Análise do tratamento da tuberculose pulmonar em idosos de um hospital universitário do Rio de Janeiro, RJ, Brasil

Filho, João Paulo Cantalice; Bóia, Márcio Neves; Sant’Anna, Clemax Couto

doi:10.1590/s1806-37132007000600013

Cited by 16 publications

(9 citation statements)

References 15 publications

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“…Elderly patients have been repeatedly reported to have a lower treatment completion rate [9], [10]. According to our respondents, elderly patients are less health conscious than younger patients, so they have to put extra effort into convincing elderly patients to seek diagnosis and complete the treatment.…”

Section: Discussionmentioning

confidence: 99%

Population Aging and Migrant Workers: Bottlenecks in Tuberculosis Control in Rural China

Bele

Jiang²,

Lü

et al. 2014

PLoS ONE

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BackgroundTuberculosis is a serious global health problem. Its paradigms are shifting through time, especially in rapidly developing countries such as China. Health providers in China are at the forefront of the battle against tuberculosis; however, there are few empirical studies on health providers' perspectives on the challenges they face in tuberculosis control at the county level in China. This study was conducted among health providers to explore their experiences with tuberculosis control in order to identify bottlenecks and emerging challenges in controlling tuberculosis in rural China.MethodsA qualitative approach was used. Semi-structured, in-depth interviews were conducted with 17 health providers working in various positions within the health system of one rural county (ZJG) of China. Data were analyzed based on thematic content analysis using MAXQDA 10 qualitative data analysis software.ResultsHealth providers reported several problems in tuberculosis control in ZJG county. Migrant workers and the elderly were repeatedly documented as the main obstacles in effective tuberculosis control in the county. At a personal level, doctors showed their frustration with the lack of new drugs for treating tuberculosis patients, and their opinions varied regarding incentives for referring patients.ConclusionThe results suggest that several problems still remain for controlling tuberculosis in rural China. Tuberculosis control efforts need to make reaching the most vulnerable populations a priority and encourage local health providers to adopt innovative practices in the local context based on national guidelines to achieve the best results. Considerable changes in China's National Tuberculosis Control Program are needed to tackle these emerging challenges faced by health workers at the county level.

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Section: Discussionmentioning

confidence: 99%

Population Aging and Migrant Workers: Bottlenecks in Tuberculosis Control in Rural China

Bele

Jiang²,

Lü

et al. 2014

PLoS ONE

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“…Moreover, age-related factors have been found to enhance the susceptibility to TB infection, abetting outbreaks in institutionalized settings [12]–[13]. To date, several published studies have reported on TB and its treatment outcomes in the elderly in India, Taiwan, Hong Kong, U.S.A, Mexico, Brazil and Germany [3]–[4], [10]–[12], [14]–[18]. Data from African populations have been scarce [19].…”

Section: Introductionmentioning

confidence: 99%

Profile and Treatment Outcomes of Tuberculosis in the Elderly in Southeastern Nigeria, 2011–2012

Oshi

Alobu³

et al. 2014

PLoS ONE

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BackgroundThe demographic transition and increasing life expectancy in Africa has lead to a rising elderly population. In Nigeria, little is known about the profile of and treatment outcomes of tuberculosis (TB) in the elderly.MethodsRetrospective cohort study of adult TB patients treated between January 2011 and December 2012 in two large health facilities in Nigeria. The demographic, clinical and treatment outcomes of patients aged 60 and older were compared with those aged 15 to 59 years.ResultsElderly (≥60 years) TB patients accounted for 12.7% of all (1668) adult TB enrolled. Elderly patients had a higher proportion of men compared to non-elderly (64.2% vs 56.8%; p = 0.043); but a lower proportion of smear-positive TB at baseline (40.7% vs 65.8%; p<0.001). A higher proportion of elderly patients failed to smear convert after the intensive phase of treatment (23.7% vs 19.8%; p = 0.06), and overall elderly patients had lower treatment success rates (68.9% vs 77.1%; p = 0.009). Unsuccessful outcomes were mainly due to higher default and deaths in the elderly. The risk factors for unsuccessful outcomes in the elderly were: extrapulmonary TB case (adjusted odds ratio (aOR) 10.9; 95% confidence interval (CI) 1.1–108), and HIV co-infection (aOR 3.6; CI 1.1–11.7).ConclusionsTreatment outcomes of elderly TB patients were inferior to non-elderly adults with higher death and default rates being implicated. With the rising elderly population, specific strategies are needed to quickly address TB management in the elderly in resource-limited settings.

