

8

"

I?FC\

# A

"

F

F

@E\

#

f

6<HHD7

&

4 <L

F

8

<HME

<HMHF

5

;

2

1

2 #

.

X "

" 6; " Z " F ( 2

&

,

.

F <HH<7F

2

f 6<H?L7 . ! & 4 "

CE\ _

F

6LM\7

6DE\7

4

6D\7# )

`

&

"

# 4 F

& X @FD . F 5

"

"

#

0

Z

4

F

"

Z

X

!

F

F

&

"

# +

X

F

" 2 X

verdadeira

F

Z

Z

&

6<!<FI

<!MFH

F

&

7

"

F

" 5

X #

0W

F

F G

6<HHI7F

&

2

1

2 F

F

"

8

F

&

X

F

4

F

X

D?

0

.

6<HHC7

"

N.

meningitidis

H. influenzae

) +F

8

<HMH H@# '

0

[

6

"

5

4

F

-

7

F

. , 5 8 F Z # A "

! 7 " CE\ " _

7

4

8

I\

2

LE\

" Z _ 7 Z

5" F F

F X

. 2 " _ 7 "

" ?E\

H. Influenzae

F

?M\# ;

F

&

X

8

Z F `5

#

+ %

F 1 %2

F

W

6<HHL7

F

)

;

e

%F

) +F <<E

"

0

[

<HH<F F

F <H?

4

( 2 F 8 F # +

H<\

F

" ! F

4

[

2

8

5

F

X

'*

#

+

F

2

"

HI\ " # 0 F F

` Z &

8 2 F " Z 8

- - #

0 2

2

.

F

[

F

) +

6 & <E 2Z 2 7#

[ HL\ " # ) F

DM

"

F

"

aX

#

)

1

F 1

.

6<HHH7F

F

"

D<\

[

# (

F 0

F 1

6<HHH7

"

Z

[

R

F '

5F

"

!

;

"

Z

"

"

( 2 6 <HHD HC7# ) "

LCFC\ 4 F LE\ " #

.

( , . 6C#@EH#LDD 2 7 * 5 F 8 <HHC <HHLF

X " 8 60 [ " F 0

[ 2 ( 2 7# +

ML\

5

F

"

! 7

<HH

6IL\7 "

5 " _ 7 " Z

0

[

"

C?\F

( 2 " ??\# F 4 F "

"

! DE\

F DM\

IM\ 2 " #

; 1 F 8 " F

4 F

" 5

# 1

2 6@EE<7F

F

F

8 <HHE @EEEF " " F 4 F F @#C?L

# ; F D#DHI Z 2 F

4

F

F

8

<HHD @EEE#

25

G

6<HH?7

"

Z

;

; F <HHCF 4 F

Z 0 0 # + " &

" F & X #

+ [ 4

F `5 " &

# ;

F

[

F

"

F

D<\

DH

, ;)eF <HHC_ 1+(R )

.

F F & #

f

6<HHD7

"

" 5 4 2 F "8 " #

2.3

OS SISTEMAS DE INFORMAÇÃO: DE AGRAVOS DE NOTIFICAÇÃO

(SINAN), HOSPITALARES (SIH-SUS) E DE MORTALIDADE (SIM)

+

"

4

[

#

2

" "

2

Z

-

6 + f

'+(A+,G F <HHH7# F `

"

Z

F

8

F

- Z 6 ); )0 #F @EEE7#

+ [

" " Z

8 Z

#

; 1

F 2

F

"

4

?E

ME

"

.

)

F

. - .

"

Z

# +

0

K

0

-60 07F

.

F

"

8

F

X

F

a

F

" X

"

4

"

8

"

F

.

"

-

61(+0*,F <HHC

<HHM_ +, )* +F <HHM_ ,)00+

#F

@EEE7# + F

-" 5

IE

" # "

-`

6

7

X

F

"

5

"

F

5

F F F 5 " 6 (+)0F

<HHI7#

+ F 4 .

- F ! [ F

8

6

. F 7

F 4F " " # ) F

"

Z

!

+

;

"

60*;+;7F G

0 K 0 - 60*G 0 07 60* 7# )

`

4

0 -

F

F " Z X

6'+(A+,G F <HH?_ + f '+(A+,G F <HHH7# + 0*;+; "

Z

[

6,)00+

#F

@EEE7#

)

&

X

"

Z

5 8" F [ " "

#

.

