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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46804

RESUMO

Ministro da Saúde assume presidência do conselho da Stop TB, organização internacional que atua para eliminar a tuberculose. SUS ofertará nova formulação para o tratamento em crianças


Assuntos
Tuberculose , Qualidade de Vida , Tuberculose/prevenção & controle
2.
Rev. méd. panacea ; 8(2): 58-63, mayo-ago. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1015872

RESUMO

Objetivo: Determinar la influencia de la sintomatología depresiva en la adherencia al tratamiento antituberculoso en pacientes del Hospital Santa Maria del Socorro de Ica, (HSMSI), 2018. Materiales y métodos: Estudio de tipo transversal, observacional y analítico. La variable independiente fue el nivel de sintomatología depresiva medida con el Test de depresión de Zung; la variable dependiente fue la adherencia al tratamiento recibido mediante el Test de Morisky- Green, se incluyeron todos los pacientes mayores de 18 años atendidos en la Estrategia Sanitaria de Prevención y Control de Tuberculosis del HSMS registrados en el Libro de seguimiento del año 2018. Resultados: La mediana de edad fue de 30 años, RIQ (21 a 44). El 58,6% de los pacientes fueron hombres; el, 58,6% lleva recibiendo más de tres meses tratamiento, el 10,3% presentaban otras comorbilidades como Diabetes Mellitus y VIH/SIDA; el 17,2% refieren como habito nocivo consumo de alcohol. El grado de sintomatología depresiva leve fue del 37,9%, seguido de un grado moderado y severo con el 34.5% y 10,3% respectivamente. El 65,5% de los pacientes presentaron mala adherencia al tratamiento. Se encontró que conforme aumenta los grados de sintomatología depresiva la probabilidad de no adherencia al tratamiento se incrementa, sin embargo, no existe asociación significativamente estadística tanto en el análisis crudo como en el ajustado por edad y sexo. Conclusiones: Los grados de manifestación de sintomatología depresiva se incrementan con una mala adherencia al tratamiento antituberculoso en los pacientes atendidos en el Hospital Santa María de Socorro de Ica- 2018. (AU)


Objective: To determine if depressive symptomatology influences the adherence to antituberculous treatment in HSMS-Ica patients, 2018. Materials and methods: It is a cross-sectional, observational, analytical and prospective study. The Zung depression test was used to measure the level of depression; while the Morisky-Green Test was used to measure adherence to antituberculous treatment, and the population of patients treated in the Health Strategy for Prevention and Control of Tuberculosis of the HSMS registered in the follow-up book was studied. year 2018, over 18 years. Results: Patients without depressive symptomatology 60% are adhered and 40% are not adherent to antituberculous treatment. Among patients with mild depressive symptoms, the highest percentage is 63.6% and 36.4% adheres to treatment. Patients with moderate depressive symptomatology 70% are not adherent to the treatment and 30% if they are adherent to the treatment. Finally, 100% of patients with severe depressive symptoms are not adherent to the treatment. As the degree of depressive symptomatology increases, the probability of non-adherence to treatment increases, however, there is no statistically significant association in both the crude analysis and that adjusted for age and sex. (p = 0.425). Conclusions: According to the results of the study, depressive symptomatology is associated with poor adherence to antituberculous treatment in patients of Santa Maria de Socorro Hospital in Ica- 2018. (AU)


Assuntos
Humanos , Masculino , Feminino , Tuberculose/terapia , Depressão , Cooperação e Adesão ao Tratamento , Estudos Transversais , Estudos Observacionais como Assunto
3.
Pan Afr Med J ; 33: 31, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31384346

