Obitos atribuidos a tuberculose no Estado do Rio de Janeiro



Document title: Obitos atribuidos a tuberculose no Estado do Rio de Janeiro
Journal: Jornal brasileiro de pneumologia
Database: PERIÓDICA
System number: 000297435
ISSN: 1806-3713
Authors: 1
1




Institutions: 1Secretaria de Estado de Saude do Rio de Janeiro, Rio de Janeiro. Brasil
Year:
Season: Jul-Ago
Volumen: 30
Number: 4
Pages: 335-342
Country: Brasil
Language: Portugués
Document type: Artículo
Approach: Caso clínico, analítico
English abstract BACKGROUND: In 1998, tuberculosis incidence and mortality rates in the state of Rio de Janeiro (RJ) were the highest in Brazil. However, the RJ tuberculosis database (SINAN-TB-RJ) has proven unreliable. OBJECTIVE: To evaluate the current tuberculosis control program by analyzing tuberculosis-attributed deaths. METHODS: Descriptive studies of the SINAN-TB-RJ and tuberculosis mortality (SIM-TB-RJ) databases were carried out. Both databases were linked using the Reclink program. A study based on medical records was performed in the five hospitals where the greatest numbers of tuberculosis deaths occurred. RESULTS: In the SINAN-TB-RJ database, 16,567 cases were registered in adults (> 14 years of age). Pulmonary disease was present in 13,989 (84.5%), of whom 8223 (56.8%) presented sputum smears that were positive for acid fast bacilli. Anti-HIV testing, recommended for all patients with tuberculosis, was performed in only 4141 (25%) of tuberculosis cases. The SIM-TB-RJ database showed 1146 deaths that were attributed to tuberculosis. Only 478 (41.7%) of those had been reported to the health care system (SINAN-TB-RJ). Among the 302 medical records analyzed, 154 (50.9%) recorded hospitalizations of up to 10 days and 143 (47.3%) had respiratory symptoms for more than 60 days before diagnosis. Among 125 cases of retreatment, the RHZE regimen recommended by the Brazilian Ministry of Health was prescribed for only 43 (34.4%). CONCLUSION: This study demonstrates weakness in the RJ tuberculosis control program, characterized by delayed diagnosis, limited use of the recommended tests, poor reporting, and non-compliance with the Ministry of Health guidelines
Portuguese abstract CONCLUSÃO: O estudo demonstra que a tuberculose é sub-notificada, o diagnóstico é tardio, a utilização dos exames laboratoriais recomendados é baixa e as normas do Ministério da Saúde não são cumpridas
Disciplines: Medicina
Keyword: Neumología,
Salud pública,
Terapéutica y rehabilitación,
Mortalidad,
Tuberculosis,
Epidemiología,
Evaluación de programas
Keyword: Medicine,
Pneumology,
Public health,
Therapeutics and rehabilitation,
Tuberculosis,
Epidemiology,
Program evaluation,
Mortality
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