Características dos serviços de saúde associadas à adesão ao tratamento da tuberculose

OBJECTIVE: To analyze characteristics related to adherence to tuberculosis treatment in tuberculosis outpatient clinics. METHODS: An ecological study was conducted in outpatient clinics for the treatment of tuberculosis cases in the sanitary districts of Salvador, Northeastern Brazil, in 2006. The sample was composed of the municipal health units that assisted 67.2% of the 2,283 tuberculosis cases that were reported during the year. The following variables were analyzed: cure, dropout, tests, health team and benefits offered to the patients. Chi-square test or Fisher's exact test was used to verify the association between variables, and associations with pOBJETIVO: Analisar características relacionadas à adesão ao tratamento dos casos de tuberculose em serviços de referência para tuberculose. MÉTODOS: Trata-se de um estudo ecológico nas unidades de referência no tratamento dos casos de tuberculose dos distritos sanitários de Salvador, BA, em 2006. A amostra foi composta pelas unidades de saúde municipais que atenderam 67,2% dos 2.283 casos notificados de tuberculose no ano. Foram analisadas as variáveis: cura, abandono, exames realizados, equipe de saúde e benefícios aos pacientes. Para verificar associação entre as variáveis, foi utilizado o teste qui-quadrado ou exato de Fisher, sendo consideradas estatisticamente significantes as associações com pOBJETIVO: Analizar características relacionadas a la adhesión al tratamiento de los casos de tuberculosis en servicios de referencia para tuberculosis. MÉTODOS: Se trata de estudio ecológico en las unidades de referencia en el tratamiento de los casos de tuberculosis de los distritos sanitarios de Salvador, Noreste de Brasil, en 2006. La muestra fue compuesta por las unidades de salud municipales que atendieron 67,2% de los 2.283 casos notificados de tuberculosis en el año. Fueron analizadas las variables: cura, abandono, exámenes realizados, equipo de salud y beneficios a los pacientes. Para verificar asociación entre las variables, fue utilizada la prueba chi-cuadrado o exacto de Fisher, siendo consideradas estadísticamente significativas las asociaciones con

Common mental disorders associated with tuberculosis: a matched case-control study.

INTRODUCTION: Despite the availability of treatment and a vaccine, tuberculosis continues to be a public health problem worldwide. Mental disorders might contribute to the burden of the disease. OBJECTIVE: The objective of this study was to investigate the association between common mental disorders and tuberculosis. METHODS: A matched case-control study was conducted. The study population included symptomatic respiratory patients who attended three referral hospitals and six community clinics in the city of Salvador, Brazil. A doctor's diagnosis defined potential cases and controls. Cases were newly diagnosed tuberculosis cases, and controls were symptomatic respiratory patients for whom tuberculosis was excluded as a diagnosis by the attending physician. Cases and controls were ascertained in the same clinic. Data collection occurred between August 2008 and April 2010. The study instruments included a structured interview, a self-reporting questionnaire for the identification of common mental disorders, and a questionnaire for alcoholism. An univariate analysis included descriptive procedures (with chi-square statistics), and a multivariate analysis used conditional logistic regression. RESULTS: The mean age of the cases was 38 years, and 61% of the cases were males. After adjusting for potential confounders, the odds of tuberculosis were significantly higher in patients diagnosed with a common mental disorder (OR: 1.34; 95% CI 1.05-1.70). CONCLUSION: There appears to be a positive and independent association between common mental disorders and tuberculosis; further epidemiological studies are required to increase our understanding of the possible biological and social mechanisms responsible for this association. Independent of the direction of the association, this finding has implications for the provision of care for mental disorders and for tuberculosis

Non-compliance with health surveillance is a matter of Biosafety: a survey of latent tuberculosis infection in a highly endemic setting

