A multilevel analysis of tuberculosisassociated factors

Gonçalves, Maria Jacirema Ferreira; Leon, Antonio Carlos Ponce de; Penna, Maria Lúcia Fernandes

doi:10.1590/s0124-00642009000600008

Cited by 7 publications

(9 citation statements)

References 9 publications

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“…TB is considered a disease of poverty, and its distribution has been traditionally associated with different types of factors, ranging from individual characteristics and living conditions, to the characteristics of the place of residence. In the same way, it is believed that different types of factors influence adherence to treatment 15,16,17,18 .…”

Section: Introductionmentioning

confidence: 99%

“…For this reason, the identification of personal characteristics and environmental characteristics connected with the place of residence of patients can advance our understanding of the social determinants of nonadherence to TB treatment 17,18,19 . To date, only one article, encompassing a narrow spectrum of risk factors for dropping out of treatment, has addressed this issue in Argentina 5 .…”

Section: Introductionmentioning

confidence: 99%

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Social determinants of nonadherence to tuberculosis treatment in Buenos Aires, Argentina

et al. 2015

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This study aimed to identify the individual and environmental determinants of nonadherence to tuberculosis (TB) treatment in selected districts in the Buenos Aires Metropolitan Area, in Argentina. We conducted a cross-sectional study using a hierarchical model. Using primary and secondary data, logistic regression was performed to analyze two types of determinants. The likelihood of nonadherence to treatment was greatest among male patients. The following factors led to a greater likelihood of nonadherence to treatment: patients living in a home without running water; head of household without medical insurance; need to use more than one means of transport to reach the health center; place of residence in an area with a high proportion of households connected to the natural gas network; place of residence in an area where a large proportion of families fall below the minimum threshold of subsistence capacity; place of residence in an area where a high proportion of households do not have flushing toilets and basic sanitation. Our results show that social and economic factors – related to both individual and environmental characteristics – influence adherence to TB treatment.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Social determinants of nonadherence to tuberculosis treatment in Buenos Aires, Argentina

et al. 2015

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“…Em que pese a tendência de concentração dos casos de TB em aglomerados urbanos (Gonçalves et al 2009;Hijjar et al 2007), a centralização das ações do PCT na área urbana de Coari pode ter contribuído para ampliar essa diferença. O acesso do usuário da zona rural é dificultado pelas características amazônicas; em alguns casos, a pessoa precisa percorrer, viajando em pequenos barcos durante vários dias, cerca de 51 km para chegar ao atendimento na cidade (Vásquez 2008).…”

Section: Resultsunclassified

Avaliação do programa de controle da tuberculose em cenário Amazônico: desafios em Coari

2013

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RESUMOPesquisa avaliativa, tipo estudo de caso, do contexto e grau de implantação do Programa de Controle da Tuberculose (PCT) no município de Coari, Amazonas, 2001. As técnicas de pesquisa conjugaram abordagens quantitativa e qualitativa, com uso de modelo lógico e matriz de julgamento. O componente quantitativo utilizou dados do Sistema de Informação de Agravos de Notificação e dados populacionais do Departamento de Informática do Sistema Único de Saúde. As variáveis foram, idade, sexo, forma clínica, procedência, tipo de entrada, meios diagnósticos e situação de encerramento. Para a população foram feitos cálculos de interpolação geométrica, por faixa etária, sexo e procedência (urbana e rural). O componente qualitativo combinou técnicas e fontes: pesquisa documental; observação e entrevista. O modelo lógico propiciou o entendimento da estrutura, processo e resultado do PCT; e a matriz de julgamento permitiu identificar o grau de implantação. A taxa média de incidência da tuberculose na área urbana foi 27 casos por 100.000 habitantes e de 9,4 por 100.000 habitantes na área rural, com razão masculino/feminino de 1,6. A avaliação do contexto externo, vigilância epidemiológica e operacionalização do PCT mostrou grau de implantação intermediário. No contexto organizacional, estrutura física das Unidades Saúde, recursos humanos e efetividade, o resultado foi incipiente. No geral, o grau de implantação foi intermediário. A flutuação nas notificações e taxas anuais de incidência, associada ao não cumprimento das metas do PCT, à desarticulação entre o PCT e o restante da atenção básica e à não interiorização da assistência indicam sérias dificuldades na operacionalização das ações de controle da tuberculose. Research techniques combined quantitative and qualitative approaches, using a logical model and a judgment matrix. The quantitative component used data from the Information System for Notifiable Diseases and Population Data from the Department of the Brazilian National Health System. The variables assessed were age, sex, clinical form, origin area, type of entry, diagnostic and outcome. For population there were calculated geometric interpolation, by age, gender and residence (urban or rural). The qualitative component combined techniques and sources: documentary research and observation and interview. The logical model led to the understanding of the structure, process and outcome of the PCT, and with the judgment matrix we identified the degree of implementation. The mean tuberculosis incidence was 27 cases per 100.000 inhabitants in urban area, and 9.4 per 100,000 in rural area, with a male / female ratio of 1.6. The external context assessment, surveillance and operation of the PCT showed intermediate degree of implementation. In the organizational context, the physical structure of the Health Units, human resources and effectiveness, the result was incipient. In general, the level of implementation was intermediate. Oscillations in notifications and annual rates of incidence indicate serious difficulties in ...

