Clinical and epidemiological profile of tuberculosis in an urban area with high human development index in southeastern Brazil. Time series study.

Rodolpho Telarolli Junior,Leonor Castro Monteiro Loffredo,Rosangela Maria Gasparetto

doi:10.1590/1516-3180.2016.0260210317

Rodolpho Telarolli Junior, Leonor Castro Monteiro Loffredo + Show 1 more

Open Access

https://doi.org/10.1590/1516-3180.2016.0260210317

Copy DOI

Abstract

In the twenty-first century, tuberculosis remains a serious public health problem in Brazil. The aim here was to characterize tuberculosis in a municipality with a high human development index (HDI), based on clinical and epidemiological variables. Epidemiological study with analysis of incidence that included 533 new cases of tuberculosis in the municipality of Araraquara, São Paulo, reported to the Brazilian Notifiable Diseases Information System (SINAN) between 2002 and 2011. To identify trends, this period was divided into two five-year periods (2002-2006 and 2007-2011). The incidence rates were compared using ratios and confidence intervals. The incidence of tuberculosis was 26.82 cases per 100,000 inhabitants, and decreased by 22% between the two periods, which was statistically significant. Cases were more prevalent among men (72.61%) and among adults between 30 and 59 years of age with non-specialized professions and low education levels. There was a statistically significant reduction in cases among individuals over 50. The age group with highest incidence was 50-59 years in the first period and 30-39 years in the second. Total recovery occurred in more than 70%. There was a reduction in the number of diagnoses made within primary care and an increase within public hospital care between the two periods. The most common coinfections were AIDS and hepatitis C. The incidence of tuberculosis in this municipality was lower than the national incidence, with a declining trend and a high cure rate, and the main coinfections were AIDS and hepatitis C.

Highlights

Tuberculosis (TB) was declared a global emergency by the World Health Organization (WHO) in 1993
WHO has recommended directly observed treatment, or DOTS, which focuses on detection, increasing the cure rate and decreasing patient withdrawal from treatment.[1]
The objective of this study was to characterize the TB cases reported in a municipality in the southeastern region of Brazil, from 2002 to 2011, based on demographic and clinical variables, as well as on the type of healthcare institution where the diagnosis was made. This was an epidemiological study on incidence that was exploratory and analytical in nature. It used different time series and included all new cases of TB among residents of the municipality of Araraquara, São Paulo, that were reported to the Brazilian Notifiable Diseases Information System (SINAN) from 2002 to 2011

Summary

Introduction

Tuberculosis (TB) was declared a global emergency by the World Health Organization (WHO) in 1993. WHO has recommended directly observed treatment (short-course treatment), or DOTS, which focuses on detection, increasing the cure rate and decreasing patient withdrawal from treatment.[1] DOTS was quickly adopted by the Brazilian government, and resulted in improved care for TB carriers. Between 1995 and 2012, 56 million people were successfully treated in countries that adopted DOTS, with 22 million lives saved.[2]. In view of the improvement in the epidemiological situation of TB attained through DOTS, WHO adopted SDGs (Sustainable Development Goals) in 2015. These aim to reduce the incidence by 80% and mortality by 90%, by the year 2030. WHO adopted the End TB Strategy with the objective of reducing TB incidence by 90%, by 2035, in comparison with 2015 estimates.[3]

Methods

Results

Conclusion