Objective This study aimed at identifying demographic, socio-economic and tuberculosis (TB) exposure factors associated with non-compliance with the tuberculin skin test, the management and prevention of non-compliance to the test. It was carried out in the context of a survey of latent TB infection among undergraduate students taking healthcare courses in two universities in Salvador, Brazil, a city highly endemic for TB. Methods This is a cross-sectional study of 1164 volunteers carried out between October 2004 and June 2008. Bivariate analysis followed by logistic regression was used to measure the association between non-compliance and potential risk factors through non-biased estimates of the adjusted OR for confounding variables. A parallel evaluation of occupational risk perception and of knowledge of Biosafety measures was also conducted. Results The non-compliance rate was above 40% even among individuals potentially at higher risk of disease, which included those who had not been vaccinated (OR 3.33; 95% CI 1.50 to 7.93; p=0.0018), those reporting having had contact with TB patients among close relatives or household contacts (p=0.3673), or those whose tuberculin skin test status was shown within the survey to have recently converted (17.3% of those completing the study). In spite of the observed homogeneity in the degree of Biosafety knowledge, and the awareness campaigns developed within the study focussing on TB prevention, the analysis has shown that different groups have different behaviours in relation to the test. Family income was found to have opposite effects in groups studying different courses as well as attending public versus private universities. Conclusions Although the data presented may not be directly generalisable to other situations and cultural settings, this study highlights the need to evaluate factors associated with non-compliance with routine testing, as they may affect the efficacy of Biosafety program

Statement of Second Brazilian Congress of Mechanical Ventilarion : part I

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A infecção pelo retrovírus HTLV-I como fator de risco da tuberculose

Submitted by Repositório Arca ([email protected]) on 2019-09-04T17:23:34Z No. of bitstreams: 1 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2019-09-11T12:06:19Z (GMT) No. of bitstreams: 2 Jamocyr Moura Marinho A infecção...2003.pdf: 4222649 bytes, checksum: 0e5e0fafb7ac778474447ffda1cdc973 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Made available in DSpace on 2019-09-11T12:06:19Z (GMT). No. of bitstreams: 2 Jamocyr Moura Marinho A infecção...2003.pdf: 4222649 bytes, checksum: 0e5e0fafb7ac778474447ffda1cdc973 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2003Fundação Bahiana para o Desenvolvimento das Ciências. Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.As pessoas infectadas pelo vírus linfotrópico de células T humana do tipo 1 (HTLV-1) apresentam hiporreatMdade e anergia ao teste tuberculínico (PPD), e têm maior prevalência de tuberculose do que a população em geral. Tais fatos conduzem à hipótese de que haja uma associação de risco entre o HTLV-1 e a tuberculose, o que até o momento n foi esclarecido. Avaliar se a infecção pelo HTLV-1 é um fator de risco para o aumento da incidência de tuberculose. Estudo caso controle realizado no período de setembro de 2001 a outubro de 2002, com 753 indivíduos moradores da cidade do Salvador, sendo 375 do grupo de pacientes com tuberculose e 378 do grupo controle, sem tuberculose, selecionados por freqüência de idade e sexo. Todos foram submetidos ao teste de triagem através do ELISA; o Western blot foi utilizado para confirmação. Os pacientes soropositivos para o HIV foram excluídos. A prevalência do HTLV-1 no grupo de pacientes com tuberculose foi de 4,27% (16/375) e nos indivíduos do grupo controle de 1,32% (5/378). No presente estudo, a razão de chance (OR) foi de 3,32 e o intervalo de confiança (IC) de 1,15 — 11,7; quando ajustada, a OR foi de 3,01 e o IC de 1,06 — 8,58. O Risco atribuível populacional neste estudo foi de 2,99%. O presente estudo encontrou uma associação significativa entre o HTLV-1 e a tuberculose, a qual sugere fortemente que o HTLV-1 seja um fator de risco para o aumento da incidência de tuberculose.Individuals infected with human T cell lymphotropic virus, type I (HTLV-1) present hyporeactivity and anergy to the tuberculin purified protein derivative skin testing (PPD), as well as an increased prevalence of tuberculosis raising hypotheses of a risk association between HTLV-1 and tuberculosis, which has not been clarified up to this point. OBJECTIVES: To evaluate if infection by HTLV-1 could be a risk factor for increased incidence of tuberculosis. MATERIAL AND METHODS: case- control study carried out September 2001 to October 2002, with 753 subjects from the city of Salvador. 375 of the subjects were in the group of patients with tuberculosis and 378 in the control group, paired by age and gender. Plasma were screened for HTLV-1 antibodies by ELISA and the positive sample were tested by a confirmative assay (Western blot). HIV-1 Infected individuals were excluded. RESULTS: the prevalence of HTLV-1 in tuberculosis patients was 4.27% (16/375) and In the control group 1.32% (5/378). One person in each group was not included in this calculation due to seropositivity to HTLV-2. The odds ratio (OR) was 3.32 and the confidence interval (Cl) 1,15 - 11,7. When adjusted for income, the OR was 3.01 and Cl 1,06 - 8,58. The attributed risk in this study was 2.99%. CONCLUSION: Our present results showed an association with HTLV-1 infection and tuberculosis. The HTLV-1 could be a risk factor to increased incidence of tuberculosis

