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1.
ABCS health sci ; 46: e021204, 09 fev. 2021. tab
Article in English | LILACS | ID: biblio-1147174

ABSTRACT

INTRODUCTION: The Brazilian National Tuberculosis Control Program was created to recommend and direct clinical actions, organizational setting, information systems and surveillance of tuberculosis. The process of implementation of control actions in Primary Care took place in several formats and with different outcomes, due to the influences of local organizational configuration. OBJECTIVE: To identify the facilities and difficulties reported by nurses in the implementation of the Tuberculosis Control Program in Primary Health Care. METHODS: A descriptive cross-sectional study with a quantitative approach, conducted in the city of Natal, Brazil. Data collected from November from 2017 to February 2018, with 80 nurses from Primary Health Care, through a structured questionnaire. Data were categorized according to similarity criteria and analyzed using descriptive statistics. RESULTS: The availability of nurses to work in the program (47.5%) and the presence of materials (31.2%) were the most frequently mentioned facilities. The most frequently mentioned difficulties were: adherence to treatment (21.2%) and the performance of complementary tests (15.0%). CONCLUSION: The findings of the study may contribute to reflection and planning of actions by health teams, as well as a tool for local managers to organize their services, in order to ensure the person with tuberculosis comprehensive care.


INTRODUÇÃO: O Programa Nacional de Controle da Tuberculose Brasileiro foi criado no intuito de preconizar e direcionar ações clínicas, das configurações organizacionais, de sistemas de informações e vigilância da tuberculose. O processo de implantação das ações de controle na Atenção Primária ocorreu em diversos formatos e com resultados diferenciados, devido às influências da configuração organizacionais locais. OBJETIVO: Identificar as facilidades e dificuldades referidas por enfermeiros na implantação do Programa de Controle da Tuberculose na Atenção Primária à Saúde. MÉTODOS: Estudo descritivo, realizado de forma transversal, com abordagem quantitativa, conduzido no município de Natal, a partir de dados coletados entre novembro de 2017 a fevereiro de 2018, com 80 enfermeiros da Atenção Primária à Saúde, mediante questionário estruturado. Os dados foram categorizados de acordo com critérios de semelhança e analisados por meio da estatística descritiva. RESULTADOS: Verificou-se que a disponibilidade do enfermeiro para atuação no programa (47,5%) e a presença de materiais (31,2%) foram as facilidades mais frequentemente referidas. As dificuldades mais referidas foram: adesão ao tratamento (21,2%) e a realização de exames complementares (15,0%). CONCLUSÃO: Os achados do estudo podem contribuir para reflexão e planejamento das ações pelas equipes de saúde, bem como ferramenta para os gestores locais organizarem seus serviços, no intuito de garantir à pessoa com tuberculose um cuidado integral.


Subject(s)
Humans , Primary Health Care , Tuberculosis/prevention & control , Health Programs and Plans , Nurses , Health Evaluation
2.
Rev. cuba. pediatr ; 92(3): e1056, jul.-set. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126762

ABSTRACT

Introducción: La presencia de tuberculosis infantil constituye una señal de alerta de transmisión en la comunidad. Objetivos: Determinar incidencia y características de la tuberculosis infantil en Cuba en su etapa más reciente. Métodos: Estudio descriptivo, transversal y retrospectivo de los 107 casos diagnosticados 0-18 años, periodo 2013-2017, según datos de la Dirección de Registros Médicos y Estadísticas de Salud, la ficha epidemiológica y datos del Centro de Referencia Nacional de tuberculosis infantil. Se estudiaron variables demográficas, epidemiológicas, clínicas y de estudios que contribuyeron al diagnóstico, así como a la evolución final de los casos. Resultados: Predominó el grupo de edad de 15 - 18 años (52,0 - 48,6 por ciento) , sexo masculino (59,0-55,1 por ciento) y los procedentes de La Habana (43,0 - 40,2 por ciento). La tuberculosis en menores de 19 años representó entre 1,8 y 4,4 por ciento del total de casos en el país. La tasa de incidencia por 100 mil habitantes se comportó en menores de 15 años entre 0,4 y 0,8 con tendencia descendente; en el grupo 15-18 años, entre 0,8 y 3,0 con tendencia ascendente. Predominaron las formas pulmonares (87,0 - 82,6 por ciento) con pobre confirmación bacteriológica (49,0 - 45,7 por ciento). Ningún caso tuvo coinfección VIH-TB ni drogorresistencia. Hubo una fallecida (0,9 por ciento). Conclusiones: Cuba tiene muy baja incidencia de tuberculosis infantil, no es un problema de salud, pero sí un indicador de transmisión de la enfermedad en la comunidad. Para su eliminación, hay que fortalecer las acciones del Programa Nacional de Control, particularmente en La Habana y en el grupo de edad de 15 a 18 años(AU)


