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de Lucena LA, Dantas GBDS, Carneiro TV, Lacerda HG. Factors Associated with the Abandonment of Tuberculosis Treatment in Brazil: A Systematic Review. Rev Soc Bras Med Trop 2023; 56:S0037-86822023000100301. [PMID: 36700598 PMCID: PMC9870282 DOI: 10.1590/0037-8682-0155-2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/19/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis. In Brazil, TB is a public health problem, and the treatment dropout rate contributes to it. METHODS This systematic review investigated the factors associated with TB treatment dropout in Brazil using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. The databases used were Bireme, Scopus, PubMed, Medline, Pan-American Health Organization (PAHO), and Latin-American and Caribbean Literature on Health Sciences (LILACS). The search was conducted on May 16, 2021. Nine articles were reviewed, and all were published within the last 5 years in English, Spanish, or Portuguese. RESULTS The sample sizes in the studies ranged from 148 to 77,212 individuals, and the studies enrolled only adult patients (aged 18-59 years) in Brazil. Evidence suggests that the significant risk factors associated with TB treatment dropout are male sex, black race/ethnicity, age between 19 and 49 years, human immunodeficiency virus (HIV) co-infection, low education (<8 years), use of alcohol and illicit drugs, and unsupervised treatment. This study's limitations were the small number of articles published on this topic with stronger study designs, use of secondary data sources in most articles, and a moderate to high risk of bias in most papers. CONCLUSIONS There was a significant association between abandonment of TB treatment and HIV/acquired immunodeficiency syndrome co-infection; socioeconomic factors (low education and homelessness); use of alcohol, tobacco, and illicit drugs; and failure to use directly observed treatment. These results can guide more efficient measures to prevent dropout.
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Affiliation(s)
| | | | | | - Hênio Godeiro Lacerda
- Universidade Federal do Rio Grande do Norte, Departamento de Infectologia, Natal, RN, Brasil
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Soeiro VMDS, Caldas ADJM, Ferreira TF. [Abandonment of tuberculosis treatment in Brazil, 2012-2018: trend and spatiotemporal distribution]. CIENCIA & SAUDE COLETIVA 2022; 27:825-836. [PMID: 35293461 DOI: 10.1590/1413-81232022273.45132020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/09/2020] [Indexed: 11/22/2022] Open
Abstract
Ecological study that analyzes the trend and the spatiotemporal distribution of new cases of tuberculosis (TB) that abandoned treatment in Brazil, notified in the Notifiable Diseases Information System, in the period from 2012 to 2018. For the study of the trend used the Prais-Winsten generalized linear regression model was used and the Moran Global and Local indices for spatial analysis. The mean and median proportion of TB treatment dropout in Brazil was 10.4%. The highest averages of the indicator were concentrated in the Southeast (10.78 ± 1.38), South (10.70 ± 2.94) and North (10.35 ± 1.13), and; in the states of Rondônia (14.35 ± 2.34), Rio Grande do Sul (13.60 ± 4.23) and Rio de Janeiro (12.64 ± 1.73), only Acre and Piauí showed this indicator below 5%. In Brazil, there was a tendency towards stability in the proportion of abandonment of TB treatment, a decrease in the North, Northeast and South regions and only in the Federal District there was growth. There was a heterogeneous and non-random distribution, with five capitals comprising the High-Risk cluster. We conclude that the proportion of TB treatment abandonment in Brazil is above what is acceptable and that the identification of high-risk areas can contribute to the elaboration and strengthening of more specific control actions.
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Affiliation(s)
- Vanessa Moreira da Silva Soeiro
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil.
