Delay in the diagnosis and treatment of tuberculosis in prisons in Mato Grosso do Sul, Brazil

Sociedade Brasileira de Medicina Tropical. Revista

article

Gonçalves, Crhistinne Cavalheiro Maymone¹  Andrews, Jason²  Ko, Albert³  Croda, Julio⁴  Ribeiro, Carla Celina⁵  Santos, Andrea da Silva⁵  Tshua, Daniel Henrique¹  Oliveira, Roberto Dias de⁵  Lemos, Everton Ferreira⁴  Bourdillon, Paul³  Laranjeira, Alexandre⁶ 

[1] Secretaria Estadual de Saúde de Mato Grosso do Sul;Stanford University School of Medicine;Yale University School of Public Health;Universidade Estadual de Mato Grosso do Sul;Universidade Federal da Grande Dourados;Faculdade de Medicina de São José do Rio Preto

关键词: Tuberculosis;    Prisons;    Delayed diagnosis;    Time to treatment;    Brazil;   

DOI  :  10.1590/0037-8682-0015-2023

学科分类：农业科学（综合）

来源: Sociedade Brasileira de Medicina Tropical

【 摘 要 】

Background:The number of tuberculosis (TB) cases in prisons is higher than that in the general population and has been reported as the most common cause of death in prisons. This study evaluated the delay in the diagnosis and treatment of TB in Brazilian prisons.Methods: A retrospective cohort study was conducted between 2007 and 2015 using data from the five largest male prisons in Mato Grosso do Sul, Brazil. TB case data was collected from the National Database of Notifiable Diseases (SINAN), GAL-LACEN, and prison medical records. The following variables were recorded: prison, year of diagnosis, age, race, education, HIV status, smoking status, comorbidities, number of symptoms, percentage of cures, delay in diagnosis, patient delay, provider delay, laboratory delay, and delay in treatment. Descriptive statistics were used for the variables of interest.Results: A total of 362 pulmonary TB cases were identified. The average time between the first symptom and reporting of data was 94 days. The mean time between symptom onset and laboratory diagnosis was 91 days. The average time from symptom onset to first consultation was 80 days. The time between diagnosis and treatment initiation was 5 days.Conclusions: Delays were significant between reporting of the first symptoms and diagnosis and significantly smaller from the time between notification and start of treatment. Control strategies should be implemented to diagnose cases through active screening, to avoid delays in diagnosis and treatment, and to reduce TB transmission.

【 授权许可】

CC BY