Clinical and epidemiological profiles of individuals with drug-resistant tuberculosis

Abstract

Drug-resistant tuberculosis (TB) is a growing global threat. Approximately 450,000 people developed multidrug-resistant TB worldwide in 2012 and an estimated 170,000 people died from the disease. This paper describes the sociodemographic, clinical-epidemiological and bacteriological aspects of TB and correlates these features with the distribution of anti-TB drug resistance. Mycobacterium tuberculosis (MT) cultures and drug susceptibility testing were performed according to the BACTEC MGIT 960 method. The results demonstrated that MT strains from individuals who received treatment for TB and people who were infected with human immunodeficiency virus were more resistant to TB drugs compared to other individuals (p < 0.05). Approximately half of the individuals received supervised treatment, but most drug-resistant cases were positive for pulmonary TB and exhibited positive acid-fast bacilli smears, which are complicating factors for TB control programs. Primary healthcare is the ideal level for early disease detection, but tertiary healthcare is the most common entry point for patients into the system. These factors require special attention from healthcare managers and professionals to effectively control and monitor the spread of TB drug-resistant cases.

Caracterização da tuberculose drogarresistente no Brasil, 2014*

“…5,9,20 Diabetes has the potential to interfere with TB treatment, with higher risk of treatment failure, TB recurrence and death. 25 The relative frequency of substance use is consistent with that found in São José do Rio Preto between 2009 and 2013, 6 as well as among MDR-TB cases at the São Paulo State Referral Center in 2010. 19 In Espírito Santo, among DR-TB cases reported between 2002 and 2012, 9 a higher percentage of tobacco and alcohol users was reported.…”

“…5,7,9 Notwithstanding, predominant mono-resistance to streptomycin had already been reported in the municipality of São José do Rio Preto, in the state of São Paulo, between 2009 and 2013. 6 The number of pulmonary MDR-TB cases reported in 2014 accounted for 43.7% of those estimated by WHO for Brazil that year (19.4% of primary cases and 64.7% of acquired cases). 15 The WHO estimates were based on reported cases, on underreporting estimated by specialists and on the most recent Brazilian survey on drug resistance.…”

“…The predominance of men, Afro-Brasilian, young people, and people with low levels of education was also found in other municipal, state and local studies between 2000 and 2013; with an exception in the municipality of Porto Alegre, in the state of Rio Grande do Sul, between 2006 and 2007, when most DR-TB cases (64.3%) were w hite individuals. [5][6][7][8][9][17][18][19][20] This variation is possibly due to regional differences in the ethnic composition of population. The DR-TB case profile is the same as that associated with treatment of drug-sensitive TB cases loss to follow-up.…”

“…3 In 2006, 1.4% of new TB cases and 7.5% of previously treated cases were MDR-TB. 4 When describing the epidemiological profile of DR-TB, recent Brazilian studies have used local data [5][6][7][8][9] rather than national data.…”

Perfil dos municípios brasileiros, a presença de tuberculosee sua forma drogarresistente

“…Municipalities with DR-TB cases had a significantly higher percentage of retreatment cases. Retreatment is pointed out in the literature as the largest predictor of DR-TB 2 and is associated with DR-TB cases within Brazil [24][25][26] and abroad 18,[27][28][29][30][31] . This result may indicate a lower capacity to manage TB cases in municipalities with drug-resistant cases, either due to their health network characteristics or to their complex social dynamics.…”