Fatores associados à tuberculose resistente no Espírito Santo, Brasil
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng por |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/132863 |
Resumo: | OBJECTIVE To analyze the prevalence and factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. METHODS This is a cross-sectional study of cases of tuberculosis tested for first-line drugs (isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin) in Espírito Santo between 2002 and 2012. We have used laboratory data and registration of cases of tuberculosis – from the Sistema Nacional de Agravos de Notificação and Sistema para Tratamentos Especiais de Tuberculose. Individuals have been classified as resistant and non-resistant and compared in relation to the sociodemographic, clinical, and epidemiological variables. Some variables have been included in a logistic regression model to establish the factors associated with resistance. RESULTS In the study period, 1,669 individuals underwent anti-tuberculosis drug susceptibility testing. Of these individuals, 10.6% showed resistance to any anti-tuberculosis drug. The rate of multidrug resistance observed, that is, to rifampicin and isoniazid, has been 5%. After multiple analysis, we have identified as independent factors associated with resistant tuberculosis: history of previous treatment of tuberculosis [recurrence (OR = 7.72; 95%CI 4.24–14.05) and re-entry after abandonment (OR = 3.91; 95%CI 1.81–8.43)], smoking (OR = 3.93; 95%CI 1.98–7.79), and positive culture for Mycobacterium tuberculosis at the time of notification of the case (OR = 3.22; 95%CI 1.15–8.99). CONCLUSIONS The partnership between tuberculosis control programs and health teams working in the network of Primary Health Care needs to be strengthened. This would allow the identification and monitoring of individuals with a history of previous treatment of tuberculosis and smoking. Moreover, the expansion of the offer of the culture of tuberculosis and anti-tuberculosis drug susceptibility testing would provide greater diagnostic capacity for the resistant types in Espírito Santo. |
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Fatores associados à tuberculose resistente no Espírito Santo, BrasilRisk factors associated with multidrug-resistant tuberculosis in Espírito Santo, BrazilTuberculose Resistente a Múltiplos MedicamentosepidemiologiaFarmacorresistência Bacteriana MúltiplaRecidivaFatores de RiscoFatores SocioeconômicosTuberculosisMultidrug-ResistantepidemiologyDrug ResistanceMultipleBacterialRecurrenceRisk FactorsSocioeconomic Factors OBJECTIVE To analyze the prevalence and factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. METHODS This is a cross-sectional study of cases of tuberculosis tested for first-line drugs (isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin) in Espírito Santo between 2002 and 2012. We have used laboratory data and registration of cases of tuberculosis – from the Sistema Nacional de Agravos de Notificação and Sistema para Tratamentos Especiais de Tuberculose. Individuals have been classified as resistant and non-resistant and compared in relation to the sociodemographic, clinical, and epidemiological variables. Some variables have been included in a logistic regression model to establish the factors associated with resistance. RESULTS In the study period, 1,669 individuals underwent anti-tuberculosis drug susceptibility testing. Of these individuals, 10.6% showed resistance to any anti-tuberculosis drug. The rate of multidrug resistance observed, that is, to rifampicin and isoniazid, has been 5%. After multiple analysis, we have identified as independent factors associated with resistant tuberculosis: history of previous treatment of tuberculosis [recurrence (OR = 7.72; 95%CI 4.24–14.05) and re-entry after abandonment (OR = 3.91; 95%CI 1.81–8.43)], smoking (OR = 3.93; 95%CI 1.98–7.79), and positive culture for Mycobacterium tuberculosis at the time of notification of the case (OR = 3.22; 95%CI 1.15–8.99). CONCLUSIONS The