RESUMO
Delays in diagnosing Tuberculosis (TB) are associated with increased transmission. TB may present as a clinical syndrome that mimics community-acquired pneumonia (CAP). The aim of this paper was to determine frequency of TB among patients with CAP at a referral hospital in Gaborone, Botswana. We performed a retrospective study of adults presenting with CAP from April 2010-October 2011 to the Emergency Department (ED);we matched this cohort to the National Botswana Tuberculosis Registry (NBTR) to identify individuals subsequently diagnosed with TB. We assessed demographics, time to TB diagnosis, clinical outcomes and performed logistic regressions to identify factors associated with TB diagnosis. We identified 1305 individuals presenting with CAP;TB was subsequently diagnosed in 68 (5.2%). The median time to TB diagnosis was 9.5 days. Forty percent were AFB sputum smear positive and 87% were identified as being HIV-positive. Subsequent diagnosis of TB is common among individuals with CAP at our ED, suggesting that TB may be present at the time of CAP presentation. Given the lack of distinguishing clinical factors between pulmonary TB and CAP, adults presenting with CAP should be evaluated for active TB in Botswana
Assuntos
Botsuana , Coinfecção , Serviços Médicos de Emergência , Infecções por HIV , Tuberculose/diagnóstico , Tuberculose/transmissãoRESUMO
Background: South Africa has one of the highest burdens of tuberculosis globally. Transmission of tuberculosis in health-care settings is common and healthcare workers face an increasing threat of becoming infected. Objective: The aim of this study was to calculate the incidence of tuberculosis reported among healthcare workers in public sector hospitals and clinics within eThekwini Health District in KwaZulu-Natal; South Africa; from 2006 to 2010. Methods: A retrospective review of tuberculosis registers at occupational health clinics was conducted in 11 hospitals andfour community health centres in the District. All healthcare workers who were diagnosed and treated for tuberculosis at these facilities were included in the study.Results: Six hundred and eighteen healthcare workers were diagnosed with tuberculosis during the study period; a total of 67 562 healthcare workers were employed. The mean incidence of tuberculosis over the study period was 908 cases per 100 000 (95% CI 771 - 1 046). The incidence of tuberculosis in healthcare workers was higher than that in the general population but lower than in the provincial and district populations. Conclusion: Tuberculosis among healthcare workers remains an important occupational health issue. The high burden of tuberculosis in KwaZulu-Natal; and under-reporting of tuberculosis among healthcare workers are likely to have masked the high incidence among healthcare workers
Assuntos
Atenção à Saúde , Exposição Ocupacional , Setor Público , Tuberculose/transmissãoRESUMO
Maladie infectieuse due a une mycobacterie (Bacille de Koch; Mycobacterium tuberculosis; mycobacterium africanum); la tuberculose connait ces derniers temps une veritable recrudescence dans notre pays. La localisation pulmonaire de la maladie tuberculeuse demeure la plus frequente et c'est elle qui; en raison de sa contagiosite; devient responsable de la transmission du bacille. Le moyen le plus efficace de rompre la chaine de transmission du bacille consiste a la decouverte precoce des sources de contamination (malades M+) et a leur negativation rapide grace a un traitement adequat; le BCG n'ayant qu'un role d'appoint