"

F

4F

.

"

Z

`

F 4

5

" .

Z

8 6'+(A+,G F <HH?7#

2.3.1

O SISTEMA DE INFORMAÇÃO DE AGRAVOS DE NOTIFICAÇÃO

(SINAN)

+

<HH@F "

0

* "

+ ; " 60*;+;7F .

<HHD# O

"

"

" " , U L#@CH DE <H?C

6+;)T +7 4

" 5 0 - # ) " Z

[ #

I<

#

F

5

F

-

8

X

F

F

( 0 - 8 2 ` 61 ),G F

@EE<7# )

"

5

5

F

, E _L#@CHV?C U

_?M#@D<V?L

)

<HH?F

<#MM@

4

0 -

<LV<@VH?

" X + X 15 6 +17

8

2

0*;+;

6'+(A+,G F <HH?_ ,*A)*(+F @EEE7F

"

"

Z

0

#

4 F

4

[ 6+, )* + f +,);'+(F @EEE7#

0*;+; "

.

.

"

X

"

F 8 4 F 4 . F

" & " Z F

8

5

5

8 Z 0 ;

A

[

)

0 0 6'+(A+,G F <HH?7#

-8

0*;+;

F

" F . F

6 )()*(+F <HHC7#

!

F

2 *

;

"

F 4

2

5 [ F

8

" 5

#

F

2

*

*

F

"

F F "

[

# +

"

5

8 6'+(A+,G F <HH?7#

2.3.2

O SISTEMA DE INFORMAÇÕES HOSPITALARES DO SISTEMA

ÚNICO DE SAÚDE (SIH-SUS)

)

<H?LF

8

0

;

'

I@

; X + X 0 60*; +07F `

* ; + X 4 X 6*;+ 07F

X 4 5 8 # .

" ! *

G 6 *G7F 5&

. G 5 4 F

" " &

0 6 07# ) . 8

" 2 F a F

*;+ 0 X 4 # +

X

"

6,)A' A* PF <HHD ); )0 #F @EEE7#

0*G 0 0 "

<HMDF

.

Z 2 4 X # ) <HMLF

"

"

F

2 . 2

" F <HM? 5 F <HH<F 2

- F "

4 F . *;+ 0F

F 0 ) 0 - # +

0 * " Z G 0 0#

0

+

X

4

G

X 0 60+ G 07 0+ G 0V+*G " " 2

F "

4

0 6 07# 0*G 0 0F 2 0 +*GF

. " & F

4

F

8

" &

4 0 - F .5 X

2

6 )(()*(+F @EEE7# O

"

F

`

"

2

2 2

F

4

4 X 5 #

0*G 0 0

-

?E\

2

ID

0 0F

8 6 ); )0F @EEE_ 0'G(+

f 0P$+('$+, F

@EEE7#

0

"

5

4

Autorização de Internação

Hospitalar (AIH),

.

2

8

0 0# '

4

"

Z

2 F F F

4 F '* 6' " * 7

. #

+ +*G

! 7

"

2

_ 7

" _ 7 " 5 _ 7

.

_ 7

_ "7

" # ) 8 `

" #

+ 4 4 +*G " 4

0 -

0

)

0 -

F

F 8 <HHCF 4 H\

6

*1 )7

F

` F <V<@

H\

X #

4

5

h

i

8

F

4

!

*

Q

*

X

# F # *

.

X

"

"

-Z

#

+ +*G

aX

!

4

0 0

-

6"

F

6" 7 0 0F 4

+*GF

4

"

F 6

7F '

4

F

8

2

F

` " F 2 F '* F

# 0*G 0 0

.

.

,

4

F

2 . " 6,)00+

.

F @EEE7#

)

5

0 0F

II

F

2

8

&

F

F

F

& # ) 4 2 0 0

-60 07 . 5& ?@ 2 # + . 0 0 4

F - +*G 5 &

5

# (

F

Z 5 4 F F 5 2

+*G

5

0 0

6

7

F

. F ` " 6

5 7F F #

+*G &

4

F

2

.

"

"

6,)00+

#F @EEE7#

F

4

F

- F # 0

. + +0 0F *

Bulletin Board

System

) . ! h iF

F h . iF

" #

0*G 0 0 .

