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1.
Medicina (B.Aires) ; 81(2): 143-148, June 2021. graf
Article in Spanish | LILACS | ID: biblio-1287263

ABSTRACT

Resumen Para hacer frente a la pandemia causada por el SARS CoV-2, en la Ciudad Autónoma de Buenos Aires se establecieron Unidades Febriles de Urgencias anexas a los hospitales de alta compleji dad. Se realizó un estudio observacional y retrospectivo con el objeto de evaluar el perfil de las personas que consultaron durante el período comprendido entre las semanas epidemiológicas 28 y 42, 2020. Se recibieron 12 571 consultas, el promedio de edad fue 38.2 años y 6801 (54.1%) pacientes eran varones. Se realizaron 9501 hisopados (RT-PCR para SARS-CoV-2) y 2499 (26.3%) fueron confirmados positivos. La edad media de los confirmados para COVID-19 fue 37.9 años, 1367 (54.7%) eran varones y 143 (5.7%) requirieron internación en la primera consulta. Tantos como 6097 (48.5%) participantes contaban con obra social o medicina prepaga. Consultaron solo 160 pacientes con HIV, se diagnosticó coinfección HIV/COVID-19 en 39/160 (24.4%) infectados con HIV y requirieron internación 9/39 (23.1%) coinfectados. Consultaron 128 pacientes con tuberculosis (TB), se diagnosticó coinfección TB/COVID-19 en 31/128 (24.2%) y requirieron internación 8/31 (25.8%) coinfectados. La triple asociación HIV/TB/COVID-19 fue constatada en 2 pacientes. Contrariamente a lo esperado, las dos principales enfermedades atendidas en el hospital, TB y HIV, estuvieron poco representadas en la consulta, pero el requerimiento de internación para los coinfectados fue elevado. Esto puede deberse a consulta tardía por restricciones de movilidad y asistencia durante la cuarentena. Nuestros datos también indican que el sector público de la ciudad debió absorber demanda insatisfecha del sector privado.


Abstract Febrile Emergency Units were annexed to tertiary hospitals to face the pandemic caused by SARS CoV-2 in Buenos Aires City. We performed a retrospective observational study in order to evaluate the profile of people consulting the Unit annexed to the Muñiz Hospital, during the period comprising epidemiological weeks 28 to 42, 2020. The total number of consultations was 12 571; 6801 (54.1%) patients were male, and the average age was 38 years. A total of 2499 (26.3 %) of 9501 swabs resulted positive for SARS-CoV-2 when analyzed by RT-PCR. The average age of confirmed COVID-19 patients was 37.9 years; 1367 (54.7%) were male and 143 (5.7%) required hospitalization at the first consultation. As many as 6097 (48.5%) participants were beneficiaries of social security or prepaid medicine. Only 160 (1.3%) were HIV positive, with COVID-19 coinfection diagnosed in 39/160 (24.4%), of which 9 (23.1%) required hospitalization. Only 128 (1%) had tuberculosis (TB); TB/CO VID-19 coinfection was diagnosed in 31 of them (24.2%), and 8/31 (25.8%) required hospitalization. The triple association HIV/TB /COVID-19 was reported in only 2 patients. Contrary to expectations, TB and HIV, the two main diseases treated in our hospital, were under-represented in this Emergency Unit, but the requirement of hospitalization for coinfected patients was quite frequent. This may be due to late consultation caused by mobility and assistance restrictions during quarantine. Interestingly, our data also indicate that the city's public sector had to absorb unsatisfied demand from the private sector and suburban population.


Subject(s)
Humans , Male , Female , Adult , Tuberculosis/diagnosis , Tuberculosis/epidemiology , HIV Infections/complications , HIV Infections/epidemiology , COVID-19 , Emergency Service, Hospital , SARS-CoV-2 , Hospitals
2.
Esc. Anna Nery Rev. Enferm ; 25(5): e20200546, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1286374

ABSTRACT

Resumo Objetivo avaliar o impacto econômico domiciliar do adoecimento pela tuberculose no Brasil. Método pesquisa transversal multicêntrica de 2016 a 2018, em cinco capitais do Brasil, em pacientes diagnosticados com tuberculose. Os custos totais foram a soma dos custos diretos e indiretos incorridos antes e durante o diagnóstico e tratamento. A regressão logística foi utilizada para estudar determinantes de custos catastróficos. A pobreza foi medida como renda familiar per capita diária < U$ 5,5. Resultados trezentos e sessenta e um pacientes foram inscritos no estudo. O custo extrapolação foi de R$3.664,47 (DP: R$ 2.667,67) e o custo total de extrapolação foi de R$22.291,82 (DP: R$ 16.259,50). No geral, 29% dos participantes do estudo foram caracterizados como pobres antes da tuberculose, e 39% depois. Em média, a renda diminuiu em 11% dos participantes e 41% tiveram custos catastróficos. Os determinantes estatisticamente significativos de experimentar custos catastróficos foram: participante ser o chefe da família, vivendo na pobreza antes da tuberculose, desemprego e interrupção do trabalho durante o tratamento (p < 0,05). Conclusão e implicações para a prática embora o tratamento seja financiado pelo governo, a tuberculose continua resultando em custos catastróficos e diminuição da renda para muitas famílias no Brasil.


Resumen Objetivo evaluar el impacto económico domiciliario de enfermarse por tuberculosis en Brasil. Método Investigación multicéntrica transversal de 2016 a 2018, en cinco capitales de Brasil, en pacientes diagnosticados con tuberculosis. Los costos totales fueron la suma de los costos directos e indirectos incurridos antes y durante el diagnóstico y el tratamiento. Se utilizó la regresión logística para estudiar los determinantes de los costos catastróficos. La pobreza se midió como un ingreso familiar diario per cápita < U$ 5,5. Resultados se inscribieron 361 pacientes en el estudio. El costo de extrapolación fue de R$ 3.664,47 (DE: R$ 2.667,67) y el costo total de extrapolación fue R$ 22.291,82 (DE: R$ 16.259,50). En general, el 29% de los participantes se caracterizaron como pobres antes de la tuberculosis y el 39%, después. En promedio, los ingresos disminuyeron en 11% de los participantes y el 41% tuvo costos catastróficos. Determinantes estadísticos de costos catastróficos: participante ser cabeza de familia; vivir en pobreza antes de la tuberculosis; desempleo; interrupción del trabajo durante el tratamiento (p<0.05). Conclusión e implicaciones para la práctica aunque el tratamiento es financiado por el gobierno, la tuberculosis sigue teniendo costos catastróficos y una disminución de los ingresos para muchas familias en Brasil.


