Epidemiological, clinical, and evolution characteristics of tuberculosis in the Bauru region, São Paulo.
THESIS: J. F. C. Monti submitted this dissertation for his Masters in Tropical Diseases at Botucatu School of Medicine, São Paulo State University-UNESP, Botucatu, São Paulo, Brazil, 1999.
Advisor: Professor Jussara Marcondes Machado
Address to correspondence Address to correspondence J. F. C. Monti Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu, UNESP Distrito Rubião Junior, s/n 18618-000, Botucatu, SP, Brasil email@example.com
ABSTRACT: This study deals with the description of epidemiological, clinical, and evolution characteristics of tuberculosis in the Bauru region, São Paulo state. Information was obtained from disease registration data. Between July 1992 and December 1995, 865 cases in the seventh month after the beginning of treatment were included in this study. During the study period, a decrease was seen both in the number of reported cases and incidence rates. Incidence of tuberculosis decreased from 53.6 to 45.1 cases per 100,000 inhabitants between 1993 and 1995. In the same period, however, the number of reported cases increased in HIV patients and prison inmates. Prevalence of the disease was higher in males, with about 75% of cases. The age group that includes 40% of cases was 25-39 years. Incidence was higher in males in all age groups, and the highest incidence coefficient was found in males between 60 and 69 years old. In relation to origin, 82.38% of patients were from urban areas and 9.7% were prison inmates. In relation to clinical aspects, 88.8% of patients had pulmonary tuberculosis. In the HIV-infected cases, 27.5% showed extra-pulmonary and associated diseases. Concerning pulmonary cases, only 50% had bacteriological confirmation while, in the other half, diagnosis was mainly by radiology means. Associated disease was detected in 29.5% of patients. AIDS was the most frequent (11.3%), followed in order by alcoholism, diabetes mellitus, and mental disease. HIV co-infection was found in 11.3% for all patients studied; in prisoner inmates, this proportion was close to 50%. With regard to the evolution of cases, cure rate was approximately 60%, reaching higher rates in towns with population ranging from 10,000 to 50,000 inhabitants. Lack of adherence to treatment was found in 14.1% of the studied population and was more frequent in Bauru and in towns with less than 10,000 inhabitants. The worst cure rates were found in patients who had been submitted to a previous tuberculosis treatment. Cure rates were even worse in those who had a history of non-adherence to previous treatment. Lack of adherence to treatment was also observed in alcoholics. The best cure rate was in diabetics; the worst in HIV patients, who also presented the highest mortality rates. Mortality rates from all causes were approximately 9%. Death by tuberculosis was 3.6% of cases, mainly in towns with less than 10,000 inhabitants, in the elderly and in females. This study shed light to some particular characteristics of tuberculosis in the Bauru region and could be useful in suggesting ways to improve disease control in this area.
Key words: epidemiological characteristics, clinical characteristics, evolution aspects, tuberculosis, Bauru, HIV.
Publication in this collection
09 Dec 2003
Date of issue