Cargando…
Evaluation of underreporting tuberculosis in Central Italy by means of record linkage
BACKGROUND: Tuberculosis (TB) surveillance systems have some pitfalls outside of a National Tuberculosis Program and lack of efficient surveillance hampers accurate epidemiological quantification of TB burden. In the present study we assessed the quality of surveillance at the University Hospital in...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3490729/ https://www.ncbi.nlm.nih.gov/pubmed/22897910 http://dx.doi.org/10.1186/1471-2458-12-472 |
_version_ | 1782248859125153792 |
---|---|
author | Melosini, Lorenza Vetrano, Umberto Dente, Federico L Cristofano, Michele Giraldi, Mauro Gabbrielli, Luciano Novelli, Federica Aquilini, Ferruccio Rindi, Laura Menichetti, Francesco Freer, Giulia Paggiaro, Pierluigi L |
author_facet | Melosini, Lorenza Vetrano, Umberto Dente, Federico L Cristofano, Michele Giraldi, Mauro Gabbrielli, Luciano Novelli, Federica Aquilini, Ferruccio Rindi, Laura Menichetti, Francesco Freer, Giulia Paggiaro, Pierluigi L |
author_sort | Melosini, Lorenza |
collection | PubMed |
description | BACKGROUND: Tuberculosis (TB) surveillance systems have some pitfalls outside of a National Tuberculosis Program and lack of efficient surveillance hampers accurate epidemiological quantification of TB burden. In the present study we assessed the quality of surveillance at the University Hospital in Pisa (UHP), Italy, and TB incidence rates over a ten year period (1999–2008). METHODS: Assessment of underreporting was done by record-linkage from two sources: databases of TB diagnoses performed in the UHP and the Italian Infectious Disease Surveillance (IIDS) system. Two different databases were examined: a) TB diagnoses reported in the Hospital Discharge Records (HDR) from three Units of UHP (Respiratory Pathophysiology, Pulmonology and Infectious Diseases Units) (TB database A); b) TB diagnoses reported in HDR of all Units of UHP plus TB positive cases obtained by the Laboratory Register (LR) of UHP (TB database B). For the TB database A, the accuracy of TB diagnosis in HDR was assessed by direct examination of the Clinical Record Forms of the cases. For the TB database B, clinical and population data were described, as well as the trend of incidence and underreporting over 10 yrs. RESULTS: In the first study 293 patients were found: 80 patients (27%) with a confirmed TB diagnosis were underreported, 39 of them were microbiologically confirmed. Underreporting was related to age (Reported vs Non Reported, mean age: 49.27 ± 20 vs 55 ± 19, p < 0.005 ), diagnosis (smear positive vs negative cases 18.7 vs 81.2%, p = 0.001), microbiological confirmation (49% vs 51%, p < 0.05), X-ray findings (cavitary vs non-cavitary cases: 12.5 vs 87.5%, p = 0.001) but not to nationality. In the second study, 666 patients were found. Mean underreporting rate was 69.4% and decreased over time (68% in 1999, 48% in 2008). Newly diagnosed TB cases were also found to decrease in number whereas immigration rate increased. Underreporting was related to nationality (Immigrants vs Italians: 18% vs 68%, p < 0.001), diagnosis (microbiological confirmation: 25% vs 75%, p < 0.01), kind of hospital regimen (hospitalized patients vs Day Hospital: 70% vs 16%, p < 0.001), and position of TB code in the HDR (TB code in first position vs in the following position: 39,5% vs 45% p < 0.001). CONCLUSIONS: TB is underreported in Pisa, particularly in older patients and those without microbiological confirmation. The TB code in first position of HDR seems fairly accurate in confirming TB diagnosis. |
format | Online Article Text |
id | pubmed-3490729 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-34907292012-11-07 Evaluation of underreporting tuberculosis in Central Italy by means of record linkage Melosini, Lorenza Vetrano, Umberto Dente, Federico L Cristofano, Michele Giraldi, Mauro Gabbrielli, Luciano Novelli, Federica Aquilini, Ferruccio Rindi, Laura Menichetti, Francesco Freer, Giulia Paggiaro, Pierluigi L BMC Public Health Research Article BACKGROUND: Tuberculosis (TB) surveillance systems have some pitfalls outside of a National Tuberculosis Program and lack of efficient surveillance hampers accurate epidemiological quantification of TB burden. In the present study we assessed the quality of surveillance at the University Hospital in