ABSTRACT
Rationale: In the health-disease process of tuberculosis (TB), mortality is one of the health indicators that most reflects the social link with the biological aspect. Death from TB is a sentinel event because it is preventable and indicates a failure of the social network and the health system. Objectives: To describe the sociodemographic and operational characteristics of patients who died of TB and the temporal distribution of the TB mortality rate in Brazil. Methods: A descriptive, cross-sectional, quantitative study performed from the database of the Mortality Information System (Portuguese acronym: SIM), in which all deaths with TB as the main cause registered from 2001 to 2011 were considered. Data analyzed through descriptive statistics. Results: During the study period, 53,747 deaths were recorded with TB as the basic cause. There was a higher percentage of cases of male sex (n = 39,597; 73.6%), mixed race (n=21,697; 40.3%), single marital status (n=23,518; 43.8%), schooling of up to eight years (n=19,443; 36.2%). A higher number of deaths occurred at the hospital (n=43,028; 80.1%) and 19,712 cases (36.7%) received medical assistance before death. The annual crude mortality rate decreased during the study period, ranging from 3.2 to 2.4 deaths per 100 thousand inhabitants. Conclusion: The results show the need for strategies differentiated by sex, age and education at the local level in TB control programs, as well as for planning health promotion and prevention actions available to populations living in these areas.(AU)
Justificativa: No processo saúde-doença da tuberculose (TB), a mortalidade constitui um dos indicadores de saúde que mais traduz o enlace social com o biológico. O óbito por TB é considerado um evento sentinela por ser evitável, indicativo de falha da rede social e do sistema de saúde. Objetivos: Descrever as características sociodemográficas e operacionais dos pacientes que evoluíram a óbito por TB e a distribuição temporal da taxa de mortalidade por TB no Brasil. Métodos: Estudo descritivo do tipo transversal e abordagem quantitativa, realizado a partir do banco de dados do Sistema de Informação sobre Mortalidade (SIM), na qual foram considerados todos os óbitos que apresentaram a TB como causa básica, registrados de 2001 a 2011, analisados por meio da estatística descritiva. Resultados: No período do estudo, foram registrados 53.747 óbitos com TB como causa básica, sendo maior percentual dos casos do sexo masculino (n= 39.597; 73,6%), raça/cor parda (n= 21.697; 40,3%), estado civil solteiro (n= 23.518; 43,8%), escolaridade até 8 anos de estudo (n=19.443; 36,2%), maior ocorrência dos óbitos no hospital (n= 43.028; 80,1%) e 19.712 casos (36,7%) receberam assistência médica antes do óbito. As taxas brutas anuais de mortalidade apresentaram redução no período de estudo, variando de 3,2 a 2,4 óbitos por 100 mil habitantes. Conclusão: Os resultados evidenciam a necessidade de propor estratégias diferenciadas por sexo, idade e escolaridade em nível local nos programas de controle de TB, assim como planejamento de ações de promoção e prevenção da saúde disponíveis às populações residentes nessas áreas.(AU)
Justificación: En el proceso salud-enfermedad de la tuberculosis (TB), la mortalidad es uno de los indicadores de salud que más refleja el vínculo social con el biológico. La muerte por TB se considera un evento centinela porque es prevenible, lo que indica un fallo de la red social y el sistema de salud. Objetivos: Describir las características sociodemográficas y operativas de los pacientes fallecidos por TB y la distribución temporal de la tasa de mortalidad por TB en Brasil. Métodos: un estudio descriptivo, de corte transversal y cuantitativo, realizado a partir de la base de datos del Sistema de Información de Mortalidad (SIM), en el cual se consideraron todas las muertes que presentaron TB como causa básica, registradas desde 2001 hasta 2011. Los datos fueron analizados mediante estadística descriptiva. Resultados: Durante el período de estudio, se registraron 53,747 muertes con TB como la causa básica. Hubo un mayor porcentaje de casos de sexo masculino (n=39,597; 73.6%), raza mixta (n=21,697; 40.3%), estado civil soltero (n=23,518; 43.8%), escolaridad de hasta ocho años (n=19,443; 36.2%). Un mayor número de muertes ocurrieron en el hospital (n=43,028; 80,1%) y 19,712 casos (36.7%) recibieron asistencia médica antes de la muerte. La tasa de mortalidad bruta anual disminuyó durante el período de estudio, oscilando desde 3.2 a 2.4 muertes por cada 100 mil habitantes. Conclusión: Los resultados muestran la necesidad de estrategias diferenciadas por sexo, edad y educación a nivel local en los programas de control de la TB, así como la planificación de acciones de promoción y prevención de la salud disponibles para las poblaciones que viven en estas áreas.(AU)
Subject(s)
Humans , Tuberculosis , Brazil , Mortality , Health-Disease Process , Health Status Indicators , Sentinel SurveillanceABSTRACT
Introduction: Tuberculosis (TB) is an ancient contagious disease, and continues to be the leading cause of morbidity and mortality among infectious contagious diseases. It can be considered an occupational infectious disease when it happens in health professionals. These professionals are directly exposed to TB and are considered to be a high risk population for latent tuberculosis infection (LTBI) and active TB. The primary aim of this study was to estimate the prevalence of LTBI among the clinical and administrative staff of an oncology referral hospital in Rio Grande do Sul. The secondary aim of this study was evaluate tuberculin skin test (TST) conversion rate and the risk factors for TST positivity in this population. Methods: A cross-sectional study was carried out in a retrospective cohort with data collected in March 2013 and March 2014. Data of professionals from different hospital units were included. Those with induration ≥ 10 mm were considered as reactors, and conversion rate was assessed by an increase ≥ 10 mm in induration in the second TST compared with the first one. Results: Among the 225 professionals evaluated in 2013, 135 (60%) were reactors and 90 (40%) were non-reactors. The mean age was 32.9 (± 9.55), 176 (78.22%) were female, and most of the reactors worked in the hospital for 4 years or less. Non-reactors in 2013 were recommended to repeat the test in 2014, and the conversion rate was 9.37%. There was no significant difference in prevalence among the different professional categories, and the assessed risk factors were not associated with ILTB. Conclusions: The prevalence of LTBI in the study population was high, reinforcing the need to implement effective control measures to prevent LTBI in the hospital where the study was conducted (AU)