Estudo clínico-radiológico de crianças e adolescentes indígenas Suruí, Região Amazônica

Basta, Paulo Cesar; Rios, Diana Patrícia Giraldo; Alves, Luíz Carlos; ́Anna, Clemax Couto Sant; Coimbra, Carlos E. A.

doi:10.1590/s0037-86822010000600024

Cited by 18 publications

(31 citation statements)

References 12 publications

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“…Analysis of the coefficients of incidence shows that the indigenous were in a disadvantaged situation compared with other race/color categories throughout the period. As seen in other investigations, 3,4,5,7,12 the present findings reinforce the hypothesis that the indigenous in Brazil are more vulnerable to falling ill from tuberculosis compared Abandoning treatment proved to be associated with being male and with being in the 20 to 44 year old age group, as in other contexts. 1,19,20,23 This phenomenon may be related to factors that make it difficult to adhere to treatment, including smoking, drug and alcohol use, low levels of schooling, the adverse effects of the medication, co-infection with HIV and previous abandonment, in addition to other socioeconomic disadvantages.…”

Section: 15-17supporting

confidence: 90%

“…[3][4][5]7,10,17 Although there have been advances in knowledge, there are still gaps concerning follow up of cases undergoing treatment and in monitoring contacts. Moreover, little is known about the characteristics related to those cases that end in death, abandonment of treatment of multidrug-resistant tuberculosis (MRTB) among the indigenous, especially in comparison with other populations.…”

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confidence: 99%

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Desigualdades sociais e tuberculose: análise segundo raça/cor, Mato Grosso do Sul

et al. 2013

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OBJECTIVE:To describe the sociodemographic and clinical-epidemiological characteristics of tuberculosis cases and identify associated factors with abandoning treatment and death whilst undergoing treatment. METHODS:Epidemiological study based on cases of tuberculosis recorded in indigenous and non-indigenous individuals according to race/color in Mato Grosso do Sul, Midwestern Brazil, between 2001 and. Descriptive analysis of the cases was carried out according to the variables of sex, age group, residence, type of test used in the diagnosis, clinical form, supervised treatment and final status, according to race/color. Univariate/multivariate logistic regression analyses were used to identify predictors of abandoning treatment and death, using odds ratio as a measure of association. A time series of incidence according to race/color was constructed. RESULTS:In the period, 6,962 new cases of tuberculosis were registered, 15.6% being among indigenous. The illness was predominantly found in men and adults (20-44 years old) in all groups. Most of the indigenous patients lived in rural areas (79.8%) and 13.5% of the records in indigenous occurred in children aged < 10 years. The average incidence in the state was 34.5/100,000 inhabitants, being 209.0, 73.1, 52.7, 23.0 and 22.4 in indigenous, and those with yellow, black, white and brown skin, respectively. Patients aged 20 to 44 years (OR = 13.3, 95%CI 1.9;96.8), male (OR = 1.6, 95%CI 1.1;2.3) and of black race/color (OR = 2.5, 95%CI 1.0;6.3) were associated with abandoning treatment, while patients aged > 45 years (OR = 3.0, 95%CI 1.2;7.8) and with the mixed form (OR = 2.3, 95%CI 1.1;5.0) showed association with death. Although they only account for 3.0% of the population, the indigenous were responsible for 15.6% of cases recorded during the period. CONCLUSIONS:Major inequalities in the tuberculosis illness process were found between the categories studied. Incidence in the indigenous population was consistently higher than recorded in any other group, reaching more than six times the national average. It was among those with black and brown skin that the worst treatment results were observed, as they were twice as likely to abandon treatment as the indigenous. Poor program performance was strongly associated with abandoning treatment and death. It is thought that as long as there is no reduction in poverty inequalities in health indicators will remain.

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Section: 15-17supporting

confidence: 90%

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confidence: 99%

Desigualdades sociais e tuberculose: análise segundo raça/cor, Mato Grosso do Sul

et al. 2013

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“…In indigenous TB contacts 0–19 years of age residing in the Brazilian Amazon, a similar prevalence (33%) of radiographic features possibly associated with TB sequelae was observed and calcifications were also the most frequently observed abnormality [50]. Both in the Brazilian as well as in our study population reported TB rates are extraordinarily high (>30 times higher than national estimates) [21,51].…”

