Incidência e fatores de risco para tuberculose em Pelotas, uma cidade do Sul do Brasil

Menezes, Ana; Costa, Juvenal Dias da; Gonçalves, Helen; Morris, Saul S.; Menezes, Marcelo Bezerra de; Lemos, S; Oliveira, Ricardo Kaempf de; Palma, Eduardo L.

doi:10.1590/s1415-790x1998000100006

Cited by 25 publications

(22 citation statements)

References 15 publications

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“…However, the proportion of tuberculosis patients co-infected with HIV is 20.3%, which is higher than the 15.0% reported for Brazil as a whole. (5,6) The proportion of tuberculosis patients co-infected with HIV found in the present study (i.e., 50.0%) is in agreement with the findings of another group of researchers, (7) who reported that proportion to be 48.9% among inpatients at hospitals in southern Brazil. The fact that the proportion of HIV-positive individuals among patients hospitalized with tuberculosis is higher than is that of those among all of the reported cases of tuberculosis might denote greater disease severity in that group or reflect the trend toward hospitalization at referral hospitals for the treatment of infectious and parasitic diseases.…”

Section: Discussionsupporting

confidence: 93%

Manifestações clínicas, radiológicas e laboratoriais em indivíduos com tuberculose pulmonar: estudo comparativo entre indivíduos HIV positivos e HIV negativos internados em um hospital de referência

2011

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Objective: To compare clinical, radiological, and laboratory characteristics of individuals with pulmonary tuberculosis co-infected or not with HIV. Methods: A cross-sectional study, in which signs and symptoms were assessed by anamnesis and physical examination in patients hospitalized with pulmonary tuberculosis. The results of sputum smear microscopy and culture for Mycobacterium tuberculosis, as well as hemoglobin levels and CD4 + T-cell counts, were obtained from medical records, and chest X-ray reports were consulted. Results: We included 50 pulmonary tuberculosis patients, who were divided into two groups (HIV-positive and HIV-negative; n = 25 per group). The mean age of the participants was 38.4 ± 10.5 years; 46 (92%) were males; and 27 (54%) were White. Expectoration was presented by 21 (84%) and 13 (52%) of the patients in the HIV-negative and HIV-positive groups, respectively (p = 0.016). Radiological findings of cavitation were present in 10 (43%) and 2 (10%) of the patients in the HIV-negative and HIV-positive groups, respectively (p = 0.016), whereas an interstitial pattern was observed in 18 (78%) and 8 (40%), respectively (p = 0.012). The mean hemoglobin level was 11.1 ± 2.9 g/ dL and 9.3 ± 2.2 g/dL in the HIV-negative and HIV-positive groups, respectively (p = 0.015). Conclusions: In our sample of tuberculosis patients, expectoration was less prevalent, hemoglobin levels were lower, and cavitation was less common, as was an interstitial pattern, among those co-infected with HIV than among those without HIV co-infection.Keywords: HIV; Tuberculosis; Acquired immunodeficiency syndrome. ResumoObjetivo: Comparar as manifestações clínicas, radiológicas e laboratoriais de indivíduos com tuberculose pulmonar coinfectados com HIV com aqueles sem a coinfecção. Métodos: Estudo transversal, no qual sinais e sintomas foram analisados por meio de anamnese e exame físico em pacientes internados com tuberculose pulmonar. A baciloscopia, a cultura para Mycobacterium tuberculosis, a dosagem de hemoglobina e a contagem de células T CD4 + foram obtidas de registros dos prontuários, assim como os laudos das radiografias de tórax. Resultados: Foram incluídos 50 pacientes com tuberculose pulmonar, que foram divididos em dois grupos (HIV positivo e HIV negativo; n = 25 por grupo). A média de idade dos participantes foi de 38,4 ± 10,5 anos, 46 (92%) eram do sexo masculino, e 27 (54%) eram caucasianos. Apresentaram expectoração 21 (84%) e 13 (52%) dos pacientes nos grupos HIV negativo e HIV positivo, respectivamente (p = 0,016). Achados radiológicos de cavitação estavam presentes em 10 (43%) e 2 (10%) dos pacientes nos grupos HIV negativo e HIV positivo, respectivamente (p = 0,016), ao passo que padrão intersticial estava presente em 18 (78%) e 8 (40%) dos pacientes nesses grupos (p = 0,012). O nível médio de hemoglobina foi de 11,1 ± 2,9 g/dL e 9,3 ± 2,2 g/dL nos grupos HIV negativo e HIV positivo, respectivamente (p = 0,015). Conclusões: Entre pacientes coinfectados com tuberculose e HIV desta amostra, houve me...