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Prado Junior JC, Medronho RDA. Spatial analysis of tuberculosis cure in primary care in Rio de Janeiro, Brazil. BMC Public Health 2021; 21:1841. [PMID: 34641849 PMCID: PMC8507316 DOI: 10.1186/s12889-021-11834-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 09/22/2021] [Indexed: 11/29/2022] Open
Abstract
Background Tuberculosis (TB) presents a high burden of disease and is considered a global emergency by the World Health Organization (WHO), as the leading cause of death from infectious disease in adults. TB incidence is related directly to access to health services and socioeconomic determinants and inequality. Providing primary care settings can lead to improved access, shorter waiting times for patients, and enhanced TB case detection. The article aims to identify the spatial and temporal risk areas for TB and the relationship between TB cure and primary healthcare coverage from 2012 to 2014 in Rio de Janeiro, Brazil. Methods A cross-sectional study was conducted in Rio de Janeiro, Brazil. All cases of TB reported to the Information System on Diseases of Notification (SINAN) from 2012 to 2014 were included. Socioeconomic variables from the 2010 Brazilian national census were also added. Socioeconomic variables were selected from multivariate analysis using principal factors analysis. Spatial association was verified with generalized additive model (GAM). It was possible to identify areas at higher risk of failure to cure TB. Results TB rates showed strong positive spatial autocorrelation. TB cure rate varied according to schooling (individuals with complete secondary schooling had higher cure rates than illiterate individuals; OR 1.72, 95% CI 1.30–2.29), alcohol consumption (OR 0.47, 95% CI 0.35–0.64), contact investigation (OR 2.00, 95% CI 1.56–2.57), positive HIV serology (OR 0.31, 95% CI 0.23–0.42), and census tracts with higher elderly rates (OR 9.39, 95% CI 1.03–85.26). Individuals who had been covered by primary healthcare (PHC) for 35 to 41 months had 1.64 higher odds of cure, compared to those with no PHC coverage (95% CI 1.07–2.51). Conclusion A comprehensive risk map was developed, allowing public health interventions. Spatial analysis allowed identifying areas with lower odds of TB cure in the city of Rio de Janeiro. TB cure was associated statistically with time of coverage by primary healthcare. TB cure rate also varied according to sociodemographic factors like schooling, alcohol abuse, and population density. This methodology can be generalized to other areas and/or other public health problems. Highlights We studied standardized municipal TB cure rates in an area of social inequality in Brazil. TB rates showed strong positive spatial autocorrelation. Higher rates were associated with population density and socioeconomic conditions. Illiterate individuals were less likely to achieve TB cure. TB cure was less likely in individuals with HIV and alcohol abuse. TB cure was greater in areas with high primary healthcare coverage.
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Affiliation(s)
- José Carlos Prado Junior
- Centro de Estudos Estratégicos, Fundação Oswaldo Cruz, Avenida Brasil 4036, 10° andar, Prédio da Expansão, Manguinhos, Rio de Janeiro, RJ, 21040-361, Brazil
| | - Roberto de Andrade Medronho
- Instituto de Estudos em Saúde Coletiva, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco, 255, 6° andar, Rio de Janeiro, RJ, 21941-913, Brazil.
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Bhering M, Sarubbi Junior V, Kritski A, Souza F, Duarte R. Multidrug-Resistant Tuberculosis in Portugal: Patients’ Perception of the Challenges Faced during Treatment. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2020. [DOI: 10.1159/000511198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> The increase in drug-resistant tuberculosis (TB) threatens global progress in eliminating TB, and constitutes a major challenge for patients, health-care workers and health services. Treatment for multidrug-resistant TB (MDR-TB) can last almost 2 years, and is more expensive, more toxic, and less effective than treating TB caused by drug-sensitive bacilli. This study aims to analyze patients’ narratives about the challenges they face during MDR-TB treatment and identify the support factors that help patients being treated in the most populous district of Portugal. <b><i>Methods:</i></b> Semi-structured interviews were conducted with patients being treated for MDR-TB. The interviews were coded using thematic analysis. They were audio-recorded, transcribed, and transported into NVivo v12 for data management and coding. <b><i>Results:</i></b> Depression, social discrimination, and the side effects of drugs are the main challenges faced by patients with MDR-TB. A good relationship of the patients with the health team, emotional support, and supervised treatment stand out as the factors that generate better adherence and treatment success. <b><i>Conclusion:</i></b> In addition to modern diagnostic techniques and new treatments, MDR-TB can be fought by focusing on the care and needs of patients. We suggest that the Lisbon Tuberculosis Program adopts the following measures: build the health-care team’s capacity to identify symptoms of depression early, increase public awareness of the disease, expand the multidisciplinary team, and expand the options for individualized social support for patients.