Introduction: The presence of children tuberculosis constitutes a transmission alert sign in the community. Objectives: To determine the incidence and characteristics of children tuberculosis in Cuba in its earliest stage. Methods: Descriptive, cross-sectional and restrospective study of 107 diagnosed cases in the ages from 0 to 18 years during the period 2013-2017, according to data provided by the National Division of Medical Records and Health Statistics, epidemiological records and data from the Center of National Reference on Children Tuberculosis. There were studied demographic, epidemiological, clinical and study variables which contributed to the diagnosis as well as to the final evolution of the cases. Results: There was a predominance of the age of group of 15 - 18 years (52.0 - 48.6 percent), masculine sex (59.0 - 55.1 percent) and patients from Havana city (43.0 - 40.2 percent). Tuberculosis in patients under 19 years represented between the 1.8 and 4.4 percent of all the cases in the country. The incidence rate per 100 000 inhabitants in patients under 15 years was 0.4 to 0.8 with a decreasing trend; in the group age of 15 to 18 years it was between 0.8 and 3.0 with an increasing trend. Pulmonary conditions predominated (87.0 - 82.6 percent) with poor bacteriological confirmation (49.0 - 45.7 percent). None of the cases had HIV-TB co-infection nor drugs resistance. There was one deceased girl (0,9 percent). Conclusions: Cuba has a very low incidence of children tuberculosis; it does not represent a health problem but it actually is an indicator of transmission of the disease in the community. For its erradication, it is needed to strenght the actions of the Control´s National Program, particularly in Havana city and the age group of 15 to 18 years(AU)


Subject(s)
Humans , Male , Female , Adolescent , Tuberculosis/prevention & control , Tuberculosis/epidemiology , Community-Acquired Infections/transmission , National Health Programs/standards , Cuba
3.
Rev. cuba. med ; 59(3): e802, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1139063

ABSTRACT

El Programa Nacional y Normas de procedimiento para la Prevención y Control de la Tuberculosis en Cuba de 2013 constituye la guía de trabajo cotidiana del personal de salud para el manejo de la enfermedad. Este necesita ser actualizado para adecuarse a las nuevas condiciones y retos que plantea la tuberculosis a tono con las experiencias nacionales y las recomendaciones internacionales las cuales buscan estandarizar la atención. Deben modificarse términos en la clasificación de casos, incorporar nuevos métodos diagnósticos (imagenológicos, inmunológicos y genotípicos) y fundamentalmente en el tema de tratamiento con la incorporación de nuevas drogas, esquemas terapéuticos y la reorganización de los fármacos según su efectividad(AU)


The 2013 National Program and Rules of Procedure for the Prevention and Control of Tuberculosis in Cuba constitutes the daily work guide of health personnel for the management of the disease. This Program and Rules of Procedure needs to be updated to meet the new conditions and challenges posed by tuberculosis in line with local experiences and international recommendations seeking to standardize care. Modificatins are needed for terms of case classification, new diagnostic methods need to be included (imaging, immunological and genotypic) and basically on the subject of treatment with the integration of new drugs, therapeutic forms and the reorganization of drugs according to their effectiveness(AU)


