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Completeness of TB notification in Portugal, 2015: an inventory and capture-recapture study
METHODS: We implemented an inventory study and a three-source log-linear capture-recapture analysis using two additional data sources that were deterministic and probabilistically linked: the national notifiable diseases surveillance system (Sistema Nacional de Vigilância Epidemiológica SINAVE) and the national hospital discharge database (Grupos de Diagnósticos Homogéneos GDH).
RESULTS: We identified 2328 unique probable/confirmed TB cases across the three data sources. We found a positive dependency between SVIG-TB and SINAVE (incidence rate ratio IRR 8.9, 95%CI 6.6–12.0) and between GDH and SINAVE (IRR 2.6, 95%CI 2.0–3.4). After adjusting for these dependencies, we estimated that 266 cases (95%CI 198–358) were not reported, indicating a notification (to SVIG-TB) completeness rate of 77.0%.
CONCLUSION: True incidence rate of TB in Portugal in 2015 could have been as high as 26.1 per 100 000. This could be an overestimation because of false-positive cases recorded in both SINAVE and GDH or on a smaller scale, false non-matches. Studies aimed at validating potentially false-positive cases should be implemented to address these limitations.
Keywords: Portugal; TB; capture-recapture; completeness of notification; record-linkage
Document Type: Research Article
Affiliations: 1: Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal 2: Royal Tropical Institute, KIT Health, Amsterdam, The Netherlands 3: National Infection Service, Public Health England, London 4: Institute for Global Health, University College of London, London, UK 5: Department of Tuberculosis Control, Regional Public Health Service (GGD) Groningen, Groningen, The Netherlands 6: Braga Health Centre Group, Portuguese Northern Regional Health Administration Cávado I, Braga 7: EPIUnit, Institute of Public Health, University of Porto (ISPUP), Porto, Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal
Publication date: 01 November 2020
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