Abstract Objective to assess the home economics impact of illness from Tuberculosis in Brazil. Method multicenter cross-sectional research from 2016 to 2018, in five capitals of Brazil, in patients diagnosed with tuberculosis. The total costs were the sum of the direct and indirect costs incurred before and during diagnosis and treatment. Logistic regression was used to study determinants of catastrophic costs. Poverty was measured as daily household income per capita < U$ 5.5. Results 361 patients were enrolled in the study. The extrapolation cost was R$ 3,664.47 (SD: R$ 2,667.67) and the total extrapolation cost was R$ 22,291.82 (SD: R$ 16,259.50). Overall, 29% of study participants were characterized as poor before tuberculosis, and 39% afterwards. On average, income declined by 11% among participants and 41% had catastrophic costs. The statistically significant determinants of experiencing catastrophic costs were: participant being the head of the family; living in poverty before tuberculosis; unemployment and interruption of work during treatment (p <0.05). Conclusion and implications for practice although treatment is financed by the government, tuberculosis continues to cause catastrophic costs and decreased of income for many families in Brazil.


Subject(s)
Humans , Male , Female , Adult , Tuberculosis/economics , Costs and Cost Analysis/economics , Poverty/statistics & numerical data , Socioeconomic Factors , Tuberculosis/diagnosis , Tuberculosis/therapy , Brazil/ethnology , Cross-Sectional Studies , Costs and Cost Analysis/statistics & numerical data , Social Protection in Health , Income/statistics & numerical data
3.
Esc. Anna Nery Rev. Enferm ; 25(5): e20210068, 2021. tab, graf
Article in Spanish | LILACS, BDENF | ID: biblio-1339870

ABSTRACT

Resumen Objetivo analizar el control de la tuberculosis en un sistema penitenciario de un Estado brasileño. Método estudio mixto explicativo secuencial. Fase I: descriptiva retrospectiva de los casos de tuberculosis en presos del estado de São Paulo en el periodo 2010-2016. Los casos se analizaron con frecuencias simples en el software SPSS 20.0 de la IBM y tendencia temporal en el software Stata/SE 14.0, por auto regresión de Prais-Winsten. Fase II: cualitativa. Se realizó con seis informantes-clave (profesionales sanitarios de una prisión) con base en la Teoría Fundamentada Constructivista. Resultados de 16.640 casos, 95,8% eran pulmonares, la Demanda Ambulatoria posibilitó el diagnóstico del 51,4%, y la curación fue la conclusión de tratamiento más frecuente. La categoría central fue: "Hacer bien su trabajo" y las subcategorías fueron: "Descubrir la enfermedad" e "Implicarse en el tratamiento". Éstas señalaron las estrategias y acciones desarrolladas por los profesionales para diagnosticar y tratar a los presos enfermos. Conclusión e implicaciones para la práctica los resultados sugieren una importante situación de la tuberculosis en penitenciarías, lo que trae consigo la necesidad de mejor articulación con el equipo de seguridad para un adecuado desarrollo de las estrategias que posibilitan un diagnóstico temprano y un tratamiento adecuado.


Resumo Objetivo analisar o controle da tuberculose em um sistema prisional de um Estado brasileiro. Método estudo sequencial, misto, explanatório: fase I - retrospectiva descritiva em que foram incluídos todos os casos de tuberculose em presidiários de um Estado brasileiro, período 2010-2016, e analisados ​​por frequências simples, no software IBM SPSS 20.0, e tendência temporal, no Software Stata / SE 14.0, por autorregressão de Prais-Winsten; Fase II - qualitativa, realizada com seis informantes-chave (profissionais de saúde de uma prisão), e a análise ocorreu segundo os procedimentos da Teoria Fundamentada Construtivista. Resultados dos 16.640 casos, 95,8% eram pulmonares, a Demanda Ambulatorial permitiu o diagnóstico de 51,4%, e a cura foi a finalização de tratamento mais frequente. "Fazer bem o seu Trabalho" foi apresentado como categoria central, e as subcategorias, "Descobrindo a doença" e "Envolvendo-se no tratamento", indicaram as estratégias e ações desenvolvidas pelos profissionais para diagnosticar e tratar os presos enfermos. Conclusão e implicações para a prática os resultados sugerem uma situação importante da tuberculose nas prisões, sendo necessária uma melhor articulação com a equipe de Segurança para o desenvolvimento adequado de estratégias que permitam um diagnóstico precoce e tratamento adequado.


Abstract Objective to analyze tuberculosis control in a prison system of a Brazilian state. Method this was a sequential explanatory mixed study. In phase I, a quantitative retrospective description was conducted of recorded tuberculosis cases among prisoners in the state of São Paulo from 2010-2016, which were analyzed using simple frequencies with IBM SPSS 20.0 software and time-trend with Stata software/SE 14.0 via Prais-Winsten regression. Phase II was qualitative and was based on interviews with six key informants (health professionals working at a prison). Data analysis took place according to the procedures set forth in constructivist grounded theory. Results of 16,640 cases of tuberculosis, 95.8% were pulmonary, outpatient care accounted for the diagnosis in 51.4% of cases, and tuberculosis cure was the most frequent treatment outcome. "Doing your job well" emerged as the central category, while the subcategories: "discovering the disease" and "getting involved in treatment" described the strategies and actions developed by the professionals to diagnose and treat sick prisoners. Conclusions and implications for practice the results indicate the significant presence of tuberculosis in penitentiaries and the need to better coordinate the actions of security teams with health staff to develop adequate strategies that allow for early diagnosis and proper treatment.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Prisons , Prisoners , Tuberculosis/prevention & control , Patient Isolation , Tuberculosis/diagnosis , Tuberculosis/therapy , Brazil/ethnology , HIV Infections , Retrospective Studies , Acquired Immunodeficiency Syndrome , Health Personnel , Substance-Related Disorders , Directly Observed Therapy , Qualitative Research , Drug Users
4.
Braz. arch. biol. technol ; 64(spe): e21210127, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285571

ABSTRACT

Abstract The rapid and accurate diagnosis of tuberculosis (TB), especially considering limited resources, is still a challenge. Development of new methodologies and tests are needed to overcome several disadvantages of the available standard tests. We evaluated the diagnostic potential of two antigens specific for Mycobacterium tuberculosis, the CFP10 and ESAT6 recombinant proteins, and developed stable formulations thereof. Sensitivity and specificity of the delayed-type hypersensitivity (DTH) skin testing and the induction of gamma interferon production (IFN-γ) by lymphocytes, as a non-invasive test, were evaluated using the CFP10 and ESAT6 protein formulations. The recombinant proteins produced by our group presented a high DTH response and the ability to differentiate between tuberculosis infection, BCG vaccination, and the contact with non-tuberculous mycobacteria (NTM). The production of IFN-γ by stimulation with individual and combined proteins was detected in a panel of 40 individuals and showed a specificity of 100% and a sensitivity of 90% when the two proteins were used together. Lyophilized formulations were stable under all conditions, while soluble formulations were stable under freezing at -20 ºC and -80 ºC. The proposed formulations containing the ESAT6 and CFP10 recombinant antigens constitute satisfactory tools for TB testing, suitable to be developed and implemented in a large-scale trial.


