Clinical presentation and survival of smear-positive pulmonary tuberculosis patients of a University General Hospital in a developing country

From January 1995 to August 1997 we evaluated prospectively the clinical presentation, laboratory findings and short-term survival of smear-positive pulmonary tuberculosis (TB) patients who sought care at our hospital. After providing informed, written consent, the patients were interviewed and laboratory tests were performed. Information about survivorship and death was collected through September 1998. Eighty-six smear-positive pulmonary TB patients were enrolled; 26.7% were HIV-seropositive. Seventeen HIV-seronegative pulmonary TB patients (19.8%) presented chronic diseases in addition to TB. In the multiple logistic regression analysis a CD4+ cell count or = 50 years were independently associated with decreased survival. Among HIV-seronegative persons, the presence of an additional disease increased the risk of death of almost six-fold. Use of antiretroviral drugs was associated with a lower risk of death among HIV-seropositive smear-positive pulmonary TB patients (RH = 0.32, 95% CI 0.10-0.92). In our study smear-positive pulmonary TB patients had a low short-term survival rate that was strongly associated with HIV infection, age and co-morbidities. Therapy with antiretroviral drugs reduced the short-term risk of death among HIV-seropositive patients after TB diagnosis

Clinical presentation and survival of smear-positive pulmonary tuberculosis patients of a University General Hospital in a developing country

From January 1995 to August 1997 we evaluated prospectively the clinical presentation, laboratory findings and short-term survival of smear-positive pulmonary tuberculosis (TB) patients who sought care at our hospital. After providing informed, written consent, the patients were interviewed and laboratory tests were performed. Information about survivorship and death was collected through September 1998. Eighty-six smear-positive pulmonary TB patients were enrolled; 26.7% were HIV-seropositive. Seventeen HIV-seronegative pulmonary TB patients (19.8%) presented chronic diseases in addition to TB. In the multiple logistic regression analysis a CD4+ cell count <= 200 cell/mm³ was independently associated with HIV seropositivity. In the Cox regression model, fitted to all patients, HIV seropositivity and age > or = 50 years were independently associated with decreased survival. Among HIV-seronegative persons, the presence of an additional disease increased the risk of death of almost six-fold. Use of antiretroviral drugs was associated with a lower risk of death among HIV-seropositive smear-positive pulmonary TB patients (RH = 0.32, 95% CI 0.10-0.92). In our study smear-positive pulmonary TB patients had a low short-term survival rate that was strongly associated with HIV infection, age and co-morbidities. Therapy with antiretroviral drugs reduced the short-term risk of death among HIV-seropositive patients after TB diagnosis

Promoting adherence to Tuberculosis (TB) treatment: experience of evaluation and production of educational material on TB.

Submitted by Sandra Infurna ([email protected]) on 2019-02-12T09:59:45Z No. of bitstreams: 1 ValeriaS_trajano_etal_IOC_2018.pdf: 890812 bytes, checksum: b78b923e11a362385056710e33505f4a (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-02-12T10:08:37Z (GMT) No. of bitstreams: 1 ValeriaS_trajano_etal_IOC_2018.pdf: 890812 bytes, checksum: b78b923e11a362385056710e33505f4a (MD5)Made available in DSpace on 2019-02-12T10:08:37Z (GMT). No. of bitstreams: 1 ValeriaS_trajano_etal_IOC_2018.pdf: 890812 bytes, checksum: b78b923e11a362385056710e33505f4a (MD5) Previous issue date: 2018Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnologia em Saúde. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.Secretaria Estadual de Saúde. Programa Estadual de Tuberculose. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.A tuberculose (TB) é hoje a principal causa de morte por doença infecciosa no mundo. No Brasil, o abandono do tratamento da TB representa o maior desafio a ser superado no controle da doença. No presente estudo, profissionais da área da saúde, educação e comunicação avaliaram e produziram material educativo sobre TB tendo como tema principal o tratamento da doença. A primeira fase do projeto consistiu na avaliação do material educativo sobre TB já existente, feita por meio da ficha para avaliação de material impresso em saúde da Organização Panamericana de Saúde (OPAS). Em seguida, foram realizados outros quatro encontros para discussão e definição do texto, das imagens e do design gráfico do novo material a ser produzido. Foram elaborados um calendário e um folder, utilizando fotografias de acesso livre na internet. Procurou-se transmitir mensagens positivas como “Tuberculose tem cura” e de encorajamento para a realização da terapia, ressaltando a necessidade do acompanhamento clínico durante o tratamento pelos profissionais de saúde. A possibilidade da ocorrência de efeitos colaterais ao tratamento anti-TB também foi abordada, sendo inseridas mensagens relativas à transmissibilidade do bacilo, fator que ainda gera muitas dúvidas entre pacientes e familiares e é causa de isolamento dos pacientes do convívio social. O teste de legibilidade escolhido avaliou o texto final do folder e do calendário, respectivamente, como história em quadrinhos e excepcional. O calendário “Tuberculose tem cura” foi distribuído em janeiro de 2016 na Clínica da Família Rinaldo De Lamare, que assiste à população da Rocinha, no Rio de Janeiro.Tuberculosis (TB) is today the leading cause of death from infectious disease in the world. In Brazil, default of TB treatment represents the greatest challenge to be overcome in controlling the disease. In the present study, health, education and communication professionals evaluated and produced educational material on TB, the treatment of the disease being the main theme addressed. The first phase of the project consisted in the evaluation of the existing educational material on TB, made through the evaluation form of the Pan American Health Organization (PAHO) printed material in health. Then, four other meetings were held to discuss and define the text, images and graphic design of the new material to be produced. A calendar and a folder were developed using free access photos on the internet. We sought to transmit positive messages such as "Tuberculosis is curable", encouraging the completion of treatment and emphasizing the need for clinical follow-up by health professionals. The possibility of side effects to anti-TB treatment was also considered, as well as messages related to the transmissibility of the bacillus, a factor that still generates many doubts among patients and their families and is a cause of patients´ isolation from social life. The readability test chosen evaluated the final text of the folder and calendar, respectively, as comics and exceptional. The calendar "Tuberculosis is curable" was distributed in January 2016 at the Family’s Clinic Rinaldo de Lamare, that assists Rocinha’s population, in Rio de Janeiro