Tuberculose e infecção pelo HIV no Brasil: magnitude do problema e estratégias para o controle

Jamal, Leda Fátima; Moherdaui, Fábio

doi:10.1590/s0034-89102007000800014

Cited by 76 publications

(80 citation statements)

References 10 publications

(7 reference statements)

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“…A infecção pelo HIV exacerba a epidemia da tuberculose, seja por aumentar a suscetibilidade à infecção pelo Mycobacterium tuberculosis, seja por torná-la uma doença ativa 7,8,9,10 .…”

Section: Introductionunclassified

Fatores associados ao abandono do tratamento da tuberculose pulmonar no Maranhão, Brasil, no período de 2001 a 2010

2014

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Os objetivos foram analisar os fatores associados e determinar a taxa de abandono do tratamento da tuberculose pulmonar no Estado do Maranhão, Brasil, de 2001 a 2010. Realizou-se estudo transversal analítico com dados do Sistema de Informações sobre Agravos de Notificação (SINAN), incluídos 2.850 casos novos com baciloscopia positiva que tiveram como situação de encerramento alta por cura ou abandono. As variáveis em estudo foram a faixa etária, sexo, cor, escolaridade em anos de estudo, exame para HIV, alcoolismo, diabetes, doença mental e outras doenças. Para identificar os fatores associados ao abandono, foi utilizado o modelo de regressão logística. Apresentaram-se associados ao abandono a faixa etária de 20-39 anos (OR = 1,51; IC95%: 1,15-1,97; p = 0,002), a escolaridade, 1-8 anos de estudo (OR = 2,05; IC95%: 1,43-2,95; p < 0,001), analfabetismo (OR = 1,64; IC95%: 1,02-2,65; p = 0,041), alcoolismo (OR = 2,53; IC95%: 1,75-3,67; p < 0,001) e doença mental. Foi observada alta taxa de abandono no estado (9,1%), jovens com baixa escolaridade, usuários de álcool e doentes mentais podem estar contribuindo para este aumento.

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Section: Introductionunclassified

Fatores associados ao abandono do tratamento da tuberculose pulmonar no Maranhão, Brasil, no período de 2001 a 2010

2014

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“…(2)(3)(4) However, in the presence of TB/HIV coinfection, the proportion of extrapulmonary cases reaches 20%. (5,6) Pleural TB is historically considered a primary manifestation resulting from hematogenous or lymphatic dissemination from a pulmonary focus (first infection). (7)(8)(9) The secondary form, which occurs years after the first infection, is considered consequence of the reactivation of pulmonary foci contaminating the pleural space.…”

Section: Introductionmentioning

confidence: 99%

Aspectos epidemiológicos da tuberculose pleural no estado de São Paulo (1998-2005)

et al. 2009

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Objective: To analyze the epidemiological characteristics of and trends regarding the incidence of pleural TB. Methods: This was a retrospective descriptive study of TB cases reported between 1998 and 2005 and compiled from the Epidemiological Surveillance Tuberculosis System (Epi-TB database). Results: A total of 144,347 new cases of TB were reported during the period studied. Pulmonary TB was the predominant form (118,575 cases; 82.2%). Among the extrapulmonary forms (25,773 cases; 17.8%), pleural TB was the form most often reported (12,545 cases; 48.7%). For all forms, the incidence (per 100,000 population) decreased (from 49.7 in 1998 to 44.6 in 2005; R 2 = 0.898; p < 0.001), whereas the incidence of pleural TB remained stable (4.1 in 1998 and 3.8 in 2005; R 2 = 0.433; p = 0.076). The highest incidence of pleural TB was found among males (2:1) aged from 30 to 59 years. Of the 12,545 patients with pleural TB, 4,018 (32.0%) presented comorbidities: alcoholism (9.5%); HIV (8.0%); diabetes (3.3%); and mental illness (1.2%). The diagnosis was based on bacteriological (14.2%) and histological (30.2%) methods, as well as on unspecified methods (55.6%). Conclusions: Pleural TB was the predominant extrapulmonary form of TB in the state of São Paulo, with a stable incidence between 1998 and 2005, although there was a trend toward a decrease in the incidence of the pulmonary forms. The diagnosis of pleural TB was confirmed through histology and bacteriology in 44.4% of the cases. A incidência (por 100.000 habitantes) de todas as formas diminuiu, (49,7 em 1998 e 44,6 em 2005; R 2 = 0,898; p < 0,001), enquanto a incidência de TB pleural permaneceu estável (4,1 em 1998 e 3,8 em 2005; R 2 = 0,433; p = 0,076). A maior incidência de TB pleural ocorreu em pacientes do sexo masculino (2:1) entre 30 e 59 anos de idade. Dos 12.545 pacientes com TB pleural, 4.018 (32,0%) apresentaram comorbidades: alcoolismo (9,5%); HIV (8,0%); diabetes (3,3%); e doença mental (1,2%). O diagnóstico referido fundamentou-se em métodos bacteriológicos (14,2%) e histológicos (30,2%), assim como outros não especificados (55,6%). Conclusões: No estado de São Paulo, a TB pleural foi a forma extrapulmonar predominante, apresentando incidência estável no período entre 1998 e 2005, apesar da tendência de diminuição das formas pulmonares. A histologia e a bacteriologia definiram o diagnóstico em 44,4% dos casos. Keywords Original ArticleEpidemiological aspects of pleural tuberculosis in the state of São Paulo, Brazil (1998-2005 MethodsThis was a retrospective, observational, descriptive study carried out in the Pulmonology

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“…Human immunodeficiency virus (HIV)/TB co-infection carries even worse numbers, including unfavorable outcome rates above 60% (Diniz et al 2003) and mortality rates above 25% in some settings (Jamal & Moherdaui 2007). Illness severity is the major cause of treatment failure among co-infected patients, while lack of compliance to the treatment regimen, drug resistance and nontuberculous mycobacteria (NTM) may also play a role.…”

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confidence: 99%

High prevalence of drug-resistant tuberculosis and other mycobacteria among HIV-infected patients in Brazil: a systematic review

Bammann

Zamarioli

Pinto

et al. 2010

Mem. Inst. Oswaldo Cruz

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There is a little-noticed trend involving human immunodeficiency virus (HIV)-infected patients suspected of having tuberculosis: the triple-treatment regimen recommended in Brazil for years has been potentially ineffective in over 30% of the cases. This proportion may be attributable to drug resistance (to at least 1 drug) and/or to infection with non-tuberculous mycobacteria. This evidence was not disclosed in official statistics, but arose from a systematic review of a few regional studies in which the diagnosis was reliably confirmed by mycobacterial culture. This paper clarifies that there has long been ample evidence for the potential benefits of a four-drug regimen for co-infected patients in Brazil and it reinforces the need for determining the species and drug susceptibility in all positive cultures from HIV-positive patients

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Tuberculose e infecção pelo HIV no Brasil: magnitude do problema e estratégias para o controle

Cited by 76 publications

References 10 publications

Fatores associados ao abandono do tratamento da tuberculose pulmonar no Maranhão, Brasil, no período de 2001 a 2010

Fatores associados ao abandono do tratamento da tuberculose pulmonar no Maranhão, Brasil, no período de 2001 a 2010

Aspectos epidemiológicos da tuberculose pleural no estado de São Paulo (1998-2005)

High prevalence of drug-resistant tuberculosis and other mycobacteria among HIV-infected patients in Brazil: a systematic review

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