Epidemiological profile of tuberculosis infection and disease among cocaine users admitted to hospitals of the Greater São Paulo city

OBJECTIVE: To evaluate the prevalence and the risk factors for tuberculosis (TB) infection and disease among hospitalized cocaine users. METHOD: A cross-sectional study performed on a sample of 440 addicts over 18 years of age, admitted to hospitals of the metropolitan area of the Greater São Paulo city, whose clinical conditions allowed them to answer a standard questionnaire, and who agreed to participate in the study. The prevalence of TB infection was assessed through positive tuberculin testing (PPD), and of TB disease by the finding of M. tuberculosis in the sputum of patients with respiratory symptoms. RESULTS: Respiratory symptoms were present in 21% of the patients, the most frequent being weight loss and cough, which disappeared when cocaine use was discontinued. The general prevalence of TB infection was 28%. The prevalence of TB disease was 0.6%. The factors which were associated with positive PPD were: age, color/race, time spent in prison, and drug use in prison. CONCLUSION: No increased prevalence of TB infection and disease was found in these patients. Older addicts had a higher probability of having TB infection, and so had those who had been in prison

A infecção tuberculosa e o tempo de prisão da população carcerária dos Distritos Policiais da zona oeste da cidade de São Paulo Tuberculosis infection and the length of stay of County Jails prisoners in the western sector of the city of São Paulo

INTRODUÇÃO: A tuberculose sempre foi um grave problema de saúde para grupos de pessoas confinadas, especialmente em presídios, devido à sua transmissão respiratória. OBJETIVO: Verificar a associação entre o tempo de prisão e a taxa de infecção tuberculosa na população carcerária dos Distritos Policiais da zona oeste da cidade de São Paulo. METODOLOGIA:Foi realizado um estudo observacional, no período de março de 2000 a maio de 2001, com a aplicação de um inquérito individual e da prova tuberculínica (PPD-RT23 - 2UT/0.1ml) nos detentos. RESULTADOS E DISCUSSÃO: Do total de 1.052 presos entrevistados, 932 concordaram em fazer a prova tuberculínica e, destes, 64,5% estavam infectados. Para as análises, os detentos foram classificados como primários e reincidentes e como não reatores e reatores à prova tuberculínica, segundo o tempo de prisão. Entre os 134 detentos primários que estavam presos há menos de 60 dias, 40,3% foram reatores ao PPD e dos 53 com mais de 366 dias de prisão a percentagem de reatores foi de 62,3%. Entre os 146 detentos reincidentes presos há menos de 60 dias, 72,6% foram reatores ao PPD e dos 25 com mais de 366 dias de prisão, 100,0% estava infectado. Em todos os períodos de permanência na prisão, os detentos reincidentes tiveram maior percentagem de infecção tuberculosa do que os detentos primários. A associação entre tempo de prisão e reatividade ao PPD foi confirmada pelo Teste de Tendência (p<0.001) do programa Epi-Info-6. CONCLUSÕES:Quanto maior o tempo de prisão, maior a taxa de infecção tuberculosa. Detentos reincidentes são um risco de infecção para os detentos primários.<br>INTRODUCTION: Tuberculosis has always been a serious health problem for groups of confined individuals, especially in prisons, due to its respiratory transmission. OBJECTIVE: To verify the association between the length of stay in prison and the rate of tuberculosis infection in County Jail prisoners in the western sector of the city of São Paulo. METHODS:An observational study was conducted in 2000 and 2001 by interviewing prisoners and by conducting Tuberculin Skin Test (TST). RESULTS AND DISCUSSION: Of the 1,052 prisoners interviewed, 932 agreed to submit to TST (PPD-RT23 - 2TU/0.1 ml) and of these, 64.5% were reactors. For analyses, offenders were classified as first-time or recidivists, and as non- reactors and reactors to TST, according to the length of stay in prison. Among 134 first-time offenders who were imprisoned for less than 60 days, 40.3% were positive to TST and of the 53 with more than 366 days in prison, the percentage of reactors was of 62.3%. Among 146 recidivists who were imprisoned less than 60 days, 72.6% were reactors to TST and of the 25 with more than 366 days in prison, 100.0% were infected. In all periods of prison stays, recidivists registered a higher percentage of infectious tuberculosis than first-time offenders. The association between length of stay in prison and reactivity to TST was confirmed by the Epi-Info-6 Program Tendency Test (p < 0.001). CONCLUSIONS:The longer the confinement in prison, the higher the rate of tuberculosis infection. Recidivists are a risk of tuberculosis infection to first-time offenders

A Worldwide Survey of Activities and Practices in Clinical Islet of Langerhans Transplantation

A global online survey was administered to 69 islet transplantation programs, covering 84 centers and 5 networks. The survey addressed questions on program organization and activity in the 2000–2020 period, including impact on activity of national health care coverage policies. We obtained full data from 55 institutions or networks worldwide and basic activity data from 6 centers. Additional data were obtained from alternative sources. A total of 94 institutions and 5 networks was identified as having performed islet allotransplantation. 4,365 islet allotransplants (2,608 in Europe, 1,475 in North America, 135 in Asia, 119 in Oceania, 28 in South America) were reported in 2,170 patients in the survey period. From 15 centers active at the start of the study period, the number of simultaneously active islet centers peaked at 54, to progressively decrease to 26 having performed islet allotransplants in 2020. Notably, only 16 centers/networks have done >100 islet allotransplants in the survey period. Types of transplants performed differed notably between North America and the rest of the world, in particular with respect to the near-absence of simultaneous islet-kidney transplantation. Absence of heath care coverage has significantly hampered transplant activity in the past years and the COVID-19 pandemic in 2020