Original Article

Characteristics of tuberculosis in the state of Minas Gerais, Brazil: 2002-2009

Características da tuberculose no estado de Minas Gerais entre 2002 e 2009

Cláudio José Augusto, Wânia da Silva Carvalho, Alan Douglas Gonçalves, Maria das Graças Braga Ceccato, Silvana Spindola de Miranda

J Bras Pneumol.2013;39(3):357-364

Objective: To analyze the profile of tuberculosis cases reported between 2002 and 2009 in the state of Minas Gerais, Brazil, according to sociodemographic, clinical, and laboratory characteristics, as well as to comorbidities and mortality. Methods: This was a descriptive, epidemiological study based on data obtained from the Brazilian Case Registry Database and the Brazilian Mortality Database for the 2002-2009 period. Results: There were 47,285 reported cases of tuberculosis, corresponding to a mean incidence of 22.3/100,000 population. The individuals diagnosed with tuberculosis were predominantly in the 20- to 49-year age bracket and male (62.4% and 67.0%, respectively). Individuals with a low level of education accounted for 18.5% of the cases. New cases, cases of recurrence, and cases of retreatment accounted for 83.7%, 5.7%, 5.7%, respectively. The rates of cure and treatment noncompliance were 66.2% and 11.2%, respectively; multidrug-resistant tuberculosis was identified in 0.2% of the cases; and the mortality rate was 12.9%. The directly observed treatment, short-course (DOTS) strategy was applied in 21.8% of the cases. Sputum smear microscopy and culture were performed in only 73.9% and 12.9% of the cases, respectively. Chest X-rays were performed in 90.5% of the cases. Pulmonary tuberculosis was the predominant form (in 83.9%). Comorbidity with alcoholism, HIV infection, and diabetes mellitus were identified in 17.2%, 8.3%, and 3.8%, respectively. Conclusions: During the study period, the numbers of new cases, cases of treatment noncompliance, and deaths were high, comorbidities were common, and there was a failure to perform adequately basic tests for the diagnosis of tuberculosis. Multidisciplinary approaches, expanded use of the DOTS strategy, better knowledge of the distribution of tuberculosis, and improvements in the databases are needed in order to achieve better control of the disease in the state of Minas Gerais.

Keywords: Tuberculosis/epidemiology; Tuberculosis/mortality; Information systems.

Factors associated with tuberculosis and multidrug-resistant tuberculosis in patients treated at a tertiary referral hospital in the state of Minas Gerais, Brazil

Fatores associados à tuberculose e à tuberculose multirresistente em pacientes atendidos em um hospital de referência terciária em Minas Gerais, Brasil

Valéria Martins Soares1, Isabela Neves de Almeida2, Lida Jouca de Assis Figueredo2, João Paulo Amaral Haddad3, Camila Stefanie Fonseca de Oliveira3, Wânia da Silva Carvalho4, Silvana Spindola de Miranda2

J Bras Pneumol.2020;46(2):e20180386

Multidrug-resistant Mycobacterium tuberculosis at a referral center for infectious diseases in the state of Minas Gerais, Brazil: sensitivity profile and related risk factors

Perfil de sensibilidade e fatores de risco associados à resistência do Mycobacterium tuberculosis, em centro de referência de doenças infecto-contagiosas de Minas Gerais

Márcia Beatriz de Souza, Carlos Maurício de Figueiredo Antunes, Guilherme Freire Garcia

J Bras Pneumol.2006;32(5):430-437

Letters to the Editor

Adherence to long-term home oxygen therapy in patients with chronic respiratory disease in two cities in the state of Minas Gerais, Brazil

Adesão à oxigenoterapia domiciliar prolongada em pacientes com doença respiratória crônica em duas cidades do estado de Minas Gerais, Brasil

Felipe Meirelles de Azevedo1, Cristino Carneiro Oliveira1, Deborah Gollner Evangelista1, Leandro Ferracini Cabral1, Carla Malaguti1

J Bras Pneumol.2021;47(3):e20210055

Original Article

Spatial analysis of deaths from pulmonary tuberculosis in the city of São Luís, Brazil

