[Surveillance of infant deaths in local health systems: assessment of verbal autopsy reports and of information gathered from health agents].
[Surveillance of infant deaths in local health systems: assessment of verbal autopsy reports and of information gathered from health agents].
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DOI：
10.1590/s1020-49892000000500003
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发表时间：
2000-05-01
期刊：
影响因子：
--
通讯作者：
Correa, L
中科院分区：
文献类型：
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作者：
Barreto, I C;Kerr Pontes, L;Correa, L
了解人口的生命统计数据对于控制发病率和死亡率以及改善生活条件至关重要。然而，在巴西，现有的卫生信息系统没有提供可靠的生命统计数据。这项研究是在塞阿拉州的三个城市-菜阿达、伊卡普伊和朱卡斯进行的，这三个城市的初级保健服务覆盖率很高。这项研究使用了一种称为“死因推断”的流行病学工具，调查了1993年和1994年在三个社区查明的237名1岁以下儿童死亡中的215名（90%）。我们调查了社会经济特征;卫生条件;营养状况;疾病过程，卫生保健和死亡;死亡原因;以及国家死亡率信息系统和社区卫生代理系统的操作。根据口头尸检，腹泻是39%病例的死因，其次是早产（17%）和急性呼吸道感染（10%）。尽管79%的家庭在孩子生病期间寻求过正规的医疗保健服务，但49%的婴儿在家中死亡。这表明在查明和治疗患病婴儿方面的效力有限。在84%的情况下，家庭寻求民间治疗师的帮助。尽管社区卫生机构报告了78%的死亡病例，但只有29%的家庭在儿童患病期间向卫生机构寻求帮助。就社区卫生机构提供的死因信息与口头尸检提供的死因信息之间的统计一致性而言，腹泻的一致性良好，其他原因的一致性居中，急性呼吸道感染的一致性较低。使死因推断成为塞阿拉初级保健服务的一个常规部分，将为当地保健小组提供宝贵的信息，并将提高批判意识，促进降低婴儿死亡率。
Knowing the vital statistics of a population is fundamental in controlling morbidity and mortality and improving living conditions. In Brazil, however, the available health information systems do not provide reliable vital statistics. This study was carried out in Quixada, Icapui, and Jucas, three municipalities in the state of Ceara that had good coverage by primary health care services. The study used an epidemiological instrument known as a "verbal autopsy" and investigated 215 (90%) of the 237 deaths of children younger than 1 year identified in 1993 and 1994 in the three communities. We investigated socioeconomic characteristics; sanitary conditions; nutritional status; the course of illness, health care, and death; the cause of death; and the operation of the national mortality information system and of the community health agents system. According to the verbal autopsies, diarrhea was the cause of death in 39% of the cases, followed by premature birth (17%), and acute respiratory infections (10%). Even though 79% of the families had sought formal health care services during the child's illness, 49% of the infants had died at home. This suggests limited effectiveness in the identification and treatment of sick infants. In 84% of the cases the family sought help from folk healers. Although community health agents reported 78% of the deaths, only 29% of the families had sought help from the agents during the children's illnesses. In terms of the statistical agreement between the information on the cause of death provided by community health agents and by the verbal autopsies, the agreement was good for diarrhea, intermediate for other causes, and low for acute respiratory infections. Making verbal autopsy a routine part of primary health care services in Ceara would provide invaluable information for local health care teams and would raise a critical consciousness fostering a reduction in infant mortality.