Subject(s)
Humans , Male , Female , Tuberculosis/prevention & control , Health Programs and Plans/standards , Cuba
4.
Vaccimonitor (La Habana, Print) ; 29(2)mayo.-ago. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1127516

ABSTRACT

La tuberculosis pulmonar es un problema de salud pública a nivel mundial. La Organización Mundial de la Salud en el año 2018 reportó alrededor de 10 millones de enfermos y 1,5 millones de muertes. Mycobacterium tuberculosis es un patógeno intracelular y el agente causal de la enfermedad. Estudios experimentales de virulencia han permitido determinar un conjunto de genes de virulencia, que le confieren la capacidad de resistir el ambiente hostil en el macrófago, superar la actividad de la respuesta inmune y persistir en el hospedero. El objetivo de la publicación es presentar una revisión de las investigaciones de los últimos 20 años que han demostrado los genes o factores de virulencia de M. tuberculosis que contribuyen a la evasión de la respuesta inmune. Según los resultados de las investigaciones, existen múltiples factores y genes de virulencia que participan en la evasión de la respuesta inmune innata como ESAT-6, PknG, PhoP, ManLAM, SapM, katG, tpx, nuoG, sodA/secA2, pknE y Rv3654c/Rv3655c, mientras existen elementos capaces de modular la respuesta inmune adaptativa. La comprensión de la interacción entre los genes de virulencia y la actividad del sistema inmune, son importantes para estudiar nuevos métodos de diagnóstico, el diseño de nuevas vacunas y por ende, mejorar las medidas de control, prevención y tratamiento de la tuberculosis(AU)


Pulmonary tuberculosis is a public health problem worldwide. The World Health Organization in 2018 reported about 10 million patients and 1.5 million deaths. Mycobacterium tuberculosis, an intracellular pathogen, is the causative agent of the disease. Experimental virulence studies have allowed to determine a set of virulence genes that confer the ability to resist the hostile environment in the macrophage, overcome the activity of the immune response and persist in the host. The objective of the publication is to present a review of the last 20 years investigations that have shown the genes or virulence factors of M. tuberculosis that contribute to the evasion of the immune response. According to the results of the investigations, there are multiple virulence factors and genes that participate in the evasion of the innate immune response such as ESAT-6, PknG, PhoP, ManLAM, SapM, katG, tpx, nuoG, sodA/secA2, pknE and Rv3654c/Rv3655c, while there are elements capable of modulating the adaptive immune response. The understanding of the interaction between the virulence genes and the activity of the immune system, are important to study new diagnostic methods, the design of new vaccines and therefore, to improve the control, prevention and treatment measures of tuberculosis(AU)


Subject(s)
Humans , Tuberculosis/prevention & control , Tuberculosis/drug therapy , Virulence Factors , Mycobacterium tuberculosis/pathogenicity
6.
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
7.
Washington; Organización Panamericana de la Salud; mar. 19 2020. 5 p.
Non-conventional in Spanish | LILACS | ID: biblio-1096599

ABSTRACT

A medida que el mundo se une para hacer frente a la pandemia del COVID-19, es importante garantizar que los servicios y operaciones esenciales para hacer frente a los problemas de salud prevalentes, continúen protegiendo la vida de las personas con TB y otras enfermedades o condiciones de salud. Los servicios de salud, incluidos los programas nacionales para combatir la TB, deben involucrarse activamente para garantizar una respuesta efectiva y rápida al COVID-19.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Tuberculosis/complications , Tuberculosis/prevention & control , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Betacoronavirus
8.
Rev. cuba. med. trop ; 71(3): e417, sept.-dic. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093575