RESUMO

Tuberculosis (TB) is endemic in the Central African Republic (CAR) with an incidence rate of 391 per 100,000 population in 2015. This study aims to analyze current epidemiological and clinical features of TB at the Hôpital de l'Amitié in the Central African Republic. We conducted an analytic retrospective study of patients hospitalized in the Department of Medicine at the Hôpital de l'Amitié from 15 April 2010 to 14 October 2011. Data were collected using a questionnaire and then analyzed with Epi info software 3.5.3. Chi-square test was used to compare proportions, using a threshold significance level of 5%. The study included 220 patients, of whom 128 were women (58.18%). The average age of patients was 35.69± 10.65 years. In 42.70% of cases, patients had no professional activity. Prevalence of tuberculosis in hospital was 10.99%. On average, 12 cases of TB were recorded each month. Most common clinical signs included: chronic cough (71.81%), fever (96.82%), alteration of the general state (91.36%) and pulmonary condensation syndrome (63.64%). The diseases most commonly associated with tuberculosis were HIV/AIDS (73.36%), malaria (48.63%) and anemia (31.81%). The mean time between symptom onset and diagnosis was 37.65 days. Mortality rate was 18.63%. TB/HIV co-infection and neuromeningeal TB were associated with a high mortality rate (p < 0.05). Tuberculosis is a common disease in Bangui and it is often associated with HIV infection. Prognosis is poor in the case of neuromeningeal involvement. Prevention and routine monitoring in HIV infected patients may contribute to reduce the extent and severity of TB.


Assuntos
Infecções por HIV/epidemiologia , Hospitalização , Tuberculose Meníngea/epidemiologia , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Anemia/epidemiologia , República Centro-Africana/epidemiologia , Coinfecção , Feminino , Humanos , Malária/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Estudos Retrospectivos , Inquéritos e Questionários , Fatores de Tempo , Tuberculose/diagnóstico , Tuberculose/mortalidade , Tuberculose Meníngea/mortalidade , Adulto Jovem
4.
BMJ ; 366: l4920, 2019 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-31466942

RESUMO

The studyStory A, Aldridge R, Smith C, et al. Smartphone-enabled video-observed versus directly observed treatment for tuberculosis: a multicentre, analyst-blinded, randomised, controlled superiority trial. Lancet 2019;393:1216-24.The study was funded by the NIHR Programme Grants for Applied Research programme (project number RP-PG-0407-10340).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000777/smartphones-for-tb-treatment-observation.


Assuntos
Smartphone , Tuberculose , Humanos
5.
Stud Health Technol Inform ; 264: 531-535, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31437980

RESUMO

Epidemiological surveillance systems enable collection, analysis and dissemination of information on the monitored disease to different stakeholders. It may be done manually or using a software. Given the poor performances of manual systems, the software approach is generally adopted. Epidemiological surveillance systems are based on existing softwares, softwares developed from scratch given the specifications or softwares provided by a vendor. These solutions are not always suitable because epidemiological surveillance systems evolve quickly (new drugs, new treatment protocols, etc.), leading to software updates, which can take time (while waiting for a new version) and be expensive. In this article, we present the use of the Model-Driven Architecture (MDA) approach to model and generate epidemiological surveillance systems. The result is a complete MDA based methodology and tool to develop epidemiological surveillance systems. The tool was used to model and generate softwares that are now used for epidemiological surveillance of tuberculosis in Cameroon.


Assuntos
Software , Tuberculose , Camarões , Humanos
6.
Chem Commun (Camb) ; 55(69): 10214-10217, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31380528

RESUMO

The l,d-transpeptidases (Ldts) are promising antibiotic targets for treating tuberculosis. We report screening of cysteine-reactive inhibitors against LdtMt2 from Mycobacterium tuberculosis. Structural studies on LdtMt2 with potent inhibitor ebselen reveal opening of the benzisoselenazolone ring by a nucleophilic cysteine, forming a complex involving extensive hydrophobic interactions with a substrate-binding loop.


