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Lourenço LV, Coelho KSC, Merhy EE. Continuing education practices in primary health care for addressing users with tuberculosis. Salud Colect 2023; 19:e4542. [PMID: 38006654 DOI: 10.18294/sc.2023.4542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/11/2023] [Indexed: 11/27/2023] Open
Abstract
Interruption of tuberculosis treatment constitutes one of the obstacles to disease control. The standards established in health policies, at times, prove to be inflexible, tending to obscure the difficulties experienced by individuals in treatment. The aim of this article is to analyze the practices of continuous health education developed by family health teams at healthcare units in Maré, Rio de Janeiro, Brazil, in cases of tuberculosis treatment interruption. An exploratory qualitative study was conducted with twelve healthcare professionals from the team between August and November 2021. The findings from this research regard continuous health education as a strategy to enhance care processes, fostered through the lived experiences of the healthcare workers, enabling the creation of knowledge and exchanges that expand the effective treatment of tuberculosis with creativity and flexibility in the dynamics of interactions with users. This care takes place in the live work in action, whether in the hallways of healthcare units or within the community, as it occurs in real-time practice.
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Affiliation(s)
- Letícia Vieira Lourenço
- Magíster en Atención Primaria de la Salud. Coordinadora pedagógica, Programa de Residencia en Enfermería Familiar y Comunidad, Secretaría Municipal de Salud, Rio de Janeiro, Brasil
| | - Karla Santa Cruz Coelho
- Doctora en Salud Colectiva. Profesora asociada, Universidade Federal do Rio de Janeiro, Campus Macaé, Río de Janeiro, Brasil
| | - Emerson Elias Merhy
- Doctor en Salud Colectiva. Profesor Titular, Universidade Federal do Rio de Janeiro, Campus Macaé, Río de Janeiro, Brasil
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Alexandrino de Souza Pinheiro1 M, Baroni Aurilio1 R, Alice Amaral Ibiapina Parente1,2 A, de Fátima Bazhuni Pombo Sant’Anna2 M, Cristina Cisne Frota1 A, Barroso Hofer2 C, Fernandes de Abreu2 T, Ferreira2 S, Couto Sant’Anna2 C. Clinical forms and diagnosis of tuberculosis in children and adolescents during the COVID-19 pandemic. J Bras Pneumol 2022; 48:e20220240. [DOI: 10.36416/1806-3756/e20220240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: The present study aimed to describe the clinical forms and the time taken to diagnose new tuberculosis cases and to statistically analyze the isolated and combined forms of the disease in children and adolescents treated at a university hospital in Rio de Janeiro during the first year of the COVID-19 pandemic in Brazil. Methods: This was a cross-sectional study that used retrospective data on children (0-9 years old) and adolescents (10-18 years old) with pulmonary (PTB), extrapulmonary (EPTB), and combined tuberculosis (PTB + EPTB) followed up at the outpatient clinic from January 2019 to March 2021. Categorical data were analyzed by descriptive statistics and expressed as frequency and proportions. Categorical variables were compared using the Chi-square test, and numerical variables using Student's T-test. Results: A total of 51 cases were included, 63% (32/51) of which comprised patients in the year of the pandemic (group A), while 37% (19/51) were patients attended in previous years (group B). In group A, 19% (6/32) of the patients presented PTB, 59% (16/32) had EPTB, and 31% (10/32) had PTB+EPTB. In group B, 42% (8/19) of the patients presented PTB, 42% (8/19) had EPTB, and 16% (3/19) had PTB+EPTB. Conclusion: Our study revealed more tuberculosis cases in the first year of the pandemic than in the same period of the previous year, with greater variation of sites affected by the disease, including rarer and more severe forms.
