Original Article

Follow-up of patients diagnosed with and treated for tuberculosis in Brazil: financial burden on the household

Acompanhamento de pacientes com diagnóstico e tratamento de tuberculose no Brasil: ônus financeiro para a família

Rafaela Borge Loureiro ^1,2, Leticia Molino Guidoni ², Geisa Carlesso Fregona ^2,3, Sandra Maria do Valle Leone de Oliveira ^4,5, Daniel Sacramento ⁶, Jair dos Santos Pinheiro ^7,8, Denise Gomes ⁹, Ethel Leonor Noia Maciel ^1,2

J Bras Pneumol.2023;49(4):e20220368

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

Primary and acquired pyrazinamide resistance in patients with pulmonary tuberculosis treated at a referral hospital in the city of Recife, Brazil

Resistência primária e adquirida à pirazinamida em pacientes com tuberculose pulmonar atendidos em um hospital de referência no Recife

Liany Barros Ribeiro, Vera Magalhães, Marcelo Magalhães

J Bras Pneumol.2012;38(6):740-747

Who are the patients with tuberculosis who are diagnosed in emergency facilities? An analysis of treatment outcomes in the state of São Paulo, Brazil

Quem são os pacientes com tuberculose diagnosticados no pronto-socorro? Uma análise dos desfechos do tratamento no Estado de São Paulo, Brasil

Otavio Tavares Ranzani1,2,a, Laura Cunha Rodrigues2,b, Eliseu Alves Waldman3,c, Elena Prina1,d, Carlos Roberto Ribeiro Carvalho1,e

J Bras Pneumol.2018;44(2):125-133

Objective: Early tuberculosis diagnosis and treatment are determinants of better outcomes and effective disease control. Although tuberculosis should ideally be managed in a primary care setting, a proportion of patients are diagnosed in emergency facilities (EFs). We sought to describe patient characteristics by place of tuberculosis diagnosis and determine whether the place of diagnosis is associated with treatment outcomes. A secondary objective was to determine whether municipal indicators are associated with the probability of tuberculosis diagnosis in EFs. Methods: We analyzed data from the São Paulo State Tuberculosis Control Program database for the period between January of 2010 and December of 2013. Newly diagnosed patients over 15 years of age with pulmonary, extrapulmonary, or disseminated tuberculosis were included in the study. Multiple logistic regression models adjusted for potential confounders were used in order to evaluate the association between place of diagnosis and treatment outcomes. Results: Of a total of 50,295 patients, 12,696 (25%) were found to have been diagnosed in EFs. In comparison with the patients who had been diagnosed in an outpatient setting, those who had been diagnosed in EFs were younger and more socially vulnerable. Patients diagnosed in EFs were more likely to have unsuccessful treatment outcomes (adjusted OR: 1.54; 95% CI: 1.42-1.66), including loss to follow-up and death. At the municipal level, the probability of tuberculosis diagnosis in EFs was associated with low primary care coverage, inequality, and social vulnerability. In some municipalities, more than 50% of the tuberculosis cases were diagnosed in EFs. Conclusions: In the state of São Paulo, one in every four tuberculosis patients is diagnosed in EFs, a diagnosis of tuberculosis in EFs being associated with poor treatment outcomes. At the municipal level, an EF diagnosis of tuberculosis is associated with structural and socioeconomic indicators, indicating areas for improvement.

Keywords: Tuberculosis/diagnosis; Emergency treatment; Treatment outcome; Delivery of health care.

Editorial

“Post-tuberculosis financial disease”—we need to face it to eliminate tuberculosis

Doença financeira “pós-tuberculose” — precisamos enfrentá-la para eliminar a tuberculose

Ana Paula Santos1,2, Fernanda Carvalho de Queiroz Mello2

J Bras Pneumol.2023;49(4):e20230253

Original Article

Estimated rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a four‑drug fixed-dose combination regimen at a tertiary health care facility in the city of Rio de Janeiro, Brazil

Estimativas das taxas de recidiva, cura e abandono de tratamento em pacientes com tuberculose pulmonar tratados com esquema de dose fixa combinada de quatro drogas em uma unidade de saúde terciária na cidade do Rio de Janeiro

Vangie Dias da Silva1, Fernanda Carvalho de Queiroz Mello2, Sonia Catarina de Abreu Figueiredo2

J Bras Pneumol.2017;43(2):113-120

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

Juvenile household contacts aged 15 or younger of patients with pulmonary TB in the greater metropolitan area of Vitória, Brazil: a cohort study

