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A study of multidrug-resistant tuberculosis in risk groups in the city of Santos, São Paulo, Brazil
Coelho, Andréa Gobetti Vieira; Zamarioli, Liliana Aparecida; Telles, Maria Alice; Ferrazoli, Lucilaine & Waldman, Eliseu Alves
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.
Keywords
pulmonary tuberculosis - drug resistance - multidrug resistance - surveillance
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