Pediatric tuberculosis in the metropolitan area of Rio de Janeiro.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Carvalho Anna Cristina C, da Silva Martins Pedro, Cardoso Claudete Aparecida Araújo, Miceli Ana Lúcia, Martire Terezinha, Sant'Anna Maria de Fátima B Pombo, Schmidt Christiane Mello, Vieira Luiza Martins, de Azevedo Sias Selma Maria, Quintanilha Ana Paula, Barbosa Ana Paula, Moreira Adriana da Silva Rezende, Lara Carla Fernandes Dos Santos, Isidoro-Gonçalves Lorrayne, Aurilio Rafaela Baroni, de Alcantara Suzana Aparecida Greggi, Bezerra André Luis, Saderi Laura, Sotgiu Giovanni, Migliori Giovanni Battista, Kritski Afrânio L, Sant'Anna Clemax Couto
Аннотация
METHODS: This was a retrospective study, based on a medical chart review, involving children under 15 years old treated for TB between 2007 and 2016, in four primary health units (PHU) and three reference centers (RC) in five cities of Rio de Janeiro metropolitan area. Factors associated with TB treatment setting, microbiological diagnosis, and treatment outcomes were evaluated.
RESULTS: A total of 544 children were enrolled; 71% were treated in PHU, 36% were under 5 years old, and 72% had pulmonary TB (PTB). The HIV prevalence was 10% (31/322). Fifty-three percent had at least one microbiological test for TB, 68% of them (196/287) had TB confirmed. Among 222 children with previous TB contact, information on LTBI was available for 78 (35%), and only 17% (13/78) were treated. Extrapulmonary TB (56% vs 32%), microbiologically confirmed TB (77% vs 60%), and HIV positivity (18.5% vs 4.0%) were significantly more frequent in RC. Treatment in RC (odds ratio (OR) 3.08, 95% confidence interval (CI) 1.74-5.44) and PTB (OR 2.47, 95% CI 1.34-4.56) were independently associated with a microbiological diagnosis of TB. The treatment success rate was 85%. In the logistic regression analysis, HIV-infected children had a 2.5-fold higher risk of an unfavorable outcome (OR 2.53, 95% CI 1.0-6.38; p = 0.05).
CONCLUSIONS: Opportunities for TB prevention and early TB treatment are missed due to suboptimal close contact screening. Microbiological diagnosis of TB and drug susceptibility testing in children should be made available through more sensitive and accessible tests.