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Alves KKAF, Borralho LM, Araújo AJD, Bernardino ÍDM, Figueiredo TMRMD. Factors associated with recovery and the abandonment of tuberculosis treatment in the incarcerated population. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200079. [PMID: 32696931 DOI: 10.1590/1980-549720200079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/09/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the factors associated with the outcomes of recovery and abandonment in the incarcerated population with tuberculosis. METHODS A quantitative and observational analytical study was performed with data from the Notification Disease Information System (Sinan), tuberculosis data from the incarcerated population in the state of Paraiba from 2007 to 2016; Notifications of individuals over the age of 18, reported as "new cases" and the outcome, "recovery" or "abandonment" status were included. Those people who until December 2016 had no outcome information were excluded. Analyses were performed using bivariate and multivariate statistics from the Poisson regression. RESULTS Of the 614 notifications, most were male (93.8%). In the bivariate analysis, there was a statistically relevant association of outcomes with Acquired Immunodeficiency Syndrome (p = 0.044), Human Immunodeficiency Virus (HIV) serology (p = 0.048) and lack of completion of follow-up bacilloscopy (p = 0.001). In the adjusted multivariate analysis, Acquired Immunodeficiency Syndrome (RR = 1.998; 95%CI 1.078 - 3.704; p = 0.028) and lack of completion of follow-up bacilloscopy (RR = 5.251; 95%CI 2.158 - 12.583; p <0.001*) remained significantly associated with the dropout outcome. CONCLUSION Recovery and abandonment outcomes were mainly associated with whether the follow-up bacilloscopy was performed or not and Acquired Immunodeficiency Syndrome.
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Bezerra WDSP, Lemos EF, do Prado TN, Kayano LT, Zacarin de Souza S, Chaves CEV, Paniago AMM, de Souza AS, de Oliveira SMDVL. Risk Stratification and Factors Associated with Abandonment of Tuberculosis Treatment in a Secondary Referral Unit. Patient Prefer Adherence 2020; 14:2389-2397. [PMID: 33299305 PMCID: PMC7721312 DOI: 10.2147/ppa.s266475] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/25/2020] [Indexed: 12/03/2022] Open
Abstract
PURPOSE To study the factors associated with the risk of discontinuing active tuberculosis treatment among patients in an outpatient referral unit and to analyze the association between patients' abandonment risk score and their odds of discontinuing the treatment. PATIENTS AND METHODS In this cohort study, tuberculosis patients were prospectively followed up from June 2012 through July 2019 at a secondary tuberculosis referral unit in Mato Grosso do Sul, Brazil. At initial consultation, patients were interviewed using a standardized questionnaire and were assigned a score for the risk of treatment abandonment by the nurse. Univariate and multivariate analyses were performed using logistic regression. RESULTS One hundred and forty-eight patients were included in the study, of which 65.0% (96/148) were male. Their mean age was 43.3 ± 14.8 years (range: 18-89 years). Smoking, drug use, repeated admissions, and a high abandonment risk score were the variables associated with the highest risk of discontinuing the treatment. The rate of tuberculosis and human immunodeficiency virus coinfection was 37.2%. The overall rate of global treatment abandonment was 10.8% (95% confidence interval [CI]: 6.1-16.2). Upon stratification of patients that abandoned by the risk score, 22.9% (8/35) of the ones that abandoned had a high risk, 10.9% (6/55) had an intermediate risk, and 3.5% (2/58) had a low risk of treatment abandonment. In multivariate analysis, the factors associated with abandoning the treatment were smoking [adjusted odds ratio (aOR) = 4.91 (95% CI: 1.08, 22.32)] and undergoing retreatment (aOR) = 3.66 (95% CI: 1.04, 12 88). CONCLUSION Smoking and undergoing retreatment were independent risk factors for tuberculosis treatment abandonment in this center. Risk stratification can help prioritize the strengthening of treatment adherence among patients at higher risk of abandoning treatment in referral units.