ABSTRACT

Introducción: El abordaje de las desigualdades de salud en la notificación de tuberculosis resulta importante para la toma de decisiones preventivas. No obstante, su medición usualmente no es parte de las competencias del personal vinculado a las acciones de prevención y control de la enfermedad. Objetivo: Explorar la comprensión que tienen los decisores de salud vinculados al Programa Nacional de Control de la Tuberculosis de La Habana de las desigualdades en la notificación de tuberculosis y la utilidad que le atribuyen a su medición. Métodos: Se realizó un estudio cualitativo exploratorio. Se aplicó una entrevista semiestructurada a una muestra exhaustiva de decisores del programa a nivel provincial, municipal y de área de salud. El instrumento utilizado en la entrevista incluyó datos generales de los participantes, ocho preguntas abiertas y una guía de observación de elementos relevantes del proceso de la entrevista. La información se clasificó en categorías de análisis deductivas e inductivas. Resultados: Los decisores vinculados a las acciones de prevención y control de la tuberculosis en La Habana no percibieron la utilidad real que tiene la medición de las desigualdades de salud en su práctica diaria. Asimismo, los conocimientos y capacidades para la medición de estas desigualdades fueron insuficientes en el personal de los niveles gerencial y de implementación del programa de control en la provincia. Conclusiones: Se evidencia la necesidad de un cambio en la connotación que tienen de las desigualdades en salud y en las capacidades para su medición en decisores vinculados a la prevención y control de la tuberculosis en La Habana(AU)


Introduction: Approaching health inequalities in tuberculosis reporting is important for preventive decision making. However, their measurement is usually not included among the competences of the personnel involved in tuberculosis prevention and control actions. Objective: Explore the extent to which health decision makers involved in the National Tuberculosis Control Program in Havana are aware of the inequalities in tuberculosis reporting and the usefulness of their measurement. Methods: An exploratory qualitative study was conducted. A semi-structured interview was applied to an exhaustive sample of decision makers from the program on a province, municipality and health area level. The tool used for the interview included personal details of the participants, eight open-ended questions and an observation guide for relevant components of the interview process. The information was classed into deductive and inductive analysis categories. Results: Decision makers involved in tuberculosis prevention and control actions in Havana did not perceive the actual usefulness of measuring health inequalities in their daily practice. On the other hand, the knowledge and capacities required to measure these inequalities were insufficient among the personnel in charge of the management and implementation of the control program in the province. Conclusions: Evidence was found of the need for a change in the connotation of health inequalities and the capacities for their measurement among decision makers involved in tuberculosis prevention and control in Havana(AU)


Subject(s)
Humans , Male , Female , Tuberculosis/prevention & control , Health Status Disparities , Evaluation Studies as Topic
9.
Rev. cuba. med. trop ; 71(3): e374, sept.-dic. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093573

ABSTRACT

Introducción: La pesquisa activa de casos de tuberculosis en la Atención Primaria de Salud como parte del programa de control de la enfermedad en Cuba, tiene retos de implementación que requieren ser estudiados. Objetivo: Explorar las opiniones de los actores de salud involucrados en la implementación de la pesquisa activa de casos de tuberculosis en Las Tunas. Métodos: Se realizó un estudio cualitativo, en dos etapas, anidado en un estudio de intervención en Las Tunas. En la primera etapa (septiembre-diciembre, 2010) se entrevistaron médicos y enfermeras de la familia de los municipios Jobabo y Las Tunas; y en la segunda etapa (marzo, 2012), todos los jefes de programa (provincial y municipales) y un experto en tuberculosis. Se utilizaron categorías de análisis deductivas e inductivas. Resultados: La pesquisa activa de casos de tuberculosis se reconoció como un procedimiento novedoso asociado a la búsqueda de sintomáticos respiratorios en el hogar, la dispensarización y el trabajo con grupos vulnerables. Al inicio hubo barreras para la implementación del procedimiento, posteriormente fue aceptado. Las ventajas fueron: diagnóstico oportuno e incremento del número de casos pesquisados, entre otras. La falta de tiempo, el incremento en la carga de trabajo y la fluctuación del personal fueron las principales dificultades. Conclusiones: El estudio proporciona información valiosa para la implementación del procedimiento como parte del programa de control de la tuberculosis. Devela la brecha entre la percepción de los actores involucrados en la implementación de intervenciones en salud en estudios pilotos y la que tienen los implicados en su puesta en práctica(AU)


