Abstract

LOPES, Maria Luiza et al. Annual frequency and distribution of tuberculosis resistance in the public health laboratory network of Pará State, Brazil. Rev Pan-Amaz Saude [online]. 2012, vol.3, n.4, pp.27-33. ISSN 2176-6215.

This study described the frequency and variety of multidrug-resistant tuberculosis (MDR-TB) cases in Pará State, Brazil. In order to record the epidemiology and spacial distribution of the disease, antimicrobial susceptibility testing (AST) and the proportion method were used. The AST was performed on 848 samples at the Instituto Evandro Chagas and a central public health laboratory in that State. Of all patients enrolled in the study, 358 (42.2%) were resistant to at least one antituberculosis (anti-TB) drug. The percentage of primary, acquired resistance and combined MDR-TB was 30.4%, 69.3% and 42.2% respectively. MDR-TB was detected in 223 (26.3%) samples. Primary MDR-TB was found in 14% of previously treated patients, while 48% exhibited acquired resistance and 62% exhibited combined resistance. Of all age groups, from 25 to 36 years old (mean age 38.7 ± 15) showed the highest proportion of resistant cases (26.3%). Seven cities in the State presented 59.6% of the cases documented in the study. These findings reflect the poor quality of the healthcare for patients in these cities. We further suggest that clinicians need to observe their patients more directly during treatment and test them more often for anti-TB drug sensitivity. The number of TB cases in Pará did not vary significantly during the period studied, but researchers did notice a slight increase in the proportion of drug-resistant cases related to the total number of cases reported in Pará. This change in the resistance rates reflects the need to improve the quality of health services for TB care. A concentration of TB cases was observed in some municipalities and in the neighborhoods of the Belém City.

Keywords : Mycobacterium tuberculosis; Tuberculosis; Multidrug-resistant; Rifampicin; Isoniazid.

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