Subject(s)
Tuberculosis/diagnosis , Interferon-gamma , Mycobacterium tuberculosis/isolation & purification , Antigens/chemistry
5.
Rev. latinoam. enferm. (Online) ; 29: e3441, 2021. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1289785

ABSTRACT

Objective: to assess the impact of the GeneXpert® MTB/RIF rapid molecular test on tuberculosis detection, to analyze the temporal trend of the event and to identify vulnerable territories in a Brazilian municipality. Method: an ecological study carried out in Ribeirão Preto, São Paulo, Brazil, a municipality considered a priority in tuberculosis control due to the high number of cases. To classify the temporal trend, the Prais-Winsten method and the Interrupted Time Series were used to identify changes in the disease incidence. Kernel intensity analysis was applied to identify vulnerable areas. Results: the temporal trend of tuberculosis decreased by 18.1%/year and by 6.9%/year for children under 15 years old. The North District decreased by 6.67%/year and the East District increased by 17.5%/year in the incidence of tuberculosis. Resistant tuberculosis, after the implementation of the Rapid Molecular Test, increased by 0.6% per year. The South and West Districts showed a higher density of cases, with a range from 45 to 79 tuberculosis cases per square kilometer (km2). Conclusion: although resistant tuberculosis is not a problem in the scenario, the study showed an increase in its incidence, which puts it on alert. The use of spatial analysis enabled the identification of priority areas, putting them in evidence for health surveillance actions.


Objetivo: avaliar o impacto do teste rápido molecular GeneXpert® MTB/RIF na detecção da tuberculose, analisar a tendência temporal do evento e identificar territórios vulneráveis em município brasileiro. Método: estudo ecológico realizado em Ribeirão Preto, São Paulo, Brasil, município considerado prioritário no controle da tuberculose devido ao elevado número de casos. Para classificar a tendência temporal foi utilizado o método de Prais-Winsten e a Série Temporal Interrompida para identificar mudanças na incidência da doença. Aplicou-se a análise de intensidade de Kernel para a identificação de áreas vulneráveis. Resultados: a tendência temporal da tuberculose apresentou decréscimo de 18,1%/ano e de 6,9%/ano em menores de 15 anos. O Distrito Norte apresentou decréscimo de 6,67%/ano e o Distrito Leste crescimento de 17,5%/ano, na incidência de tuberculose. A tuberculose resistente, após a implementação do teste rápido molecular, apresentou aumento de 0,6% por ano. Os Distritos Sul e Oeste apresentaram maior densidade de casos, com variação de 45 a 79 casos de tuberculose por quilômetro quadrado (km2). Conclusão: apesar da tuberculose resistente não ser um problema no cenário, o estudo evidenciou um crescimento na sua incidência, o que o coloca em estado de alerta. O uso da análise espacial possibilitou a identificação das áreas prioritárias, colocando-as em evidência para ações de vigilância em saúde.


Objetivo: evaluar el impacto de la prueba rápida molecular GeneXpert® MTB/RIF en la detección de tuberculosis, analizar la tendencia temporal del evento e identificar territorios vulnerables en un municipio brasileño. Método: estudio ecológico realizado en Ribeirão Preto, São Paulo, Brasil, municipio considerado prioritario en el control de la tuberculosis por el elevado número de casos. Se utilizó el método de Prais-Winsten para clasificar la tendencia temporal y la técnica de Series de Tiempo Interrumpidas para identificar cambios en la incidencia de la enfermedad. Se aplicó un análisis de intensidad de Kernel para identificar áreas vulnerables. Resultados: la tendencia temporal de la tuberculosis disminuyó un 18,1%/año y un 6,9%/año en los menores de 15 años. La incidencia de tuberculosis disminuyó un 6,67%/año en el Distrito Norte y aumentó un 17,5%/año en el Distrito Este. La tuberculosis resistente, después de la implementación de la Prueba Molecular Rápida, aumentó un 0,6% anual. Los Distritos Sur y Oeste presentaron una mayor densidad de casos, con un rango de 45 a 79 casos de tuberculosis por kilómetros cuadrados (km2). Conclusión: aunque la tuberculosis resistente no representa un problema en el escenario, el estudio mostró un aumento en la incidencia, lo que genera una señal de alerta. El uso del análisis espacial permitió identificar áreas prioritarias, para que puedan llevarse a cabo acciones de vigilancia en salud.


Subject(s)
Humans , Child , Adolescent , Rifampin , Tuberculosis/diagnosis , Tuberculosis/epidemiology , Brazil/epidemiology , Time Series Studies , Sensitivity and Specificity , Spatial Analysis , Mycobacterium tuberculosis
6.
Rev. Soc. Bras. Med. Trop ; 54: e07552020, 2021. tab
Article in English | LILACS | ID: biblio-1155600

ABSTRACT

Abstract INTRODUCTION: The intensification of research and innovation with the creation of networks of rapid and effective molecular tests as strategies for the end of tuberculosis are essential to avoid late diagnosis and for the eradication of the disease. We aimed to evaluate the cost-effectiveness of Xpert®MTB/RIF (Xpert) in the diagnosis of drug-resistant tuberculosis in reference units, in scenarios with and without subsidies, and the respective cost adjustment for today. METHODS: The analyses were performed considering as criterion of effectiveness, negative culture or clinical improvement in the sixth month of follow-up. The comparison was performed using two diagnostic strategies for the drug susceptibility test (DST), BactecTMMGITTM960 System, versus Xpert. The cost effectiveness and incremental cost-effectiveness ratio (ICER) were calculated and dollar-corrected for American inflation (US$ 1.00 = R$ 5,29). RESULTS: Subsidized Xpert had the lowest cost of US$ 33.48 (R$67,52) and the highest incremental average efficiency (13.57), thus being a dominated analysis. After the inflation was calculated, the mean cost was DST-MGIT=US$ 74.85 (R$ 396,73) and Xpert = US$ 37.33 (R$197,86) with subsidies. CONCLUSIONS: The Xpert in the diagnosis of TB-DR in these reference units was cost-effective with subsidies. In the absence of a subsidy, Xpert in TB-DR is not characterized as cost effective. This factor reveals the vulnerability of countries dependent on international organizations' subsidy policies.