Comunicantes domiciliares jovens de pacientes com TB pulmonar na região da grande Vitória (ES): um estudo de coorte

Ethel Leonor Noia Maciel, Luiza Werner Heringer Vieira, Lucília Pereira Dutra Molina, Rosana Alves, Thiago Nascimento do Prado, Reynaldo Dietze

J Bras Pneumol.2009;35(4):359-366

Brief Communication

Prevalence of HIV infection in tuberculosis patients treated at primary health care clinics in the city of Fortaleza, Brazil

Prevalência da infecção pelo HIV em pacientes com tuberculose na atenção básica em Fortaleza, Ceará

Helder Oliveira e Silva, Marcelo Luiz Carvalho Gonçalves

J Bras Pneumol.2012;38(3):382-385

Original Article

Treatment completion and challenges in rolling out 12-dose weekly rifapentine plus isoniazid to prevent tuberculosis among people living with HIV and pediatric household contacts in Brazil

Isadora Salles1, Jamile Garcia de Oliveira2, Alexandra Brito de Souza3, Silvia Cohn1, Renata Spener-Gomes4,5, Solange Dourado de Andrade3, Valeria Saraceni2, Solange Cesar Cavalcante2,6, Jeff Weiser7, Makaita Gombe7, Violet Chihota7,8,9, Gavin Churchyard7,8,9, Richard E Chaisson1, Marcelo Cordeiro-Santos3,4,10, Betina Durovni2,11

J Bras Pneumol.2025;51(4):e20250125

Objective: In July of 2021, the Brazilian National Ministry of Health integrated three months of once-weekly isoniazid plus rifapentine (3HP) into the National Guidelines for Tuberculosis Control as a first-line tuberculosis preventive therapy (TPT) option for people living with HIV (PLHIV) and tuberculosis household contacts (HHCs). As part of the Unitaid-sponsored Increasing Market and Public Health Outcomes through Scaling up Affordable Access Models of Short Course Preventive Therapy for TB project to implement short-course TPT, we evaluated 3HP uptake, completion, and tolerability among PLHIV and pediatric HHCs in Brazil. Methods: We conducted a multicenter single-arm pragmatic project to roll out 3HP for PLHIV and HHCs in the 2- to 14-year age bracket in the cities of Rio de Janeiro and Manaus, Brazil. Participants were identified, treated, and monitored in accordance with Brazilian national tuberculosis guidelines. De-identified patient-level data on treatment initiation, adverse events, and completion were collected and analyzed. Results: From October of 2021 to March of 2023, 380 PLHIV (77.6% of whom were male; median age, 40 years [IQR, 31-51]) and 74 HHCs (54.1% of whom were male; median age, 8.6 years [IQR, 5.1-11.8]) were enrolled in the study. Treatment completion rates were 83.7% among PLHIV and 82.4% among HHCs. Completion rates were higher in Rio de Janeiro than in Manaus (PLHIV: 86.0% vs. 79.6%; HHCs: 85.2% vs. 80.9%), although completion of 10 doses was similar (PLHIV: 86.4% vs. 86.1%). Adverse event-related discontinuation was low (PLHIV: 2.4%; HHCs: 2.7%). One person living with HIV developed active tuberculosis during treatment. At six months of follow-up, 99.6% of the PLHIV remained free of tuberculosis. Conclusions: The 3HP regimen was successfully introduced, had high treatment completion rates, and was well tolerated. Widespread use of 3HP for TPT may accelerate tuberculosis elimination in Brazil.

Keywords: Tuberculosis; Latent tuberculosis; HIV infections; Isoniazid; Rifapentine; Treatment adherence and compliance.

Nutritional, clinical and socioeconomic profile of patients with cystic fibrosis treated at a referral center in northeastern Brazil

Perfil nutricional, clínico e socioeconômico de pacientes com fibrose cística atendidos em um centro de referência no nordeste do Brasil

Isabel Carolina da Silva Pinto, Cristiane Pereira da Silva, Murilo Carlos Amorim de Britto

J Bras Pneumol.2009;35(2):137-143

Review Article

Chest X-ray and chest CT findings in patients diagnosed with pulmonary tuberculosis following solid organ transplantation: a systematic review

Achados de radiografia e de TC de tórax em pacientes transplantados de órgãos sólidos e diagnosticados com tuberculose pulmonar: uma revisão sistemática

Irai Luis Giacomelli1,a, Roberto Schuhmacher Neto1,b, Edson Marchiori2,c, Marisa Pereira1, Bruno Hochhegger1,d