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“…In the state of Amazonas and in the city of Manaus, this incidence is particularly high, with rates of 73.5 and 81.7 per 100,000 individuals, respectively, in 2006. 7,8 Excisional lymph node biopsy, followed by histopathology, acid-fast staining and mycobacterial culture, is the diagnostic procedure of choice. Sensitivity with rapid direct microscopy is low and culture takes 3 to 6 weeks.…”

Section: Introductionmentioning

confidence: 99%

“…Pathologist at the Amazonas Foundation of Tropical Medicine (FMTAM), Manaus, Amazonas, Brazil. 7 PhD. Investigator at the Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil.…”

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confidence: 99%

HIV-associated tuberculous lymphadenitis: the importance of polymerase chain reaction (PCR) as a complementary tool for the diagnosis of tuberculosis - a study of 104 patients

Cortez

Oliveira

Monte

et al. 2011

An. Bras. Dermatol.

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BACKGROUND: Lymphadenitis is common in HIV-positive patients. Diagnosis of the infections associated with this condition is complex, particularly in the case of tuberculosis. Rapid and specific detection of Mycobacterium tuberculosis (M. tuberculosis) is fundamental in ensuring adequate treatment. In addition, frequent causes of lymphadenitis such as those associated with lymphoma and histoplasmosis, among others, must be eliminated as possible causes. OBJECTIVES: To evaluate the accuracy of polymerase chain reaction as a tool for the diagnosis of lymphadenitis resulting from M. tuberculosis. METHODS: In this study, a protocol was developed using the following procedures: direct microscopy using Ziehl-Neelsen staining, culture in Lowenstein-Jensen medium, histology and polymerase chain reaction. RESULTS: A total of 104 patients were included in the study. According to histopathology, 38 patients (36%) were found to have nonspecific chronic lymphadenitis, 27 (26%) had tuberculous lymphadenitis, 11 patients (10.5%) had lymphoma and 9 (8.7%) had histoplasmosis. When Lowenstein-Jensen culture was performed, positive tests for tuberculous lymphadenitis increased by 30%. With polymerase chain reaction, M. tuberculosis DNA was detected in 6 out of 38 samples of non-specific chronic lymphadenitis. Three of these patients were followed up, developed symptoms of tuberculosis and were cured following specific treatment. CONCLUSION: The data obtained in this study suggest that all cases of lymphadenopathies should be submitted to histopathology, Lowenstein-Jensen or Ogawa culture and polymerase chain reaction. Polymerase chain reaction may prove to be useful in providing an early and accurate detection of cases of extrapulmonary tuberculosis in HIV-positive patients with lymphadenopathies, avoiding empirical treatment and the possible development of resistant strains.

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A multilevel analysis of tuberculosisassociated factors

Cited by 7 publications

References 9 publications

Social determinants of nonadherence to tuberculosis treatment in Buenos Aires, Argentina

Social determinants of nonadherence to tuberculosis treatment in Buenos Aires, Argentina

Avaliação do programa de controle da tuberculose em cenário Amazônico: desafios em Coari

HIV-associated tuberculous lymphadenitis: the importance of polymerase chain reaction (PCR) as a complementary tool for the diagnosis of tuberculosis - a study of 104 patients

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