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Affiliation(s)
- Wanessa da Silva Peres Bezerra
- Postgraduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Everton Ferreira Lemos
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Larissa Taemy Kayano
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Stefany Zacarin de Souza
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Cláudia Elizabeth Volpe Chaves
- Postgraduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Maria Aparecida Pedrossian University Hospital, EBSERH, Campo Grande, Mato Grosso do Sul, Brazil
| | - Anamaria Mello Miranda Paniago
- Postgraduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Maria Aparecida Pedrossian University Hospital, EBSERH, Campo Grande, Mato Grosso do Sul, Brazil
| | - Albert Schiaveto de Souza
- Biosciences Institute, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Postgraduate Program in Family Health, Biosciences Institute, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Sandra Maria do Valle Leone de Oliveira
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Maria Aparecida Pedrossian University Hospital, EBSERH, Campo Grande, Mato Grosso do Sul, Brazil
- Postgraduate Program in Family Health, Biosciences Institute, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Correspondence: Sandra Maria do Valle Leone de Oliveira School of Medicine, Federal University of Mato Grosso do Sul, Cidade Universitária, Caixa Postal 549, Unidade 9, Campo GrandeCEP 79070-900Mato Grosso do Sul, BrazilTel +55 67 3345 7370 Email
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Silva ÉA, Da Silva GA, Leite ICG, Araújo CR, Correia BAS, De Souza INA. Perfil dos casos de abandono do tratamento da tuberculose em um município prioritário mineiro. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2018.v44.16924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: tuberculose é uma doença milenar que ainda constitui um grande problema de saúde pública. É legítima a necessidade de consideração das implicações sociais e epidemiológicas que a TB possui, para o alcance da sua prevenção e controle., e mesmo diante dos esforços já instituídos, o abandono do tratamento da tuberculose tem se tornado cada vez mais frequente. Objetivo: Descrever o perfil dos casos de s abandono do tratamento da tuberculose em um município prioritário mineiro, no período de 2008 a 2017, compreendendo fatores sociodemográficos, clínicos e comportamentais dos indivíduos e do tratamento. Material e Métodos: Trata-se de um estudo do tipo ecológico do tipo série temporal, realizado mediante consulta de dados secundários disponíveis no Sistema de Informações de Agravos e Notificação (SINAN). Os dados obtidos foram armazenados e consolidados para cálculo de frequência absoluta e relativa e representados nas tabelas. Resultados: Foram registrados 554 casos de abandono do tratamento de tuberculose, com predomínio do sexo masculino, faixa etária de 30 a 49 anos, pretos, com nível de escolaridade fundamental incompleto, apresentando tuberculose em forma pulmonar, HIV negativos, etilistas e usuários de droga. Entre os casos de abandono há preeminência do HIV negativo, baixa realização de testagem HIV, não realização de tratamento diretamente observado, sendo o serviço de referência especializada como a unidade de acompanhamento da condição de saúde. Conclusão: O perfil encontrado é consoante com os indivíduos de maiores taxas de incidência da doença, bem como com os mais elevados índices de mortalidade pela tuberculose em todo o território nacional. O nível de escolaridade do indivíduo apresentou-se como uma característica importante no seguimento do tratamento, assim como a realização do tratamento observado.
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The Perspectives of Patients and Health Professionals Regarding the Tuberculosis Control Programme in Recife, Brazil: A Contribution to Evaluation. PHARMACY 2019; 7:pharmacy7020070. [PMID: 31248173 PMCID: PMC6631100 DOI: 10.3390/pharmacy7020070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/14/2019] [Accepted: 05/29/2019] [Indexed: 11/23/2022] Open
Abstract
The study objective is to describe patients and professionals’ perspectives on the Tuberculosis Control Program (PCT) in Recife, Brazil, contributing to the program evaluation. A cross-sectional study was conducted in three purposively selected sites, representing the three levels of care in the public health system. All eligible PCT patients in sites A, B and C were invited to participate (n = 123). Physicians, nurses, pharmacists and community health agents providing care to PCT patients in these sites, plus their managers, were purposively selected. Data were collected by means of interviews with 44 patients and a questionnaire to 24 professionals. Instruments encompassed previously published items to capture stakeholders’ perspectives (16 and 12 closed-questions, respectively), grouped into categories. The overall evaluation by patients was unsatisfactory (median score 35%; third quartile below 50%; interquartile range 21.9%). Analysis of scores by categories showed that opinions about organizational accessibility were significantly worse than about economic and geographical accessibility, taken together. Overall the median score attributed by professionals was 52% (third quartile below 65%). Professionals had significantly worse opinions about diagnosis, clinical and laboratory assistance. Patients and professionals’ perspectives highlight potential opportunities for improvement. Our findings can be used by managers as a starting point for shared decision-making, potentially contributing to a better performance of the PCT in Recife and, consequently, reducing the risk posed by tuberculosis.
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Silva TC, Matsuoka PDFS, Aquino DMCD, Caldas ADJM. Factors associated with tuberculosis retreatment in priority districts of Maranhão, Brazil. CIENCIA & SAUDE COLETIVA 2017; 22:4095-4104. [PMID: 29267726 DOI: 10.1590/1413-812320172212.20612015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 04/28/2016] [Indexed: 11/22/2022] Open
Abstract
This study investigated factors associated with cases of tuberculosis retreatment due to relapse and readmission after treatment abandonment. This is an analytical cross-sectional study type of cases reported in the Information System for Notifiable Diseases in priority municipalities in the State of Maranhão, from January 2005 to December 2010. A logistic regression model was used to identify the association. Patients aged between 40 and 59 years (OR = 1.49, p = 0.029) with a pulmonary clinical form (OR = 2.79, p = 0.016) were more likely to incur relapse. Readmissions after abandonment were more likely in males (OR = 1.53, p = 0.046), aged between 20 and 39 years (OR = 1.65, p = 0.007), with less than eight years of schooling (OR = 2.01, p = 0.037) and with alcohol dependence (OR=1.66, p = 0.037), which showed a higher probability of another abandonment (OR = 5.96, p < 0.001). These data reinforce the need for strategies aimed at this group, such as increased supervised treatment, intensified active search, post-discharge follow-up and health education action.