Assuntos
Azóis/química , Azóis/farmacologia , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Mycobacterium tuberculosis/enzimologia , Compostos Organosselênicos/química , Compostos Organosselênicos/farmacologia , Peptidil Transferases/antagonistas & inibidores , Antituberculosos/química , Antituberculosos/farmacologia , Derivados de Benzeno/química , Derivados de Benzeno/farmacologia , Cisteína/metabolismo , Humanos , Simulação de Acoplamento Molecular , Mycobacterium tuberculosis/efeitos dos fármacos , Peptidil Transferases/metabolismo , Tuberculose/tratamento farmacológico , Tuberculose/microbiologia
7.
Einstein (Sao Paulo) ; 17(4): eAO4696, 2019 Aug 22.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31460617

RESUMO

OBJECTIVE: To determine the frequency of drug therapy problem in the treatment of patients with tuberculosis and HIV/AIDS. METHODS: Data were obtained through a cross-sectional study conducted between September 2015 and December 2016 at a reference hospital in infectious diseases in Belo Horizonte (MG), Brazil. Sociodemographic, clinical, behavioral and pharmacotherapeutic variables were evaluated through a semi-structured questionnaire. Drug-related problems of pharmaceutical care were classified using the Pharmacotherapy Workup method. Factors associated with indication, effectiveness, safety and compliance drug therapy problem were assessed through multiple logistic regression. RESULTS: We evaluated 81 patients, and 80% presented at least one drug therapy problem, with indication and adherence drug therapy problem being the most frequent. The factors associated with drug therapy problem were age, marital status, new case, ethnicity, time of HIV diagnosis and time to treat tuberculosis. CONCLUSION: The frequency of drug therapy problem in coinfected patients was high and the identification of the main drug therapy problem and associated factors may lead the multiprofessional health team to ensure the use of the most indicated, effective, safe and convenient medicines for the patients clinical condition. Tuberculosis and HIV/AIDS coinfected individuals aged over 40 years are more likely to have drug therapy problems during treatment; in that, the most frequente are those that signal toward need of medication for an untreated health condition and non-compliance to treatment. Thus, older patients, unmarried or married, who have treated tuberculosis before, with a shorter time to tuberculosis treatment and longer time to diagnose HIV/AIDS, should receive special attention and be better followed by a multiprofessional health team because they indicate a higher chance of presenting Problems related to the use of non-adherent drugs.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Antituberculosos/administração & dosagem , Cooperação do Paciente/estatística & dados numéricos , Medicamentos sob Prescrição/normas , Tuberculose/tratamento farmacológico , Adulto , Antituberculosos/efeitos adversos , Estudos Transversais , Feminino , Humanos , Masculino , Encaminhamento e Consulta , Fatores Socioeconômicos
9.
; Fiocruz.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46679

RESUMO

As doenças negligenciadas são aquelas causadas por agentes infecciosos ou parasitas e são consideradas endêmicas em populações de baixa renda.


Assuntos
Doenças Negligenciadas , Pobreza , Medicina Tropical , Malária , Doença de Chagas , Tripanossomíase Africana , Leishmaniose Visceral , Filariose Linfática , Dengue , Tuberculose , Esquistossomose
10.
Recurso na Internet em Inglês, Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46657

RESUMO

La TB sigue siendo la enfermedad infecciosa más letal del mundo. Cada día mueren casi 4500 personas a causa de la TB y aproximadamente 30 000 personas contraen esta enfermedad prevenible y curable. Se calcula que los esfuerzos mundiales por luchar contra la TB han salvado 54 millones de vidas desde 2000 y han reducido la tasa de mortalidad por TB en un 42%. Para acelerar la respuesta a la TB en los países con el fin de alcanzar las metas, los Jefes de Estado celebraron en septiembre de 2018 la primera Reunión de Alto Nivel de las Naciones Unidas sobre la TB, en la que se comprometieron fehacientemente a poner fin a esta enfermedad. El lema del Día Mundial de la TB 2019, «Es hora de actuar», pone el acento sobre la urgencia de adoptar medidas para cumplir los compromisos adquiridos por los líderes mundiales...


