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Abstract(s)
A emergência do Mycobacterium tuberculosis resistente aos antibacilares de
primeira linha, constitui um problema de saúde pública mundial de extrema
importância.
A tuberculose multirresistente, definida por resistência pelo menos à isoniazida e
à rifampicina, representa um desafio aos programas de controlo da tuberculose, uma vez
que o tratamento de tais casos é complexo, com recurso a fármacos de segunda linha,
mais dispendioso e frequentemente com menos sucesso que o tratamento de estirpes
sensíveis. A cirurgia tem um papel adjuvante em pacientes seleccionados.
Portugal, apesar de ter vindo a registar na última década, uma diminuição
acentuada da prevalência da tuberculose multirresistente, continua com uma das taxas
mais elevada da Europa Ocidental.
Embora alguns estudos sugiram uma associação entre a tuberculose
multirresistente e a infecção por VIH, a convergência destas duas epidemias não está
claramente explicada. Contudo, muitos factores podem contribuir para um risco mais
elevado de tuberculose multirresistente nos pacientes infectados com VIH.
A sua prevenção através de um Programa de Luta Contra a Tuberculose é de
grande importância. Para tal, é necessário dotar as estruturas de saúde com recursos
humanos, laboratoriais e financeiros e um compromisso político de forma a garantir um
correcto funcionamento do Plano Nacional de Luta contra a Tuberculose. Actualmente, decorrem vários estudos para o desenvolvimento de novos
fármacos para o tratamento da tuberculose e de novos sistemas de transporte dos
antibacilares.
The outbreak of Mycobacterium tuberculosis, resistant to first line antituberculosis drugs, is considered a worldwide public health threat of utmost importance. Multidrug-resistant tuberculosis, defined as resistance at least to isoniazid and rifampicin, represents a challenge to tuberculosis control programmes due to the complexity of the treatment in such cases, recurring to second line drugs, by far more expensive and often less successful than the treatment of sensitive strains. Surgery has a helpful role in selected patients. Despite the outstanding decrease in the prevalence of multidrug-resistant tuberculosis during the last decade in Portugal, drug resistance in this country is still one of the highest in Western Europe. Although some studies have referred to the existence of a close relationship between multidrug-resistant tuberculosis and HIV infection, the convergence of both epidemics is not clearly explained. Many factors can contribute to a higher risk of multidrug-resistant tuberculosis in patient infected with HIV. A National Tuberculosis Control Programme is of vital importance for effective prevention. Therefore, health service and institutions must be provided with laboratorial, financial and health human resources, in addition to a political commitment that assures the correct development and functioning of the National Tuberculosis Control Programme. Several studies are currently being held aiming at developing new drugs in the treatment of tuberculosis and new delivery systems for antituberculosis drugs.
The outbreak of Mycobacterium tuberculosis, resistant to first line antituberculosis drugs, is considered a worldwide public health threat of utmost importance. Multidrug-resistant tuberculosis, defined as resistance at least to isoniazid and rifampicin, represents a challenge to tuberculosis control programmes due to the complexity of the treatment in such cases, recurring to second line drugs, by far more expensive and often less successful than the treatment of sensitive strains. Surgery has a helpful role in selected patients. Despite the outstanding decrease in the prevalence of multidrug-resistant tuberculosis during the last decade in Portugal, drug resistance in this country is still one of the highest in Western Europe. Although some studies have referred to the existence of a close relationship between multidrug-resistant tuberculosis and HIV infection, the convergence of both epidemics is not clearly explained. Many factors can contribute to a higher risk of multidrug-resistant tuberculosis in patient infected with HIV. A National Tuberculosis Control Programme is of vital importance for effective prevention. Therefore, health service and institutions must be provided with laboratorial, financial and health human resources, in addition to a political commitment that assures the correct development and functioning of the National Tuberculosis Control Programme. Several studies are currently being held aiming at developing new drugs in the treatment of tuberculosis and new delivery systems for antituberculosis drugs.
Description
Keywords
Tuberculose Tuberculose multirresistente Tuberculose multirresistente - Infecção HIV Tuberculose multirresistente - Prevenção Tuberculose multirresistente - Tratamento
Pedagogical Context
Citation
Publisher
Universidade da Beira Interior