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“…And simultaneously, the decrease of the effectiveness of the immune system, unhealthy housing, overlapping debilitating chronic diseases, difficult access to health services and the atypical clinical frame delay early diagnosis, which can aggravate the condition [6][7].…”

Section: Introductionmentioning

confidence: 99%

“…In Brazil, it is estimated that by 2025 the number of elderly will reach 32 million, being the increase of this population a conditioning factor for those elderly who acquire and spread diseases of infectious nature, such as the TB [6][7]. Magnification of life expectancy is another aspect that promotes the presence of TB in the elderly population.…”

Section: Introductionmentioning

confidence: 99%

Profile Of Elderly Diagnosed With Tuberculosis In A Reference Hospital In Brazil

Lima

Araüjo²,

Trigueiro³

et al. 2016

Int Arch Med

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Introduction: The increase in life expectancy shall be related to the higher number of tuberculosis cases, which, in spite of its curableness, still stand as a major challenge for public healthcare in several countries. Objective:We sought to characterize the profile of elderly with the referred disease diagnosed in a reference hospital, residents of the city of João Pessoa-Paraíba-Brazil. Method:It was a documental, descriptive, retrospective study with a quantitative approach which utilized the Epiinfo software, version 3.3.1 so as to systematize the data. Results:The sample includes 169 diagnosis records of elderly with pulmonic tuberculosis, between the years of 2011 and 2013, of whom 6.5% are residents of the city of Bayeux, 12.4% Santa Rita, 3.6% Cabedelo, and 77.5% João Pessoa; The majority were male (65.1%), married (54.5%), with low education background (32.5%), non-institutionalized (79.9%), and actives (47.9%); of those, 32.5% were directed to reference service by another hospital unit. Among the associated comorbidities, we highlight alcoholism (25.5) and smoking (27.3%). Diabetes had higher rates in females (39.0%). The relevant symptom was coughing (66.1%); As for the closure, only 55.0% of the elderly IntroductionTuberculosis (TB) is undoubtedly a curable disease since the last century, as it has free and effective treatment. However, the grievance remains as one of the major challenges for public health in several countries, establishing a close relation between the social conditions of life, being considered one of the leading causes of death from infectious diseases [1].In the world, the 2013 epidemiological data report 9 million people with TB and 1 million deaths due to the disease [2]. Brazil´s data point outs the prevalence of 40.7 cases/100.000 thousand inhabitants. Among the locations in Brazil, Paraiba specifically expresses an incidence rate of 30.7/100.000 thousand inhabitants, being considered the 14 th Brazilian state with the highest number of notifications, especially for men, people in the range of 20 to 29 years and prevalence of pulmonary form [3][4][5].Parallel to the constancy of TB in society, the world goes through the process of demographic transition, characterized by the decrease of fertility and mortality rates, resulting in increased life expectancy. In Brazil, it is estimated that by 2025 the number of elderly will reach 32 million, being the increase of this population a conditioning factor for those elderly who acquire and spread diseases of infectious nature, such as the TB [6][7]. Magnification of life expectancy is another aspect that promotes the presence of TB in the elderly population. It is seen that the cases in people older than 60 in Brazil increased significantly, having late diagnosis due to the common comorbidities in this age range, which generates greater susceptibility of people who age with the illness and probability of death from TB [8][9].In addition to that, problems related to the aging process, like the changes in speech and memory, hi...

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Análise do tratamento da tuberculose pulmonar em idosos de um hospital universitário do Rio de Janeiro, RJ, Brasil

Cited by 16 publications

References 15 publications

Population Aging and Migrant Workers: Bottlenecks in Tuberculosis Control in Rural China

Population Aging and Migrant Workers: Bottlenecks in Tuberculosis Control in Rural China

Profile and Treatment Outcomes of Tuberculosis in the Elderly in Southeastern Nigeria, 2011–2012

Profile Of Elderly Diagnosed With Tuberculosis In A Reference Hospital In Brazil

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