Interferon-gamma production by mononuclear cells in Bacille Calmette-Guérin-revaccinated healthy volunteers predicted long-term antimycobacterial responses in a randomized controlled trial

Study group: Evelin S Oliveiraa,[email protected],Jaqueline S Rodriguesa,[email protected],Elisabete L Conceic¸ ãoa,[email protected],Mauricio R [email protected],Antonio Luis de O A [email protected],Juliana P Bezerra de [email protected],Sergio [email protected], Jamocyr M Marinhoc,[email protected],Manoel Barral-Nettoa,[email protected],Theolis Barbosaa,b,*[email protected] by Ana Maria Fiscina Sampaio ([email protected]) on 2017-08-29T12:59:28Z No. of bitstreams: 1 Oliveira ES T interferon gamma....pdf: 814815 bytes, checksum: 75d294d06aab43535db5f6f03a960006 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-08-29T13:13:07Z (GMT) No. of bitstreams: 1 Oliveira ES T interferon gamma....pdf: 814815 bytes, checksum: 75d294d06aab43535db5f6f03a960006 (MD5)Made available in DSpace on 2017-08-29T13:13:07Z (GMT). No. of bitstreams: 1 Oliveira ES T interferon gamma....pdf: 814815 bytes, checksum: 75d294d06aab43535db5f6f03a960006 (MD5) Previous issue date: 2013Fundação de Amparo à Pesquisa do Estado da Bahia–FAPESB [Convênio 160/03] and Conselho Nacional de Desenvolvimento Científico e Tecnológico [Proc. Nr. 476860/2007-5]. JSR, MP and ELC have received scholarships from FAPESB, and ESO received a scholarship from Coordenação de Aperfeiç oamento de Pessoal de Nível Superior (CAPES).Universidade Federal da Bahia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil / Hospital Santa Izabel. Salvador, BA, BrasilUniversidade Federal da Bahia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilStudy groupThe Bacille Calmette-Guérin (BCG) vaccine is the only vaccine currently available for tuberculosis, and it demonstrates variable efficacy against the disease. The assessment of new vaccine strategies is hindered by the small annual probability that an infected individual will develop tuberculosis, and the lack of simple and reliable surrogate markers of protection. The frequency of cytokine-producing T cells as well as the production of IFN-γ have been disputed as surrogate markers of protection. We evaluated the evolution of these immune parameters in a population from a high burden city where BCG revaccination has been shown to result in mild protection. We found that individuals whose in vitro IFN-γ responses to mycobacterial antigens had increased by more than 3.3-fold were more likely to maintain higher responses after 1 year and to show increased expansion of IFN-γ-producing T lymphocytes than those with lower or null increase of IFN-γ

Características dos serviços de saúde associadas à adesão ao tratamento da tuberculose Características de los servicios de salud asociadas a la adhesión al tratamiento de la tuberculosis Characteristics of healthcare services associated with adherence to tuberculosis treatment

