Internações por doenças imunopreveníveis sensíveis à atenção primária em crianças menores de cinco anos no Brasil

Abstract

This study aims to characterize hospitalizations for diphtheria, tetanus and whooping cough in children under five years old in Brazil. This topic is still poorly investigated and there is a lack of studies to understand the epidemiological pattern of these diseases. This is a descriptive study of hospitalizations for diphtheria, tetanus and whooping cough in children under five years old, in Brazil, in the period from 2009 to 2019. The hospitalization data were extracted from the Hospital Information System of the Unified Health System (SIH / SUS), of the Informatics Department of the Unified Health System (DATASUS). And population data, extracted from the Brazilian Institute of Geography and Statistics (IBGE). The following variables were considered: date of birth and hospitalization, main diagnosis, year of hospitalization, Brazilian region of residence, sex, age group, race / color, indicative of death, Intensive Care Unit (ICU). The percentages of hospitalizations for immunopreventable diseases were calculated by the sociodemographic categories, in addition to the hospitalization rates for each Brazilian region, the differences in rates between the years, average expenses and days of stay. As these are secondary data, in the public domain, the study does not require approval by the Research Ethics Committee, such as the provisions of resolution n° 510/2016. During the study period, 20.782 hospitalizations for diphtheria, tetanus and whooping cough were recorded. The age group with the most hospitalizations was the post-neonatal period (83,6%), with a similar distribution between the sexes, race / brown color (29,3%) and white (31,0%). 2014 had a peak in hospitalizations (22,8%), with a hospitalization rate of 31.8 / 100 thousand inhabitants, with emphasis on the Southeast (39,3%) and Northeast (27,1%) and diagnosis more frequent in hospitalizations for pertussis (98,0%). There was an increase in hospitalizations between 2010 and 2011 across the country (63,8%). Vaccination coverage in the years 2009, 2010 and 2011 was above the goal of the Ministry of Health (95%), with 101,7%, 98,0%, 99,6%, respectively, and hospitalizations showed low records. However, in 2014, vaccination coverage was only 50,2%. As for costs, about 28 million reais were spent, and the average length of stay was four to seven days. It was concluded that there were more records of hospitalizations for pertussis, in brown and white children, in the post-neonatal period, of both sexes, residents of the Southeast and Northeast regions, with a peak in 2014. Vaccination coverage decreased in 2012 and 2014, with an increase in hospitalizations, which caused deaths of children and avoidable expenses for the Brazilian health system. Such resources could be invested in primary care, with actions in health education for professionals and the community and maintenance of vaccination coverage, in order to prevent the spread of these diseases