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au:CARVALHO, ANNA CRISTINA CALCADA

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Tuberculosis in adolescence: an integrative review focusing on patient-centered care
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Mendes, Clara Carvalho

; Unger, Roberto José Gervasio

; Araújo-Jorge, Tania Cremonini de

; Carvalho, Anna Cristina Calçada

Revista Paulista de Pediatria

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2024, Volume 42 elocation e2023027

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To identify how patient-centered care has been addressed in tuberculosis studies with adolescents. Data source: We searched for articles published in Portuguese, Spanish and English in the Virtual Health Library (LILACS), PubMed (MedLine), and Scopus (Elsevier) databases, from 2000 to 2020, using descriptors (DeCS, MeSH) in Portuguese and English. Data synthesis: 1,322 studies were identified, of which 18 were selected. The main themes found were related to adherence to tuberculosis treatment, knowledge, attitudes and practices, health education, and public policies. Conclusions: We observed that both the number of researchers dedicated to the topic and the presence of a truly person-centered view are still scarce elements in tuberculosis among adolescents research.

RESUMO Objetivo: Identificar, por meio de uma revisão integrativa, como o cuidado centrado no paciente tem sido abordado nos estudos de tuberculose com adolescentes. Fontes de dados: Buscamos artigos publicados em português, espanhol e inglês nas bases de dados da Biblioteca Virtual em Saúde - BVS (LILACS), PubMed (MedLine) e Scopus (Elsevier), de 2000 a 2020, utilizando descritores (DeCS, MeSH) em português e inglês. Síntese dos dados: Foram identificados 1.322 estudos, dos quais 18 foram selecionados. Os principais temas encontrados foram relacionados à adesão ao tratamento da tuberculose, conhecimentos, atitudes e práticas, educação em saúde e políticas públicas. Conclusões: Observamos que tanto o número de pesquisadores dedicados ao tema quanto a presença de uma visão verdadeiramente centrada na pessoa ainda são elementos escassos na pesquisa da tuberculose entre adolescentes.

https://doi.org/10.1590/1984-0462/2024/42/2023027

Research, Innovation, and National Production of Strategic Inputs for Tuberculosis Elimination in Brazil: Contributions from the REDE-TB Research Innovation Brazil REDETB REDE TB
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Arcêncio, Ricardo Alexandre

; Chimara, Erica

; Silva, José Roberto Lapa e

; Croda, Julio

; Carvalho, Anna Cristina Calçada

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0518-2023

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0037-8682-0518-2023

[SciELO Preprints] - Learning from the Italian experience in coping with COVID-19
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Carvalho, Anna Cristina Calçada Kritski, Afrânio

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Publication date: 2020-05-29

Abstract: En

Introduction: In March 2020, the rapid increase in COVID-19 cases overburdened the Italian health system, with the country becoming the pandemic’s epicenter. Methods: We present a narrative review based on manuscripts, official documents, and newspaper articles regarding COVID-19 in Italy. Results: Characteristics of the epidemic, possible causes for its worsening, and the measures adopted across Italian regions are presented. Conclusions: In the early stages of an epidemic, effective decision-making is essential to contain the number of cases. Medical support for patients and social isolation measures are the most appropriate strategies currently available to reduce the spread and lethality of COVID-19.

https://doi.org/10.1590/0037-8682-0199-2020

Social determinants of health and catastrophic costs associated with the diagnosis and treatment of tuberculosis
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Moreira, Adriana da Silva Rezende

; Kritski, Afrânio Lineu

; Carvalho, Anna Cristina Calçada

Jornal Brasileiro de Pneumologia

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2020, Volume 46 N. 5 elocation e20200015

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A relevância epidemiológica da tuberculose está diretamente relacionada ao perfil socioeconômico dos países. A vulnerabilidade à tuberculose é influenciada por fatores biológicos, como desnutrição, infecção por HIV ou faixa etária, e fatores sociais, como habitações insalubres, alta densidade demográfica, condições de trabalho inadequadas e inacessibilidade aos serviços de saúde; porém, muitas vezes essas vulnerabilidades se somam. Propomos aqui uma reflexão sobre a tuberculose sob o ponto de vista dos determinantes sociais de saúde e dos custos associados ao seu diagnóstico e tratamento, baseando-nos não somente em dados publicados na literatura internacional, mas também nas evidências já presentes no panorama nacional. Considerando a magnitude da tuberculose como doença socialmente produzida, fica evidente a necessidade de maior envolvimento de profissionais de saúde e da comunidade científica no sentido de implementar medidas operacionais e de investigação relevantes para a compreensão dos condicionantes sociais do processo saúde-doença na tuberculose. A recente crise econômica pela qual passa o Brasil contribuiu para o aumento da mortalidade por todas as causas, incluindo por tuberculose; porém, investimentos em saúde e proteção social reduziram os danos à saúde. Essas evidências reforçam a importância de políticas públicas de proteção social para a redução dos indicadores da tuberculose visando sua eliminação no Brasil.

