Tuberculose drogarresistente no estado da Paraíba: Associação entre fatores clínicos e desfecho do tratamento

Abstract

Characterized as an infectious disease of alarming incidence nationally and internationally, Tuberculosis has continued to impact public health for thousands of years. Even in the face of a scenario where treatment is available free of charge and provides a cure by performing as recommended and in a timely manner, notifications persist as a serious problem to be faced. The mutation of the bacilli and the consequent presentation of the disease in its severe form through resistant strains has further aggravated the problem surrounding the disease. The study aims to analyze the presentation of drug-resistant Tuberculosis in the state of Paraíba in the period from 2011 to 2020 from the association between clinical factors and the outcome of the treatment. This is a retrospective analytical ecological study, with a quantitative approach, involving the 223 municipalities of the state. Obtaining data for the development of the study took place in a secondary way, through the database of the Information System of Special Tuberculosis Treatments provided by the Secretary of Health of the State of Paraíba, fed by the Center for Endemic Diseases. Data analysis was carried out by crossing the clinical data of the studied variables through the application of statistical tests to obtain a better understanding of how the disease presents itself in the territory of Paraíba with regard to the conduct of the treatment. For analysis of the outcomes, as this is a study with more than two categories, multinomial logistic regression was applied. The software used was R (R CORE TEAM, 2020). Among the cases, the occurrence of the disease predominated among men, brown, with low education, in the pulmonary form, who did not undergo Differently Observed Treatment, notified as a new case and abandonment, and who presented abandonment and complete treatment as the main outcomes, indicating low rates of cure. Five municipalities in Paraíba were responsible for 97.8% of the cases reported during the study period, with a predominance of cases resistant to Rifampicin and acquired resistance. The study highlights the importance of carrying out treatment for sensitive tuberculosis as recommended by the World Health Organization and the Ministry of Health, with a view to reducing the emergence of resistant strains and the continuity of transmission of mutant bacilli, and points to the importance of effective implementation of control measures in search of better results of reported outcomes.