Introduction: The active case finding of tuberculosis in Primary Health Care as part of the disease control program in Cuba, has challenges at implementation that need to be studied. Objective: To explore the opinions of the health stakeholders involved in the implementation of active case finding of tuberculosis in Las Tunas. Methods: A qualitative study was carried out in two stages, nested in an intervention study in Las Tunas. In the first stage (September-December, 2010) family doctors and nurses in Jobabo and Las Tunas municipalities were interviewed; and in the second stage (March 2012), all program managers (provincial and municipal) and an expert on tuberculosis were interviewed. Deductive and inductive analysis categories were used. Results: The active case finding of tuberculosis was recognized as a novel procedure associated with the screening for respiratory symptoms among all family members during home visits, classification of the entire population into risk groups and working with vulnerable groups. At the beginning there were barriers to the implementation of this procedure, which was subsequently accepted. Timely diagnosis and increase in the number of cases investigated were the advantages, among others. The lack of time, the increase in workload and the staff turnover were the main difficulties. Conclusions: This study provides valuable information for implementing this procedure as part of tuberculosis control program. It reveals the gap between the perception of the stakeholders involved in the implementation of health interventions in pilot studies and from those engaged in their implementation(AU)


Subject(s)
Humans , Male , Female , Primary Health Care/methods , Tuberculosis/prevention & control , Health Research Evaluation , Early Medical Intervention/methods , Tuberculosis/epidemiology
10.
Rev. chil. pediatr ; 90(6): 668-674, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058199

ABSTRACT

Resumen: Los pacientes con Inmunodeficiencias primarias (IDP) tienen un riesgo elevado de complicaciones severas por la vacuna BCG, incluso mortalidad. Es necesario evaluar periódicamente el riesgo versus beneficio de la vacunación universal BCG en el periodo neonatal. Chile es un país con baja incidencia de tuberculosis (TB) pero cuya epidemiología ha cambiado recientemente con un aumento de los casos. Cambios en esquemas de vacunación BCG en países con incidencias mayores o similares de TB y con coberturas de vacunación menores han sido posibles sin aumento de los casos graves de TB que son los que previene la BCG. El cambio ha evitado complicaciones graves en pacientes con IDP. Creemos que un análisis crítico de la fecha de vacunación BCG debe realizarse hoy en Chile. Más aún dada la posibilidad técnica de realizar screening neonatal de IDP.


Abstract: Patients with Primary Immunodeficiencies (PID) are at a higher risk of developing severe morbidities and mortality due to the administration of BCG vaccine. Risk-to-benefit of universal BCG vaccina tion of newborns must be assessed periodically. Chile has a low incidence of tuberculosis (TB) but the local epidemiology has recently changed with an increase of TB cases. Changes in the BCG vaccine schedule have been made in countries with similar or higher TB incidences and lower BCG vaccine coverage, with no increase in the severe TB cases, which are prevented by BCG. These changes have prevented serious complications in PID patients. We propose a critical analysis of the BCG adminis tration date in Chile due to the technical possibility of performing neonatal PID screening.


Subject(s)
Humans , Infant, Newborn , Infant , BCG Vaccine/adverse effects , Adjuvants, Immunologic/adverse effects , Primary Immunodeficiency Diseases/complications , Tuberculosis/prevention & control , Tuberculosis/epidemiology , Chile/epidemiology , Incidence , Immunization Schedule , Severe Combined Immunodeficiency/complications , Hematopoietic Stem Cell Transplantation/mortality , Contraindications, Drug
13.
Rev. cuba. med. trop ; 71(3): e393, sept.-dic. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093581

