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

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Control

Background:

• In 2006, Rio de Janeiro reported 848 tuberculosis (TB) deaths, with a mortality rate of 5.4 per 100,000.
• Brazil lacked specific TB death surveillance actions at the time of the study.

Purpose of the Study:

• To assess the effectiveness of TB death surveillance in identifying deficiencies within TB control programs.
• To evaluate the contribution of surveillance to improving TB management and reporting.

Main Methods:

• A survey of TB-related deaths was conducted over 12 months in two public hospitals.
• Investigated TB deaths and deaths from undefined causes, collecting data from mortality and TB notification databases.

Main Results:

• Seventy-three TB deaths were analyzed, revealing transmission risks among healthcare workers, firefighters, and inpatients.
• Identified management errors, including inadequate isolation, delayed diagnosis, incorrect dosages, and poor contact tracing.
• The surveillance led to the notification of 36 previously unreported cases and corrected outcomes for 29 others.

Conclusions:

• TB mortality surveillance is crucial for monitoring and evaluating TB control efforts.
• It effectively detects errors in program- and hospital-based care, enabling targeted interventions.
• Improved accuracy in TB database reporting and identification of specific local/programmatic needs are key outcomes.