X

F

*

8

6 ); )0F @EEE7#

) F F 5

" Z [ 8 61(+0*,F

<HHM_ '+

0

.

F @EEE7# +

.

"

"

F

"

Z

6A)(+0 f

+( *;0F <HHI_ $(+e

.

F <HHC_

+ G*+0 f 0 1 ,,F <HHM_ 0'G(+

f

0P$+('$+, F @EEE7# A f 5"

" " 5 8 # 2 f 0

"

5

F

"

.Z

[

#

0

0 2

f 0.b

b

F 6@EEE7

0*G 0 0 4

"

5 " 2

IC

"

Z

2

[

F 0

.

6<HHM7

0

"

8

(

2

F

8 <I ICE#EEE 2 #

+ 5 " F

@HL 2 F ML\ 2 4 " #

" " HE\ @?D # )

2

+ %

F 1 %2

F

W

;

e

% 6<HHL7# )

6<HHM7

5

0

.

6<HHM7

F

2 F 2 "

[

#

-

Z

F

F

#

2.3.3

O SISTEMA DE INFORMAÇÕES DE MORTALIDADE (SIM)

0*

4

"

Z

-

8 #

1

F

4

0 -

F

<H?C

8 <H?H# .

. Q Declaração de óbito6 7#

' 0*;+; 61(+0*,F <HHM7F 4

"

Z

8

F

F

Z

F

X

5

6 + f '+(A+,G F <HHH7# + ` <HHL . '*

<E

"

6'

+ *1*,*P+=> F <HH? 7#

" 5 4 F X 8

0

)

0 -

60)07

;

0 - V 4 0 - 6 ;0V 07# ) " &

F 0 `

2

0)0

0

0

-F "

'

(

'

# +

F " F 4 " , E

,

IL

L#@<LV?CF h 2 ` "

i 6'+(A+,G F <HH?7#

)

F

.

*

F 1 2

6+; (+ )F

1+(() F 0 P+F <HHD7F

"

LE\

5

4

&

2 F

2

&

# + 4 F

ME\ HF?\ " & CE #

2

"

F II\

2

"

<<\

" 5 #

2.4

OS MODELOS DE CAPTURA-RECAPTURA

h 5 ` i#@

0 - 8 " F 4

-

`

&

[

# )

F &

5

!

F

"

Z

"

X

60 ) G);F <HHL7#

4

2 - # ) F

5"

F "

a

4

8

6$ , )(F <HML_

A*

F @EE<7#

4

"

F

F "

60 ) G);F <HHL7# )

8

.

F

F 5 X

@C\

IE\ 6G d f () +,F <HH@ _ ,

( )F

'+( eF

,,F <HH@7#

&

5

"

5"

)

<HHEF

F 5 6 +(( 'G #F <HHD7#

'

2

[ F 4

I?

Z

60

)(

#F <HHE_ 0 ) G);F <HHL7#

# 0

4

2 Z F X .

F " 5

F +* 0F

5

"

F

"

Z

X

F

Z

F

F

5

F

F

"

6G 1)( f

)0);', 0F <HHD_ ()1*)() f

+,* )e(+

F <HHC_ +'d +;F 1*(dG)+ F

,e;;F <HHL_ ) +(*0F +0'+,F 1+ ;F <HH?_ '+*+ +F ,*A)*(+F *; *F

<HHM_

)'G+; f (* +

O()PF <HHH_ (+G* f

)P+ ) TF <HHH_ ()*; 3)0F

)( (0G *P);F

,++(F <HHH_ 0 )) ;

.

F <HHH_ ' ( +'dF

'G+; F 0 * GF @EEE_ )1( 'd

.

.

.

.

F @EE<7#

)

4

4

[ F 2 4

"

& # ) F "

# '

4

6*; )(;+'* ;+,F <HHC 7#

4

F

4

X

X

F

4 # * 5

8

6

;; f

+; () ,*F <HHI7# +

Z

"8

F

2 F X F

4 . #

+ Z 4

" #

,

<?MD

`

) +F

<HHE

6G d f () +,F <HH@ _

+(( 'G

#F <HHD_

;; f +; () ,*F <HHI7#

5 5 6<MHLF

*0

#F <H?M7

" &

&

15

,

<HDEF

" .

+ 4

;