Assuntos
Tuberculose , Estratégias Mundiais , Tuberculose Pulmonar
11.
Lima; Perú. Ministerio de Salud; 1 ed; 20190700. 15 p. ilus.
Monografia em Espanhol | LILACS, LIPECS | ID: biblio-1006509

RESUMO

La presente cartilla proporciona información sobre la tuberculosis a los agentes comunitarios de salud, a fin de que desarrollen comportamientos saludables, apliquen en su hogar entornos saludables para evitar el riesgo de desarrollar la tuberculosis; sepan reconocer los síntomas para una detección precoz; y si detectaran un posible caso de la enfermedad, acudir al establecimiento de salud para su diagnóstico y tratamiento oportuno.


Assuntos
Tuberculose , Agentes Comunitários de Saúde , Prevenção de Doenças , Promoção da Saúde
12.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 1088-1095, jul.-set. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005471

RESUMO

Objetivo: Analisar o perfil e identificar os fatores associados à tuberculose em idosos no Maranhão no período de 2010 a 2015. Métodos: Estudo transversal analítico com os casos de tuberculose em idosos no estado do Maranhão. Foram utilizados dados secundários do SINAN, disponíveis no Datasus. Para identificar as associações entre o desfecho (tuberculose em idosos) e as variáveis independentes, utilizou-se a regressão de Poisson. Resultados: Após o ajuste do modelo, a escolaridade < 8 anos de estudo, ter encerramento por não cura, exame anti HIV não realizado e ter diabetes apresentaram­se como fatores que aumenta a chance da ocorrência de tuberculose em idosos. As demais variáveis apresentaram-se como fator protetor. Conclusão: Foi observada alta prevalência de tuberculose em idosos no estado (16,6%). Há necessidade de se adotarem estratégias de acompanhamento dessa clientela


Objective: To analyze the profile and identify the factors associated with tuberculosis in the elderly in Maranhão from 2010 to 2015. Methods: An analytical cross-sectional study with cases of tuberculosis in the elderly in the State of Maranhão. Secondary data from SINAN, available on Datasus, were used. To identify the associations between the outcome (tuberculosis in the elderly) and the independent variables, Poisson regression was used. Results: After adjustment of the model, schooling < 8 years of study, closure due to non-cure, unrecovered HIV test and diabetes had a factor that increases the chance of tuberculosis occurring in the elderly. The other variables were presented as protective factor. Conclusion: A high prevalence of tuberculosis in the elderly was observed in the State (16.6%). There is a need to adopt strategies to follow up this clientele


Objetivo: Analizar el perfil e identificar los factores asociados a la tuberculosis em ancianos en Maranhão en el período de 2010 a 2015. Métodos: Estudio transversal analítico con los casos de tuberculosis en ancianos en el Estado de Maranhão. Se utilizaron datos secundarios del SINAN, disponibles en Datasus. Para identificar las asociaciones entre el desenlace (tuberculosis en ancianos) y las variables independientes se utilizó la regresión de Poisson. Resultados: Después del ajuste del modelo la escolaridad < 8 años de estudio, tener cierre por no cura, examen anti VIH no realizado y tener diabetes se presentaron como factor que aumenta la probabilidad de la ocurrencia de tuberculosis en ancianos. Las demás variables se presentaron como factor protector. Conlusión: Se observó una alta prevalencia de tuberculosis en ancianos en el Estado (16,6%). Hay necesidad de adoptar estrategias de acompañamiento de esa clientela


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Idoso de 80 Anos ou mais , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Idoso/estatística & dados numéricos , Saúde do Idoso , Serviços de Saúde para Idosos
13.
Pan Afr Med J ; 32: 159, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308862

