1
|
Pelissari DM, Kuhleis DC, Bartholomay P, Barreira D, Oliveira CLP, de Jesus RS, Possa LA, Jarczewski CA, Nemeth LT, de Araujo ND, Alves PBL, de Souza R, Arakaki D, Dal Molin DB, Werlang P, Brouwer M. Prevalence and screening of active tuberculosis in a prison in the South of Brazil. Int J Tuberc Lung Dis 2019; 22:1166-1171. [PMID: 30236184 DOI: 10.5588/ijtld.17.0526] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Tuberculosis (TB) remains a challenge in Brazil, particularly among prison inmates. OBJECTIVE To assess TB prevalence by active case finding in a public prison in southern Brazil. DESIGN Prison inmates were screened for TB using the presence of cough and chest X-ray (CXR) from October 2014 to August 2016. Presence of cough, irrespective of duration, and abnormal CXRs were further investigated using laboratory tests. RESULTS Of 10 326 inmates screened, 196 had confirmed TB (1898/100 000 inmates screened). At the first screening, 1759 inmates presented with cough only, 16 of whom had TB; among those with only abnormal CXR (n = 1273), 92 had TB. Xpert was positive in 155 patients, and negative in 15; these results were confirmed using culture. The remaining 26 patients did not undergo Xpert testing and were confirmed using microscopy (27%), culture (42%) or both (31%). CONCLUSION The combined use of symptom screening (cough) and CXR was much more effective in maximising TB yield than using either method alone. If patients presenting with cough alone had not been investigated, 10% of TB patients would have been missed; if those with abnormal CXR but no cough had not been investigated, 51% of TB patients would have been missed. We detected high TB prevalence in this prison by using active case finding.
Collapse
Affiliation(s)
- D M Pelissari
- National Tuberculosis Programme, Ministry of Health, Brasilia, Distrito Federal (DF), Brazil
| | - D C Kuhleis
- National Tuberculosis Programme, Ministry of Health, Brasilia, Distrito Federal (DF), Brazil
| | - P Bartholomay
- National Tuberculosis Programme, Ministry of Health, Brasilia, Distrito Federal (DF), Brazil
| | | | - C L P Oliveira
- Health Prison Team, Central Prison of Porto Alegre, Porto Alegre, Rio Grande do Sul
| | - R S de Jesus
- Health Prison Team, Central Prison of Porto Alegre, Porto Alegre, Rio Grande do Sul
| | - L A Possa
- Health Prison Team, Central Prison of Porto Alegre, Porto Alegre, Rio Grande do Sul
| | - C A Jarczewski
- State Tuberculosis Programme, State Health Secretary, Porto Alegre, Rio Grande do Sul, Brazil
| | - L T Nemeth
- EDGE Funders Alliance, Brussels, Belgium
| | - N D de Araujo
- Fundação Oswaldo Cruz, Brasilia DF, Brazil, United Nations Office of Drugs and Crime Health Development Programme, Vienna, Austria
| | - P B L Alves
- United Nations Office of Drugs and Crime Health Development Programme, Vienna, Austria, Secretaria de Estado da Segurança Pública e da Paz Social do Distrito Federal, Brasilia DF
| | - R de Souza
- National Tuberculosis Programme, Ministry of Health, Brasilia, Distrito Federal (DF), Brazil
| | - D Arakaki
- National Tuberculosis Programme, Ministry of Health, Brasilia, Distrito Federal (DF), Brazil
| | - D B Dal Molin
- Associação Hospitalar Vila Nova, Porto Alegre, Rio Grande do Sul, Brazil
| | - P Werlang
- National Tuberculosis Programme, Ministry of Health, Brasilia, Distrito Federal (DF), Brazil
| | - M Brouwer
- PHTB Consult, Tilburg, The Netherlands
| |
Collapse
|
2
|
Brito TC, Possuelo LG, Valim ARM, Todendi PF, Ribeiro AW, Gregianini TS, Jarczewski CA, Hutz MH, Rossetti MLR, Zaha A. Polymorphisms in CYP2E1, GSTM1 and GSTT1 and anti-tuberculosis drug-induced hepatotoxicity. AN ACAD BRAS CIENC 2014; 86:855-865. [PMID: 30514013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 02/17/2014] [Indexed: 06/09/2023] Open
Abstract
Anti-tuberculosis drug-induced hepatitis (ATD- induced hepatitis) has been linked to polymorphisms in genes encoding drug metabolizing enzymes. N-acetyltransferase 2 (NAT2), cytochrome P450 2E1 (CYP2E1) and glutathione S-transferase (loci GSTM1 and GSTT1) are involved in the metabolism of isoniazid, the most toxic drug for the treatment of tuberculosis (TB). This study was designed to determine the frequency and to evaluate whether polymorphisms at CYP2E1, GSTM1 and GSTT1 genes are associated with drug response, as well as to identify clinical risk factors for ATD-induced hepatitis. A total of 245 Brazilian patients undergoing treatment for TB were genotyped using polymerase chain reaction and restriction fragment length polymorphism and sequencing methods. The frequencies of the CYP2E1 polymorphic alleles RsaI, PstI and DraI are 8%, 8.5% and 12%, respectively. GSTM1 and GSTT1 genes are deleted in 42.9% and 12.4% of the population, respectively. Fifteen patients (6.1%) developed hepatotoxicity. Clinical (HIV, female sex and extrapulmonary TB) and genetic characteristics (CYP2E1 without any mutations, having NAT2 slow acetylator profile) are at higher risk of developing ATD-induced hepatitis in this population. Genotyping for GSTM1 and GSTT1 showed no influence on drug response.
