title: A study of multidrug-resistant tuberculosis in risk groups in the city of Santos, São Paulo, Brazil.
abstract: Monitoring the extent of and trends in multidrug-resistant tuberculosis (MDR-TB) is a priority of the Brazilian National Tuberculosis Control Programme. The current study aimed to estimate the incidence of MDR-TB, describe the profile of TB drug resistance in risk groups and examine whether screening for MDR-TB adhered to the recommended guidelines. A descriptive study that examined diagnosed cases of pulmonary TB was conducted in the city of Santos, Brazil, between 2000-2004. Of the 2,176 pulmonary TB cases studied, 671 (30.8%) met the criteria for drug sensitivity testing and, of these cases, 31.7% (213/671) were tested. Among the tested cases, 9.4% were resistant to one anti-TB drug and 15% were MDR. MDR was observed in 11.6% of 86 new TB cases and 17.3% of 127 previously treated cases. The average annual incidence of MDR-TB was 1.9 per 100,000 inhabitants-years. The extent of known MDR-TB in the city of Santos is high, though likely to be underestimated. Our study therefore indicates an inadequate adherence to the guidelines for MDR-TB screening and suggests the necessity of alternative strategies of MDR-TB surveillance.
authors.affiliation: Centro de Laboratório Regional Santos, Instituto Adolfo Lutz, São Paulo, SP, Brasil.
authors.forename: Andréa Gobetti Vieira
authors.initials: AG
authors.lastname: Coelho
authors.forename: Liliana Aparecida
authors.initials: LA
authors.lastname: Zamarioli
authors.forename: Maria Alice
authors.initials: MA
authors.lastname: Telles
authors.forename: Lucilaine
authors.initials: L
authors.lastname: Ferrazoli
authors.forename: Eliseu Alves
authors.initials: EA
authors.lastname: Waldman
mesh_terms: D000293:Adolescent; D000328:Adult; D000904:Antibiotics, Antitubercular / Q000494:pharmacology*; D001938:Brazil / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D011159:Population Surveillance; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000904:Antibiotics, Antitubercular