Health technology assessment (HTA) is the systematic evaluation of the properties and impacts of health technologies and interventions. In this article, we presented a discussion of HTA and its evolution in Brazil, as well as a description of secondary data sources available in Brazil with potential applications to generate evidence for HTA and policy decisions. Furthermore, we highlighted record linkage, ongoing record linkage initiatives in Brazil, and the main linkage tools developed and/or used in Brazilian data. Finally, we discussed the challenges and opportunities of using secondary data for research in the Brazilian context. In conclusion, we emphasized the availability of high quality data and an open, modern attitude toward the use of data for research and policy. This is supported by a rigorous but enabling legal framework that will allow the conduct of large-scale observational studies to evaluate clinical, economical, and social impacts of health technologies and social policies.

The Center for Data and Knowledge Integration for Health (CIDACS) was created in 2016 in Salvador (Bahia, Brazil). This paper aims to present a profile of CIDACS, including its current databases. CIDACS aims to conduct interdisciplinary studies and research, develop new scientific methodology and promote professional training using linked large-scale databases and high-performance computational resources in a secure environment. Administrative data is at the core of the activities conducted by CIDACS. The advantages of administrative data include significantly larger sample sizes, an inherent longitudinal structure and high-quality information. The center’s research projects are primarily focused on enhancing the understanding surrounding the impact of social protection policies (e.g., public cash-transfer and housing programs) on health outcomes in low-income populations throughout Brazil. CIDACS’ primary data source is citizens who register with the Cadastro Único program, which encompasses individuals eligible to receive benefits from over 20 governmental social programs. CIDACS has two separate environments for data handling: 1) Data Production Center, a secure room housing the computational infrastructure for ingesting, storing, cleaning, processing and linking original databases, as well as extracting research-ready datasets and 2) Data Analysis Environment, a computational infrastructure based on data safe haven principles, which allows researchers to access and process requested datasets. Brazil has a large public health community that uses national health and social databases for research programs, and the linkage of different databases has been a widely employed practice in the country. CIDACS is the result of efforts by researchers, policymakers and public health officials to use and improve the quality of Brazilian health databases. CIDACS is expected to be an important resource for researchers and policymakers interested in improving the evidence base in different aspects of health, as well as with regard to the social determinants of health and the effects of social and environmental policies on health in general.

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Background Salvador, Bahia (northeastern Brazil), has been identified as the epicenter of Human T-cell leukemia virus Human T-cell leukemia virus (HTLV) type 1 infection in the country. This study aims to estimate the rate of HTLV infection and the geographical distribution of this virus in this state. Methods All HTLV tests (chemiluminescence/ELISA assays/Western Blotting) performed in the Central Laboratory of Public Health of Bahia (LACEN) from 2004 to 2013 were included. Data was extracted from LACEN’s database using high volume extract, transformation and load throughput. Infection rate was expressed as the number of infected individuals per 100,000 inhabitants considering municipalities grouped in microregions and/or mesoregions as the unit of analysis. Results A total of 233,876 individuals were evaluated. Individuals were from 394 out of 417 municipalities of Bahia (94.5%). HTLV chemiluminescence/ELISA assay was found to be reactive for 3,138 individuals from whom 2,323 had WB results (1,978 positives, 62 negative and 282 indeterminate). Out of 1978 reactive samples, 1,813 (91.7%) were positive for HTLV-1, 58 (2.9%) for HTLV-2 and 107 (5.4%) were for both HTLV-1 and HTLV-2. The cumulative mean rate of HTLV-positive cases in Bahia was 14.4 per 100,000 inhabitants. Three microregions presented rates >20 HTLV-positive cases/100,000 inhabitants: Barreiras (24.83 cases per 100,000 inhabitants), Salvador (22.90 cases per 100,000 inhabitants), and Ilhéus-Itabuna (22.60 cases per 100,000 inhabitants). Conclusion HTLV infection is disseminated in the state of Bahia, with an overall moderate rate of infection. Further studies should be conducted to characterize the epidemiological and clinical profile of HTLV-infected individuals better and to propose effective prevention measures.