partnership between tuberculosis control programs and health teams working in the network of Primary Health Care needs to be strengthened. This would allow the identification and monitoring of individuals with a history of previous treatment of tuberculosis and smoking. Moreover, the expansion of the offer of the culture of tuberculosis and anti-tuberculosis drug susceptibility testing would provide greater diagnostic capacity for the resistant types in Espírito Santo. OBJETIVO Analisar a prevalência e fatores associados à tuberculose resistente no Espírito Santo. MÉTODOS Estudo transversal dos casos de tuberculose testados para fármacos de primeira linha (isoniazida, rifampicina, pirazinamida, etambutol e estreptomicina) no Espírito Santo entre 2002 e 2012. Foram utilizados dados laboratoriais e de registro de casos de tuberculose – Sistema Nacional de Agravos de Notificação e Sistema para Tratamentos Especiais de Tuberculose. Os indivíduos foram classificados em resistentes e não resistentes, e comparados para variáveis sociodemográficas, clínicas e epidemiológicas. Algumas variáveis foram inclusas em um modelo de regressão logística para estabelecimento de fatores associados à resistência. RESULTADOS No período do estudo, 1.669 indivíduos tiveram o teste de sensibilidade aos fármacos antituberculose realizado. Destes, 10,6% apresentaram resistência a qualquer droga antituberculose. A taxa de multirresistência observada, isto é, à rifampicina e isoniazida, foi de 5%. Após a análise múltipla, foram identificados como fatores associados independentes para tuberculose resistente: história de tratamento prévio para tuberculose [Recidiva (OR = 7,72; IC95% 4,24–14,05) e reingresso após abandono (OR = 3,91; IC95% 1,81–8,43)], tabagismo (OR = 3,93; IC95% 1,98–7,79) e cultura positiva para Mycobacterium tuberculosis no momento da notificação do caso (OR = 3,22; IC95% 1,15–8,99). CONCLUSÕES É necessário o fortalecimento da parceria entre os programas de controle de tuberculose e as equipes de saúde que atuam na rede de Atenção Primária à Saúde. Isso possibilitaria identificar e acompanhar indivíduos com história de tratamento prévio para tuberculose e tabagismo. Além disso, a ampliação da oferta de cultura e Teste de Sensibilidade a fármacos antituberculose proporcionaria maior capacidade diagnóstica para as formas resistentes no Espírito Santo.Universidade de São Paulo. Faculdade de Saúde Pública2017-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/13286310.1590/s1518-8787.2017051006688Revista de Saúde Pública; Vol. 51 (2017); 41Revista de Saúde Pública; Vol. 51 (2017); 41Revista de Saúde Pública; v. 51 (2017); 411518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPengporhttps://www.revistas.usp.br/rsp/article/view/132863/128916https://www.revistas.usp.br/rsp/article/view/132863/128917Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessFregona, GeisaCosme, Lorrayne BeliqueMoreira, Cláudia Maria MarquesBussular, José LuisDettoni, Valdério do ValleDalcolmo, Margareth PrettiZandonade, ElianaMaciel, Ethel Leonor Noia2017-12-14T10:16:01Zoai:revistas.usp.br:article/132863Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2017-12-14T10:16:01Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Fatores associados à tuberculose resistente no Espírito Santo, Brasil Risk factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil |
title |
Fatores associados à tuberculose resistente no Espírito Santo, Brasil |
spellingShingle |
Fatores associados à tuberculose resistente no Espírito Santo, Brasil Fregona, Geisa Tuberculose Resistente a Múltiplos Medicamentos epidemiologia Farmacorresistência Bacteriana Múltipla Recidiva Fatores de Risco Fatores Socioeconômicos Tuberculosis Multidrug-Resistant epidemiology Drug Resistance Multiple Bacterial Recurrence Risk Factors Socioeconomic Factors |
title_short |
Fatores associados à tuberculose resistente no Espírito Santo, Brasil |
title_full |
Fatores associados à tuberculose resistente no Espírito Santo, Brasil |
title_fullStr |