RESUMO

Introduction: Focus has been put on strengthening surveillance systems in high tuberculosis (TB) burden countries, like Zambia, however inadequate information on factors associated with unfavourable TB treatment outcomes is generated from the system. We determined the proportion of tuberculosis treatment outcomes and their associated factors. Methods: We defined unfavourable outcome as death, lost-to-follow-up, treatment-failure, or not-evaluated and favourable outcome as a patient cured or completed-treatment. We purposively selected a 1st level hospital, an urban-clinic and a peri-urban clinic. We abstracted data from TB treatment registers at these three health facilities, for all TB cases on treatment from 1st January to 31st December, 2015. We calculated proportions of treatment outcomes and analysed associations between unfavourable outcome and factors such as age, HIV status, health facility, and patient type, using univariate logistics regression. We used multivariable stepwise logistic regression to control for confounding and reported the adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results: We included a total of 1,724 registered TB patients, from one urban clinic 694 (40%), a 1st Level Hospital 654 (38%), and one peri-urban-clinic 276 (22%). Of the total patients, 43% had unfavourable outcomes. Of the total unfavourable outcomes, were recorded as treatment-failure (0.3%), lost-to-follow-up (5%), death (9%) and not evaluated (29%). The odds of unfavourable outcome were higher among patients > 59 years (AOR=2.9, 95%CI: 1.44-5.79), relapses (AOR=1.65, 95%CI: 1.15-2.38), patients who sought treatment at the urban clinic (AOR=1.76, 95%CI:1.27-2.42) and TB/HIV co-infected patients (AOR=1.56, 95%CI:1.11-2.19). Conclusion: Unfavourable TB treatment outcomes were high in the selected facilities. We recommend special attention to TB patients who are > 59 years old, TB relapses and TB / HIV co-infected. The national TB programme should strengthen close monitoring of health facilities in increasing efforts aimed at evaluating all the outcomes. Studies are required to identify and test interventions aimed at improving treatment outcomes.


Assuntos
Antituberculosos/uso terapêutico , Programas Nacionais de Saúde/organização & administração , Vigilância da População , Tuberculose/tratamento farmacológico , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Coinfecção/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Perda de Seguimento , Masculino , Pessoa de Meia-Idade , Falha de Tratamento , Resultado do Tratamento , Tuberculose/epidemiologia , Adulto Jovem , Zâmbia/epidemiologia
14.
J Glob Health ; 9(1): 010423, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31263546

RESUMO

Background: Tuberculosis (TB) is a major global health burden, which has been inadequately addressed. This study aims to analyze different patterns and gaps of care along the care cascade across countries and to develop a model to examine the relationship between performance of tuberculosis programmes in high and low burden countries along the tuberculosis care cascade and tuberculosis disease burden. Methods: We used the World Health Organization's Global TB Database for the year 2016 to construct tuberculosis care cascade consisting of four steps: incidence, diagnosed, treatment started and treatment completed. Based on the constructed care cascades, we analyzed the relationship between health system performance indicators and tuberculosis cascades performance: diagnosed rate, treatment started rate, and treatment completed rate. Results: There are wide differences in access to diagnosis and treatment between high-burden countries and non-high-burden countries. The largest gap was found between incidence and diagnosed rate, with 65% of diagnosed rate for high burden countries and 80% of diagnosed rate for non-high burden countries. We found variations in care performance among high-burden countries. We found a negative relationship between the population health indicators related to the mortality rate and TB care cascade performance. There was a positive relationship between immunization coverage rate and antenatal care indicators and TB care cascade performance. Conclusions: Well-functioning tuberculosis care cascades and effective health systems are important for the successful management of tuberculosis. While improving screening performance is essential for tuberculosis control especially for high-burden countries, resource should be allocated to improve health system performance, which is weak in high-burden countries. Performance of TB programmes across care cascade could be used as a useful tracer to measure performance of health systems.


