When is Tb-Aids Co-Infection Treatment Discontinued? an Analysis of the Situation in Brazil
Keywords:Co-infection, Epidemiological Surveillance, Public Health
Introduction:Â Brazil has high levels of TB-AIDS co-infection. Objective: To analysedifferences and similarities,with respect to each Statein Brazil and to the Federal District,concerning the stage at which TB-AIDS co-infection treatment is discontinued. The study period was 2008-13. Methods: Cross-sectional, quantitative study, using data from the Diseases and Notification Information Systemadministered by the Brazilian Health Ministry.The data were analysed using the statistics program R, and the results are represented graphically by dotplots and dendrograms. Results: 58,704 cases of tuberculosis-AIDS co-infection were recorded. Rates of cure were under 30%. In the States of ParaÃba and Pernambuco, treatment dropoutwas almost 50%.Mortality levels were high, at 70-90% in some States. Multiresistant TB was observed in less than 20%of cases. The rate of non-treated/non-resolved cases was 70% in Bahia. Transfer rates varied widely, with the highest level being recorded in Alagoas (80% of cases). Conclusion: Global goals are far from being met. There is considerable operational diversity in the public health policies of the different States. TB-AIDS co-infection should be monitored continuously and the epidemiological information system regularly updated in order to control this double epidemic.
World Health Organization (WHO). Global tuberculosis control: surveillance, planning, financing. Geneva: WHO, 2013.
World Health Organization (WHO). Global tuberculosis control: surveillance, planning, financing. Geneva: WHO, 2014.
Shah NH, Gupta J. Modelling of HIV-TB Co-infection transmission dynamics. American Journal of Epidemiology and Infectious Disease, 2014, 2(1):1-7.
Lawn SD. Harries AD, Williams BG, et al. Antiretroviral therapy and the control of HIV-associated tuberculosis. Will ART do it? J Tuberc Lung Dis, 2011, 15 (5): 571-581.
WHO. World Health Organization. Frequently asked questions about TB and HIV. Available at: http://www.who.int/occupational_health/plubications/hiv_tb_guidelines_english_final.pdf, Geneva, 2012.
Zenteno-Cuevas R, Montes-VillaseÃ±or E, Morales-Romero J, Coronel-MartÃn CG, Cuevas B. Co-infection and risk factors of tuberculosis in a Mexican HIV+ population. Rev. Soc. Bras. Med. Trop, 44( 3 ): 282-285. 2015.
BRASIL. Manual de recomendaÃ§Ãµes do para o controle da tuberculose no Brasil, MinistÃ©rio da SaÃºde, BrasÃlia â€“ DF, 2011.
Zumia A, Atun R, Maeurer M et al. Eliminating tuberculosis and tuberculosisâ€“HIV co-disease in the 21st century: Key Perspectives, Controversies, Unresolved Issues, and Needs. J Tuberc Lung Dis,2012, 205(suppl 2): 141-146.
Oliveira GP, Torrens AW, Bartholomay P, Barreira D. Tuberculosis in Brazil: last ten years analysis â€“ 2001â€“2010. Braz J Infect Dis, 17(2): 218-233.
Saita NM, Oliveira HB.Tuberculose, AIDS e coinfecÃ§Ã£o tuberculose-AIDS em cidade de grande porte. Rev. Latino-Am. Enfermagem, 2012; 20(4):8.
Hino P, Takahashi RF, Bertolozzi MR, Egry EY. CoinfecÃ§Ã£o de Tb/HIV em um distrito administrativo do MunicÃpio de SÃ£o Paulo. Acta Paul Enferm. 2012; 25(5):755-61. SÃ£o Paulo.-SP.
BRASIL, MinistÃ©rio da SaÃºde. Sistema de InformaÃ§Ã£o de Agravos de NotificaÃ§Ã£o. Tuberculose: casos confirmados diagnosticados, 2014. Available at: <http://dtr2004.saude.gov.br/sinanweb/>. Accessed: 13 de March 2015.
R Development Core Team (2011), R: A language and environment for statistical computing. Vienna, Austria : the R Foundation for Statistical Computing. ISBN: 3-900051-07-0. Available online at http://www.R-project.org/.
Wilkinson L. Dot plots. The American Statistician, 1999, 53(3), 276-281. MÃ©xico.
