Completeness of TB notification in Portugal, 2015: An inventory and capture-recapture study

C. Carvalho*, S. Alba, R. Harris, I. Abubakar, R. van Hest, A. M. Correia, G. Gonçalves, R. Duarte

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


BACKGROUND: Despite the steady decline in the last few decades, Portugal remains the Western European country with the highest TB notification rates. The aim of this study was to estimate the completeness of notification to the National Tuberculosis Programme (NTP) Surveillance System (SVIG-TB) in 2015.

METHODS: We implemented an inventory study and a three-source log-linear capture-recapture analysis using two additional data sources that were deterministic and probabilistically linked: the national notifiable diseases surveillance system (Sistema Nacional de Vigilância Epidemiológica [SINAVE]) and the national hospital discharge database (Grupos de Diagnósticos Homo-géneos [GDH]).

RESULTS: We identified 2328 unique probable/confirmed TB cases across the three data sources. We found a positive dependency between SVIG-TB and SINAVE (incidence rate ratio [IRR] 8.9, 95%CI 6.6-12.0) and between GDH and SINAVE (IRR 2.6, 95%CI 2.0-3.4). After adjusting for these dependencies, we estimated that 266 cases (95%CI 198-358) were not reported, indicating a notification (to SVIG-TB) completeness rate of 77.0%.

CONCLUSION: True incidence rate of TB in Portugal in 2015 could have been as high as 26.1 per 100 000. This could be an overestimation because of false-positive cases recorded in both SINAVE and GDH or on a smaller scale, false non-matches. Studies aimed at validating potentially false-positive cases should be implemented to address these limitations.

Original languageEnglish
Pages (from-to)1186-1193
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number11
Publication statusPublished - 1 Nov 2020

Bibliographical note

Funding Information:
This work was supported by the European Centre for Disease Prevention and Control (ECDC/2016/004—Framework Contract ‘Assessment of tuberculosis underreporting through inventory studies’). Conflicts of interest: none declared.

Publisher Copyright:
© 2020 The Union


  • Capture-recapture
  • Completeness of notification
  • K E Y W O R D S: TB
  • Portugal
  • Record-linkage


Dive into the research topics of 'Completeness of TB notification in Portugal, 2015: An inventory and capture-recapture study'. Together they form a unique fingerprint.

Cite this