ABSTRACT

Introducción: El personal de la salud tiene mayor probabilidad de contraer la infección con Mycobacterium tuberculosis por su exposición incrementada a pacientes con la enfermedad. Objetivo: Evaluar el nivel de conocimientos sobre las medidas para el control y prevención de la tuberculosis en el personal de enfermería y los posibles factores que pudieran incidir en este. Métodos: Diseño mixto con triangulación de datos, utilizando técnicas cuanti-cualitativas. Se aplicó un cuestionario autoadministrado-semiestructurado a 64 enfermeros del Instituto Pedro Kourí durante el 2017. Los conocimientos se evaluaron como bien, aceptables y deficientes. Se calcularon las proporciones de calificaciones por categoría. Se realizó análisis univariado para buscar posible asociación del nivel de conocimientos con las covariables (sexo, edad, nivel profesional, servicio, años de experiencia laboral y en el instituto, antecedentes de atención a pacientes con tuberculosis y capacitación recibida). Para las salidas cualitativas, las observaciones fueron procesadas mediante la técnica de análisis de contenido. Resultados: Los conocimientos en general fueron evaluados como deficientes en 75,4 por ciento y nadie alcanzó bien. La mejor calificación fue sobre recogida de muestras (86,2 por ciento). El resto fueron mayormente aceptables o deficientes. El tema con mayores deficiencias fue métodos de prevención. El 56,9 por ciento percibe estar en riesgo. Ser técnico de enfermería resultó asociado con deficientes resultados de la evaluación de conocimientos sobre tuberculosis. Conclusiones: Los conocimientos sobre medidas de control de infección tuberculosa se consideraron deficientes. La percepción del riesgo varía según la valoración sobre las medidas de control existentes. Los conocimientos deficientes se asociaron fundamentalmente a la categoría de técnico(AU)


Introduction: Health personnel are more likely to get infected by Mycobacterium tuberculosis because of the increased exposure to patients with the disease. Objectives: To evaluate the level of knowledge about the measures of control and prevention of tuberculosis in nursing staff and the possible factors that could influence. Methods: Mixed design with triangulation of data, using quantitative and qualitative techniques. A self-administered semi-structured questionnaire was applied to 64 nurses from Pedro Kourí Institute during 2017. Knowledge was graded good, acceptable and poor. Grade ratios were calculated by category. Univariate analysis was performed to look for possible association of the level of knowledge with the covariates (sex, age, professional level, service, years of work experience, years of work in the institute, history of care for patients with tuberculosis and training). For qualitative outputs, observations were processed using the content analysis technique. Results: Knowledge in general was graded poor in 75.4 percent and nobody was graded as good. The best grade was on sample collection (86.2 percent). The rest were mostly acceptable or poor. Prevention methods had the greatest deficiencies. 56.9 percent perceived being at risk. The category of nursing technician was associated with poor results of the assessment of tuberculosis knowledge. Conclusions: Knowledge about tuberculosis infection control measures were considered poor. The perception of risk varies according to the assessment of existing control measures. Poor knowledge was fundamentally associated with the category of technician(AU)


Subject(s)
Humans , Male , Female , Tuberculosis/prevention & control , Education, Nursing/ethics , Educational Measurement/methods
14.
Rev. bras. epidemiol ; 22: e190031, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1003491