Subject(s)
Humans , Tuberculosis/diagnosis , Tuberculosis, Multidrug-Resistant/diagnosis , Mycobacterium tuberculosis/genetics , Sensitivity and Specificity , Cost-Benefit Analysis
7.
Rev. cuba. enferm ; 36(4): e3157,
Article in Spanish | LILACS, BDENF, CUMED | ID: biblio-1280288

ABSTRACT

Introducción: La tuberculosis es la novena causa mundial de mortalidad en adultos y la primera por enfermedades infecciosas. Mortalidad evitable con diagnóstico precoz y tratamiento oportuno. Estudio motivado por baja captación de sintomáticos respiratorios. Objetivo: Valorar la percepción de los usuarios de una institución de salud sobre la calidad de la atención y de la educación para el autocuidado, durante la captación de sintomáticos respiratorios en el programa de tuberculosis. Métodos: Estudio cualitativo, de abordaje con elementos de teoría fundamentada. Realizado en una institución estatal de salud de primer nivel. Participaron 96 adultos, quienes firmaron el consentimiento informado: 70 sintomáticos respiratorios y 26 familiares acompañantes. Se realizaron seis grupos focales, con dos categorías apriorísticas: calidad de atención y educación durante el proceso de captación. Información grabada y transcrita. Con Atlas Ti se realizó codificación abierta, axial y selectiva, utilizando comparación constante y memos. El análisis se apoyó en postulados de Dorothea Orem. Resultados: Sobre calidad de atención: hubo desconocimiento de la ruta integral de atención y deficiente identificación e información sobre riesgo. Sobre educación para el autocuidado: hubo desconocimiento de aspectos relacionados con tuberculosis y déficit en educación recibida. Los participantes no relacionaron sintomáticos respiratorios con tuberculosis; esta fue estigmatizada como enfermedad contagiosa y mortal, consideraron difícil recoger muestra para baciloscopia. Se evidenciaron limitaciones de cuidado favorecidas por insuficiente apoyo educativo. Conclusiones: La percepción de los usuarios orienta hacia la necesidad de fomentar servicios seguros, accesibles y humanizados para detección temprana y cuidado del sintomático respiratorio. La educación para el autocuidado y una mayor interacción con usuarios pueden mejorar resultados institucionales(AU)


Introduction: Tuberculosis, the world ninth leading cause of death in adults, first due to infectious diseases. Avoidable mortality with early diagnosis and timely treatment. Study motivated by limited awareness of respiratory symptomatics. Objective: To assess the perception of users of a healthcare institution in regards to the quality of care and self-care education during the Tuberculosis program. Methods: A Qualitative study approach with elements from proven theory. Conducted at state-class healthcare institution. Participants: 96 consenting adults (70 respiratory symptoms, 26 accompanying relatives). Six focus groups were carried out during the recruitment process with two aprioristic categories: quality of care and self-care education. Information was recorded and transcribed. Utilizing Atlas Ti, open, axial and selective coding was performed and using constant comparisons and memos. The analysis was based on Dorothea Orem postulates. Results: Quality of care: lack of comprehensive route of care and poor identification and risk information. Self-care education: ignorance of TB-related aspects and shortfalls of received education. Participants did not link respiratory symptoms to tuberculosis; this was stigmatized as a contagious and fatal disease. They considered it difficult to collect sample(s) for baciloscopy. Care limitations are evident by insufficient educational support. Conclusions: User perception should be oriented towards promoting safe, accessible and humanized services for early detection and care of respiratory symptoms. Self-care education and greater interaction with users can improve institutional outcomes(AU)


Subject(s)
Humans , Perception , Quality of Health Care/trends , Tuberculosis/diagnosis , Early Diagnosis , Self Care
8.
Rev. chil. infectol ; 37(5): 577-583, nov. 2020. tab, graf
Article in Spanish | LILACS, BNUY | ID: biblio-1144254

ABSTRACT

Resumen Introducción: La tuberculosis es un problema de salud pública de alta prevalencia. Los niños constituyen una población de riesgo de enfermar y evolucionar a formas graves. Objetivo: Describir la frecuencia, características epidemiológicas, clínicas y evolutivas de los pacientes bajo 15 años de edad, internados por tuberculosis extra-pulmonar (TBCEP) en el Centro Hospitalario Pereira Rossell-Uruguay, durante 2009 a 2019. Pacientes y Métodos: Estudio descriptivo, retrospectivo, revisión de historias clínicas y registros de la Comisión Honoraria para la Lucha Antituberculosa. Variables: edad, sexo, nexo epidemiológico, clínica, confirmación diagnóstica, tratamiento y complicaciones. Resultados: Se registraron 77 casos de TBCEP, fueron hospitalizados en este centro 45 (58%). Media de edad 7 años, varones 25 (56%). Todos recibieron vacuna BCG. Se identificó nexo epidemiológico en 28 (62%). Las formas de TBCEP fueron: pleural 26 (58%), sistema nervioso central (SNC) 9 (20%), linfoganglionar 4 (9%), cutánea 2 (5%), ósea 1 (2%), peritoneal 1 (2%), pleural-peritoneal 1 (2%), ósea-SNC 1 (2%). Confirmación etiológica hubo en 23 (51%): mediante cultivo 16, GeneXpert 5, por ambos 2. Completaron tratamiento 36 (80%). Presentaron complicaciones 4 (9%): status convulsivo 2, hemorragia cerebral 1, fallo orgánico múltiple 1. Conclusiones: La TBCEP ocurrió en niños previamente sanos. El diagnóstico requiere alto índice de sospecha y la confirmación el empleo simultáneo de varias técnicas diagnósticas.


Abstract Background: Tuberculosis is a public health problem. Children constitute a population at risk of becoming ill and evolving into serious forms. Aim: To describe the frequency, epidemiological, clinical and evolutionary characteristics of children under 15 years of age hospitalized for extrapulmonary tuberculosis (EPTB) at the Pereira Rossell Hospital-Uruguay, during 2009-2019. Methods: Descriptive, retrospective study, review of medical records and records of the Honorary Commission for the Fight Against Tuberculosis. Variables: age, sex, epidemiological and clinical link, diagnostic confirmation, treatment and complications. Results: 77 cases of EPTB were registered, 45 (58%) were hospitalized in this center. Average age 7 years, males 25 (56%). All received the Bacillus Calmette-Guérin vaccine. An epidemiological link was identified in 28 (62%). The forms of EPTB were: pleural 26 (58%), central nervous system (CNS) 9 (20%), lymphoganglionic 4 (9%), cutaneous 2 (5%), bone 1 (2%), peritoneal 1 (2%), pleural- peritoneal 1 (2%), bone-CNS 1 (2%). Etiology was confirmed in 23 (51%): by culture 16, GeneXpert 5, by both 2. Thirty-six (80%) patients completed treatment. Four (9%) presented complications: convulsive state 2, cerebral hemorrhage 1, multiple organ failure 1. Conclusions: EPTB occurred in previously healthy children. The diagnosis requires a high index of suspicion and the confirmation of the simultaneous use of several diagnostic techniques.


