Abandono do tratamento de tuberculose utilizando-se as estratégias tratamento auto-administrado ou tratamento supervisionado no Programa Municipal de Carapicuíba, São Paulo, Brasil

Abstract

Objective: To determine treatment noncompliance rates among patients participating in a municipal tuberculosis control program and to identify the variables related to noncompliance depending on the type of treatment strategy used. Methods: A longitudinal non-concurrent cohort study was carried out involving two cohorts of patients participating in the Tuberculosis Control Program of the city of Carapicuíba, Brazil. The first cohort comprised 173 patients with tuberculosis treated from January 1, 2003 to December 31, 2003 using self administration of treatment, and the second comprised 187 patients with tuberculosis treated from July 1, 2004 to June 30, 2005 using the directly observed therapy, short-course strategy. Results: Noncompliance rates decreased from 13.3% (self administration of treatment) to 5.9% (directly observed therapy, short-course), a significant difference (p < 0.05). For the self administration of treatment strategy, the variables significantly associated with treatment noncompliance were as follows: being an unregistered worker (relative risk [RR] = 3.06); retreatment (RR = 2.73); alcoholism (RR = 3.10); and no investigation of contacts (RR = 8.94). For the directly observed therapy, short-course strategy, no variables were significantly associated with noncompliance. Conclusion: The directly observed therapy, short-course strategy decreased noncompliance rates and produced better treatment outcomes, even when the risk factors for noncompliance were the same.

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

“…Ferreira et al 19 também encontraram que a maioria dos pacientes desiste do tratamento ainda no seu início, em média aos 2,7 meses de tratamento. Alguns autores 15,20 associam o abandono à época em que os sinais e sintomas desaparecem. Essa melhora clínica nos primeiros meses de tratamento induz o paciente a se autodeterminar curado, levando-o muitas vezes ao abandono do tratamento.…”

Knowledge as a factor in vulnerability to tuberculosis among nursing students and professionals

“…Los resultados determinan necesidad de inversión en tal asunto por parte de instituciones médico-asistenciales, considerando el papel desempeñado por la enfermería en estrategias de prevención y control de la enfermedad. (1) , such as unemployment, unhealthy housing conditions, spread of aids and others (2) . Although strongly associated with unfavorable socioeconomic conditions, knowledge about TB and the propagation of misinformation, myths and stereotypes have been indicated as possible factors associated with vulnerability to the disease (3) .…”

Abandono Da Terapia Do Tratamento Da Tuberculose Multirresistente: Desafios Para Os Profissionais Da Saúde

“…Vinte por cento dos casos de doença foram encontrados na faixa acima de 61 anos, confirmando que o aumento na expectativa de vida da população tem alterado o perfil de faixa etária dos casos de tuberculose, aumentando sua ocorrência entre os idosos (2,16,28) . A localização pulmonar é a forma mais comum da TBMR corroborada no presente estudo, no qual 87,5% dos pacientes que apresentaram a forma da doença tinham a forma pulmonar (29,(30)(31) .…”