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Objetivo: Describir las causas de muerte en pacientes con virus de inmunodeficiencia humana (VIH), ingresados en el Hospital Vargas de Caracas (HVC) durante el período enero a diciembre de 2017. Materiales y Métodos: Se realizó un estudio retrospectivo, que incluyó a todos los pacientes fallecidos infectados por VIH en el HVC. Se calcularon frecuencias relativas y absolutas, medidas de tendencia central utilizando el programa SPSS Statistics. Resultados: Durante el período estudiado, fallecieron 32 pacientes con VIH, de estos últimos solo se obtuvo acceso a través del departamento de archivos médicos a 23 historias ya que las 9 restantes no pudieron ser localizadas para su revisión. El 73,9 % de la muestra estuvo representado por el sexo masculino con una edad media de 36,78 años, el 73,9 % no tenían antecedente de comorbilidades asociadas; el 73,9 % tenía menos de un año de diagnóstico y 60,9 % no recibían terapia antiretroviral. El 95,7 % de las muertes estuvieron asociadas a síndrome de inmunodeficiencia humana (SIDA). Las causas de muerte más frecuentes fueron tuberculosis pulmonar y extrapulmonar (40,9 % de la muestra) seguida de encefalitis por Toxoplasma gondii e histoplasmosis diseminada. Conclusiones: Los pacientes fallecidos tenían una edad media de 36 años, con estadio de SIDA avanzado y tuberculosis como causa principal de muerte.
Objective: To describe the causes of death in patients with human immunodeficiency virus (HIV), admitted to the Vargas Hospital of Caracas (VHC) during the period January to December 2017. Materials and Methods: A retrospective study was carried out, which included all deceased patients infected with HIV in the VHC. Relative and absolute frequencies, measures of central tendency were calculated and the statistical program SPSS Statistics was applied. Results: During the period studied, 32 patients with HIV died, we only had access to 23 medical records since the remaining 9 could not be located for review. 73.9 % of the sample was represented by the male sex with an average age of 36.78 years, 73.9 % had no history of associated comorbidities; 73.9 % had less than one year of diagnosis and 60.9 % did not receive antiretroviral therapy. 95.7 % of the deaths were associated with Human Immunodeficiency Syndrome (AIDS). Pulmonary and extrapulmonary tuberculosis was the most representative sample with 40.9 % followed by toxoplasmic encephalitis and disseminated histoplasmosis.Conclusions: The deceased patients had an average age of 36 years, with stage of advanced AIDS and tuberculosis as their main cause of death.
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ABSTRACT The objective of this study was to analyze trends in the tuberculosis mortality rate in Brazil (1990-2015) in an ecological time-series analysis. The indicators were obtained from the Brazilian National Ministry of Health. A joinpoint regression model was applied for the temporal analysis, with a level of significance of 5%. During the period in question, there was a trend toward a reduction in mortality in the country as a whole (p < 0.001) and in each of its five regions. The states with the highest tuberculosis mortality rates were Rio de Janeiro (7.0/100,000 population) and Pernambuco (5.0/100,000 population). Eleven states and the Federal District of Brasília showed downward trends. Only the state of Alagoas showed a significant increase (p < 0.001). The temporal behavior observed indicates that tuberculosis continues to be a major public health problem in Brazil.
RESUMO Objetivou-se analisar a tendência da taxa de mortalidade por tuberculose no Brasil (1990-2015) em um estudo ecológico de séries temporais. Os indicadores foram obtidos do Ministério da Saúde. Aplicou-se o modelo por pontos de inflexão para a análise temporal. Houve uma tendência significativa de redução da mortalidade no Brasil (p < 0,001) e em suas cinco regiões no período estudado. Os estados com as maiores taxas foram Rio de Janeiro (7,0/100.000 habitantes) e Pernambuco (5,0/100.000 habitantes). Onze estados e o Distrito Federal apresentaram tendência de redução da taxa. Somente Alagoas mostrou um crescimento significativo (p < 0,001). O comportamento temporal verificado indica que a tuberculose ainda figura como um importante problema de saúde pública no país.