Section: Discussionsupporting

confidence: 71%

Agreement between QuantiFERON®-TB Gold In-Tube and the tuberculin skin test and predictors of positive test results in Warao Amerindian pediatric tuberculosis contacts

et al. 2014

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BackgroundInterferon-gamma release assays have emerged as a more specific alternative to the tuberculin skin test (TST) for detection of tuberculosis (TB) infection, especially in Bacille Calmette-Guérin (BCG) vaccinated people. We determined the prevalence of Mycobacterium tuberculosis infection by TST and QuantiFERON®-TB Gold In-Tube (QFT-GIT) and assessed agreement between the two test methods and factors associated with positivity in either test in Warao Amerindian children in Venezuela. Furthermore, progression to active TB disease was evaluated for up to 12 months.Methods163 HIV-negative childhood household contacts under 16 years of age were enrolled for TST, QFT-GIT and chest X-ray (CXR). Follow-up was performed at six and 12 months. Factors associated with TST and QFT-GIT positivity were studied using generalized estimation equations logistic regression models.ResultsAt baseline, the proportion of TST positive children was similar to the proportion of children with a positive QFT-GIT (47% vs. 42%, p = 0.12). Overall concordance between QFT-GIT and TST was substantial (kappa 0.76, 95% CI 0.46-1.06). Previous BCG vaccination was not associated with significantly increased positivity in either test (OR 0.68, 95% CI 0.32-1.5 for TST and OR 0.51, 95% CI 0.14-1.9 for QFT-GIT). Eleven children were diagnosed with active TB at baseline. QFT-GIT had a higher sensitivity for active TB (88%, 95% CI 47-98%) than TST (55%, 95% CI 24-83%) while specificities were similar (respectively 58% and 55%). Five initially asymptomatic childhood contacts progressed to active TB disease during follow-up.ConclusionReplacement of TST by the QFT-GIT for detection of M. tuberculosis infection is not recommended in this resource-constrained setting as test results showed substantial concordance and TST positivity was not affected by previous BCG vaccination. The QFT-GIT had a higher sensitivity than the TST for the detection of TB disease. However, the value of the QFT-GIT as an adjunct in diagnosing TB disease is limited by a high variability in QFT-GIT results over time.

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“…Esses autores constataram elevada taxa de transmissão recente nessa população e vín-culo epidemiológico estabelecido entre 30% dos casos, confirmando a propagação interpessoal da doença. Inúmeros trabalhos apontam maior vulnerabilidade dos povos indígenas ao adoecimento por tuberculose em comparação com outros segmentos da população 21,22,23,24,25 , o que se agrava frente às condições de pobreza, falta ou limitação de acesso aos serviços de saúde, uso abusivo de álcool, deficiências nutricionais e presença de comorbidades 26,27 .…”

Section: Discussionunclassified

Magnitude da tuberculose pulmonar na população fronteiriça de Mato Grosso do Sul (Brasil), Paraguai e Bolívia

et al. 2014

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Este estudo analisou a magnitude da tuberculose pulmonar no período de 2007 a 2010 em municípios sul-mato-grossenses fronteiriços ao Paraguai e à Bolívia. Na região de fronteira, as taxas de incidência (49,1/100 mil habitantes), de mortalidade (4,0/100 mil) e de abandono do tratamento (11,3%) foram 1,6, 1,8 e 1,5 vez maiores do que na região não fronteiriça. Entre indígenas da fronteira, as taxas de incidência (253,4/100 mil habitantes), mortalidade (11,6/100 mil) e coinfecção por HIV (1,9/100 mil) foram, respectivamente, 6,4, 3,2 vezes e 1,9 vez maiores do que entre os não indígenas nesta região. Estar na região de fronteira revelou-se fator de proteção contra coinfecção por HIV. Constatou-se associação entre ser indígena e não abandonar o tratamento. Conclui-se que a população residente nesses municípios de fronteira vivencia elevado risco de adoecimento, de morte e de abandono do tratamento de tuberculose pulmonar, o que requer ações diferenciadas de vigilância em saúde.

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Estudo clínico-radiológico de crianças e adolescentes indígenas Suruí, Região Amazônica

Cited by 18 publications

References 12 publications

Desigualdades sociais e tuberculose: análise segundo raça/cor, Mato Grosso do Sul

Desigualdades sociais e tuberculose: análise segundo raça/cor, Mato Grosso do Sul

Agreement between QuantiFERON®-TB Gold In-Tube and the tuberculin skin test and predictors of positive test results in Warao Amerindian pediatric tuberculosis contacts

Magnitude da tuberculose pulmonar na população fronteiriça de Mato Grosso do Sul (Brasil), Paraguai e Bolívia

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