DIAGNOSIS AND MONITORING OF TUBERCULOSIS - DIFFERENCES BETWEEN THE GENERAL POPULATION AND THOSE WITH VULNERABILITIES

Freitas, Giselle Lima de; França, Giovanna Eliza Moreira; Souza, Thaís Rodrigues de; Macário, Vanessa de Moura; Camargo, Aline Figueiredo; Protti-Zanatta, Simone; Arcêncio, Ricardo Alexandre

doi:10.5380/ce.v27i0.87364

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ORIGINAL ARTICLE • Cogitare Enferm. 27 • 2022 • https://doi.org/10.5380/ce.v27i0.87364 copy

DIAGNOSIS AND MONITORING OF TUBERCULOSIS - DIFFERENCES BETWEEN THE GENERAL POPULATION AND THOSE WITH VULNERABILITIES

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to compare the performance of diagnostic exams and monitoring of tuberculosis between the general population and those in situations of social vulnerability from the municipality of Belo Horizonte/MG.

Method

an epidemiological study of the tuberculosis cases recorded between 2001 and 2017 in the Information System of Belo Horizonte - Brazil. A descriptive analysis and a comparison were performed between the general population and those in street situations and deprived of their freedom.

Results

diagnostic and follow-up tests were performed more frequently in vulnerable populations, in up to 30%, with low use of the rapid molecular test (mean of 35.4%) and of the observed treatment, with 22% of performance in the street population. and 38% in individuals deprived of freedom.

Conclusion

the study points to the need to prioritize the rapid test and the observed treatment, especially among vulnerable groups. Disseminating the use of these tools can determine interruption of the transmission chain, the possibility of a cure and non-occurrence resistance.

DESCRIPTORS:
Tuberculosis; Social Vulnerability; Social Determinants of Health; Street People; Inmates.

Sociodemographic Data	General Population		PDoF		SP^* * Information included since 2015
Sociodemographic Data	n	%	n	%	n	%
Gender
Male	14,056	66	271	77.65	149	79.67
Female	7,249	34	78	22.34	38	20.32
Age
0-17 years old	1,135	5.32	0	0	0	0
18-30 years old	4,886	22.93	109	31.23	28	14.97
31-49 years old	9,195	43.15	174	49.85	127	67.91
50-60 years old	3,427	16.08	40	11.46	28	14.97
Over 60 years old	2,662	12.52	26	7.46	8	2.15
Race
White	5,821	27.32	81	23.20	20	10.69
Black	3,134	14.71	51	14.61	45	24.06
Asian	124	0.58	4	1.14	1	0.53
Brown	6,947	32.60	135	38.68	82	43.85
Indigenous	26	0.12	0	0	0	0
Unknown^ Unknown information	3,393	15.92	63	18.05	38	20.32
Missing	1,860	8.75	15	4.29	1	0.53
Schooling
0-4 years of study	1,963	9.21	14	4.01	17	9.09
4-9 years of study	3,406	15.98	38	10.88	17	9.09
9-12 years of study	3,053	14.32	43	12.35	12	6.43
More than 12 years of study	954	4.44	8	2.28	0	0
Unknown	8,586	40.30	206	59.02	130	69.51
Does not apply^* ***** The information cannot be applied to the user	375	1.76	0	0	0	0
Missing	2,968	13.99	40	11.46	11	5.88
Beneficiary of the government’s Income Transfer Program^* * Information included since 2015
Yes	41	1.44	0	0	8	4.27
No	1,145	40.21	5	12.19	49	26.20
Unknown	1,478	51.91	35	85.36	123	65.77
Missing	183	6.44	1	2.45	7	3.74

Clinical Data	General Population		PDoF		SP^* * Information included since 2015
Clinical Data	n	%	n	%	n	%
Tests Performed
Quick Molecular Test for TB^* * Information included since 2015	944	33,15	14	34,14	73	39.03
Sensitivity Test^* * Information included since 2015	427	14,99	7	17,07	41	21.92
Smear Microscopy	15,266	71,65	269	77,07	169	90.37
Culture	4,420	20,74	95	27,22	98	52.40
HIV Test	12,354	57,98	258	73,92	159	85.02
Missing^ Data not filled-out and/or incorrectly filled-out	3,128		47		149
Directly Observed Treatment
Indicated	5,942	27,89	131	37,53	0	0
Performed	4,942	23,19	133	38,10	42	22.34

Mean time for treatment initiation (Days)	Before GeneXpert MTB/RIF	After GeneXpert MTB/RIF^* * Information included since 2015
General Population	17.34	0
Population Deprived of their Freedom	16.57	0.95
Street Population^* * Information included since 2015		6.87

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[1] Role of Authors:

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work - Freitas GL de, França GEM, Souza TR de, Macário V de M, Camargo AF, Protti-Zanatta S, Arcêncio RA; Drafting the work or revising it critically for important intellectual content - Freitas GL de, Souza TR de, Macário V de M, Camargo AF, Protti-Zanatta S, Arcêncio RA; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved - Freitas GL de. All authors approved the final version of the text.