Pisa (UHP), Italy, and TB incidence rates over a ten year period (1999–2008). METHODS: Assessment of underreporting was done by record-linkage from two sources: databases of TB diagnoses performed in the UHP and the Italian Infectious Disease Surveillance (IIDS) system. Two different databases were examined: a) TB diagnoses reported in the Hospital Discharge Records (HDR) from three Units of UHP (Respiratory Pathophysiology, Pulmonology and Infectious Diseases Units) (TB database A); b) TB diagnoses reported in HDR of all Units of UHP plus TB positive cases obtained by the Laboratory Register (LR) of UHP (TB database B). For the TB database A, the accuracy of TB diagnosis in HDR was assessed by direct examination of the Clinical Record Forms of the cases. For the TB database B, clinical and population data were described, as well as the trend of incidence and underreporting over 10 yrs. RESULTS: In the first study 293 patients were found: 80 patients (27%) with a confirmed TB diagnosis were underreported, 39 of them were microbiologically confirmed. Underreporting was related to age (Reported vs Non Reported, mean age: 49.27 ± 20 vs 55 ± 19, p < 0.005 ), diagnosis (smear positive vs negative cases 18.7 vs 81.2%, p = 0.001), microbiological confirmation (49% vs 51%, p < 0.05), X-ray findings (cavitary vs non-cavitary cases: 12.5 vs 87.5%, p = 0.001) but not to nationality. In the second study, 666 patients were found. Mean underreporting rate was 69.4% and decreased over time (68% in 1999, 48% in 2008). Newly diagnosed TB cases were also found to decrease in number whereas immigration rate increased. Underreporting was related to nationality (Immigrants vs Italians: 18% vs 68%, p < 0.001), diagnosis (microbiological confirmation: 25% vs 75%, p < 0.01), kind of hospital regimen (hospitalized patients vs Day Hospital: 70% vs 16%, p < 0.001), and position of TB code in the HDR (TB code in first position vs in the following position: 39,5% vs 45% p < 0.001). CONCLUSIONS: TB is underreported in Pisa, particularly in older patients and those without microbiological confirmation. The TB code in first position of HDR seems fairly accurate in confirming TB diagnosis. BioMed Central 2012-06-21 /pmc/articles/PMC3490729/ /pubmed/22897910 http://dx.doi.org/10.1186/1471-2458-12-472 Text en Copyright ©2012 Melosini et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Melosini, Lorenza Vetrano, Umberto Dente, Federico L Cristofano, Michele Giraldi, Mauro Gabbrielli, Luciano Novelli, Federica Aquilini, Ferruccio Rindi, Laura Menichetti, Francesco Freer, Giulia Paggiaro, Pierluigi L Evaluation of underreporting tuberculosis in Central Italy by means of record linkage |
title | Evaluation of underreporting tuberculosis in Central Italy by means of record linkage |
title_full | Evaluation of underreporting tuberculosis in Central Italy by means of record linkage |
title_fullStr | Evaluation of underreporting tuberculosis in Central Italy by means of record linkage |
title_full_unstemmed | Evaluation of underreporting tuberculosis in Central Italy by means of record linkage |
title_short | Evaluation of underreporting tuberculosis in Central Italy by means of record linkage |
title_sort | evaluation of underreporting tuberculosis in central italy by means of record linkage |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3490729/ https://www.ncbi.nlm.nih.gov/pubmed/22897910 http://dx.doi.org/10.1186/1471-2458-12-472 |
work_keys_str_mv | AT melosinilorenza evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT vetranoumberto evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT dentefedericol evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT cristofanomichele evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT giraldimauro evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT gabbrielliluciano evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT novellifederica evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT aquiliniferruccio evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT rindilaura evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT menichettifrancesco evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT freergiulia evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage AT paggiaropierluigil evaluationofunderreportingtuberculosisincentralitalybymeansofrecordlinkage |