Aldenderfer, MS, Blashfield RK.Cluster analysis. Beverly Hills: Sage, 1984. 88p.
Romesburg, HC. Cluster analysis for researchers. North Carolina: Lulu, 2004, 344p.
Sneath, PHA; Sokal, RR. Numeral taxonomy. New York: Hafner, 1975.
James ML; Carroll, JD; Green, PE. AnÃ¡lise de dados multivariados.SÃ£o Paulo: Cengage Learning. 2011. 245p.
Dye C, LÃ¶nnroth K, Jaramillo E, Williams BG, Raviglione M. Trends in tuberculosis incidence and their determinants in 134 countries. Bull World Health Organ. 2009;87:683-91.
Figueiredo TMRM. Acesso ao tratamento de tuberculose: avaliaÃ§Ã£o das caracterÃsticas organizacionais e de desempenho dos serviÃ§os de saÃºde. RibeirÃ£o Preto. Universidade de SÃ£o Paulo, 2008.
GuimarÃ£es RM, Lobo AP, Siqueira EA, Borges TFF, Melo SCC. Tuberculose, HIV e pobreza: tendÃªncia temporal no Brasil, AmÃ©ricas e mundo. J. Bras. Pneumol, 2012, 38(4): 511-517.
Queiroz EM, Bertolozzi MR. Tuberculose: tratamento supervisionado nas Coordenadorias de SaÃºde Norte, Oeste e Leste do MunicÃpio de SÃ£o Paulo. Rev. Esc. Enferm. USP, 2010 ,44(2): 453-461.
Sanchez M, Bartholomay P, Arakaki-Sanchez D, et al. Outcomes of TB treatment by HIV status in national recording systems in Brazil, 2003-2008. PLoS One, 2012, 7(3):e33129.
Saraceni V, King SC, Cavalcante SC. Tuberculosis as primary cause of death among AIDS cases in Rio de Janeiro, Brazil. J Tuberc Lung Dis, 12(7):769-772, 2008.
Silva PF; Moura GS; Caldas AJM. Fatores associados ao abandono do tratamento da tuberculose pulmonar no MaranhÃ£o, Brasil, no perÃodo de 2001 a 2010. Caderno de SaÃºde PÃºblica, 2014,30(8):175-1754.
Kliiman K. Altraja A. Predictors and mortality associated with treatment default in pulmonary tuberculosis. J Tuberc Lung Dis, 2012, 14 (4): 454-463.
Lacerda SNB, Temoteo RCA, Figueiredo TMRM, et al. Individual and social vulnerabilities upon acquiring tuberculosis: a literature systematic review. Int Arch Med. 2014; 7: 35.
TrÃ©bucq A, Enardson DA, Chiang CY, et al. XpertÂ® MTB/RIF for national tuberculosis programmes in low-income countries: when, where and how. J Tuberc Lung Dis, 2011, 15 (12):1567-1572.
Nogueira JA, SÃ¡ LD, FranÃ§a UM, et al. O sistema de informaÃ§Ã£o e o controle da tuberculose nos municÃpios prioritÃ¡rios da ParaÃba - Brasil. Rev. Esc. Enferm. USP.2009, 43(1): 125-131.
Santos NP, LÃrio M, Passos LAR, et al . Completude das fichas de notificaÃ§Ãµes de tuberculose em cinco capitais do Brasil com elevada incidÃªncia da doenÃ§a. J. Bras. Pneumol, 2013,39(2): 221-225.
BRASIL. MinistÃ©rio da SaÃºde. Boletim epidemiolÃ³gico. Volume 44, n 02. Brasilia, 2015. Available at: http://portalsaude.saude.gov.br/images/pdf/2014/abril/10/Boletim-Tuberculose-2014.pdf.Accessed: 17 June 2015.
Grangeiro A, Escuder MML, Castilho EA. Magnitude e tendÃªncia da epidemia de Aids em municÃpios brasileiros de 2002-2006. Rev SaÃºde PÃºblica. 2010, 4(3):430-40.
Boffo MMS, Mattos IG, Ribeiro MO, Neto ICO. Tuberculose associada Ã AIDS: caracterÃsticas demogrÃ¡ficas, clÃnicas e laboratoriais de pacientes atendidos em um serviÃ§o de referÃªncia do sul do Brasil. J. Bras. Pneumol. 2004,30( 2 ): 140-146.
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