Análise espacial dos óbitos por tuberculose pulmonar em São Luís, Maranhão

Marcelino Santos-Neto, Mellina Yamamura, Maria Concebida da Cunha Garcia, Marcela Paschoal Popolin, Tatiane Ramos dos Santos Silveira, Ricardo Alexandre Arcêncio

J Bras Pneumol.2014;40(5):543-551

Profile and follow-up of patients with Mycobacterium sp. at the Hospital das Clínicas da Universidade Federal de Minas Gerais

Perfil e seguimento dos pacientes portadores de Mycobacterium sp. do Hospital das Clínicas da Universidade Federal de Minas Gerais

Giselle Carvalho Froes, Rosane Luiza Coutinho, Marcelo Nardy de Ávila, Leandra Rocha Cançado, Silvana Spíndola de Miranda

J Bras Pneumol.2003;29(6):365-370

Background: Surveys of patients diagnosed with mycobacteriosis, taken at the Laboratory of Mycobacteriology of the Hospital das Clínicas da Universidade Federal de Minas Gerais, have shown that lack of information concerning diagnosis prevented 42% from initiating treatment. Objective: To evaluate the profile of patients with mycobacterial infection attending the Hospital das Clínicas da Universidade Federal de Minas Gerais. To describe the follow up of those patients and compare it to the guidelines made by the National Program for the Control of Tuberculosis. Methods: The files of patients diagnosed with mycobacterium infection during 2002 were selected from the archives of the Laboratory of Mycobacteriology of the Hospital das Clínicas da Universidade Federal de Minas Gerais. An active search for these patients was carried out and follow-up exams were then performed. Results: Of the 66 patients selected, 62 (94%) were positive for Mycobacterium tuberculosis and 4 (6%) had nontuberculous mycobacteriosis. Another 4 (6%) had been transferred to other institutions. Of the remaining 58, 37 (63%) had been cured, 1 (2%) had refused treatment, 9 (16%) were not found and 11 (19%) had died. Of the 11 deaths, 7 (64%) had tested positive for HIV. Conclusion: Patients failed to receive treatment not due to lack of diagnosis, but to inadequate structure, low awareness levels of all parties, and lack of tuberculosis control organization at the hospital level. Due to the high number of HIV-positive patients, the number of patients cured was lower than that required by the National Health Ministry. Deaths were attributed to HIV infection and lack of knowledge about the disease. In order to identify and address the problems associated with clinical laboratory practice, laboratory professionals must work in concert with their clinical counterparts when carrying out operational research on tuberculosis.

Keywords: Tuberculosis/diagnosis. Mycobacterium infections/complications.

Characteristics of elderly tuberculosis patients in Recife, Brazil: a contribution to the tuberculosis control program

Características da tuberculose em idosos no Recife (PE): contribuição para o programa de controle

Zilda do Rego Cavalcanti, Maria de Fátima Pessoa Militão de Albuquerque, Antônio Roberto Leite Campelo, Ricardo Ximenes, Ulisses Montarroyos, Marianne Karel Amaral Verçosa

J Bras Pneumol.2006;32(6):535-543

Objective: To describe the demographic characteristics, everyday habits, socio-economic conditions, clinico-epidemiological profiles and access to health care services among the elderly patients with tuberculosis diagnosed and treated in the city of Recife, Brazil, comparing them to those observed in young adults with tuberculosis. Methods: A case-control type strategy was used to evaluate a cohort of patients with tuberculosis, all of whom were treated in public health care facilities in Recife between May of 2001 and July of 2003. Results: The final cohort consisted of 1127 patients: 136 elderly patients (cases) and 991 young adults (controls). In both groups, males predominated, and the most common form of tuberculosis was the pulmonary form. Alcoholism was more common in the control group, whereas illiteracy was more common in the case group. There were fewer complaints of cough, sweats and chest pain among the patients in the case group than among those in the control group. Serological testing for the human immunodeficiency virus was performed in only 29 patients (2.6%). The percentage of positive sputum smear microscopy results, as well as that of positive cultures, was higher in the controls. Prior to being diagnosed with the disease, patients in both groups had sought treatment at more than two health care facilities and had waited more than two months (after first seeking treatment). The elderly patients presented higher indices of cure and were more often compliant with the treatment regimen, yet presented higher mortality rates. Conclusion: In the population studied, the elderly presented less cough, fewer episodes of night sweats and less chest pain, as well as less often presenting positivity on complementary exams. Nevertheless, the mortality rate was higher among the elderly patients than among the young adult patients. Elderly patients with tuberculosis constitute a population that should be given special attention in public health care facilities.

