Tuberculosis and intravenous drug users, impact of proximity measures in screening and treatment

Abstract

Introduction: Intravenous drug users are a risk group for tuberculosis. In 2004, measures to improve health care in this subpopulation, promoting active screening and encourage treatment were introduced in Vila Nova de Gaia. We intended to characterize intravenous drug users with TB in Vila Nova de Gaia, Portugal, from 2000 to 2012, evaluating the long term impact of the 2004 intervention. Methods: retrospective cohort of all notified tuberculosis patients living in Vila Nova de Gaia, from 2000 to 2012. Results: During the studied period, 1624 tuberculosis patients living in Vila Nova de Gaia were notified, of which 220 were intravenous drug users. From 2000 to 2003, IV drug users represented 14,8% of Tb patients, from 2004 to 2006, 16,2% and from 2007 to 2012, 10,0% (p=0,012). Since 2004, active screening has been more frequently a mean of tuberculosis case detection (p=0,002). Pulmonary location was the most common manifestation in both groups, but more frequent among drug users (p=0,013). Disseminated form of the disease was also more frequent among this group (p Considering the three periods, treatment success improved in all three groups - global population (p Discussion: Treatment success improvement was more pronounced from 2000-2003 to 2004-2006, stabilizing after that. Our results reinforced the need for the maintenance of these integrative initiatives, involving several institutions most active in the community in spite of the actual economic constraints.