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Free Content Duplicates and misclassification of tuberculosis notification records in Brazil, 2001–2007

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OBJECTIVE: To evaluate the change in tuberculosis (TB) notification rates due to the removal of unwanted duplicate records from the Brazilian notification system (2001–2007, data extracted in October 2008), and therefore extending the period of investigation of the previous study using the same methodology (2000–2004, data extracted in February 2006).

METHODS: Repeat records were identified using a probabilistic record linkage, classified into six mutually exclusive categories, and then kept, combined or removed from the database.

RESULTS: In the TB database, 22.7% of all records belonged to patients with multiple records. When we excluded the first record of every patient in this group, 43.7% were classified as transfers, 29% as returns after default, 16.3% as relapses and 6.6% as true duplicates, while 2.9% were inconclusive and 1.5% had missing data. Removal of unwanted duplicate records reduced the notification rates of new cases by 4% to 6.3%, and increased the proportion cured by 3.4% to 4.9%.

DISCUSSION: Linkage of records within the TB notification database and the implementation of procedures to distinguish between new and retreatment or transfer-in records yielded better data. Recommendations are provided on how to prevent duplicates and misclassifications in national TB databases.

Keywords: Brazil; duplications; misclassifications; record linkage; surveillance; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Stop TB Department, World Health Organization, Geneva, Switzerland 2: Programa Nacional de Controle da Tuberculose, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil 3: Departamento de Análise da Situação de Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil

Publication date: 2010-05-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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