Título:	Síndrome de Guillain-Barré na região integrada de desenvolvimento do Distrito Federal e Entorno (RIDE) : descrição dos casos, sensibilidade da vigilância e custos do paciente
Autor(es):	Oliveira, Ana Flávia de Morais
E-mail do autor:	enf.anamorais@gmail.com
Orientador(es):	Araújo, Wildo Navegantes de
Assunto:	Guillain-Barré, Síndrome Arbovírus Sistema de vigilância Custos de cuidados de saúde
Data de publicação:	1-set-2021
Data de defesa:	13-abr-2021
Referência:	OLIVEIRA, Ana Flávia de Morais. Síndrome de Guillain-Barré na região integrada de desenvolvimento do Distrito Federal e Entorno (RIDE): descrição dos casos, sensibilidade da vigilância e custos do paciente. 2021. 242 f., il. Tese (Doutorado em Medicina Tropical) — Universidade de Brasília, Brasília, 2021.
Abstract:	Introduction: Guillain-Barré Syndrome (GBS) is defined as an acute acquired immune-mediated polyneuropathy that affects the peripheral and cranial nerves. The manifestation of neurological clinical conditions is generally preceded by viral, respiratory or gastrointestinal infection, immunization or surgery. Objective: Describe GBS cases at a sentinel surveillance facility for neuroinvasive diseases in the Integrated Development Region of the Federal District and Surrounding Areas (RIDE). Materials and methods: three studies were conducted, consisting of initial case descriptions, followed by analysis of the sensitivity of hospital-based sentinel surveillance and finally a cost-of-illness study. GBS cases were analyzed in RIDE residents admitted to a referral hospital, identified by three data sources (hospital-based sentinel surveillance system, human immunoglobulin dispensing records system and the hospital information system), between March 2017 and May 2019. A clinical cohort study was conducted based on medical records and interviews. The capture-recapture method was applied to analyze the sensitivity of the surveillance system, using the Chapman estimator. The cost-of-illness study was conducted from the patient’s perspective using a bottom-up approach, with a time horizon between the disease onset and 6 months after hospital discharge, assessing direct and indirect costs and the effect on family income. Results: The diagnosis of GBS was highly reliable among the 51 cases monitored, most with the acute inflammatory demyelinating polyneuropathy variant (AIDP). Most of the individuals were of working age with average schooling levels. Diarrhea and upper respiratory tract infection were the previous events most widely recorded. A majority of the individuals admitted to the hospital were unable to walk and the main complication was aspiration pneumonia. The study that assessed surveillance sensitivity identified 259 possible cases of GBS, 58 of which were confirmed, most in residents of the Federal District. The hospital information system and sentinel surveillance were more sensitive in identifying cases. The temporal distribution of cases included periods where no cases were identified, with the largest number recorded between October and May. The median cost of GBS was US$ 1,635.50 per individual, direct costs accounting for 64.3% of this amount. Among the variants, cases with AMSAN (US$ 4,660.10) and AIDP (US$ 2,017.00) were more costly than the variants AMAN (US$ 1,635.50) and MFS (US$ 1,464.80). The costs identified compromised more than 20% of the family income of 24 (52%) patients. Conclusion: The findings show the need to care for patients with GBS in order to minimize the possibility of future complications during their hospital stay that may lead to unfavorable outcomes. We believe that the sentinel surveillance model presented would meet this demand, provided it is specialist-centered, and contribute to investigating the multiple factors that can trigger the syndrome. This study also demonstrated how costly GBS can be. It is hoped that decision makers will analyze these results and apply them to their local reality, in order to improve the structure of services and reduce the costs to individuals and their families.
Unidade Acadêmica:	Faculdade de Medicina (FM)
Informações adicionais:	Tese (doutorado) — Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Tropical, 2021.
Programa de pós-graduação:	Programa de Pós-Graduação em Medicina Tropical
Licença:	A concessão da licença deste item refere-se ao termo de autorização impresso assinado pelo autor com as seguintes condições: Na qualidade de titular dos direitos de autor da publicação, autorizo a Universidade de Brasília e o IBICT a disponibilizar por meio dos sites www.bce.unb.br, www.ibict.br, http://hercules.vtls.com/cgi-bin/ndltd/chameleon?lng=pt&skin=ndltd sem ressarcimento dos direitos autorais, de acordo com a Lei nº 9610/98, o texto integral da obra disponibilizada, conforme permissões assinaladas, para fins de leitura, impressão e/ou download, a título de divulgação da produção científica brasileira, a partir desta data.
Agência financiadora:	Fundação de Apoio à Pesquisa do Distrito Federal (FAP/DF), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) e Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).
Aparece nas coleções:	Teses, dissertações e produtos pós-doutorado

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