Keywords: Tuberculosis; Elderly; Case-control; Brazil

Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012*

Análise temporal dos casos notificados de tuberculose e de coinfecção tuberculose- -HIV na população brasileira no período entre 2002 e 2012

Renato Simões Gaspar1, Natália Nunes1, Marina Nunes2, Vandilson Pinheiro Rodrigues3

J Bras Pneumol.2016;42(6):416-422

Evaluation of surveillance of contacts of new tuberculosis cases in the state of Mato Grosso - Brazil

Avaliação da vigilância de contatos de casos novos de tuberculose no Estado de Mato Grosso - Brasil

Shaiana Vilella Hartwig, Eliane Ignotti, Beatriz Fátima Alves de Oliveira, Hellen Caroline de Oliveira Pereira, João Henrique Scatena

J Bras Pneumol.2008;34(5):298-303

The burden of disease due to tuberculosis in the state of Santa Catarina, Brazil

A carga de doença por tuberculose no estado de Santa Catarina

J Bras Pneumol.2014;40(1):61-68

Drug resistance profile of Mycobacterium tuberculosis in the state of Mato Grosso do Sul, Brazil, 2000-2006

Perfil de resistência de Mycobacterium tuberculosis no estado de Mato Grosso do Sul, 2000-2006

Marli Marques, Eunice Atsuko Totumi Cunha, Antonio Ruffino-Netto, Sonia Maria de Oliveira Andrade

J Bras Pneumol.2010;36(2):224-231

Objective: To determine the drug resistance profile of Mycobacterium tuberculosis in the state of Mato Grosso do Sul, Brazil, between 2000 and 2006. Methods: Descriptive study of reported tuberculosis cases in the Brazilian Case Registry Database. We included only those cases in which M. tuberculosis culture was positive and sensitivity to drugs (rifampicin, isoniazid, streptomycin and ethambutol) was tested. Löwenstein-Jensen and Ogawa-Kudoh solid media were used for cultures, as was an automated liquid medium system. Sensitivity tests were based on the proportion method. Results: Among the 783 cases evaluated, males predominated (69.7%), as did patients in the 20-49 year age bracket (70%), a diagnosis of pulmonary tuberculosis (94.4%) and positive HIV serology (8.6%); 645 (82.4%) were new cases, and 138 (17.6%) had previously been treated. Resistance to at least one drug was found in 143 cases (18.3%). The primary resistance (PR) rate was, respectively, 8.1%, 1.6%, 2.8% and 12.4%, for monoresistance, multidrug resistance (MDR), other patterns of resistance and resistance to at least one drug, whereas the acquired resistance (AR) rate was 14.5%, 20.3%, 10.9% and 45.7%, respectively, and the combined resistance (CR) rate was 9.2%, 4.9%, 4.2% and 18.3%, respectively. In PR, streptomycin was the most common drug, whereas isoniazid was the most common in AR and CR (7.2% and 3.7%, respectively). Conclusions: These high levels of resistance undermine the efforts for tuberculosis control in Mato Grosso do Sul. Acquired MDR was 12.7 times more common than was primary MDR, demonstrating that the previous use of drug therapy is an indicator of resistance. These levels reflect the poor quality of the health care provided to these patients, showing the importance of using the directly observed treatment, short course strategy, as well as the need to perform cultures and sensitivity tests for the early diagnosis of drug resistance.

Keywords: Tuberculosis; Drug resistance, multiple; Mycobacterium tuberculosis.