Fatores associados à tuberculose resistente no Espírito Santo, Brasil |
title_full_unstemmed |
Fatores associados à tuberculose resistente no Espírito Santo, Brasil |
title_sort |
Fatores associados à tuberculose resistente no Espírito Santo, Brasil |
author |
Fregona, Geisa |
author_facet |
Fregona, Geisa Cosme, Lorrayne Belique Moreira, Cláudia Maria Marques Bussular, José Luis Dettoni, Valdério do Valle Dalcolmo, Margareth Pretti Zandonade, Eliana Maciel, Ethel Leonor Noia |
author_role |
author |
author2 |
Cosme, Lorrayne Belique Moreira, Cláudia Maria Marques Bussular, José Luis Dettoni, Valdério do Valle Dalcolmo, Margareth Pretti Zandonade, Eliana Maciel, Ethel Leonor Noia |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Fregona, Geisa Cosme, Lorrayne Belique Moreira, Cláudia Maria Marques Bussular, José Luis Dettoni, Valdério do Valle Dalcolmo, Margareth Pretti Zandonade, Eliana Maciel, Ethel Leonor Noia |
dc.subject.por.fl_str_mv |
Tuberculose Resistente a Múltiplos Medicamentos epidemiologia Farmacorresistência Bacteriana Múltipla Recidiva Fatores de Risco Fatores Socioeconômicos Tuberculosis Multidrug-Resistant epidemiology Drug Resistance Multiple Bacterial Recurrence Risk Factors Socioeconomic Factors |
topic |
Tuberculose Resistente a Múltiplos Medicamentos epidemiologia Farmacorresistência Bacteriana Múltipla Recidiva Fatores de Risco Fatores Socioeconômicos Tuberculosis Multidrug-Resistant epidemiology Drug Resistance Multiple Bacterial Recurrence Risk Factors Socioeconomic Factors |
description |
OBJECTIVE To analyze the prevalence and factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. METHODS This is a cross-sectional study of cases of tuberculosis tested for first-line drugs (isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin) in Espírito Santo between 2002 and 2012. We have used laboratory data and registration of cases of tuberculosis – from the Sistema Nacional de Agravos de Notificação and Sistema para Tratamentos Especiais de Tuberculose. Individuals have been classified as resistant and non-resistant and compared in relation to the sociodemographic, clinical, and epidemiological variables. Some variables have been included in a logistic regression model to establish the factors associated with resistance. RESULTS In the study period, 1,669 individuals underwent anti-tuberculosis drug susceptibility testing. Of these individuals, 10.6% showed resistance to any anti-tuberculosis drug. The rate of multidrug resistance observed, that is, to rifampicin and isoniazid, has been 5%. After multiple analysis, we have identified as independent factors associated with resistant tuberculosis: history of previous treatment of tuberculosis [recurrence (OR = 7.72; 95%CI 4.24–14.05) and re-entry after abandonment (OR = 3.91; 95%CI 1.81–8.43)], smoking (OR = 3.93; 95%CI 1.98–7.79), and positive culture for Mycobacterium tuberculosis at the time of notification of the case (OR = 3.22; 95%CI 1.15–8.99). CONCLUSIONS The partnership between tuberculosis control programs and health teams working in the network of Primary Health Care needs to be strengthened. This would allow the identification and monitoring of individuals with a history of previous treatment of tuberculosis and smoking. Moreover, the expansion of the offer of the culture of tuberculosis and anti-tuberculosis drug susceptibility testing would provide greater diagnostic capacity for the resistant types in Espírito Santo. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/132863 10.1590/s1518-8787.2017051006688 |
url |
https://www.revistas.usp.br/rsp/article/view/132863 |
identifier_str_mv |
10.1590/s1518-8787.2017051006688 |
dc.language.iso.fl_str_mv |
eng por |
language |
eng por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/132863/128916 https://www.revistas.usp.br/rsp/article/view/132863/128917 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 51 (2017); 41 Revista de Saúde Pública; Vol. 51 (2017); 41 Revista de Saúde Pública; v. 51 (2017); 41 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221798352027648 |