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Affiliation(s)
| | - Rafaela Baroni Aurilio1
- 1. Instituto de Puericultura e Pediatria Martagão Gesteira. Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | - Ana Alice Amaral Ibiapina Parente1,2
- 1. Instituto de Puericultura e Pediatria Martagão Gesteira. Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil. 2. Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | | | - Ana Cristina Cisne Frota1
- 1. Instituto de Puericultura e Pediatria Martagão Gesteira. Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | - Cristina Barroso Hofer2
- 2. Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | | | - Sidnei Ferreira2
- 2. Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | - Clemax Couto Sant’Anna2
- 2. Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
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Maia CMF, Martelli DRB, Silveira DMMLD, Oliveira EA, Martelli Júnior H. Tuberculosis in Brazil: the impact of the COVID-19 pandemic. J Bras Pneumol 2022; 48:e20220082. [PMID: 35475872 PMCID: PMC9064638 DOI: 10.36416/1806-3756/e20220082] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Célia Márcia Fernandes Maia
- . Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros, Montes Claros (MG), Brasil
| | - Daniella R Barbosa Martelli
- . Programa de Pós-Graduação em Cuidado Primário em Saúde, Universidade Estadual de Montes Claros, Montes Claros (MG), Brasil
| | | | - Eduardo Araújo Oliveira
- . Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brasil.,. Universidade da California, San Diego (CA), EUA
| | - Hercílio Martelli Júnior
- . Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros, Montes Claros (MG), Brasil.,. Programa de Pós-Graduação em Cuidado Primário em Saúde, Universidade Estadual de Montes Claros, Montes Claros (MG), Brasil
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Molecular and Cellular Mechanisms of M. tuberculosis and SARS-CoV-2 Infections—Unexpected Similarities of Pathogenesis and What to Expect from Co-Infection. Int J Mol Sci 2022; 23:ijms23042235. [PMID: 35216349 PMCID: PMC8878934 DOI: 10.3390/ijms23042235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
Tuberculosis is still an important medical and social problem. In recent years, great strides have been made in the fight against M. tuberculosis, especially in the Russian Federation. However, the emergence of a new coronavirus infection (COVID-19) has led to the long-term isolation of the population on the one hand and to the relevance of using personal protective equipment on the other. Our knowledge regarding SARS-CoV-2-induced inflammation and tissue destruction is rapidly expanding, while our understanding of the pathology of human pulmonary tuberculosis gained through more the 100 years of research is still limited. This paper reviews the main molecular and cellular differences and similarities caused by M. tuberculosis and SARS-CoV-2 infections, as well as their critical immunological and pathomorphological features. Immune suppression caused by the SARS-CoV-2 virus may result in certain difficulties in the diagnosis and treatment of tuberculosis. Furthermore, long-term lymphopenia, hyperinflammation, lung tissue injury and imbalance in CD4+ T cell subsets associated with COVID-19 could propagate M. tuberculosis infection and disease progression.
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Scarim CB, Pavan FR. Recent advancement in drug development of nitro(NO 2 )-heterocyclic compounds as lead scaffolds for the treatment of Mycobacterium tuberculosis. Drug Dev Res 2022; 83:842-858. [PMID: 35106801 DOI: 10.1002/ddr.21921] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/26/2021] [Accepted: 01/13/2022] [Indexed: 11/11/2022]
Abstract
Tuberculosis (TB) is an infectious disease caused predominantly by Mycobacterium tuberculosis (Mtb). It was responsible for approximately 1.4 million deaths worldwide in 2019. The lack of new drugs to treat drug-resistant strains is a principal factor for the slow rise in TB infections. Our aim is to aid the development of new TB treatments by describing improvements (last decade, 2011-2021) to nitro(NO2 )-based compounds that have shown activity or pharmacological properties (e.g., anti-proliferative, anti-kinetoplastid) against Mtb. For all compounds, we have included final correlations of minimum inhibitory concentrations against Mtb (H37 Rv).