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Affiliation(s)
- Tereza Cristina Silva
- Departamento Acadêmico de Biologia, Instituto Federal de Educação Ciência e Tecnologia do Maranhão. Av. Getúlio Vargas 4, Monte Castelo. 65030-005 São Luís MA Brasil.
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Ferreira JT, Engstrom EM. Estigma, medo e perigo: representações sociais de usuários e/ou traficantes de drogas acometidos por tuberculose e profissionais de saúde na atenção básica. SAUDE E SOCIEDADE 2017. [DOI: 10.1590/s0104-12902017155759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Este artigo apresenta e discute dados de uma pesquisa realizada nas comunidades de Manguinhos, município do Rio de Janeiro, sobre o tratamento da tuberculose no contexto de violência urbana. Para isso, toma-se como base as teorias das ciências sociais e humanas. O estudo aborda as representações sociais que influíram na interação entre os atores envolvidos nesse processo, profissionais de saúde e doentes acometidos por tuberculose e usuários e/ou traficantes de drogas, como resultado de construções históricas e contradições sociais determinadas pelo contexto social de violência em que estavam inseridos. O método da pesquisa foi qualitativo, com entrevistas semidiretivas que seguiram um roteiro etnográfico. A interpretação das respostas buscou significados a partir de categorias temáticas, visando sua articulação em categorias mais amplas. Os achados revelaram que as interações entre os usuários e os profissionais de saúde eram determinadas pela forma de perigo, medo e estigma em relação à tuberculose e violência.
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Belchior ADS, Arcêncio RA, Mainbourg EMT. Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default. Rev Esc Enferm USP 2016; 50:622-627. [DOI: 10.1590/s0080-623420160000500012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 05/30/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract OBJECTIVE To identify the socioeconomic and clinical-epidemiological factors related to tuberculosis in new cases and retreatment cases. METHOD Comparative study with 126 patients, of which 42 were retreatment cases after default attended in a reference center, and 84 were new cases completing the first treatment and treated in Basic Health Units. The collection of primary data was through interview, and of secondary data by records of the Notifiable Diseases Information System. Comparative analysis between the two groups. RESULTS The new cases differ from retreatment cases regarding educational level. The clinical-epidemiological profile shows a significant difference in relation to performance of the tuberculin skin test, and the HIV test result (positive) in favor of new cases. In relation to performance of sputum culture and the result (positive) of the first sputum smear of the first and second samples, in favor of retreatment cases. CONCLUSION The two groups are significantly different in clinical and epidemiological characteristics that show the access to exams.
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Lima LMD, Harter J, Tomberg JO, Vieira DA, Antunes ML, Cardozo-Gonzales RI. Monitoring and assessment of outcome in cases of tuberculosis in a municipality of Southern Brazil. ACTA ACUST UNITED AC 2016; 37:e51467. [PMID: 26934610 DOI: 10.1590/1983-1447.2016.01.51467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 12/16/2015] [Indexed: 11/22/2022]
Abstract
Objectives To monitor and assess the outcome of treatment for pulmonary tuberculosis in the tuberculosis control program in a prioritized municipality in Southern Brazil. Methods a quantitative study, descriptive, documentary, using records of people with tuberculosis in treatment between 2009-2013, the collection took place between June and July 2014 in the Tuberculosis Control Program. Descriptive statistics was used. Results The average number of consultations among the 629 patients was 7.2 per patient, with a mean interval of 1.03 months between visits. The average of smears was 2.7 tests per patient during the study period. The outcome of treatment was a cure rate of 87.8%, an abandonment rate of 8.3% and 6.5% of deaths. Conclusions despite the cure rate, abandonment is still high, thus, it is necessary to explore strategies for better adherence to treatment, and the commitment of the municipal administration in articulating monitoring in primary health care.
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Affiliation(s)
| | - Jenifer Harter
- Universidade Federal do Pampa, Rio Grande do Sul, Brasil
| | | | | | - Muriel Lucero Antunes
- Faculdade de Enfermagem, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brasil
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