Capacidade funcional e fragilidade de idosos com sequela de tuberculose pulmonar / Functional capacity and fragility of the elderly with pulmonar tuberculosis sequelae

INTRODUÇÃO: A tuberculose (TB) é uma doença de caráter infectocontagiosa, de evolução crônica, causada pela Mycobacterium tuberculosis, Uma vez considerada como doença crônica entre idosos por poder gerar sequelas e resultar em comprometimento da capacidade pulmonar, e desta forma contribuir para um quadro clínico de pior prognóstico é essencial estudar a relação da TB com a síndrome da fragilidade e a capacidade funcional em idosos. OBJETIVO: Analisar a capacidade funcional de idosos com seqüela de TB Pulmonar e investigar a ocorrência de fragilidade nesta população. MATERIAIS E MÉTODOS: Trata-se de um estudo transversal com método quantitativo-correlacional, realizado no período de agosto a novembro de 2017, no ambulatório de fisioterapia do Hospital Universitário João de Barros Barreto, Belém/PA. Avaliou-se a fragilidade pelo instrumento Tilburg Frailty Indicator (TFI) e a capacidade funcional pelo "Teste de AVD-Glittre" (TGlittre). Utilizou-se a "correlação de Spearman" entre TFI e TGlittre. Adotou-se p-valor≤0,05. RESULTADOS: Avaliaram-se 24 idosos com diagnóstico clínico de TB Pulmonar, apresentando alterações e/ou sequelas pulmonares. A média de idade foi de 68,37 ± 6,01anos, 66,7% era do sexo feminino. A presença de fragilidade foi de 70,5% (IC95% 48,9-87,4), com predomínio feminino (82,4%). A média do tempo no TGlittre foi de 5,77 ± 1,71 minutos. Houve correlação moderada positiva entre TFI e TGlittre (p=0.42, p= 0.03). CONCLUSÃO: Este estudo identificou a fragilidade e comprometimento funcional em idosos com sequela de TB pulmonar, com prevalência alta de fragilidade se comparada aos outros estudos brasileiros com a população idosa, além de apresenta correlação moderada positiva entre a capacidade funcional e fragilidade, mostrando que essa população merece atenção especial nos programas de reabilitação para a manutenção ou recuperação funcional.

INTRODUCTION: Tuberculosis (TB) is an infectious and contagious disease, with a chronic evolution that is caused by Mycobacterium tuberculosis, as it is considered a chronic disease among the aged because it can cause sequelae and result in impaired lung capacity and thus contribute to a clinical picture of worse prognosis it is interesting to study the relationship between TB and frailty syndrome and functional capacity in the old age. OBJECTIVE: To analyze the functional capacity of elderly people with pulmonary TB sequelae treated at a pulmonology service in Belém-PA, and to investigate the occurrence of frailty in this population. MATERIALS AND METHODS: This is a crosssectional study with the quantitative-correlational method, conducted from August to November 2017 at the physiotherapy outpatient clinic of the João de Barros Barreto University Hospital, Belém/PA. Frailty by the Tilburg Frailty Indicator (TFI) instrument and functional capacity by the "ADL-Glittre Test" (TGlittre) were evaluated. The "Spearman correlation" between TFI and TGlittre was used. P-value was adopted≤0.05. RESULTS: The average age was 68,37 ± 6.01years, 66.7% were female, all individ-uals were literate, the majority with incomplete primary education (45.8%). The presence of frailty was 70.5% (95% CI 48.9-87.4), with a female predominance (82.4%). The average time on TGlittre was 5,77 ± 1,71 minutes. There was a moderate positive correlation between TFI and TGlittre (p=0.42, p= 0.03). CONCLUSION: This study identified frailty and functional impairment in the elderly with pulmonary TB sequelae, with a high prevalence of frailty compared to other Brazilian studies with the elderly population, besides presenting a moderate positive correlation between functional capacity and frailty, suggesting that these aspects de-serve special attention in rehabilitation programs for functional maintenance or recovery in this profile of patients.

Amerindian genetic ancestry as a risk factor for tuberculosis in an amazonian population.

In recent years, the incidence of tuberculosis (TB) has declined worldwide, although this disease still occurs at relatively high rates in Amerindian populations. This suggests that the genetic ancestry of Amerindians may be an important factor in the development of infections, and may account for at least some of the variation in infection rates in the different populations. The present study investigated the potential influence of Amerindian genetic ancestry on susceptibility to tuberculosis in an Amazon population. The study included 280 patients diagnosed with tuberculosis and 138 asymptomatic hospital employees with no history of TB, but who were in contact with bacterially active TB patients. Ancestry analysis was run on a set of 61 Ancestry-Informative Markers to estimate European, African, and Amerindian genetic ancestry using STRUCTURE v2.2. The TB group had significantly higher Amerindian ancestry in comparison with the control group, and significantly lower European ancestry. Amerindian ancestry in the 20-60% range was found to be the principal risk factor for increased susceptibility to TB. The results of the study indicate that Amerindian ancestry is an important risk factor for susceptibility to TB in the admixed population of the Brazilian Amazon region.