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Affiliation(s)
- Cauê Benito Scarim
- Department of Cell and Molecular Biology, University of Mississippi Medical Center (UMMC), Jackson, Mississippi, USA
| | - Fernando Rogério Pavan
- School of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil
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Tuberculosis forecasting and temporal trends by sex and age in a high endemic city in northeastern Brazil: where were we before the Covid-19 pandemic? BMC Infect Dis 2021; 21:1260. [PMID: 34922496 PMCID: PMC8684249 DOI: 10.1186/s12879-021-06978-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 12/13/2021] [Indexed: 11/22/2022] Open
Abstract
Background The aim of this study was to describe the temporal trend of tuberculosis cases according to sex and age group and evidence the level of disease before the Covid-19 pandemic in a TB high endemic city. Methods This was a time series study carried out in a city in northeast Brazil. The population was composed of cases of tuberculosis, excluding those with HIV-positive status, reported between the years 2002 and 2018. An exploratory analysis of the monthly rates of tuberculosis detection, smoothed according to sex and age group, was performed. Subsequently, the progression of the trend and prediction of the disease were also characterized according to these aspects. For the trends forecast, the seasonal autoregressive linear integrated moving average (ARIMA) model and the usual Box-Jenkins method were used to choose the most appropriate models. Results A total of 1620 cases of tuberculosis were reported, with an incidence of 49.7 cases per 100,000 inhabitants in men and 34.0 per 100,000 in women. Regarding the incidence for both sexes, there was a decreasing trend, which was similar for age. Evidence resulting from the application of the time series shows a decreasing trend in the years 2002–2018, with a trend of stability. Conclusions The study evidenced a decreasing trend in tuberculosis, even before the Covid-19 pandemic, for both sex and age; however, in a step really slow from that recommended by the World Health Organization. According to the results, the disease would have achieved a level of stability in the city next years, however it might have been aggravated by the pandemic. These findings are relevant to evidence the serious behavior and trends of TB in a high endemic scenario considering a context prior to the Covid-19 pandemic.
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Alves A, Aguiar A, Migliori GB, Duarte R. COVID-19 Related Hospital Re-organization and Trends in Tuberculosis Diagnosis and Admissions: Reflections From Portugal. Arch Bronconeumol 2021; 58:S0300-2896(21)00323-9. [PMID: 35312615 PMCID: PMC8464021 DOI: 10.1016/j.arbres.2021.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 01/17/2023]
Affiliation(s)
- Adelaide Alves
- Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ana Aguiar
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Giovanni Battista Migliori
- Servizio di Epidemiologia e Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Via Roncaccio 16, Tradate, Varese 21049, Italy.
| | - Raquel Duarte
- Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Unidade de Investigação Clínica da ARS Norte, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS-UP), Porto, Portugal.
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Furtado I, Aguiar A, Duarte R. Getting back on the road towards tuberculosis elimination: lessons learnt from the COVID-19 pandemic. J Bras Pneumol 2021; 47:e20210123. [PMID: 33950099 PMCID: PMC8332847 DOI: 10.36416/1806-3756/e20210123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Isabel Furtado
- . Serviço de Infeciologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Ana Aguiar
- . EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Raquel Duarte
- . EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,. Unidade de Investigação Clínica da Administração Regional de Saúde Norte, Porto, Portugal.,. Departamento de Ciências de Saúde Pública, Ciências Forenses e Educação Médica, Universidade do Porto, Porto, Portugal.,. Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Silva DR, Mello FCDQ, Migliori GB. Tuberculosis Series 2021. J Bras Pneumol 2021; 47:e20210109. [PMID: 33950097 PMCID: PMC8332828 DOI: 10.36416/1806-3756/e20210109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Denise Rossato Silva
- . Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil
| | - Fernanda Carvalho de Queiroz Mello
- . Instituto de Doenças do Tórax - IDT - Faculdade de Medicina, Universidade Federal do Rio de Janeiro - UFRJ- Rio de Janeiro (RJ), Brasil
| | - Giovanni Battista Migliori
- . Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia.,. Blizard Institute, Queen Mary University of London, London, United Kingdom
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