Assuntos
Humanos , Masculino , Feminino , Tuberculose/mortalidade , Fatores de Tempo , Brasil/epidemiologia , Análise de Regressão , Mortalidade/tendências , Análise Espaço-Temporal , Determinantes Sociais da SaúdeRESUMO
OBJECTIVE: To analyze the profile of tuberculosis cases reported between 2002 and 2009 in the state of Minas Gerais, Brazil, according to sociodemographic, clinical, and laboratory characteristics, as well as to comorbidities and mortality. METHODS: This was a descriptive, epidemiological study based on data obtained from the Brazilian Case Registry Database and the Brazilian Mortality Database for the 2002-2009 period. RESULTS: There were 47,285 reported cases of tuberculosis, corresponding to a mean incidence of 22.3/100,000 population. The individuals diagnosed with tuberculosis were predominantly in the 20- to 49-year age bracket and male (62.4% and 67.0%, respectively). Individuals with a low level of education accounted for 18.5% of the cases. New cases, cases of recurrence, and cases of retreatment accounted for 83.7%, 5.7%, 5.7%, respectively. The rates of cure and treatment noncompliance were 66.2% and 11.2%, respectively; multidrug-resistant tuberculosis was identified in 0.2% of the cases; and the mortality rate was 12.9%. The directly observed treatment, short-course (DOTS) strategy was applied in 21.8% of the cases. Sputum smear microscopy and culture were performed in only 73.9% and 12.9% of the cases, respectively. Chest X-rays were performed in 90.5% of the cases. Pulmonary tuberculosis was the predominant form (in 83.9%). Comorbidity with alcoholism, HIV infection, and diabetes mellitus were identified in 17.2%, 8.3%, and 3.8%, respectively. CONCLUSIONS: During the study period, the numbers of new cases, cases of treatment noncompliance, and deaths were high, comorbidities were common, and there was a failure to perform adequately basic tests for the diagnosis of tuberculosis. Multidisciplinary approaches, expanded use of the DOTS strategy, better knowledge of the distribution of tuberculosis, and improvements in the databases are needed ...
OBJETIVO: Analisar o perfil de casos de tuberculose no estado de Minas Gerais entre 2002 e 2009, segundo características sociodemográficas, clínicas e laboratoriais, assim como presença de comorbidades e mortalidade. MÉTODOS: Estudo epidemiológico descritivo com levantamento de dados dos casos notificados no Sistema de Informação de Agravos de Notificação e Sistema de Informação de Mortalidade entre 2002 e 2009. RESULTADOS: Foram notificados 47.285 casos de tuberculose nos anos estudados, com média de incidência 22,3/100.000 habitantes. Os indivíduos com tuberculose eram predominantemente da faixa etária de 20-49 anos (62,4%), do sexo masculino (67,0%) e tinham baixa escolaridade (18,5%). Casos novos, de recidiva e de retratamento representaram, respectivamente, 83,7%, 5,7% e 5,7% do total de casos. As proporções de cura, abandono do tratamento e tuberculose multirresistente foram, respectivamente, 73,1%, 11,2% e 0,2%, enquanto o coeficiente de mortalidade foi 12,9%. O tratamento diretamente observado (TDO) foi administrado em 21,8% dos casos. A baciloscopia e a cultura de escarro somente foram realizadas em 73.9% e 12,9% dos casos, respectivamente. A radiografia de tórax foi realizada em 90,5% dos casos. A forma pulmonar prevaleceu (83,9%). A comorbidade com alcoolismo, infecção pelo HIV e diabetes mellitus foi identificada em 17,2%, 8,3% e 3,8% dos casos, respectivamente. CONCLUSÕES: No período estudado, o número de casos novos, de abandono e de óbitos foi elevado, as comorbidades foram relevantes, e os exames básicos não foram realizados adequadamente para o diagnóstico da tuberculose. São necessários o trabalho multiprofissional, ampliação da estratégia TDO, maior conhecimento da distribuição ...