Perfil de acometimento e avaliação de métodos de diagnósticos da tuberculose

Abstract

This cross-sectional descriptive study aimed to determine the sociodemographic profile, clinical, epidemiological and economic and diagnosis of tuberculosis patients in a referral hospital in the Zona da Mata of Minas Gerais State, Brazil. We also aimed to evaluate the factors associated with biochemical and molecular characterization of mycobacteria and compare the performance of these methods. Patients were included in this study, with M. tuberculosis promoters confirmed by biochemical and / or molecular differences between March 2008 and February 2010. Data collection was performed using two instruments with the medical records and patients. The study was approved by the Ethics Committee in Research of the Hospital Foundation of the State of Minas. In 175 cases, 170 were of M. tuberculosis, two M. avium complex, and two coinfection M. tuberculosis / M. avium, two M avium and one coinfection M. bovis / M. tuberculosis. The higher prevalence of Tuberculosis (75.4% of cases) were in male patients, with median age of 40 years, and 14.3% were HIV positive and 32% with low family income, many of these in poor housing. Pulmonary disease was observed in 94.9%. These, 45.1% were cured, 24.0% abandoned the treatment and 9.7% died. Supervision of treatment occurred in 60% of patients and only 56% was achieved for HIV diagnosis. On 9.6% of paucibacillary specimens and 55.5% of extrapulmonary TB, the diagnosis was only possible after the completion of the culture of biological material. Of the 175 cases, most was characterized by both tests. Some samples had only biochemical, others only by the molecular characterization. The characterization joint showed a predominance of M. tuberculosis, one M. bovis and four M. avium. Being in three HIV-positive patients was confirmed in a disseminated form of the disease. In fact, this study showed a greater preference for adult male subjects with lung disease, patients with poor socioeconomic conditions, many without known positivity for HIV and treatment with partial supervision. The use of culture was an important diagnostic tool, complementary to smear. The associations of explanatory variables related to the biochemical and molecular characterization reveals the need for more controlled future studies with larger samples to confirm more accurately the interference of the antibiotic regimen used, if new case or relapse on the biochemical characterization mycobacteria. And others to define the best combination of binomial time / temperature favors the molecular characterization of mycobacteria by amplification of single copy genes as pncA, oxyR, set amidst others.