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Section: Discussionsupporting

confidence: 93%

Manifestações clínicas, radiológicas e laboratoriais em indivíduos com tuberculose pulmonar: estudo comparativo entre indivíduos HIV positivos e HIV negativos internados em um hospital de referência

2011

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“…Alcoholism, which the current study found to be associated with treatment failure and the combined negatives outcomes, is a classical factor 12,13 both for developing TB 24 and for poor treatment outcome.…”

Section: Discussionmentioning

confidence: 62%

Factors associated with treatment failure, dropout, and death in a cohort of tuberculosis patients in Recife, Pernambuco State, Brazil

et al. 2007

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A cohort of cases initiating tuberculosis treatment from May 2001 to July 2003 was followed in Recife, Pernambuco State, Brazil, to investigate biological, clinical, social, lifestyle, and healthcare access factors associated with three negative tuberculosis treatment outcomes (treatment failure, dropout, and death) separately and as a group. Treatment failure was associated with treatment delay, illiteracy, and alcohol consumption. Factors associated with dropout were age, prior TB treatment, and illiteracy. Death was associated with age, treatment delay, HIV co-infection, and head of family's income. Main factors associated with negative treatment outcomes as a whole were age, HIV co-infection, illiteracy, alcoholism, and prior TB treatment. We suggest the following strategies to increase cure rates: further training of the Family Health Program personnel in TB control, awareness-raising on the need to tailor their activities to special care for cases (e.g., literacy training); targeting use of directly observed therapy for higher risk groups; establishment of a flexible referral scheme to handle technical and psychosocial problems, including alcoholism; and increased collaboration with the HIV/AIDS program.

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“…9 With the decentralization of the TB control actions to the primary care services in 2004, and also with the adoption of the DOTS strategy, the Brazilian PNCT recognizes the importance of extending the fight against TB to all the healthcare services of SUS. Therefore, it aims at the integration between TB control and the primary care services, including PSF in order to ensure the effective expansion of the access to diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Desempenho da atenção básica no controle da tuberculose

et al. 2009

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OBJECTIVE:To assess the access to tuberculosis treatment in healthcare services with Programa Saúde da Família (PSF -Family Health Program) and at a reference outpatient clinic. METHODS:A descriptive inquiry was carried out in 2007 with 106 patients who received tuberculosis treatment through the PSF or the reference outpatient clinic in Campina Grande, Northeastern Brazil, from July 2006 to August 2007. To assess the health services, the instrument Primary Care Assessment Tool was used, validated and adapted to assess tuberculosis care in Brazil. The main variables analyzed referred to the transportation and distance to the service and patients' supervision. RESULTS:Of the 106 patients, 83.9% performed self-administered treatment and 16.0% received supervised treatment. The indicators from the PSF units and from the reference outpatient clinic that were similar (p>0.05) were: 65.1% "losing half work day to attend the medical visit"; 65.0% "having to use motorized transport"; 50.0% "always having to pay for motorized transport"; and 69.0% "not receiving treatment at healthcare units near home". The indicators "using motorized transport", "paying for transport to attend the medical visit" and "receiving treatment near home" were statistically different (p<0.05) between the services. Standardized and non-standardized Cronbach's alpha coefficients were, respectively, 0.7275 and 0.7075, based on the eight items of the questionnaire. CONCLUSIONS:Although the city has 85 PSF teams, supervised treatment was carried out by few health workers. Although the tuberculosis treatment is offered by the public health service, it still represents a cost to the patients, due to the distance to the healthcare service and losing half work day in order to attend medical visits.

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Incidência e fatores de risco para tuberculose em Pelotas, uma cidade do Sul do Brasil

Cited by 25 publications

References 15 publications

Manifestações clínicas, radiológicas e laboratoriais em indivíduos com tuberculose pulmonar: estudo comparativo entre indivíduos HIV positivos e HIV negativos internados em um hospital de referência

Manifestações clínicas, radiológicas e laboratoriais em indivíduos com tuberculose pulmonar: estudo comparativo entre indivíduos HIV positivos e HIV negativos internados em um hospital de referência

Factors associated with treatment failure, dropout, and death in a cohort of tuberculosis patients in Recife, Pernambuco State, Brazil

Desempenho da atenção básica no controle da tuberculose

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