Sandra Maria do Valle Leone de Oliveira

Active and latent tuberculosis in prisoners in the Central-West Region of Brazil

INTRODUCTION Jailed populations exhibit high rates of tuberculosis (TB) infection and active disease. METHODS A cross-sectional study was performed to estimate the prevalence of latent and active TB and to identify factors associated with latent infection in inmates. RESULTS The prevalence of latent TB was 49%, and the prevalence of active TB was 0.4%. The presence of a Bacille Calmette-Guérin (BCG) scar (prevalence ratio (PR)=1.65; 95% confidence interval (CI): 1.09-2.50; p=0.0162) and the World Health Organization (WHO) score for active TB in prisons (PR=1.07; 95% CI: 1.01-1.14; p=0.0181) were correlated with infection. CONCLUSIONS The identification of associated factors and the prevalence of latent and active TB allows the development of plans to control this disease in jails.

Prevalência da infecção tuberculosa entre profissionais de um hospital universitário

Several studies have demonstrated an elevated prevalence amongst professionals of mycobacterium tuberculosis, both in the rate of infections and illness. This study was carried out in a School Hospital in Campo Grande, MS, Brazil, aiming to establish the prevalence of infection with Mycobacterium tuberculosis. The results of the analysis of 194 subjects showed an overall positivity for the tuberculin test of 38.7%. There was a correlation with smoking (p=0.01, RP=1. 72 (1.20-2.45- Yatess correction). The conclusion is that the establishment of a program of tuberculin screening jointly with the implementation of interventions is necessary in order to reduce the risk of nosocomial transmission.Varios estudios han demostrado la gran existencia tanto de la infeccion tuberculosis como de la propiaenfermedad, entre profesionales de salud. Este estudio realizado en un Hospital Universitario, ubicado en laciudad de Campo Grande-MS tuvo como objetivo conocer la existencia de la infeccion causada por elMycobacterium tuberculosis. En el analisis de 194 personas, fue encontrada la existencia de la prueba tuberculinilladel 38,7%. Fue observada una asociacion con el tabaquismo (p 0,01, y RP 1,72 (1,20-2,45) corregido porYates). Concluimos que es necesario un programa de seleccion tuberculinilla de rutina para acompanar latriaje tuberculinica, junto a intervenciones para reducir el riesgo de transmision nosocomial.DESCRIPTORES: prueba de tuberculina; prevalencia; personal de salud; epidemiologia

Prevalence of mycobacterium tuberculosis among professionals in a university hospital, Mato Grosso do Sul, 2004

Several studies have demonstrated an elevated prevalence amongst professionals of mycobacterium tuberculosis, both in the rate of infections and illness. This study was carried out in a School Hospital in Campo Grande, MS, Brazil, aiming to establish the prevalence of infection with Mycobacterium tuberculosis. The results of the analysis of 194 subjects showed an overall positivity for the tuberculin test of 38.7%. There was a correlation with smoking (p=0.01, RP=1. 72 (1.20-2.45- Yatess correction). The conclusion is that the establishment of a program of tuberculin screening jointly with the implementation of interventions is necessary in order to reduce the risk of nosocomial transmission.Varios estudios han demostrado la gran existencia tanto de la infeccion tuberculosis como de la propiaenfermedad, entre profesionales de salud. Este estudio realizado en un Hospital Universitario, ubicado en laciudad de Campo Grande-MS tuvo como objetivo conocer la existencia de la infeccion causada por elMycobacterium tuberculosis. En el analisis de 194 personas, fue encontrada la existencia de la prueba tuberculinilladel 38,7%. Fue observada una asociacion con el tabaquismo (p 0,01, y RP 1,72 (1,20-2,45) corregido porYates). Concluimos que es necesario un programa de seleccion tuberculinilla de rutina para acompanar latriaje tuberculinica, junto a intervenciones para reducir el riesgo de transmision nosocomial.DESCRIPTORES: prueba de tuberculina; prevalencia; personal de salud; epidemiologia

DECREASING PREVALENCE OF THE ACUTE/SUBACUTE CLINICAL FORM OF PARACOCCIDIOIDOMYCOSIS IN MATO GROSSO DO SUL STATE, BRAZIL

With the objective to evaluate the behavior of paracoccidioidomycosis in the last three decades, clinical and epidemiological data of 595 patients admitted to clinical services of the Federal University of Mato Grosso do Sul from 1980 to 2009 were investigated. Gender, age distribution, clinical form, comorbidity with tuberculosis or AIDS, and mortality were compared by decades of clinical admission. It was shown that during the three decades there was a decrease in women percentage, and the same manner occurred a reduction in participants in the age group of 20 to 39 years. Moreover, the acute/subacute forms have been diminished in the period. These fluctuations are closely related and can be simultaneously analyzed. Increased AIDS co-infection prevalence from the first to the second decade was also revealed, coinciding with the appearance of the retroviral epidemic and stabilizing during the third decade. No change in the tuberculosis co-infection rate was observed (overall = 6.9%). It reinforces the importance of this co-morbidity. The overall mortality rate remained steady at 6.7%, not varying significantly from one decade to another. The persistent mortality rate calls attention to the importance of this neglected disease.