ABSTRACT

RESUMO: Objetivo: Descrever e avaliar os fatores associados ao conjunto de ações para o controle da tuberculose (TB) na atenção básica (AB) nas cinco macrorregiões brasileiras. Métodos: Trata-se de um estudo transversal de base em serviço com dados obtidos a partir do segundo ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). O desfecho foi construído a partir de um conjunto de itens que caracterizam a realização de ações para o cuidado no controle e tratamento da TB nas unidades básicas de saúde (UBSs). Os dados foram analisados por meio do teste do χ2 e da regressão de Poisson com variância robusta. Resultados: A prevalência nacional do conjunto de ações para controle da TB foi de 17,22%, sendo que as macrorregiões Nordeste (11,18%) e Norte (12,15%) tiveram o pior desempenho. Os resultados principais apontam que houve associação da presença do conjunto de ações para o controle da TB com as UBSs que realizam ações educativas para TB [razão de prevalência - RP = 1,53 (intervalo de confiança de 95% - IC95% 1,45 - 1,62)], sorologia para HIV [RP = 1,68 (IC95% 1,11 - 2,54)], possuem sala de acolhimento [RP=1,61(IC95% 1,46 - 1,79)] e atividades de educação permanente [RP = 1,73 (IC95% 1,54- 1,95)]. Conclusão: Os resultados demonstram fragilidade nas estruturas e no processo de trabalho da AB em relação ao controle da TB em todas as regiões brasileiras.


ABSTRACT: Objective: To describe and evaluate the factors associated with actions for the control of tuberculosis (TB) in primary care (PC) in the five Brazilian macroregions. Methods: This cross-sectional study was carried out with data from the second cycle of the National Program for Improving Access to and Quality of Primary Care. Theoutcome of the study was constructed based on a set of items that were considered essential for the treatment and control of tuberculosis in Primary Care Units (PCUs). Data were analyzed using the χ2 test and Poisson regression with robust variance. Results: The national prevalence of the set of items to control tuberculosis was 17.22%. TheNortheast (11.18%) and North (12.15%) had the worst performance. The main results indicate association with this outcome for PCUs performing educational actions for TB (PR = 1.53; 95%CI 1.45 - 1.62), those performing HIV serology (PR = 1.68; 95%CI 1.11 - 2.54), those that have a reception room (PR = 1.61; 95%CI 1.46 - 1.79) and those performing continuing education activities (PR = 1.73; 95%CI 1.54 - 1.95). Conclusion: The results show a weakness in the structures and in the work process of PC in relation to the control of tuberculosis in all Brazilian regions.


Subject(s)
Humans , Male , Female , Primary Health Care/statistics & numerical data , Tuberculosis/prevention & control , Quality of Health Care , Brazil/epidemiology , Poisson Distribution , Cross-Sectional Studies , Outcome Assessment, Health Care
15.
Mem. Inst. Oswaldo Cruz ; 114: e180420, 2019. tab
Article in English | LILACS | ID: biblio-984758

ABSTRACT

BACKGROUND Rifamycins are a group of antibiotics mainly used in the treatment of tuberculosis (TB), however they interact with antiretroviral therapy (ART). Rifabutin allows more regimens options for concomitant imunodeficiency virus (HIV) treatment compared to rifampicin. OBJECTIVE Compare the outcomes of TB-HIV co-infected patients who used rifampicin or rifabutin. METHODS We analysed data from a prospective cohort study at National Institute of Infectious Diseases Evandro Chagas, Rio de Janeiro (RJ), Brazil. Patients who were treated for TB and HIV with rifampicin or rifabutin, from February 2011 to September 2016 were included. FINDINGS There were 130 TB-HIV patients, of whom 102 were treated with rifampicin and 28 with rifabutin. All patients in the rifabutin-treated group and 55% of the rifampicin-treated group patients were ART-experienced. Patients treated with rifampicin had similar abandon and cure rates, interruptions in treatment due to adverse reactions, immune reconstitution inflammatory syndrome and a similar mortality rate as those treated with rifabutin. However, rifampicin-treated patients had higher CD4 counts and more frequently undetectable HIV viral load by the end of treatment (67% versus 18%, p < 0.001) compared to rifabutin-treated patients, even when only ART-experienced patients were evaluated (66,6% versus 36,3%, p = 0.039). CONCLUSIONS Patients who used rifabutin had worst immune and virological control. This group had more ART-experienced patients. New and simpler regimens are needed for patients who do not respond to previous antiretroviral therapies.


