Eleny Guimarães Teixeira

Bio: Eleny Guimarães Teixeira is an academic researcher from Federal University of Rio de Janeiro. The author has contributed to research in topics: Tuberculosis & Health care. The author has an hindex of 12, co-authored 20 publications receiving 453 citations.

Óbitos atribuídos à tuberculose no Estado do Rio de Janeiro

Abstract: INTRODUCAO:Em 1998, o Rio de Janeiro era o estado de maior incidencia e mortalidade por tuberculose do Brasil. O Sistema de Informacao de Agravos de Notificacao em Tuberculose (SINAN-TB-RJ) nao era confiavel. OBJETIVO: Utilizar o estudo dos obitos por tuberculose como instrumento de avaliacao do programa de controle de tuberculose. METODO: Foram realizados estudos descritivos do SINAN-TB-RJ e do Sistema de Informacao de Mortalidade em tuberculose do Rio de Janeiro (SIM-TB-RJ) e os dois bancos de dados foram cruzados utilizando-se o programa Reclink. Foi tambem realizado um estudo baseado em prontuarios dos cinco hospitais onde ocorreu o maior numero de obitos por tuberculose. RESULTADOS: Em 1998 foram registrados no SINAN-TB-RJ 16.567 casos de tuberculose em maiores de 14 anos. A forma pulmonar estava presente em 13.989 (84,5%) casos, dos quais 8.223 (56,8%) tiveram baciloscopia positiva. A sorologia anti-HIV, recomendada para todos os pacientes com tuberculose, foi solicitada em apenas 4.141 (25%) casos. No SIM-TB-RJ foram registrados 1.146 obitos, dos quais 478 (41,7%) casos haviam sido notificados no SINAN-TB-RJ, entre 1995 e 1998. Dos 302 prontuarios estudados, em 154 (50,9%) o periodo de internacao foi inferior a 10 dias. O tempo entre o inicio dos sintomas e o diagnostico foi superior a 60 dias em 143 (47,3%) pacientes. Dos 125 pacientes em re-tratamento, para apenas 43 (34,4%) foi prescrito o esquema RHZE recomendado pelo Ministerio da Saude. CONCLUSAO: O estudo demonstra que a tuberculose e sub-notificada, o diagnostico e tardio, a utilizacao dos exames laboratoriais recomendados e baixa e as normas do Ministerio da Saude nao sao cumpridas.

Knowledge about STD / AIDS and sexual behavior among high school students in Rio de Janeiro Brazil.

Abstract: The incidence of AIDS and other sexually transmitted diseases (STDs) is increasing among adolescents. In order to better understand high-risk sexual behavior among students, a cross-sectional study based on a self-answered anonymous questionnaire was conducted in 10 public and private high schools in Rio de Janeiro, Brazil. Data were obtained on sociodemographics, knowledge of STD/AIDS, and sexual behavior. Among 945 students aged 13-21, 59% were sexually initiated, and the median age at first sexual intercourse was 15 years (range: 7-19). Although 94% reported being aware of the need for condom use for protection, only 34% informed always using condoms during sex. Low family income was associated with unsatisfactory knowledge (OR = 9.40; 95% CI = 6.05-14.60) and inconsistent condom use (OR = 11.60; 95% CI = 5.54-24.30). However, unsatisfactory knowledge was not associated with inconsistent condom use. School-based educational programs should focus on sexual behavior more than on transmission of knowledge, as well as targeting low-income students.

Latent tuberculosis infection among undergraduate medical students in Rio de Janeiro State, Brazil.

Abstract: CONTEXTE : Cinq ecoles de medecine dans trois villes de l'Etat de Rio de Janeiro, Bresil, ou les taux d'incidence de la tuberculose (TB) sont differents. OBJECTIF : Estimer la prevalence de l'infection tuberculeuse latente (LTBI) et les facteurs qui y sont associes chez les etudiants en medecine. SCHEMA: Enquete transversale conduite parmi les etudiants dans les annees precliniques et les annees cliniques initiales et tardives, provenant d'ecoles dans les villes avec des taux d'incidence de TB faibles (28/100.000), intermediaires (63/100.000) et eleves (114/100.000). On a obtenu des informations sur le profil socio-demographique, une vaccination anterieure par le BCG, une exposition potentielle a la tuberculose, une comorbidite et l'utilisation de masques respiratoires protecteurs. On a pratique un test cutane tuberculinique (TST) selon la technique de Mantoux grâce a un professionnel experimente. Un TST positif defini comme une induration ≥10 mm a ete considere comme LTBI. RESULTATS: La prevalence de LTBI a ete de 6,9% (IC95% 5,4-8,6). Dans l'analyse multivariee, le sexe masculin (odds ratio ajuste [ORa] 1,8; IC95% 1,1-3,0), le fait d'etre dans les annees cliniques tardives (ORa 1,9; IC95% 1,01-3,5), une incidence intermediaire de TB (ORa 4,3; IC95% 1,3-14,6) ainsi qu'une incidence elevee de TB dans la ville ou se situe l'ecole de medecine (ORa 5,1; IC95% 1,6-16,8) ont ete associes de maniere significative a la LTBI. CONCLUSION: La prevalence plus elevee de LTBI dans les annees cliniques tardives suggere que les etudiants en medecine connaissent un risque accru d'infection nosocomiale par Mycobacterium tuberculosis. La mise en oeuvre d'un programme de lutte antituberculeuse peut etre necessaire dans les ecoles de medecine, en particulier dans les villes ou l'incidence de la TB est plus elevee.

