Profile and follow-up of patients with tuberculosis in a priority city in Brazil

Abstract

OBJECTIVE To analyze the cases of tuberculosis and the impact of direct follow-up on the assessment of treatment outcomes.METHODS This open prospective cohort study evaluated 504 cases of tuberculosis reported in the Sistema de Informação de Agravos de Notificação (SINAN – Notifiable Diseases Information System) in Juiz de Fora, MG, Southeastern Brazil, between 2008 and 2009. The incidence of treatment outcomes was compared between a group of patients diagnosed with tuberculosis and directly followed up by monthly consultations during return visits (287) and a patient group for which the information was indirectly collected (217) through the city’s surveillance system. The Chi-square test was used to compare the percentages, with a significance level of 0.05. The relative risk (RR) was used to evaluate the differences in the incidence rate of each type of treatment outcome between the two groups.RESULTS Of the outcomes directly and indirectly evaluated, 18.5% and 3.2% corresponded to treatment default and 3.8% and 0.5% corresponded to treatment failure, respectively. The incidence of treatment default and failure was higher in the group with direct follow-up (p < 0.05) (RR = 5.72, 95%CI 2.65;12.34, and RR = 8.31, 95%CI 1.08;63.92, respectively).CONCLUSIONS A higher incidence of treatment default and failure was observed in the directly followed up group, and most of these cases were neglected by the disease reporting system. Therefore, effective measures are needed to improve the control of tuberculosis and data quality.

Two decades of tuberculosis in a city in Northeastern Brazil: advances and challenges in time and space

“…The higher proportion of male patients is consistent with findings in the current literature, with a possible cultural and social determination related to exposure (1) (26) (27) (28) . Biological factors should also be considered, since there are generally significant sexual differences between respiratory tract infection (RTI) development and outcomes (29) .…”

“…However, similar to occurrences in other Brazilian cities (28) (34) (35) , case outcome analysis is hampered by the high (19.3%) percentage of cases where circumstances at the end of treatment were classified as ignored, transferred, or changed treatment, thus suggesting failings in appropriate patient monitoring by the health team or insufficient flow of existing information.…”

Drug addiction and alcoholism as predictors for tuberculosis treatment default in Brazil: a prospective cohort study

“…Brazilian TB surveillance has passively worked even in priority municipalities, including Juiz de Fora. National surveillance has been presenting fragilities, such as inadequate active search for patients with respiratory symptoms and incipient decentralisation of both the DOTS strategy and TB treatments [1,4,7,[36][37][38]. The prospective Fig.…”

“…The outcomes, defined according to the Brazilian TB Guidelines [12], were recorded during the monthly patient follow-up appointments at each service and were detailed in the first publication of this cohort study [7]. Briefly, default and cure were defined as follows:…”

Tratamento Da Tuberculose: Dificuldades Enfrentadas Por Pacientes De Uma Unidade De Saúde Do Acre

“…Características sociodemográficas de pacientes tratados para TB em uma unidade de Saúde de Rio Branco,Acre, Brasil, 2017-2018 Dados da tabela 2 revelam que a maioria dos indivíduos tinha a TB em sua forma pulmonar (80,0%). Em um trabalho desenvolvido porPereira et al (2015), na cidade de Juiz de Fora-MG, no período de 2008 a 2009, observaram que a maioria dos indivíduos também apresentava a doença na forma pulmonar (80,5%). Ainda de forma similar, em uma pesquisa realizada porMendes e Fensterseifer (2004), na cidade de Porto Alegre-RS, no período de janeiro a fevereiro de 2003, verificaram maior taxa de pacientes com a forma pulmonar (88,0%).SegundoFerri et al (2014), a TB na forma pulmonar é mais abrangente pelo fato do bacilo já entrar no organismo do indivíduo através das vias aéreas e se implantar primeiramente nos pulmões, porém para que ocorra a forma extrapulmonar da TB são necessárias condições mais específicas.…”