Strengthening Multidrug-Resistant Tuberculosis Epidemiological Surveillance in Rio de Janeiro: a multidimensional analysis
ABSTRACT This study aimed to reinforce the importance of the epidemiological surveillance of multidrug-resistant tuberculosis (MDR-TB) in Rio de Janeiro State (RJ). Here, we reviewed seven articles we published between 2018 and 2022. This study had two phases. The quantitative phase where frequency...
Published in: | Revista da Sociedade Brasileira de Medicina Tropical |
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Sociedade Brasileira de Medicina Tropical (SBMT)
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ftdoajarticles:oai:doaj.org/article:3046059456ec4c5b9b1d0f72b0a317a8 2024-09-09T19:27:27+00:00 Strengthening Multidrug-Resistant Tuberculosis Epidemiological Surveillance in Rio de Janeiro: a multidimensional analysis Marcela Bhering Afrânio Kritski 2024-07-01T00:00:00Z https://doi.org/10.1590/0037-8682-0629-2023 https://doaj.org/article/3046059456ec4c5b9b1d0f72b0a317a8 EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822024000100202&lng=en&tlng=en http://www.scielo.br/pdf/rsbmt/v57/1678-9849-rsbmt-57-e00202-2024.pdf https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0629-2023 https://doaj.org/article/3046059456ec4c5b9b1d0f72b0a317a8 Revista da Sociedade Brasileira de Medicina Tropical, Vol 57 (2024) Multidrug-Resistant Tuberculosis Epidemiological Surveillance Health Information System Qualitative Research Arctic medicine. Tropical medicine RC955-962 article 2024 ftdoajarticles https://doi.org/10.1590/0037-8682-0629-2023 2024-08-05T17:48:48Z ABSTRACT This study aimed to reinforce the importance of the epidemiological surveillance of multidrug-resistant tuberculosis (MDR-TB) in Rio de Janeiro State (RJ). Here, we reviewed seven articles we published between 2018 and 2022. This study had two phases. The quantitative phase where frequency was used to describe patient characteristics and regressions were used to evaluate the relationship between treatment outcomes and covariates. The qualitative phase where content analysis of the narratives was performed. Secondary (electronic systems) and primary (semi-structured interviews) data were used. We analyzed 2,269 MDR-TB, 58.1% MDR-TB, and 18.6% extensively drug-resistant TB (XDR-TB) cases, of which 44.3% exhibited unfavorable outcomes. Among the 140 patients with XDR-TB, 29.3% had not undergone prior treatment for MDR-TB. The primary resistance rate in MDR-TB cases was 14.7%, revealing significant demographic and clinical disparities, particularly among women, Caucasians, and those with higher education levels. The number of cases increased from 7.69% in 2000 to 38.42% in 2018, showing an increasing trend (AAPC = 9.4; 95% CI 1.4−18.0, p < 0.001), with 25.4% underreporting. A qualitative study confirmed a high proportion of primary resistance (64.5%) and delayed diagnosis of MDR-TB. In RJ, the diagnostic and therapeutic cascade of MDR-TB must be improved using molecular tests to achieve an early diagnosis of resistance and immediate initiation of appropriate treatment, promote social protection for MDR/XDR-TB patients and their families, enhance TB contact tracing, establish and monitor hospital surveillance centers integrated with Primary Care, and unify various information systems through interoperability for better integration. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista da Sociedade Brasileira de Medicina Tropical 57 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Multidrug-Resistant Tuberculosis Epidemiological Surveillance Health Information System Qualitative Research Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Multidrug-Resistant Tuberculosis Epidemiological Surveillance Health Information System Qualitative Research Arctic medicine. Tropical medicine RC955-962 Marcela Bhering Afrânio Kritski Strengthening Multidrug-Resistant Tuberculosis Epidemiological Surveillance in Rio de Janeiro: a multidimensional analysis |
topic_facet |
Multidrug-Resistant Tuberculosis Epidemiological Surveillance Health Information System Qualitative Research Arctic medicine. Tropical medicine RC955-962 |
description |
ABSTRACT This study aimed to reinforce the importance of the epidemiological surveillance of multidrug-resistant tuberculosis (MDR-TB) in Rio de Janeiro State (RJ). Here, we reviewed seven articles we published between 2018 and 2022. This study had two phases. The quantitative phase where frequency was used to describe patient characteristics and regressions were used to evaluate the relationship between treatment outcomes and covariates. The qualitative phase where content analysis of the narratives was performed. Secondary (electronic systems) and primary (semi-structured interviews) data were used. We analyzed 2,269 MDR-TB, 58.1% MDR-TB, and 18.6% extensively drug-resistant TB (XDR-TB) cases, of which 44.3% exhibited unfavorable outcomes. Among the 140 patients with XDR-TB, 29.3% had not undergone prior treatment for MDR-TB. The primary resistance rate in MDR-TB cases was 14.7%, revealing significant demographic and clinical disparities, particularly among women, Caucasians, and those with higher education levels. The number of cases increased from 7.69% in 2000 to 38.42% in 2018, showing an increasing trend (AAPC = 9.4; 95% CI 1.4−18.0, p < 0.001), with 25.4% underreporting. A qualitative study confirmed a high proportion of primary resistance (64.5%) and delayed diagnosis of MDR-TB. In RJ, the diagnostic and therapeutic cascade of MDR-TB must be improved using molecular tests to achieve an early diagnosis of resistance and immediate initiation of appropriate treatment, promote social protection for MDR/XDR-TB patients and their families, enhance TB contact tracing, establish and monitor hospital surveillance centers integrated with Primary Care, and unify various information systems through interoperability for better integration. |
format |
Article in Journal/Newspaper |
author |
Marcela Bhering Afrânio Kritski |
author_facet |
Marcela Bhering Afrânio Kritski |
author_sort |
Marcela Bhering |
title |
Strengthening Multidrug-Resistant Tuberculosis Epidemiological Surveillance in Rio de Janeiro: a multidimensional analysis |
title_short |
Strengthening Multidrug-Resistant Tuberculosis Epidemiological Surveillance in Rio de Janeiro: a multidimensional analysis |
title_full |
Strengthening Multidrug-Resistant Tuberculosis Epidemiological Surveillance in Rio de Janeiro: a multidimensional analysis |
title_fullStr |
Strengthening Multidrug-Resistant Tuberculosis Epidemiological Surveillance in Rio de Janeiro: a multidimensional analysis |
title_full_unstemmed |
Strengthening Multidrug-Resistant Tuberculosis Epidemiological Surveillance in Rio de Janeiro: a multidimensional analysis |
title_sort |
strengthening multidrug-resistant tuberculosis epidemiological surveillance in rio de janeiro: a multidimensional analysis |
publisher |
Sociedade Brasileira de Medicina Tropical (SBMT) |
publishDate |
2024 |
url |
https://doi.org/10.1590/0037-8682-0629-2023 https://doaj.org/article/3046059456ec4c5b9b1d0f72b0a317a8 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista da Sociedade Brasileira de Medicina Tropical, Vol 57 (2024) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822024000100202&lng=en&tlng=en http://www.scielo.br/pdf/rsbmt/v57/1678-9849-rsbmt-57-e00202-2024.pdf https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0629-2023 https://doaj.org/article/3046059456ec4c5b9b1d0f72b0a317a8 |
op_doi |
https://doi.org/10.1590/0037-8682-0629-2023 |
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Revista da Sociedade Brasileira de Medicina Tropical |
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57 |
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