Tuberculosis and AIDS co-morbidity in Brazil: linkage of the tuberculosis and AIDS databases

Miranda, Angélica Espinosa; Golub, Jonathan E.; Lucena, Francisca de Fátima; Maciel, Ethel Noia; Gurgel, Maria de Fátima; Dietze, Reynaldo

doi:10.1590/s1413-86702009000200013

Cited by 13 publications

(18 citation statements)

References 19 publications

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“…Schooling was not related as a risk factor to develop TB in our population, contrary to the data of (Miranda et al, 2009), who describes 3 times more risk in developing TB in people with ≤ 3 years of education.…”

Section: Discussioncontrasting

confidence: 99%

Clinical and Sociodemographic Risk Factors for Tuberculosis in Human Immunodeficiency Virus Infected Patients

Nibardo¹

2013

American Journal of Infectious Diseases

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To identify clinical and sociodemographic factors associated with the risk of tuberculosis in HIV-infected patients. A case-control study in a cohort of hiv-infected patients. Cases: patients coinfected with HIV and pulmonary or extrapulmonary tuberculosis. Controls: no clinical tuberculosis and PPD negative, matched for age and sex. Primary data were obtained from medical records and personal interviews. We identified 47 cases and 94 controls. The main risk factors identified were: underweight (malnutrition) (BMI ≤ 18.49), abscence of antiretroviral therapy, CD4 + cells count ≤ 199 cells/mm 3 , RNA HIV-1 viral load ≥ 100,000 copies/mL. Tuberculosis is associated to multiple risk factors in HIV infected patients, clinical factors are more important that sociodemographic ones. CD4+ cells count < 200 cells/µL, malnutrition IMC < 18.9 and RNA HIV-1 viral load > 100,000 copies/mL are associated with tuberculosis in HIV infected patients.

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Section: Discussioncontrasting

confidence: 99%

Clinical and Sociodemographic Risk Factors for Tuberculosis in Human Immunodeficiency Virus Infected Patients

Nibardo¹

2013

American Journal of Infectious Diseases

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“…These surveillance systems, which have been described elsewhere (27), collect data at the level of bairros, geographically defined regions with population …”

Section: Methodsmentioning

confidence: 99%

Heterogeneity in tuberculosis transmission and the role of geographic hotspots in propagating epidemics

Dowdy

Golub

Chaisson

et al. 2012

Proc. Natl. Acad. Sci. U.S.A.

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142

132

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The importance of high-incidence "hotspots" to population-level tuberculosis (TB) incidence remains poorly understood. TB incidence varies widely across countries, but within smaller geographic areas (e.g., cities), TB transmission may be more homogeneous than other infectious diseases. We constructed a steady-state compartmental model of TB in Rio de Janeiro, replicating nine epidemiological variables (e.g., TB incidence) within 1% of their observed values. We estimated the proportion of TB transmission originating from a high-incidence hotspot (6.0% of the city's population, 16.5% of TB incidence) and the relative impact of TB control measures targeting the hotspot vs. the general community. If each case of active TB in the hotspot caused 0.5 secondary transmissions in the general community for each within-hotspot transmission, the 6.0% of people living in the hotspot accounted for 35.3% of city-wide TB transmission. Reducing the TB transmission rate (i.e., number of secondary infections per infectious case) in the hotspot to that in the general community reduced city-wide TB incidence by 9.8% in year 5, and 29.7% in year 50-an effect similar to halving time to diagnosis for the remaining 94% of the community. The importance of the hotspot to city-wide TB control depended strongly on the extent of TB transmission from the hotspot to the general community. High-incidence hotspots may play an important role in propagating TB epidemics. Achieving TB control targets in a hotspot containing 6% of a city's population can have similar impact on citywide TB incidence as achieving the same targets throughout the remaining community.infectious disease transmission | theoretical models | urban population | epidemiology | communicable disease control T uberculosis (TB) remains a leading infectious cause of morbidity and mortality, with over 8.8 million cases and 1.4 million deaths annually worldwide (1). TB is known to cluster in hyperendemic "hotspots" often characterized by crowding (2), poverty (3), HIV infection (4), and other social determinants (5). However, compared with other infectious diseases [e.g., sexually transmitted diseases (6) and vector-borne diseases (7)], where 20% of the population may generate 80% of transmission (7), TB transmission appears relatively more homogeneous. As a result, though spatial targeting is often advocated as an efficient method for achieving control of diseases such as malaria (8), the degree to which hotspots contribute to community-wide transmission of TB remains uncertain. The concept of geographically defined hotspots driving TB transmission has biological plausibility. Preventing TB cases in high-transmission areas (e.g., crowded urban slums, poorly ventilated hospitals) may avert many more secondary transmissions than similar efforts in low-transmission areas. Similarly, cases in high-transmission areas are more likely to represent recent infection (which is more amenable to intervention) than reactivation of latent disease (9). Prior explorations of heterogeneity in TB tra...

