Cunha Eunice Atsuko Totumi, Marques Marli, Evangelista Maria do Socorro Nantua, Pompilio Maurício Antonio, Yassuda Renata Terumi Shiguematsu, Souza Albert Schiaveto de
Laboratório Central de Saúde Pública de Mato Grosso do Sul, Secretaria de Estado de Saúde de Mato Grosso do Sul, Campo Grande, MS, Brasil.
Programa de Controle da Tuberculose, Secretaria de Estado de Saúde de Mato Grosso do Sul, Campo Grande, MS, Brasil.
Rev Soc Bras Med Trop. 2018 May-Jun;51(3):324-330. doi: 10.1590/0037-8682-0289-2017.
High endemic levels of pulmonary tuberculosis in prisons result from overcrowding, limited access to healthcare, delayed diagnosis, sustained transmission owing to poor control measures, and multidrug resistance. This study evaluated locally implemented measures for early pulmonary tuberculosis diagnosis and evaluated resistance to anti-tuberculosis drugs.
This transversal study employed data from the Mato Grosso do Sul State Tuberculosis Control Program obtained from 35 correctional facilities in 16 counties for 2 periods (2007-2010 and 2011-2014).
Statewide prevalence (per 100,000) was 480.0 in 2007 and 972.9 in 2014. The following indicators showed improvement: alcohol-acid-fast bacillus testing (from 82.7% to 92.9%); cultures performed (55.0% to 81.8%); drug susceptibility testing of positive cultures (71.6% to 62.4%); and overall drug susceptibility testing coverage (36.6% to 47.4%). Primary and acquired resistance rates for 2007-2014 were 21.1% and 30.0%, respectively. Primary and acquired multidrug resistance rates were 0.3% and 1.3%, respectively.
Prevalence rates increased, and laboratory indicators improved as a result of capacity building and coordination of technical teams and other individuals providing healthcare to inmates. Resistance rates were high, thereby negatively affecting disease control.
监狱中肺结核的高流行水平是由过度拥挤、医疗服务获取有限、诊断延迟、控制措施不力导致的持续传播以及多重耐药性引起的。本研究评估了当地实施的早期肺结核诊断措施，并评估了对抗结核药物的耐药性。
这项横断面研究采用了来自南马托格罗索州结核病控制项目的数据，这些数据来自16个县的35个惩教设施，为期两个阶段（2007 - 2010年和2011 - 2014年）。
全州患病率（每10万人）在2007年为480.0，在2014年为972.9。以下指标有所改善：酒精 - 抗酸杆菌检测（从82.7%提高到92.9%）；进行培养（从55.0%提高到81.8%）；阳性培养物的药敏试验（从71.6%降至62.4%）；以及总体药敏试验覆盖率（从36.6%提高到47.4%）。2007 - 2014年的原发耐药率和获得性耐药率分别为21.1%和30.0%。原发和获得性多重耐药率分别为0.3%和1.3%。
由于技术团队和其他为囚犯提供医疗服务的人员的能力建设与协调，患病率上升，实验室指标得到改善。耐药率很高，从而对疾病控制产生负面影响。