Collapse
Affiliation(s)
- Tais C Brito
- Programa de Pós-Graduação em Biologia Celular e Molecular, Departamento de Biologia Molecular e Biotecnologia, Instituto de Biociências, Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul/UFRGS, Porto Alegre, RS, Brasil
| | - Lia G Possuelo
- Programa de Pós-Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, RS, Brasil
| | - Andreia R M Valim
- Programa de Pós-Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, RS, Brasil
| | - Pâmela F Todendi
- Programa de Pós-Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, RS, Brasil
| | - Andrezza W Ribeiro
- Centro de Desenvolvimento Científico e Tecnológico, Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brasil
| | - Tatiana S Gregianini
- Centro de Desenvolvimento Científico e Tecnológico, Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brasil
| | | | - Mara H Hutz
- Departamento de Genética, Universidade Federal do Rio Grande do Sul/UFRGS, Porto Alegre, RS, Brasil
| | - Maria Lucia R Rossetti
- Departamento de Biologia Molecular e Biotecnologia, IB e Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Arnaldo Zaha
- Departamento de Biologia Molecular e Biotecnologia, IB e Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| |
Collapse
|
3
|
Prellwitz IM, Alves BM, Ikeda MLR, Kuhleis D, Picon PD, Jarczewski CA, Osório MR, Sánchez A, Seuánez HN, Larouzé B, Soares MA, Soares EA. HIV behind bars: human immunodeficiency virus cluster analysis and drug resistance in a reference correctional unit from southern Brazil. PLoS One 2013; 8:e69033. [PMID: 23874857 PMCID: PMC3706441 DOI: 10.1371/journal.pone.0069033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 06/05/2013] [Indexed: 02/06/2023] Open
Abstract
People deprived of liberty in prisons are at higher risk of infection by the human immunodeficiency virus (HIV) due to their increased exposure through intravenous drug use, unprotected sexual activity, tattooing in prison and blood exposure in fights and rebellions. Yet, the contribution of intramural HIV transmission to the epidemic is scarcely known, especially in low- and middle-income settings. In this study, we surveyed 1,667 inmates incarcerated at Presídio Central de Porto Alegre, located in southern Brazil, for HIV infection and molecular characterization. The HIV seroprevalence was 6.6% (110/1,667). Further analyses were carried out on 40 HIV-seropositive inmates to assess HIV transmission clusters and drug resistance within the facility with the use of molecular and phylogenetic techniques. The molecular epidemiology of HIV-1 subtypes observed was similar to the one reported for the general population in southern Brazil, with the predominance of HIV-1 subtypes C, B, CRF31_BC and unique BC recombinants. In particular, the high rate (24%) of URF_BC found here may reflect multiple exposures of the population investigated to HIV infection. We failed to find HIV-infected inmates sharing transmission clusters with each other. Importantly, the analysis of HIV-1 pol genomic fragments evidenced high rates of HIV primary and secondary (acquired) drug resistance and an alarming proportion of virologic failure among patients under treatment, unveiling suboptimal access to antiretroviral therapy (ARV), low ARV adherence and dissemination of drug resistant HIV strains in primary infections. Our results call for immediate actions of public authority to implement preventive measures, serological screening and, for HIV-seropositive subjects, clinical and treatment follow-up in order to control HIV infection and limit the spread of drug resistance strains in Brazilian prisons.
Collapse
Affiliation(s)
| | - Brunna M. Alves
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Maria Letícia R. Ikeda
- Secretaria de Saúde de Viamão, Prefeitura de Viamão, Viamão, Brazil
- Departamento de Ensino e Pesquisa, Hospital Sanatório Partenon, Porto Alegre, Brazil
| | - Daniele Kuhleis
- Secretaria de Segurança Pública, Governo do Estado do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pedro D. Picon
- Secretaria de Segurança Pública, Governo do Estado do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carla A. Jarczewski
- Departamento de Ensino e Pesquisa, Hospital Sanatório Partenon, Porto Alegre, Brazil
| | - Marta R. Osório
- Fundação Estadual de Produção e Pesquisa em Saúde, Governo do Estado do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandra Sánchez
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Secretaria de Estado de Administração Penitenciária, Governo do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Héctor N. Seuánez
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
- Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bernard Larouzé
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- INSERM U707, Paris, France
- Université Pierre et Marie Curie - Paris 6, Paris, France
| | - Marcelo A. Soares
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
- Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Esmeralda A. Soares
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
- * E-mail:
| |
Collapse
|