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“…Ademais, há a necessidade de maior atenção no manejo farmacológico dos pacientes com coinfecção pelo HIV/Aids, comumente polimedicados, conforme já abordado em seção anterior (47).…”

Section: Tuberculoseunclassified

“…Em pacientes diabéticos em uso de isoniazida, fár-maco de primeira linha no tratamento da tuberculose, recomenda-se o uso associado de piridoxina em razão do maior risco de neuropatia periférica (47).…”

Section: Tuberculoseunclassified

“…Observou-se ainda uma diminuição dos níveis glicêmicos após o tratamento da hanseníase, sugerindo uma possível associação entre a infecção pela Mycobacterium leprae e o metabolismo dos carboidratos (53). Em adição, os fármacos utilizados para o tratamento da hanseníase e dos estados reacionais, como corticosteroides e a rifampicina, podem ter ações deletérias sobre o controle glicêmico de portadores de DM2 (47).…”

Section: Hanseníaseunclassified

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Distúrbios metabólicos em doenças infecciosas emergentes e negligenciadas

Ponte

Gurgel

Ponte

et al. 2010

Arq Bras Endocrinol Metab

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SUMÁRIOA substituição gradual e progressiva das doenças infecciosas e parasitárias pelas doenças crônico-degenerativas como causas de morbidade e mortalidade, caracterizando o processo de transição epidemiológica, não tem sido observada em várias populações, em especial em países subdesenvolvidos ou em desenvolvimento, verificando-se, na realidade, uma sobreposição desses perfis (transição incompleta). Além do aumento da prevalência de distúrbios metabólicos, várias doenças infecciosas permanecem endêmicas em diversas regiões, como é o caso da hanseníase, da tuberculose, da leishmaniose, das hepatites virais, entre outras, assim como condições emergentes nas últimas décadas, como a infecção pelo HIV/Aids. Nesse contexto, nos últimos anos tem sido dada uma maior atenção para a ocorrência de distúrbios metabólicos, principalmente a partir da observação de elevada incidência dessas anormalidades associadas à infecção pelo HIV/Aids e à sua terapia com as drogas antirretrovirais. Nesta revisão são abordados aspectos clínico-epidemiológicos dos distúrbios metabólicos reportados em algumas enfermidades infectoparasitárias de relevância mundial e local (no Brasil), assim como possíveis mecanismos e fatores envolvidos nessas associações. Arq Bras Endocrinol Metab. 2010;54(9):785-92 Descritores Infecção; distúrbios metabólicos; diabetes melito; doença cardiovascular; tuberculose; HIV; Aids; hepatite; hanseníase; leishmaniose SUMMARYThe gradual and progressive replacement of infectious and parasitic by chronic diseases as causes of morbidity and mortality, characterizing the process of epidemiological transition hasn't been observed in various populations, especially in underdeveloped or developing countries characterizing a superposition of these profiles (incomplete transition). Besides the increased prevalence of metabolic disorders, various infectious diseases remain endemic in several regions, such as leprosy, tuberculosis, leishmaniasis, viral hepatitis, among others, as well as emerging diseases in recent decades, as HIV infection/Aids. In this context, more attention has been given to the occurrence of metabolic disturbances in the recent years, mainly from the observation of a high incidence of metabolic disorders associated with HIV infection/Aids, and its therapy with antiretroviral drugs. This review addresses clinical and epidemiological aspects of metabolic disturbances reported in some infectious and parasitic diseases with worldwide and local (Brazil) relevance, as well as possible mechanisms and factors involved in these associations. Arq Bras Endocrinol Metab. 2010;54(9):785-92

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Tuberculosis and AIDS co-morbidity in Brazil: linkage of the tuberculosis and AIDS databases

Cited by 13 publications

References 19 publications

Clinical and Sociodemographic Risk Factors for Tuberculosis in Human Immunodeficiency Virus Infected Patients

Clinical and Sociodemographic Risk Factors for Tuberculosis in Human Immunodeficiency Virus Infected Patients

Heterogeneity in tuberculosis transmission and the role of geographic hotspots in propagating epidemics

Distúrbios metabólicos em doenças infecciosas emergentes e negligenciadas

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