Department of Epidemiology of the University of São Paulo School of Public Health, São Paulo, Brazil.
J Bras Pneumol. 2009 Oct;35(10):998-1007. doi: 10.1590/s1806-37132009001000009.
To characterize the profile of patients with pulmonary tuberculosis (PTB) in the city of Santos, Brazil, according to biological, environmental and institutional factors.
Descriptive study, using the TB surveillance database, including patients with PTB, aged 15 years or older, residing in the city of Santos and whose treatment was initiated between 2000 and 2004.
We identified 2,176 cases, of which 481 presented a history of TB. Of those 481 patients, 29.3% were cured, and 70.7% abandoned treatment. In 61.6% of the cases, the diagnosis was confirmed by sputum smear microscopy, whereas it was confirmed based on clinical and radiological criteria in 33.8%; 69.0% were male; and 69.5% were between 20 and 49 years of age. There were 732 hospitalizations, and the mean length of hospital stay was 32 days (first hospitalization). The prevalence of alcoholism, diabetes and TB/HIV coinfection was, respectively, 11.7%, 8.2% and 16.2%. The prevalence of TB/HIV coinfection decreased from 20.7% to 12.9% during the study period. The treatment outcome was cure, abandonment, death from TB and death attributed to TB/HIV coinfection in 71.0%, 12.1%, 3.9% and 2.5%, respectively. The directly observed treatment, short-course (DOTS) was adopted in 63.4% of cases, and there were no significant differences between DOTS and the conventional treatment approach in terms of outcomes (p > 0.05). The mean annual incidence of PTB was 127.9/100,000 population (range: 72.8-272.92/100,000 population, varying by region). The mean annual mortality rate for PTB was 6.9/100,000 population.
In areas hyperendemic for TB, DOTS should be prioritized for groups at greater risk of treatment abandonment or death, and the investigation of TB contacts should be intensified.
根据生物学、环境和制度因素，描述巴西桑托斯市肺结核（PTB）患者的特征。
本研究采用描述性研究，使用结核病监测数据库，包括年龄在 15 岁及以上、居住在桑托斯市并于 2000 年至 2004 年期间开始治疗的 PTB 患者。
共发现 2176 例病例，其中 481 例有结核病病史。在这 481 例患者中，29.3%治愈，70.7%放弃治疗。61.6%的病例通过痰涂片显微镜检查确诊，33.8%的病例根据临床和影像学标准确诊；69.0%为男性；69.5%的年龄在 20 至 49 岁之间。有 732 例住院治疗，首次住院平均住院时间为 32 天。酗酒、糖尿病和 TB/HIV 合并感染的患病率分别为 11.7%、8.2%和 16.2%。在研究期间，TB/HIV 合并感染的患病率从 20.7%下降至 12.9%。治疗结果分别为治愈、放弃、死于结核病和死于 TB/HIV 合并感染，分别占 71.0%、12.1%、3.9%和 2.5%。直接观察治疗短程化疗（DOTS）方案在 63.4%的病例中得到采用，DOTS 与常规治疗方法在结局方面无显著差异（p＞0.05）。PTB 的年发病率为 127.9/100000 人（范围：72.8-272.92/100000 人，因地区而异）。PTB 的年死亡率为 6.9/100000 人。
在结核病高度流行地区，应优先考虑 DOTS 方案用于治疗中断或死亡风险较高的人群，并加强对结核病接触者的调查。