Subject(s)
Humans , Male , Female , Child , Tuberculosis/diagnosis , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Uruguay/epidemiology , Retrospective Studies , Biological Evolution , Hospitals
9.
Rev. inf. cient ; 99(4): 321-330, jul.-ago. 2020. tab
Article in Spanish | LILACS | ID: biblio-1139192

ABSTRACT

RESUMEN Introducción: La lucha contra la tuberculosis es una responsabilidad social y profesional que requiere de su caracterización, la que no se ha realizado en Guantánamo en la última década. Objetivo: Caracterizar la tuberculosis en pacientes de la provincia Guantánamo durante el periodo comprendido entre 2012 y 2019. Método: El universo se constituyó por el total de pacientes diagnosticados (n=136). Se estudiaron las siguientes variables: edad, sexo, localización de la enfermedad, resultados de la baciloscopía, categoría al egreso y grupos de riesgo de tuberculosis. La información se obtuvo mediante los registros de enfermedades de declaración obligatoria cada año, y las encuestas epidemiológicas de los controles de focos realizados, y se resumió en números absolutos y porcentajes. Resultados: En el 80,1 % de los casos la tuberculosis se localizó en los pulmones, y fue más común el diagnóstico de pacientes con baciloscopía positiva (63,2 %). El 76,7 % de los pacientes con baciloscopía positiva fueron masculinos. Los grupos de riesgos para tuberculosis más usuales fueron: fumadores (26,4 %), inmunodeprimidos (21,6 %) y el alcoholismo (19,1 %). Conclusiones: En la provincia Guantánamo prevalece la tuberculosis de localización pulmonar y los pacientes con bacteriología positiva. Los afectados sobre todo son hombres, tienen edad entre 45 a 54 años y son de reciente diagnóstico. La enfermedad incide más en aquellos con antecedente de ser fumadores, inmunodeprimidos y los alcohólicos.


ABSTRACT Introduction: The fight against tuberculosis is a social and professional responsibility, which requires its characterization, which has not been carried out in Guantánamo in the last decade. Objective: To characterize tuberculosis in patients in the Guantánamo province during the period between 2012 and 2019. Method: The universe was made up of the total number of diagnosed patients (n = 136). The following variables were studied: age, sex, location of the disease, smear results, category at discharge, and tuberculosis risk groups. The information was obtained through the notifiable disease registries for each year and the epidemiological surveys of the outbreak controls carried out, and was summarized in absolute numbers and percentages. Results: In 80.1% of cases, tuberculosis is in the lungs, and the diagnosis of patients with positive smear microscopy (63.2%) is more common. 76.7% of smear-positive patients are male. The most common risk groups for tuberculosis are: smokers (26.4%), immunosuppressed (21.6%) and alcoholism (19.1%). Conclusions: In Guantánamo province, pulmonary localization tuberculosis and patients with positive bacteriology prevail. Those affected are mainly men, they are between 45 and 54 years old and have recently been diagnosed. The disease affects more in those with a history of being smokers, immunosuppressed and alcoholics.


Subject(s)
Humans , Tuberculosis/classification , Tuberculosis/diagnosis , Tuberculosis/epidemiology , Risk Factors , Tuberculosis, Pulmonary , Observational Study
11.
Washington; Organización Panamericana de la Salud; abr. 13, 2020.
Non-conventional in Spanish | LILACS | ID: biblio-1096694

ABSTRACT

Ante la situación actual de la pandemia del COVID-19 se aconseja a los países que continúen con la adopción de los algoritmos de diagnóstico de TB recomendados por OPS/OMS. A pesar de las diferencias en los modos de transmisión de TB y COVID-19, ciertas medidas de protección personal son relevantes para ambas enfermedades. Las medidas habituales para protegerse de la TB deben continuar junto con las precauciones adicionales para proteger a los trabajadores de COVID-19.


Subject(s)
Pneumonia, Viral/prevention & control , Tuberculosis/diagnosis , Tuberculosis/prevention & control , DNA, Viral/analysis , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Betacoronavirus
12.
Rev. chil. enferm. respir ; 36(1): 18-25, mar. 2020. tab
Article in Spanish | LILACS | ID: biblio-1115458

ABSTRACT

Las enfermedades granulomatosas incluyen una amplia gama de enfermedades. Sin embargo, en la práctica clínica, muchos casos de enfermedad granulomatosa permanecen sin etiología después del examen histológico. Nuestro objetivo fue determinar, a partir de las biopsias de pulmón, pleura y ganglios linfáticos mediastínicos, en los que se informaron granulomas, las características clínicas y los diagnósticos de estos pacientes. Así también la mortalidad a un año de seguimiento. Metodología: Analizamos retrospectivamente biopsias de pulmón, pleura y/o ganglios linfáticos mediastínicos con granulomas de 75 pacientes del Instituto Nacional del Tórax (2012-2016), sus características clínicas y de laboratorio. La información se obtuvo de los registros médicos. Los datos de mortalidad se obtuvieron del registro civil. Resultados: Se determinó una etiología en todos los casos, excepto en 3 (4%). Los diagnósticos más frecuentes fueron tuberculosis (n = 37; 49%) y sarcoidosis (n = 18; 24%). Otras causas fueron silicosis (5,3%), vasculitis (4%) y neumonitis por hipersensibilidad (2,7%). Los pacientes con tuberculosis (TB) tenían parámetros inflamatorios más altos, como velocidad de eritrosedimentación y proteína C reactiva. Además, sólo se encontraron granulomas con necrosis caseosa en pacientes con tuberculosis. En cambio, los pacientes con sarcoidosis tenían lesiones cutáneas y una mayor frecuencia de linfadenopatías. Cuatro (5.3%) pacientes fallecieron a un año de seguimiento: dos debido a neumonía, uno por hipersensibilidad crónica y uno por TB. Conclusión: La tuberculosis y la sarcoidosis fueron las causas más frecuentes de granulomas respiratorios en este estudio retrospectivo. Se logró determinar una etiología en el 96% de los casos, considerando variables clínicas, de laboratorio e histopatológicas para un diagnóstico diferencial correcto.


Granulomatous diseases comprise a wide range of pathologies. However, in clinical practice, many pulmonary granulomas remain without etiology after the histologic examination. Our aim was to determine from the biopsies of the lung, pleura and mediastinal lymph nodes in which granulomas were reported, the clinical characteristics and diagnoses of the patients. Methodology: We analyzed retrospectively biopsies of the lung, pleura and mediastinal lymph nodes with granulomas from 75 patients handled at our institution (2012-2016), as well as their clinical and laboratory data. The information was obtained from medical records. A one-year mortality date was obtained from the civil registry. Main results: A cause was determined in all the cases, except in three of them (4%). The most frequent diagnoses were tuberculosis (n =37; 49%) and sarcoidosis (n =18; 24%). Other causes were silicosis (5.3%), vasculitis (4%) and hypersensitivity pneumonitis (2.7%). Patients with tuberculosis (TB) had higher inflammatory parameters such as erythrocyte sedimentation rate and C-reactive protein. Besides granulomas with caseous necrosis were only found in TB patients. Instead, patients with sarcoidosis had skin lesions and a higher frequency of lymphadenopathy. Four patients (5.3%) died in a one-year of follow-up: two of them because of pneumonia and the other two patients because of chronic hypersensitivity and TB respectively. Conclusion: Tuberculosis and sarcoidosis were the most common causes of respiratory granulomas in this retrospective study. A specific cause was determined in 96% of cases, considering clinical, laboratory and histopathological variables to do a right differential diagnosis.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Granuloma/diagnosis , Granuloma/pathology , Lung Diseases/diagnosis , Lung Diseases/pathology , Sarcoidosis/diagnosis , Sarcoidosis/pathology , Tuberculosis/diagnosis , Tuberculosis/pathology , Biopsy , Retrospective Studies , Follow-Up Studies , Diagnosis, Differential
13.
J. coloproctol. (Rio J., Impr.) ; 40(1): 79-82, Jan.-Mar. 2020. graf
Article in English | LILACS | ID: biblio-1090849