Subject(s)
Humans , Rifamycins/therapeutic use , Tuberculosis/prevention & control , Outcome Assessment, Health Care , Rifabutin/therapeutic use , Rifampin , HIV
16.
Article in English | AIM | ID: afr-200982

ABSTRACT

Background: Tuberculosis (TB) is a major global health challenge, and South Africa is one of the high-burden countries. A national TB infection control (TBIC) guideline has stipulated three areas of infection control at health facilities: work practice and administrative control, environmental control, and personal protection for health workers. Aim: The aim of this study was to identify the gaps and address the challenges in institutional TBIC. Setting: The district hospital and a primary health care clinic within the Mossel Bay sub-district in the Western Cape. Methods: According to the national TBIC draft guideline, a quality improvement cycle was used to evaluate and improve TBIC. Each facility had an existing infection and prevention control and occupational health and safety team, which were used as the audit teams. Results: A baseline assessment was followed by a set of interventions, which did not show a significant improvement in TBIC. The difference between the pre- and post-intervention TB screening rate was not statistically significant. An assessment of time interval between 101 patients presenting with TB symptoms and diagnosed with TB was 4 days at baseline and post-intervention. Most of the anticipated improvements were dependent on the health workers’ adherence to the local TBIC policies, which emerged as an unexpected finding. Conclusion: We found good managerial commitment reflected by the presence of various policies, guidelines, specific personnel and committees to deal with infection control in general. This study has created awareness about TBIC among staff and pointed out the complexity of health workers’ behaviour towards adhering to policies


Subject(s)
Tuberculosis , Tuberculosis/prevention & control , Health , Africa
19.
Buenos Aires; GCBA. Gerencia Operativa de Epidemiología; 20 jul. 2018. a) f: 30 l:34 p. graf.(Boletín Epidemiológico Semanal: Ciudad Autónoma de Buenos Aires, 3, 100).
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1116531

ABSTRACT

El hospital general de agudos donación Francisco Santojanni se encuentra enclavado en el oeste de la Ciudad Autónoma de Buenos Aires. Fue fundado en el año 1940 como hospital para tuberculosos en terrenos cedidos por el filántropo que le dio nombre a la institución. En 1981 se constituyó en hospital polivalente de agudos. Por año se asisten aproximadamente 480.000 personas provenientes, en especial, de su área de influencia: los barrios de Liniers, Mataderos y Lugano, además de los partidos colindantes de la provincia de Buenos Aires. Se caracterizan los casos notificados de TBC en el hospital Santojanni entre enero de 2017 y junio de 2018.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Tuberculosis/diagnosis , Tuberculosis/prevention & control , Tuberculosis/therapy , Tuberculosis/epidemiology , Health Surveillance/statistics & numerical data , Communicable Disease Control/instrumentation , Communicable Disease Control/statistics & numerical data , Disease Notification/methods , Disease Notification/statistics & numerical data
20.
Buenos Aires; GCBA. Gerencia Operativa de Epidemiología; 20 jul. 2018. a) f: 21 l:25 p. graf, tab.(Boletín Epidemiológico Semanal: Ciudad Autónoma de Buenos Aires, 3, 100).
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1116498

ABSTRACT

El área programática del Hospital Parmenio Piñero (AP-HGAPP) se localiza en el sur de la ciudad, e incluye parte de las comunas 7, 8, 9, 10, 6 y 4. Según datos provenientes del Censo 20105, se registraron 324.179 personas viviendo en este territorio, con un porcentaje de población con Necesidades Básicas Insatisfechas de 10,4% (superior al valor promedio de CABA de 7%). Se presenta en este informe un análisis de situación de tuberculosis, tomando como eje el territorio y la población a cargo del hospital y sus centros de salud y acción comunitaria. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Tuberculosis/classification , Tuberculosis/complications , Tuberculosis/ethnology , Tuberculosis/mortality , Tuberculosis/prevention & control , Tuberculosis/transmission , Tuberculosis/epidemiology , Catchment Area, Health/statistics & numerical data , Epidemiologic Studies , Hospitals, Municipal/statistics & numerical data
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