Tuberculosis cases in a prison in the extreme south of Brazil.

Introduction. Tuberculosis (TB) control is a challenge, especially in vulnerable populations, such as prisoners.Hypothesis. In prison houses, the transmission of micro-organisms that cause infectious diseases can occur due to the susceptibility and immune compromise of prisoners, and due to the precarious physical conditions of the prison houses. However, strategies such as monitoring by health professionals, can mitigate the transmission of these micro-organisms, as well as, reduce the number of coinfections and antimicrobials resistance.Aim. This study attempted to analyse the dynamics of transmission and the antimicrobial resistance profile of Mycobacterium tuberculosis strains obtained from prisoners and to characterize the epidemiological, clinical and laboratory profiles of prisoners diagnosed with TB.Methodology. A cross-sectional and retrospective study was conducted with sputum samples collected from 228 distinct prisoners who were treated at the Health Unit located in the Regional Penitentiary of Rio Grande, Rio Grande do Sul, Brazil. The antimicrobial resistance profile of the strains was evaluated using the Resazurin Microtiter Assay and the transmission dynamics was investigated using 15-loci MIRU-VNTR.Results. Thirty-five patients (15.4 %) were diagnosed with TB, and when a TB/HIV coinfection was assessed, 8.6 % (3/35) of the patients were positive. In addition, all patients with results available for HBV, HCV, syphilis and diabetes mellitus were negative. Based on the genotypic profile, 55.9 % of the clinical isolates were grouped into five groups. One isolate with mono-resistance to isoniazid and two with mono-resistance to streptomycin were found.Conclusion. The presence of a Health Unit may have influenced the low numbers of TB/HIV, TB/HBV, TB/HCV, TB/syphilis coinfections and TB cases resistant to antimicrobials. Recent M. tuberculosis transmission can be inferred based on the high percentage of formatting of clusters. This situation stresses the need to improve active and passive detection, the screening of individuals for TB upon entrance into prison for early detection, and the implementation of prophylactic measures to reduce M. tuberculosis transmission.

Autonomia e reinserção social: percepção de familiares e profissionais que trabalham com redução de danos / Autonomy and social reintegration: perception of families and professionals who work with harm reduction / Autonomía y reinserción social: percepción de familiares y profesionales que trabajan con reducción del danõ

Objetivo: Identificar a percepção de familiares de dependentes de álcool e outras drogas e profissionais da área da saúde sobre as concepções de autonomia e reinserção social que embasam a abordagem redução de danos. Metodologia: Estudo qualitativo, realizado com 21 participantes 11 familiares e 10 profissionais recrutados em CAPS sediados no Sul do Brasil. Os dados, coletados entre junho/2013 e maio/2014, utilizando entrevistas semiestruturadas, foram submetidos à análise temática. Resultados: Para os familiares a concepção de autonomia comporta uma dualidade: um grupo a associa com instabilidade nos relacionamentos, prejuízos no trabalho e insegurança pelo fato de a pessoa manter contato com ambientes de comercialização de drogas; outro grupo a considera uma estratégia que ajuda a pessoa dependente a aceitar o tratamento, controlar a ingesta e amenizar os sintomas da abstinência. Para os profissionais, é uma estratégia que estimula a pessoa a refletir sobre sua relação com a(s) droga(s) e tomar suas decisões. A reinserção social é considerada promissora pelos profissionais e pelas famílias, pois favorece a substituição do grupo anterior de convivência e a integração em atividades ocupacionais. Conclusão: A autonomia e a reinserção social são, sem dúvida, conceitos importantes para o trabalho com dependentes químicos, mas desde que envolva a família e uma rede de apoio social. [AU]

Objective: Identify the perception of family's dependent on alcohol and other drugs and health professionals about the concepts of autonomy and social reintegration that supports harm-reduction approach. Methodology: Qualitative study, performed with 21 11 10 professionals and family participants recruited in CAPS located in the South of Brazil. The data, collected between June 2013 and may/2014, using semi-structured interviews, were subjected to analysis. Results: For family members of autonomy involves a duality: a group associated with instability in relationships, job losses and insecurity because the person keep in touch with the marketing environments of drugs; another group to consider a strategy that helps a person dependent on accepting the treatment, control food intake and alleviate the symptoms of withdrawal. For professionals, it is a strategy that encourages the person to reflect on your relationship with (s) drug (s) and make their decisions. Social reintegration is considered promising by the professionals and families, because it favors the replacement of the previous group of coexistence and integration in occupational activities. Conclusion: Autonomy and social reintegration are undoubtedly important concepts for working with drug addicts, but since that involves family and a social support network. [AU]

Objetivo: Identificar la percepción de familiares de dependientes de alcohol y otras drogas y profesionales del área de la salud sobre las concepciones de autonomía y reinserción social que basan el abordaje de la reducción del daño. Metodología: Estudio cualitativo, realizado con 21 participantes: 11 familiares y 10 profesionales reclutados en CAPS (Colegios de Aplicaciones Pedagógicas) ubicados en el Sur de Brasil. Los datos, recolectados entre junio/2013 y mayo/2014, utilizando entrevistas semiestructuradas, fueron sometidos al análisis temático. Resultados: Para los familiares la concepción de autonomía comporta una dualidad: un grupo la asocia con inestabilidad en las relaciones, perjuicios en el trabajo e inseguridad por el hecho de que la persona mantiene contacto con ambientes de comercialización de drogas; otro grupo la considera una estrategia que ayuda a la persona dependiente a aceptar el tratamiento, controlar la ingesta y amenizar los síntomas de la abstinencia. Para los profesionales, es una estrategia que estimula a la persona a reflexionar sobre su relación con la(s) droga(s) y a tomar sus decisiones. La reinserción social es considerada esperanzadora por los profesionales y las familias, pues favorece la sustitución del grupo anterior de convivencia y la integración en actividades ocupacionales. Conclusión: La autonomía y reinserción social son, sin duda, conceptos importantes para el trabajo con dependientes químicos, desde que involucre a la familia y una red de apoyo social. [AU]