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Authors
Abstract(s)
Introdução
A Tuberculose é a doença provocada pelo complexo Mycobacterium Tuberculosis. Esta é uma infecção bacteriana causada por inalação das micobactérias. Esta infecção afecta normalmente os pulmões, sendo que pode atingir qualquer outro órgão ou sistema do organismo. Durante a década de 1980 surgiram os primeiros casos de Tuberculose multirresistente e de infecção por VIH tendo sido considerada pela OMS uma emergência mundial. Ainda hoje é considerada um problema de saúde pública, a nível mundial, com elevada morbilidade e mortalidade associadas e com enormes custos inerentes, no seu diagnóstico e tratamento. Devido a inúmeros esforços, a Tuberculose em Portugal tem vindo a diminuir a prevalência e incidência nas últimas décadas. Porém, permanece como o único país da Europa Ocidental com incidência anual de mais de 20 casos por 100000 habitantes. A Beira Interior é uma região díspar dos grandes centros urbanos no que diz respeito à sua demografia e geografia, e actualmente possui níveis de incidência entre os 12 e os 14 casos por 100000 habitantes, abaixo da média nacional.
Materiais e Métodos
Este trabalho pretende demonstrar a epidemiologia da Tuberculose Pulmonar na Beira Interior de Janeiro de 2003 a Dezembro de 2012. O estudo é longitudinal, retrospectivo e descritivo e conta com a autorização da DGS e da ARSC. A análise estatística foi realizada com o programa informático SPSS Statistics 21 e o Microsoft Excel 2010. Assim, pretendemos analisar os novos casos dos distritos da Guarda e de Castelo Branco e classificá-los segundo idade, sexo, profissão, residência e serologia VIH, elaborando um perfil do doente de TP na Beira Interior. Os dados da mortalidade de 2011 e 2012 serão também analisados consoante a idade, o sexo, as patologias associadas e os contactos rastreados. Os dados serão também comparados com os dados nacionais.
Resultados
Foram identificados 490 casos de Tuberculose Pulmonar na Beira Interior de 2003 a 2012, 357 homens e 133 mulheres sendo o rácio H:M 2,7:1. As idades entre os 20 e os 60 e os 65 e os 80 anos foram as mais encontradas no estudo com uma média de 48 anos de idade. Cerca de 75% dos doentes viviam em ambiente rural. As profissões mais representadas foram os reformados e os trabalhadores não qualificados. Dentro dos últimos, as profissões ligadas à construção civil ocuparam grande destaque com 65 casos. Ao longo da década, apenas 12 casos dos analisados eram VIH-positivos, sendo que 131 casos tinham resultado desconhecido da serologia. Desde 2003 a 2012 diminuíram bastante os casos anuais, de 68 para 21. Destacam-se os anos 2009 e 2011 onde a tendência de diminuição se alterou. Em 2011 e 2012 faleceram 5 pessoas vítimas de Tuberculose Pulmonar nesta região. Em 2012, a incidência da Tuberculose Pulmonar na Beira Interior foi de 5,9 enquanto em Portugal foi de 17,5 casos por 100000 habitantes. A percentagem de VIH-positivos, dos doentes com serologia conhecida, em Portugal foi de 14 % enquanto na região foi de 2 % de 2010 a 2012.
Discussão
As idades mais representadas no estudo relacionam-se com o facto de ser a população activa a maior portadora da doença, e isso tem repercussões na sua disseminação e contágio e, possivelmente, com a Tuberculose de reactivação no caso da segunda faixa etária. No nosso estudo, é no ambiente rural que residem a larga maioria dos doentes de TP. O sector da sociedade mais afectado quanto à TP é o dos reformados, seguido pelos trabalhadores não qualificados. Isto deve-se em parte, a uma grande percentagem de casos serem na sétima e oitava décadas de vida. Para medidas de controlo de infecção e de diminuição dos parâmetros de incidência e de mortalidade na região, o nosso estudo aponta, apoio à população rural no acesso aos serviços de saúde e melhor articulação nos rastreios aos contactos regulares dos doentes.
