Tuberculosis: a study of 111 cases in an area of high prevalence in the extreme south of Brazil

ABSTRACT

Tuberculosis is an increasingly important public health problem in developing countries. We studied 111 tuberculosis patients confirmed by mycobacteria isolation between 1998 and 2000 in Rio Grande, in south Brazil. One-hundred-thirteen pulmonary and extrapulmonary clinical materials were examined through culture by the Ogawa-Kudoh method and through smear examination by the Ziehl-Nielsen or Kinyoun methods. The identification of Mycobacterium tuberculosis was done through the usual phenotypical methods. The proportion method (indirect technique) was used to determine the resistance of isolates. The man/woman ratio was 2.61, 75 percent were white, and the group had a mean age of 39.7±12.7. Risk factors were present in 38.7 percent (34 men and 9 women, p=0.2), with a mean age of 35 (p=0.002); infection by HIV was the most frequent (28.8 percent), followed by alcoholism (16.2 percent) and injected drug use (15.3 percent). The frequency of M. tuberculosis isolates was 99.1 percent. Pulmonary disease occurred in 88.3 percent of the cases, extrapulmonary in 9.9 percent and 1.8 percent in both. There was an association between extrapulmonary tuberculosis and the presence of risk factors (p=0.0001). Resistance to isoniazid was found in 4 percent of the isolates and to isoniazid and rifampin in 2 percent, all being patients with some risk factors. The profile of tuberculosis in the population of this study followed the pattern described for developing regions of the world.