Original Article

Outcomes of tuberculosis treatment among inpatients and outpatients in the city of São Paulo, Brazil

Desfechos de tratamento de tuberculose em pacientes hospitalizados e não hospitalizados no município de São Paulo

Mirtes Cristina Telles Perrechi, Sandra Aparecida Ribeiro

J Bras Pneumol.2011;37(6):783-790

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.

Analysis of treatment outcomes related to the tuberculosis control program in the city of Campinas, in the state of São Paulo, Brazil

Análise do programa de controle da tuberculose em relação ao tratamento, em Campinas - SP

Helenice Bosco de Oliveira, Leticia Marin-León, Jovana Gardinali

J Bras Pneumol.2005;31(2):133-138

Background: Tuberculosis cure is dependent upon treatment adherence. Objective: To analyze the results of tuberculosis treatment in public health clinics in the city of Campinas, in the state of São Paulo, Brazil, during 2002. Method: From a cohort of 484 patients diagnosed with tuberculosis, we evaluated 436. Treatment outcomes were described for all patients, whether new patients or patients in retreatment, including those presenting the pulmonary form, with or without acquired immunodeficiency syndrome (AIDS) comorbidity. Results: The success rate was 68.6% (72.3% among non-AIDS patients and 57.6% among AIDS patients). Among new cases, the non-AIDS group presented a 2.2-times greater chance of presenting favorable results. In the AIDS group, no differences were observed between new patients and those in retreatment. Among the unfavorable outcomes, only lethality presented a difference (18.9% among AIDS patients and 8.0% among non-AIDS patients). In patients presenting the pulmonary form, the success rate was similar between those who were initially acid-fast bacilli positive and those who were not. Conclusion: The tuberculosis control program in Campinas presented low effectiveness. In comparison to the 2001 national cohort, success rates were higher for non-AIDS patients but lower for AIDS patients. The higher success rate among cases of tuberculosis without AIDS was primarily derived from the treatment of new cases. The unfavorable profile of tuberculosis patients co-infected with AIDS, characterized by the (18.9%) lethality and the (15.3%) noncompliance, were partially responsible for the lower success rate seen among such patients. It is notable that such high proportions of noncompliant patients were seen in a city providing easy access to treatment. In order to improve the program, medical teams should receive further training in supervised treatment, health education and techniques for interacting with patients, all of which will require considerable investment.

Keywords: Key words: Tuberculosis. Treatment Refusal. Retreatment. Acquired Immunodeficiency Syndrome. Comorbidity

Tuberculosis treatment: integration between hospitals and public health care clinics in the city of São Paulo, Brazil

Tratamento de tuberculose: integração entre assistência hospitalar e rede básica na cidade de São Paulo

Mirtes Cristina Telles Perrechi, Sandra Aparecida Ribeiro

J Bras Pneumol.2009;35(11):1100-1106

Tuberculosis recurrence in a priority city in the state of São Paulo, Brazil

Recorrência de tuberculose em município prioritário do estado de São Paulo

Amadeu Antonio Vieira1,2, Danila Torres Leite3, Solange Adreoni2

J Bras Pneumol.2017;43(2):106-112

Retreatment of tuberculosis patients in the city of Porto Alegre, Brazil: outcomes

Desfechos do retratamento de pacientes com tuberculose com o uso do esquema 3 em Porto Alegre, Brasil

Pedro Dornelles Picon, Carlos Fernando Carvalho Rizzon, Sergio Luiz Bassanesi, Luiz Carlos Correa da Silva, Maria de Lourdes Della Giustina

J Bras Pneumol.2011;37(4):504-511

Brief Communication

Analysis and comparison of tuberculosis treatment outcomes in the homeless population and in the general population of Brazil

Análise e comparação dos desfechos do tratamento de tuberculose na população em situação de rua e na população geral do Brasil

Andresa Cristine Estrella dos Santos1a, Camila Brunfentrinker1a, Larissa da Silva Pena2a, Suélen dos Santos Saraiva3a, Antonio Fernando Boing4a

J Bras Pneumol.2021;47(2):e20200178

Original Article

Food baskets given to tuberculosis patients at a primary health care clinic in the city of Duque de Caxias, Brazil: effect on treatment outcomes

Efeito do incentivo alimentício sobre o desfecho do tratamento de pacientes com tuberculose em uma unidade primária de saúde no município de Duque de Caxias, Rio de Janeiro

João Paulo Cantalice Filho

J Bras Pneumol.2009;35(10):992-997

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

Adverse effects of tuberculosis treatment: experience at an outpatient clinic of a teaching hospital in the city of São Paulo, Brazi

Efeitos adversos no tratamento da tuberculose: experiência em serviço ambulatorial de um hospital-escola na cidade de São Paulo

Denise Eri Onodera Vieira, Mauro Gomes

J Bras Pneumol.2008;34(12):1049-1055

Determinants of smoking experimentation and initiation among adolescent students in the city of Salvador, Brazil

Determinantes da experimentação do cigarro e do início precoce do tabagismo entre adolescentes escolares em Salvador (BA)

Adelmo de Souza Machado Neto, Tarcisio Matos Andrade, Carlos Napoli, Lilian Carine Souza de Lima Abdon, Mônica Rocha Garcia, Francisco Inácio Bastos

J Bras Pneumol.2010;36(6):674-682

Prevalences of asthma and rhinitis among adolescents in the city of Fortaleza, Brazil: temporal changes