ABSTRACT

Abstract Background Mycobacterial infections are a serious public health problem worldwide. Involvement of the anal canal and perineum is very rare, but constitute an important differential diagnosis with other equally serious pathologies that may affect the region, such as malignant neoplasms and Crohn's disease. Objectives To conduct a literature review on mycobacterial infections of the perianal region considering the most recent information for diagnostic and therapeutic guidance of this disease. Methods Research was performed on the PUBMED and LILACS databases with the expressions Mycobacterium, Anal, Infection and Tuberculosis. We reviewed articles referring to series of treated cases, clinical reports and literature review published since 2005. Results Information was compiled on the epidemiology of mycobacterial infections; the clinical behavior of affected individuals; diagnostic options and their validity in clinical practice; and, finally, therapeutic options. Conclusions Mycobacterial infections of the anus and perineum are rare. The most common clinical presentations are the presence of ulceration and fistulization. The diagnosis involves more than one procedure for identifying the bacilli and should consider the presence of manifestations in more than one organ. The treatment is based on pharmacological intervention. Surgery is recommended for acute complications or chronic sequelae of the disease.


Resumo Introdução Infecções micobacterianas constituem um grave problema de saúde pública a nível mundial. As manifestações anoperineais são raras, mas constituem um importante diagnóstico diferencial com outras patologias igualmente graves que podem acometer a região, como as neoplasias malignas e a doença de Crohn. Objetivos Realizar um levantamento da literatura sobre infecções micobacterianas da região anoperineal, considerando as informações mais atuais para orientação diagnóstica e terapêutica dessa enfermidade. Métodos Foi realizada pesquisa nos bancos de dados PUBMED e LILACS com as expressões Mycobacterium, Anal, Infection e Tuberculosis. Foram revisados artigos referentes a séries de casos tratados, relatos clínicos e revisão da literatura publicada a partir de 2005. Resultados Foram compiladas informações sobre a epidemiologia das infecções micobacterianas; o comportamento clínico dos indivíduos afetados; opções diagnósticas e sua validade na prática clínica; e, por fim, opções terapêuticas. Conclusões Infecções micobacterianas da região anoperineal são raras. As apresentações clínicas mais comuns são a formação de ulceras e a fistulização. O diagnóstico envolve mais de um procedimento para identificação dos bacilos, e deve considerar a presença de manifestações em mais de um órgão. O tratamento é principalmente medicamentoso, sendo a cirurgia recomendada nas complicações agudas ou sequelas crônicas da doença.


Subject(s)
Humans , Anus Diseases/diagnosis , Mycobacterium Infections/diagnosis , Anal Canal/microbiology , Anus Diseases/therapy , Anus Diseases/epidemiology , Perineum/microbiology , Skin Ulcer/microbiology , Tuberculosis/diagnosis , Tuberculosis/therapy , Tuberculosis/epidemiology , Fissure in Ano/microbiology , Mycobacterium Infections/therapy , Mycobacterium Infections/epidemiology
14.
Rev. chil. infectol ; 37(1): 51-63, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092722

ABSTRACT

Resumen La tuberculosis en etapa neonatal tiene una alta morbimortalidad, es de difícil diagnóstico e involucra al binomio madre-hijo y su entorno. Las características particulares del sistema inmune en la mujer gestante y el recién nacido, impactan en la presentación clínica de esta enfermedad. Su diagnóstico es complejo y la instauración del tratamiento debe ser oportuna e impostergable. Se abarcan aspectos relevantes para el diagnóstico y manejo del recién nacido expuesto a la tuberculosis


Abstract Tuberculosis in the neonatal stage has a high morbidity and mortality, is difficult to diagnose and involves the mother-child binomial and their environment. The particular characteristics of the immune system in pregnant women and the newborn, impact the clinical presentation of this disease. Its diagnosis is complex and the establishment of treatment must be timely and cannot be postponed. Relevant aspects for the diagnosis and management of the newborn exposes to the tuberculosis are covered.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Child , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/prevention & control , Pregnancy Complications, Infectious/drug therapy , Tuberculosis/diagnosis , Tuberculosis/prevention & control , Tuberculosis/drug therapy
15.
Mem. Inst. Oswaldo Cruz ; 115: e200229, 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1135249

ABSTRACT

Malaria and tuberculosis are no longer considered to be neglected diseases by the World Health Organization. However, both are huge challenges and public health problems in the world, which affect poor people, today referred to as neglected populations. In addition, malaria and tuberculosis present the same difficulties regarding the treatment, such as toxicity and the microbial resistance. The increase of Plasmodium resistance to the available drugs along with the insurgence of multidrug- and particularly tuberculosis drug-resistant strains are enough to justify efforts towards the development of novel medicines for both diseases. This literature review provides an overview of the state of the art of antimalarial and antituberculosis chemotherapies, emphasising novel drugs introduced in the pharmaceutical market and the advances in research of new candidates for these diseases, and including some aspects of their mechanism/sites of action.


Subject(s)
Humans , Tuberculosis/drug therapy , Malaria/drug therapy , Antimalarials/therapeutic use , Antitubercular Agents/therapeutic use , Tuberculosis/diagnosis , Neglected Diseases , Malaria/diagnosis
16.
Rev. saúde pública (Online) ; 54: 67, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1127231

ABSTRACT

ABSTRACT OBJECTIVES To calculate the rate of tuberculosis cases per prison unit in Espírito Santo; present the individual, clinical, and institutional characteristics of the cases in persons deprived of liberty (PPL); and analyze the association between these characteristics and treatment outcome in this population. METHODS The study included cases of tuberculosis in the PPL of Espírito Santo from 2014 to 2016. Rate calculation, descriptive analysis and hierarchical logistic regression were performed considering the individual, clinical and institutional levels. RESULTS The rate of diagnosed cases per prison unit in the state ranged from 0 to 17.3 cases per 1,000 inmates. Of all reported cases, 218 (72.6%) healed, 21 (7.0%) dropped out, 1 (0.3%) died of tuberculosis, 2 (0.7%) died from other causes, 56 (18.7%) transferred the treatment site and 2 (0.7%) developed drug-resistant tuberculosis. The adjusted analysis showed that supervised treatment ensures success (CR = 0.29; 95%CI 0.01-0.76). CONCLUSIONS The study highlighted the importance of knowing the TB treatment outcome in the PPL to implement measures to reduce failure, and the contribution of supervised treatment in this process.