Teste tuberculínico: pesquisa operacional no Mato Grosso do Sul

OBJECTIVE: To investigate operational aspects of tuberculin skin test (TST) use in tuberculosis control programs and at specialized Brazilian National Sexually Transmitted Diseases/AIDS and Viral Hepatitis Program health care clinics in priority municipalities for tuberculosis control in the state of Mato Grosso do Sul, Brazil. METHODS: This was a descriptive, cross-sectional, epidemiological survey. Data on qualifications/training of professionals administering TSTs, timing of the TST, procedures in cases of loss to follow-up (reading), material availability, and material storage were collected through interviews and technical visits. For the 2008-2009 period, we determined the numbers of screenings in vulnerable populations, of TSTs performed, and of patients treated for latent tuberculosis. RESULTS: We interviewed 12 program managers in six municipalities. Some programs/clinics did not perform TSTs. Nursing teams administered the TSTs, results were read by non-specialists, and specialization/refresher courses were scarce. The PPD RT23 was stored in 5-mL flasks under appropriate conditions. Insulin syringes were commonly used. Testing was available during business hours, three times a week. In cases of loss to follow-up, telephone calls or home visits were made. Of the 2,305 TSTs evaluated, 1,053 (46%) were performed in indigenous populations; 831 (36%) were screenings in prisons, performed for training; and only 421 (18%) involved contacts of tuberculosis patients or vulnerable populations. Four vulnerable patients and 126 indigenous subjects were treated for latent tuberculosis. CONCLUSIONS: These priority municipalities showed operational difficulties regarding human resources, materials, and data records.

Efeito booster na prova tuberculínica em um hospital universitário de Mato Grosso do Sul

A triagem tuberculinica tem por objetivo realizar o rastreio da infeccao tuberculosa. Uma retestagem em uma a tres semanas tem sido recomendada quando a prova tuberculinica for 10 mm com aumento de pelo menos 6 mm em relacao a primeira dose, tem-se, entao, o efeito booster. Este estudo teve como sujeitos os profissionais de saude de um hospital universitario e foi realizado na cidade de Campo Grande-MS com o objetivo de estimar a taxa de efeito booster. Dentre os 194 participantes, 65 (33,5%) foram reatores fortes ao PPD na primeira testagem e 129 foram reatores fracos ou nao-reatores. Estes foram submetidos a uma segunda testagem, na qual, em 10 (7,8%) observou-se o efeito booster. A prevalencia da infeccao tuberculosa, avaliada em dois tempos, foi de 38,7%. Conclui-se que identificar o efeito booster na triagem tuberculinica e importante sob pena de obter-se taxas subestimadas de infeccao tuberculosa. Util tambem no acompanhamento da infeccao recente e na avaliacao segura da viragem tuberculinica, reduzindo a probabilidade de falsos negativos, que de outra forma seriam erroneamente interpretados como profissionais recem-infectados.

Fatal Cronobacter sakazakii Sequence Type 494 Meningitis in a Newborn, Brazil

We describe a case of infection with Cronobacter sakazakii sequence type 494 causing bacteremia and meningitis in a hospitalized late premature infant in Brazil. We conducted microbiological analyses on samples of powdered infant formula from the same batch as formula ingested by the infant but could not identify the source of contamination.

High Prevalence of Treponema pallidum Infection in Brazilian Prisoners.

The number of new syphilis cases in Brazil has risen alarmingly in recent years. However, there is limited data regarding syphilis prevalence in the Brazilian prison population. To facilitate the development of effective interventions, a cross-sectional study was undertaken to determine the prevalence of Treponema pallidum infection, active syphilis, and associated risk factors among Brazilian prisoners. We administered a questionnaire to a population-based sample of prisoners from 12 prisons in Central-West Brazil and collected sera for syphilis testing, from January to December 2013. Univariable and multivariable regression analyses were performed to assess associations with active syphilis. We recruited 3,363 prisoners (men: 84.6%; women: 15.4%). The overall lifetime and active syphilis prevalences were 10.5% (9.4% among men; 17% among women, P < 0.001) and 3.8% (2% among men; 9% among women, P < 0.001), respectively. The variables associated with active syphilis in men prisoners were homosexual preference, history of sexually transmitted infections, and human immunodeficiency virus status. Among women, the factors were sex with intravenous drug users, genital ulcer disease, and previous incarceration. Despite the high prevalence of active syphilis, 88.5% reported unawareness of their serological status and 67% reported unprotected sexual practices. Women had the highest rates of infection, including them in a high-risk group for the development of syphilis during pregnancy. Thus, implementing screening programs to enable continuous measures of control and prevention of T. pallidum infection in the prison environment, mainly in women institutions, is important to prevent severe forms of this disease and congenital infections.

Existencia de la infección tuberculosis entre profesionales de un hospital universitario en Mato Grosso do Sur, 2004

Several studies have demonstrated an elevated prevalence amongst professionals of mycobacterium tuberculosis, both in the rate of infections and illness. This study was carried out in a School Hospital in Campo Grande, MS, Brazil, aiming to establish the prevalence of infection with Mycobacterium tuberculosis. The results of the analysis of 194 subjects showed an overall positivity for the tuberculin test of 38.7%. There was a correlation with smoking (p=0.01, RP=1. 72 (1.20-2.45- Yatess correction). The conclusion is that the establishment of a program of tuberculin screening jointly with the implementation of interventions is necessary in order to reduce the risk of nosocomial transmission.Varios estudios han demostrado la gran existencia tanto de la infeccion tuberculosis como de la propiaenfermedad, entre profesionales de salud. Este estudio realizado en un Hospital Universitario, ubicado en laciudad de Campo Grande-MS tuvo como objetivo conocer la existencia de la infeccion causada por elMycobacterium tuberculosis. En el analisis de 194 personas, fue encontrada la existencia de la prueba tuberculinilladel 38,7%. Fue observada una asociacion con el tabaquismo (p 0,01, y RP 1,72 (1,20-2,45) corregido porYates). Concluimos que es necesario un programa de seleccion tuberculinilla de rutina para acompanar latriaje tuberculinica, junto a intervenciones para reducir el riesgo de transmision nosocomial.DESCRIPTORES: prueba de tuberculina; prevalencia; personal de salud; epidemiologia