This is a retrospective profile study of MRTB cases in Espírito Santo, between 2000 and 2004. Sixty-one patients were identified as MRTB, in a sample of 57 cases. All clinical charts of these cases were reviewed for the variables studied. The combined prevalence of MRTB was estimated as 0.87% (0.66 - 1.13; 95% CI). Anti-HIV tests were performed in 78.9% of cases, yielding 5 (11.1%) positive results. Regarding co-morbidity, alcoholism and smoking have a special importance. 11 cases (19.3%) of primary resistance (IR) were found, while 46 (80.7%) were cases of acquired resistance (AR), with an average of 2.3 ± 1.3 previous treatments. 35.1% of the cases informed a known previous contact with a person with tuberculosis, while for 67.9%, the contact was denied or was not the case. 10 patients (17.5%) had been treated with a 1st line regimen, 18 (31.6%) with a 2nd line one, and 27 (47.4%) with 3rd line. Eighteen (31.6%) had had self-administered treatment, while 39 (68.4%) had undergone supervised treatment. Outcome for 33 cases (71.7%) was cure, abandon for 7 (15.2%) and death for 5 (10.9%); there was one case of treatment failure and 11 (19.3%) were still in treatment. Of the 10 cases of IR with a defined outcome, 80% (8/10) were cured, against 69.4% (25/36) of AR cases. We concluded that the prevalence of MRTB is low in the state of Espírito Santo. Cure was reached in about 70% of all treatments. Associated co-morbidity can be a major drawback for satisfactory treatment outcome. Our results emphasize the need for case finding, search, diagnosis and performance of SAT for the identification of IR and implementation of supervised treatment for all tuberculosis cases.
Multidrug-resistant tuberculosis; Epidemiological Surveillance; Epidemiological profiles
