Record linkage in tuberculosis epidemiological surveillance in Brazil: systematic methodological literature review

To describe the literature on the methodological characteristics and use of record linkage techniques applied to tuberculosis surveillance in Brazil.

A systematic methodological review (PROSPERO: CRD42024623969) was conducted following the 2020 guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Searches were performed on the following databases: PubMed, Embase, Scopus, Virtual Health Library (VHL), Scientific Electronic Library Online (Scielo), and Latin American and Caribbean Literature on Health Sciences (LILACS) on February 5, 2025. Scientific articles produced in Brazil and whose authors applied record linkage between health information systems for epidemiological surveillance purposes were included. Grey literature, studies without a focus on tuberculosis, studies without application of linkage, and studies conducted outside Brazil were excluded. Descriptive synthesis was used, reporting frequencies, proportions, and measures of central tendency. Risk of bias or methodological quality were not assessed due to the heterogeneity of study designs and objectives, and because this review aimed to describe the methodological characteristics of the studies rather than synthesize effect estimates or epidemiological associations.

The search retrieved 1,549 records; 49 studies were included. Most studies used the tuberculosis module of the Notifiable Diseases Information System (SINAN-TB, 98.0%) and the Mortality Information System (SIM, 67.3%); the most frequently used software was OpenRecLink (57.1%). The most common key variables were "name," "date of birth," and "mother's name." The linkage percentage ranged from 0.1 to 97.3%. The most frequent objectives were the description of epidemiological scenarios (24.5%), analysis of associated factors (20.4%), and investigation of underreporting (16.3%). Cohort (49.0%) and descriptive (34.7%) study designs predominated.

Record linkage integrates complementary databases and may strengthen tuberculosis surveillance. The findings suggest the potential usefulness of record linkage to support epidemiological analyses, improve records, and inform surveillance actions.