Castro Sybelle de Souza, Scatena Lúcia Marina, Miranzi Alfredo, Miranzi Neto Almir, Nunes Altacílio Aparecido
Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Programa de Pós-Graduação Strictu Sensu em Saúde na Comunidade, Ribeirão Preto, São Paulo, Brazil.
Universidade Federal do Triângulo Mineiro, Departamento de Saúde Coletiva, Programa de Pós-Graduação Strictu Sensu em Atenção à Saúde, Uberaba, Minas Gerais, Brazil.
Rev Inst Med Trop Sao Paulo. 2019;61:e21. doi: 10.1590/S1678-9946201961021. Epub 2019 Apr 8.
This study aimed to characterize the cases of tuberculosis (TB) co-infected with the human immunodeficiency virus (HIV) in Minas Gerais State, Brazil, after the notification sheet modification, and to verify the association between the new variables and the treatment outcome. It is an analytical cross-sectional study with TB/HIV cases notified in the year 2016 to the Brazilian Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificação). Descriptive statistics, chi-square test, and multiple correspondence analysis were performed to verify the association between the outcome, ageand associated diseases. Of the 180 cases, most were male (75.6%) between 30 and 49 years old (63.3%), mixed ethnicity (black and white) (49.4%), 94.4% had the Acquired Immunodeficiency Syndrome (AIDS) and 60.6% had pulmonary TB. The molecular test was not performed at the time of diagnosis in 70.5% of the cases. Homeless people (4.4%) and prisoners (3.9%) featured prominently among the special populations. People between 40 and 49 years old without concurrent diseases were cured in 40.0% of the cases; 18.9% abandoned the treatment due to smoking, drug abuse and mental illness in the age group between 20 and 29 years old. The deaths were associated with the age group between 30 and 39 years old and the occurrence of AIDS. The results have shown that the groups considered vulnerable (drug users, smokers and people with mental illness) abandoned the treatment, the notification upon death from AIDS in adults was late and some treatments were inadequate. The epidemiological surveillance, prevention and assistance strategies towards cases of TB/HIV must be improved in order to achieve the goal of the Brazilian National Plan to end Tuberculosis as a Public Health Problem until 2035 in the state.
本研究旨在对巴西米纳斯吉拉斯州在通知单修改后合并感染人类免疫缺陷病毒(HIV)的结核病(TB)病例进行特征描述,并验证新变量与治疗结果之间的关联。这是一项分析性横断面研究,研究对象为2016年向巴西法定传染病信息系统(Sistema de Informação de Agravos de Notificação)报告的TB/HIV病例。进行了描述性统计、卡方检验和多重对应分析,以验证结果、年龄和相关疾病之间的关联。在180例病例中,大多数为男性(75.6%),年龄在30至49岁之间(63.3%),种族为混血(黑人和白人)(49.4%),94.4%患有获得性免疫缺陷综合征(AIDS),60.6%患有肺结核。70.5%的病例在诊断时未进行分子检测。无家可归者(4.4%)和囚犯(3.9%)在特殊人群中占比较大。40至49岁无并发疾病的患者中,40.0%的病例治愈;20至29岁年龄组中,18.9%的患者因吸烟、药物滥用和精神疾病而放弃治疗。死亡与30至39岁年龄组以及AIDS的发生有关。结果表明,被视为弱势群体的群体(吸毒者、吸烟者和精神疾病患者)放弃了治疗,成人AIDS死亡报告延迟,且一些治疗不充分。为了在该州实现巴西国家计划到2035年消除结核病作为公共卫生问题的目标,必须改进对TB/HIV病例的流行病学监测、预防和援助策略。