J Bras Pneumol.2018;44(2):161-166

Letters to the Editor

What is the link between household garbage and tobacco control? The case of Brazil

Qual é a ligação entre o lixo doméstico e o controle do tabaco? O caso do Brasil

André Salem Szklo1, Maria Raquel Fernandes Silva2, Bianca Ramalho Quintaes3, Alessandra Trindade Machado4

J Bras Pneumol.2020;46(4):e20200094

Original Article

Nontuberculous mycobacteria in patients with suspected tuberculosis and the genetic diversity of Mycobacterium avium in the extreme south of Brazil

Micobactérias não tuberculosas em pacientes com suspeita de tuberculose e a diversidade genética de Mycobacterium avium no extremo sul do Brasil

Caroline Busatto1, Júlia Silveira Vianna1, Ana Barbara Scholante Silva1, Rossana Basso2, Jussara Silveira2, Andrea Von Groll1, Ivy Bastos Ramis1, Pedro Eduardo Almeida da Silva1

J Bras Pneumol.2020;46(2):e20190184

Clinical evolution of a group of patients with multidrug-resistant TB treated at a referral center in the city of Rio de Janeiro, Brazil

Evolução clínica de um grupo de pacientes com TB multirresistente atendidos em um centro de referência na cidade do Rio de Janeiro

Helio Ribeiro de Siqueira, Flávia Alvim Dutra de Freitas, Denise Neves de Oliveira, Angela Maria Werneck Barreto, Margareth Pretti Dalcolmo, Rodolpho Mattos Albano

J Bras Pneumol.2009;35(1):54-62

Profile of patients with tuberculosis: evaluation of the Brazilian national tuberculosis control program in Bagé, Brazil

Perfil dos pacientes com tuberculose e avaliação do programa nacional de controle da tuberculose em Bagé (RS)

Marysabel Pinto Telis Silveira, Raquel Fabiane Roscoff de Adorno, Tiago Fontana

J Bras Pneumol.2007;33(2):199-205

Ninety-day outcomes in patients diagnosed with COVID-19 in São Paulo, Brazil: a cohort study

Desfechos em 90 dias entre pacientes com diagnóstico de COVID-19 em São Paulo (SP): estudo de coorte

Renata Rego Lins Fumis1, Eduardo Leite Vieira Costa1,2, Bruno Martins Tomazini1,3, Leandro Utino Taniguchi1,4, Livia do Valle Costa1, Christian Valle Morinaga1, Marcia Martiniano de Sousa e Sá1, Luciano Cesar Pontes de Azevedo1,4, Teresa Cristina Nascimento1, Carla Bernardes Ledo1, Maura Salaroli de Oliveira1, Luiz Francisco Cardoso1, Laerte Pastore Junior1, José Mauro Vieira Junior1

J Bras Pneumol.2023;49(3):e20230056

Epidemiological profile of adult patients with tuberculosis and AIDS in the state of Espírito Santo, Brazil: Cross-referencing tuberculosis and AIDS databases

Perfil epidemiológico de pacientes adultos com tuberculose e AIDS no estado do Espírito Santo, Brasil: Relacionamento dos bancos de dados de tuberculose e AIDS

Thiago Nascimento do Prado, Antonio Luiz Caus, Murilo Marques, Ethel Leonor Maciel, Jonathan E. Golub, Angélica Espinosa Miranda

J Bras Pneumol.2011;37(1):93-99

Speeding up the diagnosis of multidrug-resistant tuberculosis in a high-burden region with the use of a commercial line probe assay

Agilizando o diagnóstico da tuberculose multirresistente em uma região endêmica com o uso de um teste comercial de sondas em linha

Angela Pires Brandao1,2,a, Juliana Maira Watanabe Pinhata1,b, Rosangela Siqueira Oliveira1,c, Vera Maria Neder Galesi3,d, Helio Hehl Caiaffa-Filho1,e, Lucilaine Ferrazoli1,f

J Bras Pneumol.2019;45(2):e20180128

Epidemiological profile of lung tuberculosis infection and disease among cocaine users being treated in hospitals of São Paulo, Brazil

Perfil epidemiológico da tuberculose infecção e doença entre usuários de cocaína internados em serviços hospitalares da Grande São Paulo

Olavo Franco Ferreira Filho, Marilia Dalva Turchi, Ronaldo Laranjeiras, Adauto Castelo

J Bras Pneumol.2003;29(3):125-132

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