Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default

Belchior, Aylana de Souza; Arcêncio, Ricardo Alexandre; Mainbourg, Evelyne Marie Therese

doi:10.1590/S0080-623420160000500012

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 50 (04) • Jul-Aug 2016 • https://doi.org/10.1590/S0080-623420160000500012 copy

Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default^* * Extracted from the thesis "O conhecimento dos pacientes acerca da tuberculose", Programa de Pós-Graduação em Enfermagem, Universidade Federal do Amazonas, Universidade do Estado do Pará, 2012.

Diferencias en el perfil clínico-epidemiológico entre casos nuevos de tuberculosis y casos en retratamiento tras abandono

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE

To identify the socioeconomic and clinical-epidemiological factors related to tuberculosis in new cases and retreatment cases.

METHOD

Comparative study with 126 patients, of which 42 were retreatment cases after default attended in a reference center, and 84 were new cases completing the first treatment and treated in Basic Health Units. The collection of primary data was through interview, and of secondary data by records of the Notifiable Diseases Information System. Comparative analysis between the two groups.

RESULTS

The new cases differ from retreatment cases regarding educational level. The clinical-epidemiological profile shows a significant difference in relation to performance of the tuberculin skin test, and the HIV test result (positive) in favor of new cases. In relation to performance of sputum culture and the result (positive) of the first sputum smear of the first and second samples, in favor of retreatment cases.

CONCLUSION

The two groups are significantly different in clinical and epidemiological characteristics that show the access to exams.

Descriptors
Tuberculosis; Patients; Patient Dropouts; Epidemiology; Health Profile; Public Health Nursing

Variables	Retreatment cases n (%)	New cases n (%)	P-value
Gender
Male	28 (66.7)	49 (58.3)	0.3600
Female	14 (33.3)	35 (41.7)
Age range (years)
18 to 29	11(26.2)	24(28.2)	0.9800
30 to 39	11(26.2)	21(25.0)
40 to 49	9(21.4)	19(22.6)
50 or over	11(26.2)	20(23.8)
Color/Race
Asian	3(7.1)	9(10.7)	0.1200
White	2(4.8)	11(13.1)
Indigenous	2(4.8)	0(0.0)
Mixed race	29(69.0)	57(67.9)
Black	6(14.3)	7(8.3)
Marital status
Single, widowed, separated, divorced	13(31.0)	37(44.0)	0.1500
Married, common-law marriage	29(69.0)	47(56.0)
Educational level (years of study)
Average (SD)	5.9(3.7)	7.9(4.3)	0.0110^§ § Student's t test.
Occupation
With occupation	25(59.5)	56(66.7)	0.3300
No occupation	17(40.5)	28(33.3)
Type of occupation
Autonomous	8(19.0)	15(17.9)	0.7700
Unemployed, house worker, student	13(31.0)	24(28.6)
Top member of public service	4(9.5)	15(17.9)
Service worker	8(19.0)	12(14.3)
Repair worker	9(21.4)	18(21.4)
Income
No income	9(21.4)	15(17.9)	0.6300
Less than a minimum wage^ Minimum wage value: R$ 622.00 in December 2011 (Banco Central do Brasil).	4(9.5)	14(16.7)
One to two minimum wages^ Minimum wage value: R$ 622.00 in December 2011 (Banco Central do Brasil).	24(57.1)	42(50.0)
More than two minimum wages^ Minimum wage value: R$ 622.00 in December 2011 (Banco Central do Brasil).	5(11.9)	13(15.5)
Total	42(100)	84(100)

Variables	Retreatment cases n (%)	New cases n (%)	P-value
Chest X-ray
Not performed	4(9.5)	15(17.9)	0.2200
Performed	38(90.5)	69(82.1)
Result
Abnormal	36(94.7)	64(92.8)	0.6900
Normal	2(5.3)	5(7.2)
Tuberculin skin test
Not performed	41(97.6)	53(63.1)	0.0000**
Performed	1(2.4)	31(36.9)
Result
Positive	0(0.0)	26(83.9)	0.1800^a
Negative	1(100)	5(16.1)
Clinical form
Pulmonary	39(92.9)	64(76.2)	0.0700
Extrapulmonary	3(7.1)	19(22.6)
Pulmonary + extrapulmonary	0(0.0)	1(1.2)
Extrapulmonary
Cutaneous	0(0.0)	2(10.0)	1.0000
Peripheral ganglionic	1(33.3)	5(25.0)
Bone	0(0.0)	1(5.0)
Anal	0(0.0)	3(15.0)
Pleural	2(66.7)	9(45.0)
Bacilloscopy 1^st sample
Not performed	3(7.1)	12(14.3)	0.2400
Performed	39(92.9)	72(85.7)
Result
Positive	33(84.6)	47(65.3)	0.0300^* * Fisher's exact test (5% significance level).
Negative	6(15.4)	25(34.7)
Bacilloscopy 2^nd sample
Not performed	3(7.1)	14(16.7)	0.1400
Performed	39(92.9)	70(83.3)
Result
Positive	30(76.9)	32(45.7)	0.0000^* * Fisher's exact test (5% significance level).
Negative	9(23.1)	38(54.3)
Sputum culture
Not performed	17(40.5)	75(89.29)	0.0000^* * Fisher's exact test (5% significance level).
Performed/in progress	25(59.5)	9(10.71)
Result
Positive	18(72)	5(55.6)	0.4200
Negative	7(28)	4(44.4)
HIV test
Not performed	21(50.0)	43(43.4)	0.5700
Performed/in progress	21(50.0)	56(56.6)
Result
Positive	1(4.8)	9(34.6)	0.0100^* * Fisher's exact test (5% significance level).
Negative	20(95.2)	17(65.4)
Associated diseases
Aids
Yes	2(4.8)	10(11.9)	0.6400^* * Fisher's exact test (5% significance level).
No or unknown	40(95.2)	74(88.1)
Alcoholism
Yes	7(16.7)	8(9.5)	0.2432
No or unknown	35(83.3)	76(90.5)
Mental disease
Yes	0(0.0)	1(1.2)	0.4777^* * Fisher's exact test (5% significance level).
No or unknown	42(100.0)	83(98.8)
Diabetes
Yes	1(2.4)	8(9.5)	0.1422^* * Fisher's exact test (5% significance level).
No or unknown	41(97.6)	76(90.5)
Total	42(100)	84(100)

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Evelyne Marie Therese Mainbourg. Instituto Leônidas e Maria Deane. Rua Teresina, 476 - Adrianópolis. CEP 69057-070 - Manaus, AM, Brazil. evelyne.mainbourg@gmail.com