Garrido M da S, Bührer-Sékula S, Souza A B, de Oliveira G P, Antunes I A, Mendes J M, Saraceni V, Martinez-Espinosa F E, Ramasawmy R
Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil; Fundação de Vigilância em Saúde do Amazonas, Manaus, Amazonas, Brazil; Secretaria Municipal de Saúde de Manaus, Manaus, Amazonas, Brazil.
Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil; Instituto de Patologia e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.
Int J Tuberc Lung Dis. 2015 May;19(5):531-6. doi: 10.5588/ijtld.14.0291.
Amazonas is facing increasing challenges in tuberculosis (TB) control, with nearly 3000 cases per year, and multidrug-resistant TB (MDR-TB) may jeopardise the TB control programme.
To assess the number of MDR-TB cases in the Amazonas and to improve estimates of the burden of TB.
The Brazilian National Mandatory Disease Reporting System (SINAN) and the Brazilian Epidemiological Surveillance System of Multidrug Resistance (TBMR) were searched for MDR-TB cases in the State of Amazonas from 2000 to 2011.
Eighty-one MDR-TB cases were notified. The rates of primary MDR-TB, initial MDR-TB during the first treatment regimen and acquired MDR-TB were respectively 3.8%, 13.7% and 82.7%; 26.9% of previously treated patients had ⩾ 4 treatment cycles. The MDR-TB cases reported 263 contacts, only 35.0% of whom were examined. The cure and death rates among the 81 patients with MDR-TB were respectively 45.7% and 25.9%.
The number of MDR-TB cases seems incompatible with the high TB prevalence in the Amazonas. Most patients were unaware of contact with TB patients. TB is endemic in the Amazonas. This highlights the need for improving resistance investigation among all TB cases.
亚马孙州在结核病控制方面面临着越来越大的挑战，每年有近3000例病例，耐多药结核病（MDR-TB）可能会危及结核病控制项目。
评估亚马孙州耐多药结核病病例的数量，并改进对结核病负担的估计。
在巴西国家法定疾病报告系统（SINAN）和巴西耐多药流行病学监测系统（TBMR）中搜索2000年至2011年亚马孙州的耐多药结核病病例。
共报告了81例耐多药结核病病例。原发性耐多药结核病、首次治疗方案期间的初始耐多药结核病和获得性耐多药结核病的发生率分别为3.8%、13.7%和82.7%；26.9%的既往治疗患者有≥4个治疗周期。81例耐多药结核病病例报告了263名接触者，其中仅35.0%接受了检查。81例耐多药结核病患者的治愈率和死亡率分别为45.7%和25.9%。
耐多药结核病病例数似乎与亚马孙州高结核病患病率不相称。大多数患者不知道与结核病患者有接触。结核病在亚马孙州呈地方流行。这突出表明需要改进对所有结核病病例的耐药性调查。
