Performance of drug sales and primary care encounters data for early detection of influenza-like illness surges in Brazil: a national time series analysis
Oliveira, J. F.; Cerqueira-Silva, T.; Brito, P. A. N.; da Silva, N. B.; Fiaconne, R. L.; Cunha, M. C. S. L.; Cunha, G. G.; Miranda, R. B.; Dias, L. M.; Filho, F. M. H. S.; Ramos, P. I. P.; Marcilio, I.; Barral-Netto, M.; Boaventura, V. S.
Show abstract
Effective pandemic preparedness relies on integrating diverse data sources for early outbreak detection. This study assessed whether over-the-counter (OTC) drug sales and primary health care (PHC) data could anticipate surges in respiratory-disease-related hospitalizations in Brazil. From November 2022 to June 2025, we analysed weekly time-series across 510 regions using a negative binomial autoregressive model within Statistical Process Control techniques. OTC data anticipated 56.6% of 746 hospitalization surges 1-3 weeks in advance, detected 9.5% concurrently, and missed 33.9%. PHC data anticipated 59.5%, detected 10.3% concurrently, and missed 30.2%. PHC data showed higher sensitivity and specificity than OTC (69.8% vs. 66.1%, and 49.5% vs. 47.8%). Performance varied regionally, and in 76.7% of regions, at least one stream showed high precision. These findings support the value of OTC drug sales, alongside PHC data, as early indicators of hospitalization surges in respiratory illness surveillance.
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