Tuberculosis and HIV among homeless persons in Rio de Janeiro

Abstract

Background Tuberculosis is the first cause of death among infectious diseases worldwide (WHO, 2019). People with HIV have 28 times more chances to be infected with TB (MS, 2018) and it represents 29% of the TB deaths in Brazil (SANTOS, 2018). In 2017, the TB incidence ratio in HIV+ patiences was 5.3 out of 100.000 inhabtants in Brazil WHO, 2019). Among homeless persons, socially excluded and disregarded by the public authorities, the scenario of these diseases are even worse, considering that the greater exposure of TB occurs in people with lower incomes (UN, 2016), more vulnerable at the social and programmatic level. The aim of this article is to present the epidemiological profile for TB and HIV infection in homeless persons in the city of Rio de Janeiro between 2014 until 2018. Methods The data to this research are of public acess from 2014 to 2018 for the analysis of vulnerability factors in the notification form for TB and HIV in homeless persons. The data are originate from SINAN NET provided by the Rio de Janeiro Municipal Health Department. Results and Conclusions There were 1644 notifications for TB, among whom 15.8% had AIDS co-infection and 15,9% had HIV co-infection. Co-infected with TB and HIV 45,5% were brown people, followed by 36.2% black and 18.3% white. Among the homeless people with TB and HIV co-infection (262), were in the 20 to 39 age group 58%, followed by 37.4% in the 40 to 59 age group. Among the TB notifications, 30,8% achieved a cure, 60,4% abandoned treatment and 4,2% died due to TB. General speaking about the city population, the proportion of TB/AIDS coinfection in Rio de Janeiro is 11,5% and 12,2% for TB and HIV. Brown people (41,7%) between 20 and 39 years old (91,2%) were the majority infected as well. About the outcome, 65,8% achieved cure, 12,4% abandoned treatment and 3,5% died from TB. According to the analyzed data, homeless persons presents worst results when compared to the general citizens of Rio de Janeiro. Key messages Homeless persons presents worst TB and HIV results when compared to the general citizens of Rio de Janeiro. Study of witch social vulnerabilities are associated with this health conditions.

Perfil sociodemográfico das pessoas em situação de rua notificadas com tuberculose no Município do Rio de Janeiro, Brasil, nos anos de 2015 a 2019

“…Entre as PSR, em que se verifica esse mesmo perfil, há também maior chance de abandono de tratamento para TB entre negros. Os resultados também mostram prognóstico desfavorável quanto aos desfechos possíveis para o acometimento pela TB, o que condiz com achados de outros estudos realizados recentemente 14,15,17 , principalmente quando comparados à população geral da cidade do Rio de Janeiro 30 . A alta porcentagem de coinfecção por TB e HIV e a forma de manifestação desse agravo são preocupantes devido à associação desses fatores com desfechos de abandono e óbito 26 .…”

Associations of bullying victimisation in different frequencies and types with suicidal behaviours among school-going adolescents in low- and middle-income countries

“…Moreover, the rate of suicidal behaviours among teenagers in Southeast Asia was significantly lower, while the highest incidence was in African countries, where information on suicidal behaviours and mental health is particularly lacking. Research and public health efforts are mainly directed towards infectious diseases such as tuberculosis, malaria and AIDS (Uchechukwu et al ., 2019 ; Gioseffi and Brignol, 2020 ). Thus, the socioeconomic and cultural context for suicide in different areas should be mentioned, and the limited availability or low utilisation of mental health systems could contribute to the reduced detection of mental disorders that can lead to suicide (Knipe et al ., 2017 ).…”