ABSTRACT The epidemiological relevance of tuberculosis is directly related to the socioeconomic profile of a given country. Vulnerability to tuberculosis is influenced by biological factors (e.g., malnutrition, HIV infection, and age) and social factors (e.g., unhealthy housing, high population density, inappropriate working conditions, and lack of access to health services). In many cases, multiple vulnerabilities occur in conjunction. We propose here a reflection on tuberculosis from the point of view of the social determinants of health, as well as the costs associated with its diagnosis and treatment in Brazil, based not only on data in the international literature but also on evidence related to the national context. Given the magnitude of tuberculosis as a socially mediated disease, there is an evident need for greater involvement of health professionals and of the scientific community to implement relevant operational and research measures to understand the social conditions influencing the health-illness continuum for tuberculosis patients. Although the recent economic crisis in Brazil has contributed to increased mortality from all causes, including tuberculosis, health and social protection expenditures have mitigated detrimental health effects. The evidence presented here underscores the importance of public social protection policies for minimizing the effects of tuberculosis indicators, with the aim of eliminating tuberculosis in Brazil.

https://doi.org/10.36416/1806-3756/e20200015 915 downloads

Learning from the Italian experience in coping with COVID-19
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Carvalho, Anna Cristina Calçada

; Kritski, Afrânio

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20200199

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: In March 2020, the rapid increase in COVID-19 cases overburdened the Italian health system, with the country becoming the pandemic’s epicenter. METHODS: We present a narrative review based on manuscripts, official documents, and newspaper articles regarding COVID-19 in Italy. RESULTS: Characteristics of the epidemic, possible causes for its worsening, and the measures adopted across Italian regions are presented. CONCLUSIONS: In the early stages of an epidemic, effective decision-making is essential to contain the number of cases. Medical support for patients and social isolation measures are the most appropriate strategies currently available to reduce the spread and lethality of COVID-19.

https://doi.org/10.1590/0037-8682-0199-2020 1357 downloads

A summary of the proceedings of a meeting on the treatment of latent tuberculosis infection in target populations in Brazil
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Rolla, Valeria

; Trajman, Anete

; Kawamura, Masae

; Cavalcante, Solange

; Soares, Elizabeth

; Perini, Filipe de Barros

; Carvalho, Anna Cristina Calçada

; Croda, Julio

; Silva, Jose Roberto Lapa e

; Schmaltz, Carolina Arana Stanis

; Sant’Anna, Flavia Marinho

; Bastos, Mayara

; Gomes, Adriano

; Durovni, Betina

; Saraceni, Valeria

; Silva, Elisangela

; Mello, Fernanda Carvalho de Queiroz

; Santos, Marcelo Cordeiro dos

; Pinto, Marcia

; Santos, Marisa

; Sanches, Fernando Augusto Dias e

; Oliveira, Sandra Maria do Valle Leone de

Jornal Brasileiro de Pneumologia

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2020, Volume 46 N. 4 elocation e20200023

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36416/1806-3756/e20200023 296 downloads

Diagnosis of pulmonary tuberculosis in children and adolescents: comparison of two versions of the Brazilian Ministry of Health scoring system
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Carvalho, Roberta Feijó

; Carvalho, Anna Cristina Calçada

; Velarde, Luis Guillermo Coca

; Rossoni, Andrea Maciel de Oliveira

; Aurilio, Rafaela Baroni

; Sias, Selma Maria de Azevedo

; Schmidt, Christiane Mello

; Moreira, Adriana da Silva Rezende

; Martins, Pedro da Silva

; Gonçalves, Lorrayne Isidoro

; Martire, Terezinha Miceli

; Barbosa, Ana Paula Ferreira

; Santos, Ana Paula Quintanilha dos

; Romanelli, Roberta Maia de Castro

; Oliveira, Maria das Graças Rodrigues de

; Diniz, Lilian Martins Oliveira

; Carvalho, Andrea Lucchesi de

; Lucena, Sheila Cunha

; Cruz, Maria Letícia Santos

; Saavedra, Mariza Curto

; Tahan, Tony Tannous

; Rodrigues, Cristina de Oliveira

; Kritski, Afrânio Lineu

; Sant’Anna, Clemax Couto

; Cardoso, Claudete Aparecida Araújo

; Sant’Anna, Maria de Fátima Bazhuni Pombo

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e81

Abstract: En | Text: En | PDF: En

ABSTRACT The aim of this study was to evaluate the concordance between two versions of the scoring system (2011 and 2019), recommended by the Brazilian Ministry of Health, for the diagnosis of pulmonary tuberculosis (PTB) in children and adolescents. A retrospective descriptive study was performed to assess the medical records of children and adolescents with PTB, in TB units from Brazilian cities located in Rio de Janeiro, Minas Gerais, and Parana States, from January 1 st , 2004, to December 1 st , 2018. Patients aged 0 to 18 years old with a diagnosis of PTB were included. The comparison between the two scoring systems showed a moderate concordance according to the κ coefficient value = 0.625. Fourteen patients showed a reduction in the TB score, going from 30 points in the 2011, to 25 points or less in the 2019 one. Seventy one percent of these 14 patients had radiological changes suggestive of PTB and 86% had tuberculin skin tests greater than 10 mm. The study concluded that a moderate agreement was observed between the 2011 and 2019 scoring systems, with an increase in the number of patients scoring 25 points or less in 2019, which can eventually hinder the diagnosis of PTB.

