Free Content The study of tuberculosis-attributed deaths as a tool for disease control planning in Rio de Janeiro, Brazil

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Abstract:

SETTING: Two tuberculosis (TB) reference hospitals and three general hospitals in Rio de Janeiro (RJ).

OBJECTIVE: To analyze TB-attributed deaths as a tool for evaluating the TB control program in RJ.

DESIGN: Retrospective study based on 302 medical records selected from the 1998 death database.

RESULTS: Of 1146 registered adult (>14 years) TB-attributed deaths in RJ, 328 occurred in five hospitals, and 302 records were analyzed. Median age was 47.5 (17–89) years; 237 (78.5%) were male. Median time elapsed from onset of symptoms until diagnosis was 60 (7–730) days; median hospitalization was 60 (0–517) days. Acid-fast bacilli sputum smears were performed in 200 (69%) of 290 cases of pulmonary disease. Among 32 (36%) smear-negative patients, culture was done in only one. The recommended regimen (RHZ) was used in 175 (58%). Among 125 re-treatment patients, 55 (44%) were on RHZ instead of RHZE. Notification to health authorities was recorded in 131 (43.4%) cases.

CONCLUSION: In RJ, young people die from TB. Major issues identified in the public health system were poor detection and notification and a high default rate, perpetuating the spread of TB. Treating professionals do not follow guidelines, and political commitment is needed to ensure TB control in the state and in the country.

Keywords: death; mortality; program evaluation; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Medicine, Gama Filho University, Rio de Janeiro, Brazil; School of Medicine, Serra Dos Órgãos Foundation, Rio de Janeiro, Brazil; and the Department of Paediatrics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil 2: Department of Medicine, Gama Filho University, Rio de Janeiro, Brazil; and the School of Medicine, Souza Marques Foundation, Rio de Janeiro, Rio de Janeiro, Brazil 3: Department of Medicine, Gama Filho University, Rio de Janeiro, Brazil; Department of Paediatrics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; and the School of Medicine, Souza Marques Foundation, Rio de Janeiro, Rio de Janeiro, Brazil 4: Department of Paediatrics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil 5: School of Medicine, Souza Marques Foundation, Rio de Janeiro, Rio de Janeiro, Brazil 6: School of Medicine, Serra Dos Órgãos Foundation, Rio de Janeiro, Brazil 7: Department of Medicine, Gama Filho University, Rio de Janeiro, Brazil

Publication date: September 1, 2003

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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