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Free Content Uses of tuberculosis mortality surveillance to identify programme errors and improve database reporting

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BACKGROUND: In 2006, 848 persons died from tuberculosis (TB) in Rio de Janeiro, Brazil, corresponding to a mortality rate of 5.4 per 100 000 population. No specific TB death surveillance actions are currently in place in Brazil.

SETTING: Two public general hospitals with large open emergency rooms in Rio de Janeiro City.

OBJECTIVE: To evaluate the contribution of TB death surveillance in detecting gaps in TB control.

METHODS: We conducted a survey of TB deaths from September 2005 to August 2006. Records of TB-related deaths and deaths due to undefined causes were investigated. Complementary data were gathered from the mortality and TB notification databases.

RESULTS: Seventy-three TB-related deaths were investigated. Transmission hazards were identified among firefighters, health care workers and in-patients. Management errors included failure to isolate suspected cases, to confirm TB, to correct drug doses in underweight patients and to trace contacts. Following the survey, 36 cases that had not previously been notified were included in the national TB notification database and the outcome of 29 notified cases was corrected.

CONCLUSION: TB mortality surveillance can contribute to TB monitoring and evaluation by detecting correctable and specific programme- and hospital-based care errors, and by improving the accuracy of TB database reporting. Specific local and programmatic interventions can be proposed as a result.
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Keywords: death certificate; hospital mortality; programme evaluation; surveillance; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Serra dos Órgãos University, Rio de Janeiro, Brazil; Rio de Janeiro State Health Department, Rio de Janeiro, Brazil 2: Rio de Janeiro State Health Department, Rio de Janeiro, Brazil 3: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil 4: State University of Rio de Janeiro, Rio de Janeiro, Brazil 5: Gama Filho University, Rio de Janeiro, Rio de Janeiro, Brazil

Publication date: August 1, 2009

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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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