RESUMO OBJETIVOS Calcular a taxa de casos diagnosticados com tuberculose por unidades prisionais do Espírito Santo, apresentar as características individuais, clínicas e institucionais dos casos na população privada de liberdade (PPL) do ES e analisar a associação entre essas características e o encerramento do tratamento da tuberculose nessa população. MÉTODOS A população de estudo foram os casos de tuberculose na PPL do ES de 2014 a 2016. Realizou-se o cálculo de taxa, a análise descritiva e a regressão logística hierarquizada considerando os níveis individual, clínico e institucional. RESULTADOS A taxa de casos diagnosticados por unidade prisional no estado variou de 0 a 17,3 casos por 1.000 presos. Do total de casos notificados, 218 (72,6%) se curaram, 21 (7,0%) abandonaram o tratamento, 1 (0,3%) morreu por tuberculose, 2 (0,7%) morreram por outras causas, 56 (18,7%) transferiram o local de tratamento e 2 (0,7%) desenvolveram tuberculose drogarresistente. A análise ajustada mostrou que o tratamento supervisionado é um fator protetor para o insucesso (RC = 0,29; IC95% 0,01-0,76). CONCLUSÕES O estudo apontou a importância do conhecimento do desfecho do tratamento da TB na PPL visando à implementação de ações para a redução do insucesso, bem como a contribuição do tratamento supervisionado nesse processo.


Subject(s)
Humans , Male , Female , Adult , Prisons , Prisoners/statistics & numerical data , Tuberculosis/drug therapy , Health Services Accessibility , Antitubercular Agents/therapeutic use , Tuberculosis/diagnosis , Tuberculosis/epidemiology , Brazil , Treatment Outcome , Tuberculosis, Multidrug-Resistant , Freedom
17.
Rev. bras. epidemiol ; 23: e200009, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1092617

ABSTRACT

RESUMO: Introdução: A comorbidade tuberculose e diabetes ainda continua um desafio para a saúde pública mundial. Objetivo: Analisar o perfil sociodemográfico e as características do diagnóstico e tratamento dos casos de tuberculose com e sem diabetes no Brasil. Métodos: Estudo transversal, com dados do Sistema de Informação de Agravos de Notificação e do Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica, no período de 2007 a 2011. Modelo de regressão de Poisson com variância robusta foi utilizado para estimar a razão de prevalência (RP) e seus respectivos intervalos de confiança. Resultados: A comorbidade estudada foi encontrada em 7,2% dos casos. Modelo hierárquico mostrou maior RP entre indivíduos do sexo feminino (RP = 1,31; intervalo de confiança de 95% - IC95% 1,27 - 1,35); maior associação nas faixas etárias 40-59 anos e ≥ 60 anos (RP = 11,70; IC95% 10,21 - 13,39 e RP = 17,49; IC95% 15,26-20,05) e com resultado positivo da baciloscopia - primeira amostra (RP = 1,40; IC95% 1,35 - 1,47). Reingresso após abandono e abandono foram inversamente associados na comorbidade (RP = 0,66; IC95% 0,57 - 0,76 e RP = 0,79; IC95% 0,72 - 0,87). Conclusão: Os achados, como a relação inversa do abandono ao tratamento da tuberculose no grupo das pessoas com comorbidade, reforçam a importância de ações integradas nos serviços para mudar o cenário dessa desafiadora comorbidade.


ABSTRACT: Introduction: Tuberculosis and diabetes comorbidity remains a challenge for global public health. Objective: To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. Methods: This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. Results: We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). Conclusion: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Tuberculosis/complications , Tuberculosis/epidemiology , Diabetes Complications/epidemiology , Socioeconomic Factors , Tuberculosis/diagnosis , Tuberculosis/therapy , Brazil/epidemiology , Comorbidity , Prevalence , Cross-Sectional Studies , Sex Distribution , Age Distribution , Diabetes Complications/diagnosis , Diabetes Complications/therapy , Middle Aged
18.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1102731

ABSTRACT

Objetivou-se analisar o discurso de sujeitos gestores relacionado ao retardo do diagnóstico da Tuberculose em pessoas idosas em municípios da região do Curimataú-Paraíba. Trata-se de um estudo qualitativo, cuja amostra contou com nove gestores de saúde de municípios pertencentes a 4ª Região de Saúde da Paraíba. Os dados foram coletados pela técnica da entrevista e analisados com base na Análise de Discurso de matriz francesa. Para os gestores, os fatores que levam ao retardo do diagnóstico da Tuberculose relacionam-se a demora em procurar os serviços de saúde e perceber o adoecimento, à falta de conhecimento sobre a doença, o preconceito, dificuldades no acesso aos serviços de saúde e a falta de percepção dos profissionais em identificar os casos suspeitos. Faz-se necessário que gestores e profissionais de saúde criem ações direcionadas tanto para família quanto para o idoso, o qual necessita ser visto como grupo de risco ao adoecimento de Tuberculose


Objective: To analyze the discourse of management subjects related to the delay of the diagnosis of Tuberculosis in elderly people in municipalities of the Curimataú-Paraíba region. Method: This is a qualitative study whose sample had nine health managers from municipalities belonging to the 4th Health Region of Paraíba. The data were collected by the interview technique and analyzed based on French Discourse Analysis. Results: For managers, the factors leading to the delay in the diagnosis of Tuberculosis are related to the delay in seeking health services and to perceive illness, lack of knowledge about the disease, prejudice, difficulties in accessing health services and lack of perception of professionals in identifying suspected cases. Conclusion: It is necessary that managers and health professionals create actions aimed at both the family and the elderly, which needs to be seen as a group at risk of tuberculosis


Objetivo: Analizar el discurso de sujetos gestores relacionado al retraso del diagnóstico de la Tuberculosis en personas ancianas en municipios de la región del Curimataú-Paraíba. Método: Se trata de un estudio cualitativo, cuya muestra contó con nueve gestores de salud de municipios pertenecientes a la 4ª Región de Salud de Paraíba. Los datos fueron recolectados por la técnica de la entrevista y analizados con base en el Análisis de Discurso de matriz francesa. Resultados: Para los gestores, los factores que llevan al retraso del diagnóstico de la Tuberculosis se relacionan con la demora en buscar los servicios de salud y percibir el enfermo, la falta de conocimiento sobre la enfermedad, el prejuicio, dificultades en el acceso a los servicios de salud y la la falta de percepción de los profesionales en identificar los casos sospechosos. Conclusión: Se hace necesario que gestores y profesionales de salud creen acciones dirigidas tanto para la familia y para el anciano, el cual necesita ser visto como grupo de riesgo al enfermarse de Tuberculosis


Subject(s)
Humans , Tuberculosis/diagnosis , Health Manager , Delayed Diagnosis , Aged , Address
19.
Acta Paul. Enferm. (Online) ; 32(5): 554-563, Set.-Out. 2019. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1038052

ABSTRACT

Resumo Objetivo Analisar os aspectos associados ao desfecho dos casos de tuberculose nas pessoas que vivem com HIV. Métodos Estudo transversal, realizado entre 2010 a 2014 em um município de grande porte localizado no interior do estado de São Paulo, o qual é considerado prioritário para o controle da tuberculose. Utilizou-se dados secundários coletados nos sistemas de informação TBWEB, SINAN, SISCEL e SICLOM. Foram utilizadas técnicas de estatística descritiva e Regressão Logística Multinomial, considerando o desfecho (cura, abandono e óbito) como variável dependente e as informações sociodemográficas, clínicas e de acompanhamento clínico/terapêutico como independentes. Resultados Observou-se uma maior chance de ocorrência de desfecho desfavorável do tratamento da tuberculose entre as pessoas que viviam com HIV com menor escolaridade, com histórico de internação e sem o registro do tipo de tratamento realizado. Conclusão Reforça-se a necessidade de integração entre os programas de controle da tuberculose e de HIV/aids, bem como entre esses e os demais serviços das redes de atenção à saúde e rede de apoio social para a oferta de ações e serviços que contemplem as necessidades sociais, econômicas e de saúde, visando o adequado seguimento dos casos de coinfecção TB-HIV e a obtenção de desfechos favoráveis da tuberculose nas pessoas vivendo com HIV.