https://doi.org/10.1590/s1678-9946202062081 664 downloads

The role of the Brazilian Tuberculosis Research Network in national and international efforts to eliminate tuberculosis
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Kritski, Afranio

; Dalcolmo, Margareth Pretti

; Mello, Fernanda Carvalho Queiroz

; Carvalho, Anna Cristina Calçada

; Silva, Denise Rossato

; Oliveira, Martha Maria de

; Croda, Julio

Jornal Brasileiro de Pneumologia

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apr 2018, Volume 44 N. 2 Pages 77 - 81

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/s1806-37562017000000435 2738 downloads

Epidemiological aspects, clinical manifestations, and prevention of pediatric tuberculosis from the perspective of the End TB Strategy
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Carvalho, Anna Cristina Calçada

; Cardoso, Claudete Aparecida Araújo

; Martire, Terezinha Miceli

; Migliori, Giovanni Battista

; Sant’Anna, Clemax Couto

Jornal Brasileiro de Pneumologia

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apr 2018, Volume 44 N. 2 Pages 134 - 144

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A tuberculose continua sendo uma prioridade de saúde pública em muitos países. Em 2015, a tuberculose matou 1,4 milhão de pessoas, incluindo 210.000 crianças. Apesar dos recentes progressos no controle da tuberculose no nosso país, o Brasil ainda é um dos países com maior carga de tuberculose. Em 2015, houve 69.000 casos de tuberculose notificados no Brasil e a tuberculose foi a causa de 4.500 mortes no país. Em 2014, a Organização Mundial da Saúde aprovou a Estratégia End TB, que estabeleceu 2035 como data-alvo para atingir suas metas de redução da incidência de tuberculose em 90% e do número de mortes por tuberculose em 95%. No entanto, para alcançar essas metas no Brasil, há a necessidade de colaboração entre os diversos setores envolvidos no controle da tuberculose e de priorização de atividades, incluindo medidas de controle voltadas às populações mais vulneráveis. As crianças são altamente vulneráveis à tuberculose, e há particularidades específicas dos pacientes pediátricos quanto ao desenvolvimento da tuberculose (rápida progressão da infecção para a doença ativa), prevenção (baixa eficácia da vacinação contra as formas pulmonares e disponibilidade limitada de tratamento preventivo da infecção tuberculosa latente), diagnóstico (baixa taxa de diagnóstico confirmado bacteriologicamente); e tratamento (pouca disponibilidade de fármacos antituberculose próprios para crianças). Nesta revisão, discutimos a epidemiologia, as manifestações clínicas e a prevenção da tuberculose na infância e adolescência, destacando as peculiaridades da tuberculose ativa e latente nessas faixas etárias, a fim de promover a reflexão sobre novas abordagens para o manejo da tuberculose pediátrica no àmbito da Estratégia End TB.

ABSTRACT Tuberculosis continues to be a public health priority in many countries. In 2015, tuberculosis killed 1.4 million people, including 210,000 children. Despite the recent progress made in the control of tuberculosis in Brazil, it is still one of the countries with the highest tuberculosis burdens. In 2015, there were 69,000 reported cases of tuberculosis in Brazil and tuberculosis was the cause of 4,500 deaths in the country. In 2014, the World Health Organization approved the End TB Strategy, which set a target date of 2035 for meeting its goals of reducing the tuberculosis incidence by 90% and reducing the number of tuberculosis deaths by 95%. However, to achieve those goals in Brazil, there is a need for collaboration among the various sectors involved in tuberculosis control and for the prioritization of activities, including control measures targeting the most vulnerable populations. Children are highly vulnerable to tuberculosis, and there are particularities specific to pediatric patients regarding tuberculosis development (rapid progression from infection to active disease), prevention (low effectiveness of vaccination against the pulmonary forms and limited availability of preventive treatment of latent tuberculosis infection), diagnosis (a low rate of bacteriologically confirmed diagnosis), and treatment (poor availability of child-friendly anti-tuberculosis drugs). In this review, we discuss the epidemiology, clinical manifestations, and prevention of tuberculosis in childhood and adolescence, highlighting the peculiarities of active and latent tuberculosis in those age groups, in order to prompt reflection on new approaches to the management of pediatric tuberculosis within the framework of the End TB Strategy.

https://doi.org/10.1590/s1806-37562017000000461 21718 downloads

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