Introduction Tuberculosis is a disease caused by Mycobacterium tuberculosis complex. This is a bacterial infection caused by inhalation of mycobacteria. This infection usually affects the lungs, but can reach any other organ or system of the human body. During the 1980s emerged the first cases of multidrug-resistant TB and HIV infection which have been considered a global emergency by WHO. Even today it is considered a worldwide public health issue, with high morbidity and mortality associated and huge costs involved in its diagnosis and treatment. Due to numerous efforts, Tuberculosis in Portugal has decreased the prevalence and incidence in recent decades. However, it remains as the only country in Western Europe with an annual incidence over 20 cases per 100,000 inhabitants. The Beira Interior is a disparate region of large urban centers with regard to its demography and geography , and currently owns levels of incidence between 12 and 14 cases per 100,000 habitants, below the national average. Materials and Methods This articles discusses the epidemiology of Pulmonary Tuberculosis in Beira Interior from January 2003 to December 2012. The study is longitudinal, retrospective and descriptive and has permission from the DGS and ARSC. Statistical analysis was performed with the software SPSS 21 and Microsoft Excel 2010. Accordingly, we intend to analyze new cases of the districts of Guarda and Castelo Branco and classify them according to age, sex, occupation, residence and HIV status, developing a Pulmonary Tuberculosis profile of the patient in Beira Interior. The mortality data covers the years 2011 and 2012 and the information is also analyzed according to the age, sex, and conditions associated tracked contacts. The data will also be compared with national data. Results 490 cases of pulmonary TB were identified in Beira Interior from 2003 to 2012, 357 men and 133 women, being the ratio 2,7:1. Ages between 20 to 60 and 65 to 80 were the most frequent in the study with an average of 48 years of age. About 75 % of patients live in a rural environment. The most represented professions were pensioners and unskilled workers. From unskilled workers, the occupations of construction occupied great highlight with 65 cases. Throughout the decade, only 12 cases of HIV - positive were identified, and 131 cases had unknown results of serology. From 2003 to 2012 the annual cases decreased markedly, from 68 to 21. Noteworthy are the years 2009 and 2011 where the downward trend has changed. In 2011 and 2012 5 people died of Pulmonary Tuberculosis in “Beira Interior”. In 2012, the incidence of Pulmonary Tuberculosis in Beira Interior was 5.9 while in Portugal was 17.5 cases per 100,000 population., From the percentage of patients with known serology in Portugal, the HIV - positive were 14 % while in the region were 2% from 2010 to 2012 . Discussion The most represented ages in the study are related to the fact that the working population the largest carrier of the disease, and this has an impact on its spread and possibly with TB reactivation in the case of the second age group. In our study, residents in the rural environment are the vast majority of Pulmonary Tuberculosis patients. The sector of society most affected as the TP is the pensioners, followed by unskilled workers. This is due in part to a large percentage of cases are in the seventh and eighth decades of life. Our study suggests that supporting the rural population access to health services and better articulation in the surveys to regular contacts of patients are possible measures to control infection and decrease the parameters of incidence and mortality in the region.
Introduction Tuberculosis is a disease caused by Mycobacterium tuberculosis complex. This is a bacterial infection caused by inhalation of mycobacteria. This infection usually affects the lungs, but can reach any other organ or system of the human body. During the 1980s emerged the first cases of multidrug-resistant TB and HIV infection which have been considered a global emergency by WHO. Even today it is considered a worldwide public health issue, with high morbidity and mortality associated and huge costs involved in its diagnosis and treatment. Due to numerous efforts, Tuberculosis in Portugal has decreased the prevalence and incidence in recent decades. However, it remains as the only country in Western Europe with an annual incidence over 20 cases per 100,000 inhabitants. The Beira Interior is a disparate region of large urban centers with regard to its demography and geography , and currently owns levels of incidence between 12 and 14 cases per 100,000 habitants, below the national average. Materials and Methods This articles discusses the epidemiology of Pulmonary Tuberculosis in Beira Interior from January 2003 to December 2012. The study is longitudinal, retrospective and descriptive and has permission from the DGS and ARSC. Statistical analysis was performed with the software SPSS 21 and Microsoft Excel 2010. Accordingly, we intend to analyze new cases of the districts of Guarda and Castelo Branco and classify them according to age, sex, occupation, residence and HIV status, developing a Pulmonary Tuberculosis profile of the patient in Beira Interior. The mortality data covers the years 2011 and 2012 and the information is also analyzed according to the age, sex, and conditions associated tracked contacts. The data will also be compared with national data. Results 490 cases of pulmonary TB were identified in Beira Interior from 2003 to 2012, 357 men and 133 women, being the ratio 2,7:1. Ages between 20 to 60 and 65 to 80 were the most frequent in the study with an average of 48 years of age. About 75 % of patients live in a rural environment. The most represented professions were pensioners and unskilled workers. From unskilled workers, the occupations of construction occupied great highlight with 65 cases. Throughout the decade, only 12 cases of HIV - positive were identified, and 131 cases had unknown results of serology. From 2003 to 2012 the annual cases decreased markedly, from 68 to 21. Noteworthy are the years 2009 and 2011 where the downward trend has changed. In 2011 and 2012 5 people died of Pulmonary Tuberculosis in “Beira Interior”. In 2012, the incidence of Pulmonary Tuberculosis in Beira Interior was 5.9 while in Portugal was 17.5 cases per 100,000 population., From the percentage of patients with known serology in Portugal, the HIV - positive were 14 % while in the region were 2% from 2010 to 2012 . Discussion The most represented ages in the study are related to the fact that the working population the largest carrier of the disease, and this has an impact on its spread and possibly with TB reactivation in the case of the second age group. In our study, residents in the rural environment are the vast majority of Pulmonary Tuberculosis patients. The sector of society most affected as the TP is the pensioners, followed by unskilled workers. This is due in part to a large percentage of cases are in the seventh and eighth decades of life. Our study suggests that supporting the rural population access to health services and better articulation in the surveys to regular contacts of patients are possible measures to control infection and decrease the parameters of incidence and mortality in the region.
Description
Keywords
Beira Interior Epidemiologia Incidência Mortalidade Tuberculose Pulmonar