[Anti- tuberculosis treatment evaluation in northern districts of Buenos Aires suburbs]. / Evaluacion del tratamiento antituberculoso en la zona norte del conurbano bonaerense.

The aim of this study was to analyze the epidemiologic impact produced by Direct Observed Treatment Strategy (DOTS) application regarding to its success in the 51h Sanitary Region during the year 2 003. The cure was evaluated by a cohort study comparing two groups. Group 1: Districts in which DOTS were applied in 65% or more TB patients; group 2: Districts applying DOTS in 64% or less, or without its implementation. The global mortality was analyzed on HIV (-) as well as on HIV (+) patients in both groups. In Municipalities where DOTS strategy was applied in >65% of notified cases, the treatment success was 85.7%; the cure rate of bacteriological confirmed pulmonary disease was 86.2% and non-adherence was proved in 8.8% of cases. When DOTS was applied in equal or less than 64% of the cases, the global cure reached 67.6%; in confirmed pulmonary disease it was 68.1%, and non-adherence was proved in 21.8% of cases. Global mortality due to TB was 5.2%; 22.3% in HIV (+) and 4.1% in HIV (-). While In group 1, the cure rate of co-infected TB/HIV patients was 55.2%, non-adherence was 6.9%, in group 2 these figures were 46.4% and 19.7% respectively. Mortality rate in HIV (+) patients was 31.0% in group 1, and 16.1% in group 2. These results show that DOTS application proved to be an efficient tool to cure most of the patients, reaching the proposed goal of 85%, therefore reducing the risk of illness in the community.

Evaluación del tratamiento antituberculoso en la zona norte del conurbano bonaerense / Anti- tuberculosis treatment evaluation in Northern districts of Buenos Aires suburbs

El objetivo del presente estudio fue analizar el impacto epidemiológico producido por la aplicación de la estrategia del tratamiento para tuberculosis (TB) de corta duración y directamente observado (DOTS), y su correlación con el éxito en la Región Sanitaria V, durante el año 2003. Se evaluó la curación comparando dos grupos de estudio. Grupo 1: municipios con 65% o más de los casos con DOTS, y Grupo 2: con 64% o menos de los pacientes bajo esta estrategia o sin su aplicación. Se analizó la letalidad global y de pacientes HIV (+) en ambos grupos. En el grupo 1 el éxito del tratamiento fue 85.7%, con curación en las formas pulmonares confirmadas de 86.2% y abandono de 8.8%. En el grupo 2 la curación alcanzó el 67.6%, en pulmonares confirmados 68.1% y el abandono de 21.8%. La letalidad global fue 5.2%, en pacientes HIV (+) 22.3% y en los HIV (-) 4.1%. La curación en TB/HIV en el grupo 1 fue 55.2%, con abandono de 6.9%; en el grupo 2 curó el 46.4% y abandonó el 19.7%. El 31.0% de pacientes HIV (+) fallecieron en el grupo 1 y 16.1% en el grupo 2. La implementación del DOTS, permitió alcanzar la meta de curar el 85% de los casos, probando ser una herramienta eficaz, capaz de garantizar la curación de la mayoría de los pacientes y reducir el riesgo de enfermar de la comunidad.(AU)

The aim of this study was to analyze the epidemiologic impact produced by Direct Observed Treatment Strategy (DOTS) application regarding to its success in the 5th Sanitary Region during the year 2 003. The cure was evaluated by a cohort study comparing two groups. Group 1: Districts in which DOTS were applied in 65% or more TB patients; group 2: Districts applying DOTS in 64% or less, or without its implementation. The global mortality was analyzed on HIV (-) as well as on HIV (+) patients in both groups. In Municipalities where DOTS strategy was applied in >65% of notified cases, the treatment success was 85.7%; the cure rate of bacteriological confirmed pulmonary disease was 86.2% and non-adherence was proved in 8.8% of cases. When DOTS was applied in equal or less than 64% of the cases, the global cure reached 67.6%; in confirmed pulmonary disease it was 68.1%, and non-adherence was proved in 21.8% of cases. Global mortality due to TB was 5.2%; 22.3% in HIV (+) and 4.1% in HIV (-). While In group 1, the cure rate of co-infected TB/HIV patients was 55.2%, non-adherence was 6.9%, in group 2 these figures were 46.4% and 19.7% respectively. Mortality rate in HIV (+) patients was 31.0% in group 1, and 16.1% in group 2. These results show that DOTS application proved to be an efficient tool to cure most of the patients, reaching the proposed goal of 85%, therefore reducing the risk of illness in the community.(AU)

Evaluación del tratamiento antituberculoso en la zona norte del conurbano bonaerense / Anti- tuberculosis treatment evaluation in Northern districts of Buenos Aires suburbs

El objetivo del presente estudio fue analizar el impacto epidemiológico producido por la aplicación de la estrategia del tratamiento para tuberculosis (TB) de corta duración y directamente observado (DOTS), y su correlación con el éxito en la Región Sanitaria V, durante el año 2003. Se evaluó la curación comparando dos grupos de estudio. Grupo 1: municipios con 65% o más de los casos con DOTS, y Grupo 2: con 64% o menos de los pacientes bajo esta estrategia o sin su aplicación. Se analizó la letalidad global y de pacientes HIV (+) en ambos grupos. En el grupo 1 el éxito del tratamiento fue 85.7%, con curación en las formas pulmonares confirmadas de 86.2% y abandono de 8.8%. En el grupo 2 la curación alcanzó el 67.6%, en pulmonares confirmados 68.1% y el abandono de 21.8%. La letalidad global fue 5.2%, en pacientes HIV (+) 22.3% y en los HIV (-) 4.1%. La curación en TB/HIV en el grupo 1 fue 55.2%, con abandono de 6.9%; en el grupo 2 curó el 46.4% y abandonó el 19.7%. El 31.0% de pacientes HIV (+) fallecieron en el grupo 1 y 16.1% en el grupo 2. La implementación del DOTS, permitió alcanzar la meta de curar el 85% de los casos, probando ser una herramienta eficaz, capaz de garantizar la curación de la mayoría de los pacientes y reducir el riesgo de enfermar de la comunidad.

The aim of this study was to analyze the epidemiologic impact produced by Direct Observed Treatment Strategy (DOTS) application regarding to its success in the 5th Sanitary Region during the year 2 003. The cure was evaluated by a cohort study comparing two groups. Group 1: Districts in which DOTS were applied in 65% or more TB patients; group 2: Districts applying DOTS in 64% or less, or without its implementation. The global mortality was analyzed on HIV (-) as well as on HIV (+) patients in both groups. In Municipalities where DOTS strategy was applied in >65% of notified cases, the treatment success was 85.7%; the cure rate of bacteriological confirmed pulmonary disease was 86.2% and non-adherence was proved in 8.8% of cases. When DOTS was applied in equal or less than 64% of the cases, the global cure reached 67.6%; in confirmed pulmonary disease it was 68.1%, and non-adherence was proved in 21.8% of cases. Global mortality due to TB was 5.2%; 22.3% in HIV (+) and 4.1% in HIV (-). While In group 1, the cure rate of co-infected TB/HIV patients was 55.2%, non-adherence was 6.9%, in group 2 these figures were 46.4% and 19.7% respectively. Mortality rate in HIV (+) patients was 31.0% in group 1, and 16.1% in group 2. These results show that DOTS application proved to be an efficient tool to cure most of the patients, reaching the proposed goal of 85%, therefore reducing the risk of illness in the community.