Comparação temporal das prevalências de asma e rinite em adolescentes em Fortaleza, Brasil

Maria de Fátima Gomes de Luna, Gilberto Bueno Fischer, João Rafael Gomes de Luna, Marcelo Gurgel Carlos da Silva, Paulo César de Almeida, Daniela Chiesa

J Bras Pneumol.2013;39(2):128-137

Compliance with tuberculosis treatment after the implementation of the directly observed treatment, short-course strategy in the city of Carapicuíba, Brazil

Adesão ao tratamento da tuberculose após a instituição da estratégia de tratamento supervisionado no município de Carapicuíba, Grande São Paulo

Amadeu Antonio Vieira, Sandra Aparecida Ribeiro

J Bras Pneumol.2011;37(2):223-231

Factors associated with death by tuberculosis in the eastern part of São Paulo city, 2001

Fatores associados ao óbito por tuberculose na zona leste da cidade de São Paulo, 2001

Monica Hid Haddad Pelaquin, Rebeca Souza e Silva, Sandra Aparecida Ribeiro

J Bras Pneumol.2007;33(3):311-317

Lateral flow urine lipoarabinomannan assay for tuberculosis diagnosis in HIV-positive inpatients and outpatients

Giovana Rodrigues Pereira1,2, Márcia Silva Barbosa2, Carina Secchi2, Maiara Priscila dos Passos2, André Kulzer Santos3, Raimunda Sinthia Lima de Braga3, Marina Scheffer de Souza3, Gean Souza Ramos3, João Vitor Vigne Duz3, Denise Rossato Silva1,3,4

J Bras Pneumol.2025;51(4):e20250152

PLATINO, a nine-year follow-up study of COPD in the city of São Paulo, Brazil: the problem of underdiagnosis

PLATINO, estudo de seguimento de nove anos sobre DPOC na cidade de São Paulo: o problema do subdiagnóstico

J Bras Pneumol.2014;40(1):30-37

Objective: To determine the underdiagnosis rate in new COPD cases at the end of a nine-year follow-up period-in the study designated "Projeto Latino-Americano de Investigação em Obstrução Pulmonar" (PLATINO, Latin-American Pulmonary Obstruction Investigation Project)-and compare that with the underdiagnosis rate during the initial phase of the study, as well as to identify the clinical features exhibited by the subjects who were not diagnosed until the end of the follow-up phase. Methods: The study population comprised the 1,000 residents of the city of São Paulo, Brazil, who took part in the PLATINO study. Of those, 613 participated in the follow-up phase, during which the subjects were assessed with the same instruments and equipment employed in the initial phase of the study. We used the chi-square test or the independent sample t-test to analyze the underdiagnosis rate and to identify the characteristics of the subjects who were not diagnosed until the end of the follow-up phase. Results: The underdiagnosis rate for new COPD cases at the end of the nine-year follow-up period was 70.0%. The underdiagnosis rate during the follow-up phase was 17.5% lower than that reported for the initial phase of the study. The subjects who were not diagnosed until the end of the follow-up phase presented with fewer respiratory symptoms, better pulmonary function, and less severe disease than did those previously diagnosed with COPD. Conclusions: The underdiagnosis rate for new COPD cases was lower in the follow-up phase of the study than in the initial phase. The subjects who were not diagnosed until the end of the follow-up phase of the PLATINO study presented with the same clinical profile as did those who were not diagnosed in the initial phase. These findings underscore the need for spirometry in order to confirm the diagnosis of COPD and provide early intervention.

Keywords: Pulmonary disease, chronic obstructive/diagnosis; Pulmonary disease, chronic obstructive/epidemiology; Spirometry.

Impact of smoking on sputum culture conversion and pulmonary tuberculosis treatment outcomes in Brazil: a retrospective cohort study

Impacto do tabagismo na conversão de cultura e no desfecho do tratamento da tuberculose pulmonar no Brasil: estudo de coorte retrospectivo

Michelle Cailleaux-Cezar1,a, Carla Loredo1,b, José Roberto Lapa e Silva1,c, Marcus Barreto Conde1,2,d

J Bras Pneumol.2018;44(2):99-105

Noncompliance with tuberculosis treatment involving self administration of treatment or the directly observed therapy, short-course strategy in a tuberculosis control program in the city of Carapicuíba, Brazil

Abandono do tratamento de tuberculose utilizando-se as estratégias tratamento auto-administrado ou tratamento supervisionado no Programa Municipal de Carapicuíba, São Paulo, Brasil

Amadeu Antonio Vieira, Sandra Aparecida Ribeiro

J Bras Pneumol.2008;34(3):159-166

Prevalence of and variables related to smoking among medical students at a university in the city of Passo Fundo, Brazil

Prevalência e fatores associados ao tabagismo em estudantes de medicina de uma universidade em Passo Fundo (RS)

Leandro Mazzoleni Stramari, Munique Kurtz, Luiz Carlos Corrêa da Silva

J Bras Pneumol.2009;35(5):442-448

Predictors of tuberculosis treatment outcomes

Preditores dos desfechos do tratamento da tuberculose

Renata de Lima Orofino, Pedro Emmanuel Americano do Brasil, Anete Trajman, Carolina Arana Stanis Schmaltz, Margareth Dalcolmo, Valéria Cavalcanti Rolla

J Bras Pneumol.2012;38(1):88-97

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