A DECADE TREND OF MULTIDRUG RESISTANT TUBERCULOSIS IN SÃO PAULO STATE, BRAZIL.
The aim of this retrospective study was to review all the notified cases of multidrug-resistant tuberculosis (MDR-TB) in São Paulo State (Brazil), as well as to describe and discuss the clinical, microbiological and radiologic aspects in a single reference center, within the same state, from 2000 to 2012. There were 1,097 notifications of MDR-TB in São Paulo State over this period, 70% affecting men aged on average 38 years (10-77). There was a significant fall in the MDR-TB mortality rate from 30% to 8% (2000-2003 versus 2009-2012). The same trend was observed in the cases studied at the reference center. The number of notified cases increased and death rate reduced from 37.5% (2000-2005) to 3.4% (2006-2012). Among the 48 drug-resistant TB cases, 17 non-tuberculous Mycobacteria were isolated in the sputum culture of nine patients, without any clinical significance. TB and fungus co-infection was diagnosed in 15% (7/48) of these cases: three with confirmed chronic pulmonary aspergillosis and four with positive serological markers for paracoccidioidomycosis. Overall, the reports show that MDR-TB diagnosis and cure rates have increased, while the mortality rate has decreased significantly in São Paulo State including in the studied reference center.
University of São Paulo (FMRP-USP), Tisiology Outpatient Clinic, Hospital das Clínicas, School of Medicine of Ribeirão Preto. Ribeirão Preto, SP, Brazil.
Valdes Roberto
VR
Bollela
University of São Paulo (FMRP-USP), Tisiology Outpatient Clinic, Hospital das Clínicas, School of Medicine of Ribeirão Preto. Ribeirão Preto, SP, Brazil.
Fernanda Guioti
FG
Puga
University of São Paulo (FMRP-USP), Tisiology Outpatient Clinic, Hospital das Clínicas, School of Medicine of Ribeirão Preto. Ribeirão Preto, SP, Brazil.
Maria Janete
MJ
Moya
Hospital Epidemiology Nucleus, Hospital das Clínicas (FMRP-USP). Ribeirão Preto, SP, Brazil.
Mauro
M
Andrea
São Paulo State Health Secretariat, Tuberculosis Control Division, Epidemiological Surveillance Center, São Paulo, SP, Brazil.
Maria de Lourdes Viude
ML
Oliveira
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002648:Child; D018563:Disease Notification / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*; D055815:Young Adult