Improving tuberculosis control through the partnership between university and the health system

Abstract

<jats:p>INTRODUCTION: Tuberculosis (TB) control is linked to the availability of qualified methods for microbiological diagnostics; however, microscopy with limited sensitivity is the only method available in many locations. The objective of this study was to evaluate the introduction of culture, drug susceptibility testing (DST), and genotyping in the routine of a Municipal Program of Tuberculosis Control. METHODS: Direct microscopy of sputum and culture in Ogawa-Kudoh were performed on 1,636 samples from 787 patients. DST of positive cultures was performed by resazurin microtiter assay and genotyping by mycobacterial interspersed repetitive units-variable number tandem repeat. RESULTS: A total 91 patients with TB were identified. The culture increased case detection by 32% compared with the microscopy; acquired resistance was 3.3% and the genotyping showed high genetic diversity. CONCLUSIONS: Ogawa-Kudoh contributed significantly to the increase in case detection and is suitable for implementation in poor-resource locations. The acquired resistance rate was lower than that reported in a recent Brazilian survey. The high genetic diversity is possibly related to the high TB prevalence in the population, as well as to early detection and suitable treatment of patients. The interaction between research and health care is important for reorienting the practice, transferring technology, and improving TB control.</jats:p>

Prevalence of tuberculosis in prisons: risk factors and molecular epidemiology

“…This result is within the expected rate of 30-40% in locations where samples are cultured; 15 it is also similar to that reported among the general population of the city of the study prison, Pelotas. 25 The five cases diagnosed by microscopy alone may indicate that the use of 2% sodium hydroxide for sample decontamination, although effective, is drastic for micro-organisms and may affect the viability of bacteria in culture. 15 In these cases, response to treatment confirmed the TB diagnosis.…”

“…It should also be noted that the genotype of these 12 strains had previously been identified in the same prison. 25 While it is possible that some cases may have developed from latent infections, recent infection has been considered an important problem in other molecular epidemiology studies in prisons. 7,8,26 12locus MIRU-VNTR has been used in other studies in this region and shown high discriminatory power; 25,29,30 it is therefore a suitable tool for molecular epidemiology studies in this scenario.…”

Recent transmission of drug-resistant Mycobacterium tuberculosis in a prison population in southern Brazil

“…Although HIV testing is mandatory for patients with tuberculosis, HIV test results were available for only 52.8%, with one case of HIV-tuberculosis coinfection being identified (5.3%), a value that is lower than that reported in studies conducted in southern Brazil. 15 , 16 …”

Clinical and epidemiological profiles of individuals with drug-resistant tuberculosis

“…An inadequate capacity to quickly and accurately diagnose tuberculosis (TB) in developing countries ( WHO 2011 ) and the growing threat of multidrug-resistant TB strains (MDR-TB) are global concerns ( Said et al 2012 ). Approximately 450,000 people developed MDR-TB worldwide in 2012, with an estimated 170,000 deaths annually.…”