Doenças tropicais e infecciosas como causa de morte atestada e classificada: um estudo de concordância, no estado do Pará, no período de 1996 a 2001

Abstract

The lack of precision in the assertion of the basic cause of death is a particularly important source of mistakes in the analysis of mortality according to causes. The objective of this study was to evaluate the concordance between the cause of death attested by the doctor and the cause classified with the use of international rules of basic cause of death and its influence in the profile of mortality caused by tropical, infectious and parasitic diseases, in the State of Pará, from 1996 to 2001. The study was of the descriptive, exploratory type, and had as data base the death certificates from the regional system of mortality information. The selection of data was made with the use of the softwares Excel 7.0 and EPI-INFO 6.04, while the mortality coefficient (MC) by cause, the observed concordance (OC) and the Kappa were used for analysis. The found results show a similarity between the attested and the classified causes (septicemias, diarrheas and gastroenteritis of presumably infectious origin, AIOS, tuberculosis and malaria), with significant divergences in the values of MC by cause the in years studied (1996, p=0.0426; 1997, p=0.0223; 1998, p=0.001; 1999, p=0.0023; 2000, p=0.009 and 2001, p=0.0023). The values found for the OC and the Kappa reflect the restrictions imposed by the incorrect fill of the death certificates and the necessity to implement the tabulations of multiple causes of death in the municipal districts.