M da S Garrido1, S Bührer-Sékula2, A B Souza3, G P de Oliveira4, I A Antunes5, J M Mendes6, V Saraceni7, F E Martinez-Espinosa8, R Ramasawmy9. 1. 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. 2. 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. 3. Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil. 4. Programa Nacional de Tuberculose, Ministério da Saúde, Brasília, Brazil. 5. Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil, Centro de Referência para Tuberculose Cardoso Fontes, Manaus, Amazonas, Brazil. 6. Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil; Centro de Referência para Tuberculose Cardoso Fontes, Manaus, Amazonas, Brazil. 7. Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil; Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. 8. Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil; Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Manaus, Amazonas, Brazil. 9. Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil; Universidade Nilton Lins, Manaus, Amazonas, Brazil; Programa de Pós-graduação em Imunologia Básica e Aplicada, Universidade Federal de Amazonas, Manaus, Amazonas, Brazil.
Abstract
SETTINGS: 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. OBJECTIVE: To assess the number of MDR-TB cases in the Amazonas and to improve estimates of the burden of TB. DESIGNS: 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. RESULTS: 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%. CONCLUSIONS: 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.
SETTINGS: 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. OBJECTIVE: To assess the number of MDR-TB cases in the Amazonas and to improve estimates of the burden of TB. DESIGNS: 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. RESULTS: 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%. CONCLUSIONS: 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.
Authors: Camilla Resende Bonin; Romário Costa Fochat; Isabel Cristina Gonçalves Leite; Thamiris Vilela Pereira; Marina de Oliveira Fajardo; Carmen Perches Gomide Pinto; Raquel Leite Macedo; Marcio Roberto Silva; Pillar Pace Lacerda Menezes; Nilma Maria José Mendes de Araújo; Ronaldo Rodrigues da Costa Journal: Einstein (Sao Paulo) Date: 2019-10-28