OBJETIVO: Analisar características relacionadas à adesão ao tratamento dos casos de tuberculose em serviços de referência para tuberculose. MÉTODOS: Trata-se de um estudo ecológico nas unidades de referência no tratamento dos casos de tuberculose dos distritos sanitários de Salvador, BA, em 2006. A amostra foi composta pelas unidades de saúde municipais que atenderam 67,2% dos 2.283 casos notificados de tuberculose no ano. Foram analisadas as variáveis: cura, abandono, exames realizados, equipe de saúde e benefícios aos pacientes. Para verificar associação entre as variáveis, foi utilizado o teste qui-quadrado ou exato de Fisher, sendo consideradas estatisticamente significantes as associações com p<0,05. RESULTADOS: Dos casos estudados, 78,4% resultaram em cura, 8,6% em abandono, 2,2% em óbito e 8,1% em transferência. As taxas de adesão por unidade de saúde apresentaram variabilidade entre 66,7% a 98,1%. As variáveis cura e abandono mostraram associação estatisticamente significante com a adesão na comparação de proporções. Todas as unidades com alta adesão possuíam equipe de saúde completa. CONCLUSÕES: A adesão foi fator importante para o desfecho cura e abandono, mas foi baixo o índice de unidades que alcançaram as metas de cura. A presença de equipe multidisciplinar completa no programa de tuberculose pode contribuir para a compreensão pelo paciente sobre a sua enfermidade e a adesão ao tratamento para a cura.<br>OBJETIVO: Analizar características relacionadas a la adhesión al tratamiento de los casos de tuberculosis en servicios de referencia para tuberculosis. MÉTODOS: Se trata de estudio ecológico en las unidades de referencia en el tratamiento de los casos de tuberculosis de los distritos sanitarios de Salvador, Noreste de Brasil, en 2006. La muestra fue compuesta por las unidades de salud municipales que atendieron 67,2% de los 2.283 casos notificados de tuberculosis en el año. Fueron analizadas las variables: cura, abandono, exámenes realizados, equipo de salud y beneficios a los pacientes. Para verificar asociación entre las variables, fue utilizada la prueba chi-cuadrado o exacto de Fisher, siendo consideradas estadísticamente significativas las asociaciones con p<0,05. RESULTADOS: De los casos estudiados, 78,4% resultaron en cura, 8,6% en abandono, 2,2% en óbito y 8,1% en transferencia. Las tasas de adhesión por unidad de salud presentaron variabilidad entre 66,7% a 98,1%. Las variables cura y abandono mostraron asociación estadísticamente significativa con la adhesión en la comparación de proporciones. Todas las unidades con alta adhesión poseían equipo de salud completo. CONCLUSIONES: La adhesión fue factor importante para el resultado cura y abandono, pero fue bajo el índice de unidades que alcanzaron las metas de cura. La presencia de equipo multidisciplinar completo en el programa de tuberculosis puede contribuir para la comprensión por el paciente sobre su enfermedad y la adhesión al tratamiento para la cura.<br>OBJECTIVE: To analyze characteristics related to adherence to tuberculosis treatment in tuberculosis outpatient clinics. METHODS: An ecological study was conducted in outpatient clinics for the treatment of tuberculosis cases in the sanitary districts of Salvador, Northeastern Brazil, in 2006. The sample was composed of the municipal health units that assisted 67.2% of the 2,283 tuberculosis cases that were reported during the year. The following variables were analyzed: cure, dropout, tests, health team and benefits offered to the patients. Chi-square test or Fisher's exact test was used to verify the association between variables, and associations with p<0.05 were considered to be statistically significant. RESULTS: Of the studied cases, 78.4% resulted in cure, 8.6% in dropout, 2.2% in death and 8.1% in transference. Adherence rates per health unit varied between 66.7% and 98.1%. The variables cure and dropout showed a statistically significant association with adherence in the comparison of proportions. All the units with high adherence rates had complete health teams. CONCLUSIONS: Adherence was an important factor for the outcomes cure and dropout, but the index of units that achieved the cure goals was low. The presence of a complete multidisciplinary team in the tuberculosis program may help the patient understand his/her illness and contribute to adherence to treatment