Factors affecting successful antituberculosis treatment: a single-center experience.

OBJECTIVE: The identification of factors that influence a favorable antituberculosis treatment outcome could be of great use for the promotion of specific health actions to increase the success rate. Thus, the objective of this study was to investigate the factors affecting successful antituberculosis treatment in patients seen at a reference service in the Western region of São Paulo State/Brazil. METHODS: A retrospective study was carried out from 2010 to 2016 based on the data obtained from the Notification Disease Information System of TB patients treated at a reference service in Brazil. The study included patients with treatment outcomes and excluded those from the penitentiary system or with resistant or multidrug-resistant TB. Patients were categorized as having a successful (cured) or unsuccessful (treatment default and death) treatment outcome. The association between TB treatment outcomes and social and clinical factors was analyzed. RESULTS: A total of 356 cases of TB were treated between 2010 and 2016. Among the cases, the majority were cured and the overall treatment success rate was 85.96%, with a range between 80.33% (2010) and 97.65% (2016). After the exclusion of resistant/multidrug-resistant TB, 348 patients were analyzed. In the final logistic regression model analysis, education less than 8 years (OR 1.66; p<0.0001) and people living with human immunodeficiency virus/acquired immunodeficiency syndrome (OR 0.23; p<0.0046) were found to be significantly related to an unfavorable treatment outcome. CONCLUSION: Low education and being a person living with human immunodeficiency virus/acquired immunodeficiency syndrome are vulnerability factors that can affect the successful outcome of antituberculosis treatment.

Factors affecting successful antituberculosis treatment: a single-center experience

SUMMARY OBJECTIVE: The identification of factors that influence a favorable antituberculosis treatment outcome could be of great use for the promotion of specific health actions to increase the success rate. Thus, the objective of this study was to investigate the factors affecting successful antituberculosis treatment in patients seen at a reference service in the Western region of São Paulo State/Brazil. METHODS: A retrospective study was carried out from 2010 to 2016 based on the data obtained from the Notification Disease Information System of TB patients treated at a reference service in Brazil. The study included patients with treatment outcomes and excluded those from the penitentiary system or with resistant or multidrug-resistant TB. Patients were categorized as having a successful (cured) or unsuccessful (treatment default and death) treatment outcome. The association between TB treatment outcomes and social and clinical factors was analyzed. RESULTS: A total of 356 cases of TB were treated between 2010 and 2016. Among the cases, the majority were cured and the overall treatment success rate was 85.96%, with a range between 80.33% (2010) and 97.65% (2016). After the exclusion of resistant/multidrug-resistant TB, 348 patients were analyzed. In the final logistic regression model analysis, education less than 8 years (OR 1.66; p<0.0001) and people living with human immunodeficiency virus/acquired immunodeficiency syndrome (OR 0.23; p<0.0046) were found to be significantly related to an unfavorable treatment outcome. CONCLUSION: Low education and being a person living with human immunodeficiency virus/acquired immunodeficiency syndrome are vulnerability factors that can affect the successful outcome of antituberculosis treatment.

Níveis inatos de C3 e C4 em pacientes curados para a leishmaniose visceral e associação com os aspectos clínico-laboratoriais / Innate levels of C3 and C4 in patients cured for visceral leishmaniasis and association with clinical and laboratory aspects

Introdução: assim que inoculada pelo flebotomíneo, a Leishmania entra em contato com o sistema complemento, sendo que poucos estudos têm avaliado os níveis inatos dos componentes iniciais C3 e C4. Objetivo: avaliar os níveis inatos dos componentes C3 e C4 do sistema complemento em pacientes curados de leishmaniose visceral (LV) e sua associação com aspectos clínico-laboratoriais no momento de diagnóstico da doença. Metodologia: foram estudados 29 pacientes com LV curada. Os níveis de C3 e C4 séricos foram dosados pela técnica de imunodifusão radial simples, após um tempo médio de 59,48 meses pós-tratamento, formados os grupos: C3: baixo (< 84 mg/dl; n=10), normal (84 a 193 mg/dl; n=14) e elevado (> 193 mg/dl; n=5); C4: muito baixo (< 20 mg/dl; n=10), baixo (20 a 40 mg/dl; n=15) e normal (> 40 mg/dl; n=4). Os dados clínicos e laboratoriais empregados para as análises foram coletados por levantamento dos prontuários, considerando o período de diagnóstico da doença de cada paciente. Resultados: foi observada uma correlação positiva fraca entre os níveis de C3 e C4 (rho=0,46; p=0,01). Verificou-se que a maioria dos pacientes sintomáticos no momento do diagnóstico apresentavam níveis inatos normais de C3 e baixos de C4. Pacientes com C3 baixo apresentaram maiores níveis do hematócrito em relação ao grupo C3 normal (p=0,0406). Conclusão: conclui-se que o componente C3 do sistema complemento está associado às alterações do hematócrito, sugerindo o acompanhamento dos seus níveis em pacientes com LV.