Assuntos
Assistência à Saúde/organização & administração , Saúde Global/estatística & dados numéricos , Tuberculose/prevenção & controle , Bases de Dados como Assunto , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Incidência , Modelos Organizacionais , Avaliação de Programas e Projetos de Saúde , Tuberculose/epidemiologia , Organização Mundial da Saúde
16.
Biomed Environ Sci ; 32(6): 427-437, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31262388

RESUMO

OBJECTIVE: This study aimed to characterize the diagnostic and vaccine potential of a novel Mycobacterium tuberculosis antigen Rv0674. METHODS: To evaluate the diagnostic potential and antigenicity of Rv0674, IgG was evaluated using ELISA and interferon (IFN)-γ was done by using ELISpot assay among TB patients and healthy donors. For immunogenicity evaluation, BALB/c mice were immunized with Rv0674. Cytokine production was determined by cytokine release assay using an ELISA kit, and the antibodies were tested using ELISA. RESULTS: The results of serum Elisa tests showed that Rv0674 specific immunoglobulin G (IgG) response was higher in TB patients than negative controls. And Rv0674 had good performance in serological test with sensitivity and specificity of 77.1% and 81.1%, respectively. While it shows poor sensitivity and specificity of 26.23% and 79.69% for IFN-γ tests. In BALB/c mice, Rv0674 adjuvant by DDA/Poly I:C could also induce a high level of IFN-γ, interleukin-2 and interleukin-6 as well as a high IgG titer in both high- and low-dose groups indicating that Rv0674 is essential in humoral and cellular immunity. Moreover, the cytokine profile and IgG isotype characterized Rv0674 as a Th1/Th2-mixed-type protective immunity with the predominance of Th1 cytokines. CONCLUSION: Rv0674 may be a good potential candidate for the development of TB serological diagnosis and a new TB vaccine.


Assuntos
Antígenos de Bactérias/imunologia , Tuberculose/imunologia , Adulto , Idoso , Animais , Feminino , Humanos , Imunidade Celular , Imunidade Humoral , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Pessoa de Meia-Idade , Tuberculose/diagnóstico , Adulto Jovem
17.
Pan Afr Med J ; 32: 206, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31312318

RESUMO

Introduction: Tuberculosis (TB) is currently causing more deaths than Human Immunodeficiency Virus (HIV) globally. Ghana as one of the 30 high burden TB/HIV countries has a high annual TB case-fatality rate of 10%. The study sought to assess the effect of HIV infection on TB treatment outcomes and assess the time to mortality after treatment onset. Methods: We conducted a review of treatment files of TB patients who were treated from January 2013 to December 2015 in two urban hospitals in the Accra Metropolis. Modified Poisson regression analysis was used to measure the association between HIV infection and TB treatment outcomes. Kaplan-Meier survival estimates were used to plot survival curves. Results: Seventy-seven percent (83/107) of HIV infected individuals had successful treatment, compared to 91.2% (382/419) treatment success among HIV non-infected individuals. The proportion of HIV-positive individuals who died was 21.5% (23/107) whilst that of HIV-negative individuals was 5.5% (23/419). Being HIV-positive increased the risk of adverse outcome relative to successful outcome by a factor of 2.89(95% CI 1.76-4.74). The total number of deaths recorded within the treatment period was 46; of which 29(63%) occurred within the first two months of TB treatment. The highest mortality rate observed was among HIV infected persons (38.6/1000 person months). Of the 107 TB/HIV co-infected patients, 4(3.7%) initiated ART during TB treatment. Conclusion: The uptake of ART in co-infected individuals in this study was very low. Measures should be put in place to improve ART coverage among persons with TB/HIV co-infection to help reduce mortality.