Resumen Objetivo analizar los aspectos asociados al desenlace de los casos de tuberculosis en personas que viven con el VIH. Métodos estudio transversal, realizado entre 2010 y 2014 en un municipio de gran tamaño localizado en el interior del estado de São Paulo, considerado prioritario para el control de la tuberculosis. Se utilizaron datos secundarios recolectados en los sistemas de información TBWEB, SINAN, SISCEL y SICLOM. Se utilizaron técnicas de estadística descriptiva y regresión logística multinomial, considerando el desenlace (cura, abandono y óbito) como variable dependiente y la información sociodemográfica, clínica y de seguimiento clínico/terapéutico como independiente. Resultados se observó una mayor posibilidad de desenlace desfavorable del tratamiento de la tuberculosis entre las personas que vivían con el VIH con menos escolaridad, con antecedentes de internación y sin registro del tipo de tratamiento realizado. Conclusión se refuerza la necesidad de integración entre los programas de control de la tuberculosis y de VIH/sida, así como también entre estos y los demás servicios de las redes de atención en salud y red de apoyo social para la oferta de acciones y servicios que contemplen las necesidades sociales, económicas y de salud, a fin de proporcionar un seguimiento adecuado de los casos de coinfección TB-HIV y obtener desenlaces favorables de la tuberculosis en las personas que viven con el VIH.


Abstract Objective To analyze the aspects associated with tuberculosis cases outcome among people living with HIV. Methods A cross-sectional study conducted between 2010 and 2014 in a large municipality located in the countryside of São Paulo State, which was considered a priority city for tuberculosis control. Secondary data collected in the TBWEB, SINAN, SISCEL and SICLOM information systems were used. Descriptive statistics and Multinomial Logistic Regression techniques were used, considering outcome (cure, default and death) as a dependent variable, and sociodemographic, clinical and clinical/therapeutic follow-up information as independent. Results A higher chance of occurrence of unfavorable TB treatment outcome in people living with HIV was observed among those with lower education degree, hospitalization history and without record of the treatment type received. Conclusion There should be integration between tuberculosis and HIV/AIDS control programs, as well as other services of health care networks and social support network for the provision of actions and services that address social, economic and health needs, aiming at the adequate follow-up of TB-HIV co-infection cases and the achievement of favorable tuberculosis outcomes in people living with HIV.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Tuberculosis/diagnosis , HIV , Treatment Outcome , Cross-Sectional Studies , Acquired Immunodeficiency Syndrome/diagnosis
20.
Rev. bras. enferm ; 72(5): 1211-1218, Sep.-Oct. 2019. tab
Article in English | LILACS, BDENF | ID: biblio-1042141

ABSTRACT

ABSTRACT Objective: To describe and compare the epidemiological profile of cases of tuberculosis and HIV coinfection of the District Administration Health Units of Porto Alegre, Brazil, from 2009 to 2013. Method: Retrospective cohort with data from national health information systems. Sociodemographic, clinical and follow-up variables were investigated through association tests. Results: 2,419 cases of tuberculosis and HIV coinfection were reported, with a mean age of 38 ± 9.91 years, predominantly white and with up to 7 years of study. The comparison between the District Administration Health Units was significant in terms of race/color (p<0.001), gender (p<0.001), schooling (p<0.004), age (p<0.003), place of origin (p<0.001), (p<0.001), alcoholism (p<0.001), indication and performance of Directly Observed Therapy (p<0.001), closure (p<0.001). Conclusion: Socioeconomic and treatment variables influence the occurrence of coinfection in different areas of Porto Alegre, reinforcing that the sum of different factors explains the indicators of the disease.


RESUMEN Objetivo: Describir y comparar el perfil epidemiológico de los casos de coinfección por Tuberculosis y VIH, por la Gerencia Distrital de Porto Alegre, en el período de 2009 a 2013. Método: Cohorte, retrospectiva, con datos de sistemas nacionales de información en salud. Se investigaron variables sociodemográficas, clínicas y de seguimiento, por medio de pruebas de asociación. Resultados: Se notificaron 2.419 casos de coinfección Tuberculosis y VIH, con una media de edad de 38 ± 9,91 años, predominantemente blancos y con hasta 7 años de estudio. La comparación entre las Gerencias Distritales fue significativa como raza/color (p <0,001), sexo (p <0,001), escolaridad (p <0,004), edad (p <0,003), lugar de origen (p <0,001), situación de origen (p <0,001), alcoholismo (p <0,001), indicación y realización de tratamiento directamente observado (p <0,001), situación de cierre (p <0,001). Conclusión: Las variables socioeconómicas y de realización del tratamiento influencian la ocurrencia de la coinfección en diferentes áreas de Porto Alegre, reforzando que la suma de diferentes factores explica los indicadores de la enfermedad.


RESUMO Objetivo: Descrever e comparar o perfil epidemiológico dos casos de coinfecção por Tuberculose e HIV, pela Gerência Distrital de Porto Alegre, no período de 2009 a 2013. Método: Coorte retrospectivo, com dados de sistemas nacionais de informação em saúde. Foram investigadas variáveis sociodemográficas, clínicas e de acompanhamento, por meio de testes de associação. Resultados: Foram notificados 2.419 casos de coinfecção Tuberculose e HIV, com média de idade de 38 ±9,91 anos, predominantemente brancos e com até 7 anos de estudo. A comparação entre as Gerências Distritais foi significativa quanto raça/cor (p<0,001), sexo (p<0,001), escolaridade (p<0,004), idade (p<0,003), local de origem (p<0,001), situação de entrada (p<0,001), alcoolismo (p<0,001), indicação e realização de Tratamento Diretamente Observado (p<0,001), situação de encerramento (p<0,001). Conclusão: Variáveis socioeconômicas e de realização do tratamento influenciam a ocorrência da coinfecção em diferentes áreas de Porto Alegre, reforçando que a soma de diferentes fatores explica os indicadores da doença.


Subject(s)
Humans , Male , Female , Adult , Tuberculosis/diagnosis , HIV Infections/diagnosis , Tuberculosis/epidemiology , Brazil/epidemiology , Chi-Square Distribution , HIV Infections/epidemiology , Retrospective Studies , Cohort Studies , Middle Aged
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