Introduction: once inoculated by the sand fly, Leishmania comes into contact with the complement system, and few studies have evaluated the innate levels of the initial components C3 and C4. Objective: to evaluate the innate levels of the C3 and C4 components of the complement system in patients cured of visceral leishmaniasis (VL) and its association with clinical and laboratory aspects at the time of diagnosis of the disease. Methodology: twenty-nine patients with cured VL were studied. Serum C3 and C4 levels were measured by simple radial immunodiffusion technique, after an average time of 59.48 months post-treatment, forming the groups: C3: low (< 84 mg/dl; n=10), normal (84 to 193 mg/dl; n=14) and high (> 193 mg/dl; n=5); C4: very low (< 20 mg/dl; n=10), low (20 to 40 mg/dl; n=15) and normal (> 40 mg/dl; n=4). The clinical and laboratory data used for the analyzes were collected by surveying the medical records, considering the period of diagnosis of the disease of each patient. Results: a weak positive correlation was observed between C3 and C4 levels (rho=0.46; p=0.01). Most symptomatic patients at the time of diagnosis were found to have normal C3 and low C4 levels. Low C3 patients had higher levels of hematocrit compared to the normal C3 group (p=0.0406). Conclusion: in conclusion, the C3 component of the complement system is associated with changes in the hematocrit, suggesting the monitoring of its levels in patients with VL.

Baixo conhecimento de doadores de sangue sobre a hanseníase como fator de vulnerabilidade para a disseminação da doença / Low knowledge of blood donors about leprosy as a vulnerability factor for the spread of the disease

Objetivo: caracterizar o doador de sangue e seu conhecimento sobre a hanseníase, visando contribuir para identificar pontos de vulnerabilidade sobre a doença. Metodologia: foram entrevistados doadores de sangue (n=199) através de um questionário estruturado abordando características socioeconômicas e o conhecimento sobre a hanseníase. Para a análise dos dados foi utilizado o método de Goodman e considerado significativo p<0,05. Resultados: dentre as perguntas sobre a hanseníase, a maioria dos participantes (65,83%) não tinha conhecimento da doença e nem o seu modo de transmissão (75,88%) e quando computado o conhecimento da Hanseníase, 1,51% conheciam, 39,70% conheciam pouco e 58,79% não conheciam a doença. Nossos resultados demonstraram que somente a escolaridade teve associação significativa com a falta de conhecimento sobre a hanseníase (p=0,0273). Conclusão: verificou-se déficit de conhecimento da população geral quanto à hanseníase. Sugerimos um aprimoramento da divulgação das informações quanto à doença a fim de promover melhoras nos serviços de saúde, acompanhamento dos doentes e prevenção da população saudável.

Objective: to characterize the blood donor and his knowledge about leprosy, aiming to contribute to identify vulnerability points about the disease. Methodology: blood donors (n=199) were interviewed through a structured questionnaire addressing socioeconomic characteristics and knowledge about leprosy. For the data analysis, the Goodman method was used and considered significant p<0.05. Results: Among the questions about leprosy, most participants (65.83%) did not know about the disease and its mode of transmission (75.88%) and when computing the knowledge of leprosy, 1.51% knew, 39,70% knew little and 58.79% did not know the disease. Our results showed that only schooling had a significant association with the lack of knowledge about leprosy (p=0,0273). Conclusion: there was a lack of knowledge of the general population regarding leprosy. We suggest an improved dissemination of information about the disease to promote improvements in health services, patient monitoring and prevention of the healthy population.