Appropriateness of administrative data for vaccine impact evaluation: the case of pneumonia hospitalizations and pneumococcal vaccine in Brazil

Abstract

Ten-valent pneumococcal conjugate vaccine (PCV10) was recently introduced into the Brazilian Immunization Programme. Secondary data are used as a measurement of community-acquired pneumonia (CAP) burden, but their completeness and reliability need to be ascertained. We performed probabilistic linkage between hospital primary data from active prospective population-based surveillance (APS) and hospital secondary data from the Hospital Information System administrative database of the National Unified Health System (SIH-SUS). Children aged 2-23 months hospitalized during January-December 2012 were identified. Incidence rates of hospitalized CAP were estimated. Agreement of case identification was measured by kappa index. A total of 1639 (26%) CAP cases were identified in APS and 1714 (35%) in SIH-SUS. Of these 3353 records, 1127 CAP cases were present in both databases. Kappa on CAP case identification was 0·72 (95% confidence interval 0·69-0·75). CAP hospitalization incidence using administrative (5285/100 000) and hospital (5054/100 000) primary data were similar (P = 0·184). Our findings suggest that administrative databases of hospitalizations are reliable sources to assess PCV10 impact in time-series analyses.

Sustained Decrease in Gastroenteritis-related Deaths and Hospitalizations in Children Less Than 5 Years of Age After the Introduction of Rotavirus Vaccination

“…The SIH-SUS is now widely used for the analysis of pertinent public health issues, including hospital morbidity and mortality, evaluation of medical care, epidemiologic surveillance and in the validation of other health information systems. 25,26 These data are consolidated in the DATASUS web page. ICD 10 diagnostic codes (codes 1−6; ie, some infectious and parasitic diseases) captured in the SIH-SUS was used to identify occurrences of all-cause GE-related HDs and hospitalizations between 2001 and 2010.…”

“…26 Data from the 2000 census and population projections for the study period obtained from Brazilian Institute of Geography and Statistics were used in this study. [28][29][30][31][32] …”

Methods and challenges for the health impact assessment of vaccination programs in Latin America

“… 9 , 15 , 17 , 44 A study in Goiania, Midwestern Brazil, used database linkage of secondary administrative hospitalization data and primary population-based surveillance data and found similar hospitalization rates for community-acquired pneumonia in children. 50 …”

“…Primary data collection was conducted in HIA of PCV 50 and rotavirus 2 , 8 , 21 , 30 , 48 vaccination programs in LAC countries ( Tables 3 and 4 ). Primary data collection may be particularly useful in settings where health information system databases are unavailable or unreliable and the surveillance system has not been appropriately implemented.…”

“…Most of the eight HIA of PCV in LAC evaluated pneumonia, 1 , 7 , 25 , 26 , 35 , 41 , 42 two evaluated invasive pneumococcal disease 38 , 50 and one evaluated meningitis. 1 We did not identify any LAC study evaluating the impact of PCV on acute otitis media.…”