Timeliness in the notification of spotted fever in Brazil: Evaluating compulsory reporting strategies and digital disease detection.

Spotted fever is caused by rickettsia species, and is the most important tick-borne disease. In Brazil, it requires national compulsory notification to the Ministry of Health. Since 2007, all suspected cases of spotted fever have been integrated into the Notifiable Diseases Information System (SINAN). In this descriptive study we evaluate the timeliness (expressed in number of days between time of clinical suspicion and reporting) of the compulsory notification of spotted fever cases in SINAN and the strategy for digital disease detection (DDD). This study analysed the information from the SINAN and from the digital detection strategy used by ProMED-Português. Results show that detection by the SINAN system was more efficient than Promed-Português, reporting 90.4% of evaluated suspected cases 20.5days earlier. The surveillance strategy based on the mandatory case reporting using SINAN has proven to be more timely, but DDD can be considered as a complementary strategy providing a more disseminate epidemiological information to wide range readership globally.