Assuntos
Antituberculosos/uso terapêutico , Infecções por HIV/epidemiologia , Tuberculose/tratamento farmacológico , Adolescente , Adulto , Estudos de Coortes , Coinfecção , Feminino , Gana/epidemiologia , Infecções por HIV/mortalidade , Soropositividade para HIV/epidemiologia , Hospitais Urbanos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Tuberculose/mortalidade , Adulto Jovem
18.
Epidemiol Health ; 41: e2019028, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31319659

RESUMO

OBJECTIVES: Tuberculosis (TB) is common in children with human immunodeficiency virus (HIV), but its effect on the survival of HIV-infected children is not well understood. Therefore, the aim of this study was to assess the incidence and predictors of active TB among HIV-positive children at Adama Referral Hospital and Medical College, Oromia, Ethiopia. METHODS: A retrospective study was conducted over 5 years using a checklist to gather data from 428 randomly selected pediatric patient charts. The checklist was adapted from the standardized antiretroviral therapy (ART) follow-up form currently used by the institution's ART clinic. Data were analyzed by bivariate and multivariable analysis using Cox regression proportional hazards models, as appropriate. Survival was calculated and compared using the Kaplan-Meier and log-rank tests. RESULTS: Of the 466 charts reviewed, 428 patient records were included in the analysis. A total of 67 new TB cases were observed during the follow-up period. Hence, the incidence rate in this cohort was found to be 6.03 per 100 child-years of observation. A baseline hemoglobin level <10 g/dL (adjusted hazard ratio [aHR], 7.04; 95% confidence interval [CI], 1.03 to 48.15), moderate wasting (aHR, 2.86; 95% CI, 1.02 to 7.99), and not receiving isoniazid preventive therapy (aHR, 8.23; 95% CI, 2.11 to 32.06) were among the independent predictors of TB occurrence. CONCLUSIONS: The incidence of TB was high, particularly in pre-ART patients receiving chronic care for HIV. Close followup of HIV-positive children is crucial to protect them against the development of TB. Initiating isoniazid preventive therapy, averting malnutrition, and managing anemia are also of significant importance.


Assuntos
Coinfecção/epidemiologia , Infecções por HIV/epidemiologia , Tuberculose/epidemiologia , Antirretrovirais/uso terapêutico , Antituberculosos/uso terapêutico , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Seguimentos , Infecções por HIV/tratamento farmacológico , Humanos , Incidência , Isoniazida/uso terapêutico , Masculino , Encaminhamento e Consulta , Estudos Retrospectivos , Fatores de Risco , Tuberculose/prevenção & controle
19.
Stud Health Technol Inform ; 262: 101-104, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349276

RESUMO

Tuberculosis (TB) represents a global challenge in terms of prevention, care and control. Decision support systems (DSS) can supply the necessary knowledge basis to underpin investigators, policy makers and health personnel actions and to provide crucial elements that can help reducing TB burden. Thus, the objectives of this work are to present the protocol to be followed for carrying out a scoping review to identify topics where DSSs are used, to define appropriate categories and to clarify main outcomes and research gaps. As part of the protocol, five electronic bibliographic databases will be searched for articles from 2006 to 2019 and two investigators will independently screen each work using the study inclusion criteria. Data extraction will be performed, and findings will be reported. The results will be used to provide a broad understanding of how DSSs for TB are being used.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Tuberculose , Assistência à Saúde , Pessoal de Saúde , Humanos , Projetos de Pesquisa , Pesquisadores , Literatura de Revisão como Assunto , Tuberculose/terapia
20.
Stud Health Technol Inform ; 262: 264-267, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349318

RESUMO

Data sharing, information exchange, knowledge acquisition and health intelligence are the basis of an efficient and effective evidence-based decision-making tool. A decentralized blockchain architecture is a flexible solution that can be adapted to institutional and managerial culture of organizations and services. Blockchain can play a fundamental role in enabling data sharing within a network and, to achieve that, this work defines the high-level resources necessary to apply this technology to Tuberculosis related issues. Thus, relying in open-source tools and in a collaborative development approach, we present a proposal of a blockchain based network, the TB Network, to underpin an initiative of sharing of Tuberculosis scientific, operational and epidemiologic data between several stakeholders across Brazilian cities.


Assuntos
Segurança Computacional , Tuberculose , Brasil , Confidencialidade , Humanos , Disseminação de Informação
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