Tuberculosis and gender in a priority city in the state of Rio de Janeiro, Brazil

Abstract: The objective of this study was to compare gender differences among tuberculosis patients in a city with a high incidence of tuberculosis. This was a cross-sectional questionnaire-based study involving 560 tuberculosis patients (373 males and 187 females). Sociodemographic and clinical data, as well as data related to diagnostic criteria and treatment outcome, were collected (from the questionnaires and medical records) and subsequently compared between the genders. The median time from symptom onset to diagnosis was 90 days. There were no differences between the genders regarding the clinical presentation, diagnostic criteria, previous noncompliance with treatment, time from symptom onset, number of medical appointments prior to diagnosis, or treatment outcome. Gender-specific approaches are not a priority in Brazil. However, regardless of patient gender, the delay in diagnosis is a major concern.

Tuberculosis and gender in a priority city in the state of Rio de Janeiro, Brazil* , ** Tuberculose e gênero em um município prioritário no estado do Rio de Janeiro

Abstract: The objective of this study was to compare gender differences among tuberculosis patients in a city with a high incidence of tuberculosis. This was a cross-sectional questionnaire-based study involving 560 tuberculosis patients (373 males and 187 females). Sociodemographic and clinical data, as well as data related to diagnostic criteria and treatment outcome, were collected (from the questionnaires and medical records) and subsequently compared between the genders. The median time from symptom onset to diagnosis was 90 days. There were no differences between the genders regarding the clinical presentation, diagnostic criteria, previous noncompliance with treatment, time from symptom onset, number of medical appointments prior to diagnosis, or treatment outcome. Gender-specific approaches are not a priority in Brazil. However, regardless of patient gender, the delay in diagnosis is a major concern.

Tuberculosis among Health-Care Workers in Low- and Middle-Income Countries: A Systematic Review

Abstract: Background The risk of transmission of Mycobacterium tuberculosis from patients to health-care workers (HCWs) is a neglected problem in many low- and middle-income countries (LMICs). Most health-care facilities in these countries lack resources to prevent nosocomial transmission of tuberculosis (TB). Methods and Findings We conducted a systematic review to summarize the evidence on the incidence and prevalence of latent TB infection (LTBI) and disease among HCWs in LMICs, and to evaluate the impact of various preventive strategies that have been attempted. To identify relevant studies, we searched electronic databases and journals, and contacted experts in the field. We identified 42 articles, consisting of 51 studies, and extracted data on incidence, prevalence, and risk factors for LTBI and disease among HCWs. The prevalence of LTBI among HCWs was, on average, 54% (range 33% to 79%). Estimates of the annual risk of LTBI ranged from 0.5% to 14.3%, and the annual incidence of TB disease in HCWs ranged from 69 to 5,780 per 100,000. The attributable risk for TB disease in HCWs, compared to the risk in the general population, ranged from 25 to 5,361 per 100,000 per year. A higher risk of acquiring TB disease was associated with certain work locations (inpatient TB facility, laboratory, internal medicine, and emergency facilities) and occupational categories (radiology technicians, patient attendants, nurses, ward attendants, paramedics, and clinical officers).

The global prevalence of latent tuberculosis: a systematic review and meta-analysis

Abstract: In 1999, the World Health Organization (WHO) estimated that one-third of the world9s population had latent tuberculosis infection (LTBI), which was recently updated to one-fourth. However, this is still based on controversial assumptions in combination with tuberculin skin test (TST) surveys. Interferon-γ release assays (IGRAs) with a higher specificity than TST have since been widely implemented, but never used to estimate the global LTBI prevalence. We conducted a systematic review and meta-analysis of LTBI estimates based on both IGRA and TST results published between 2005 and 2018. Regional and global estimates of LTBI prevalence were calculated. Stratification was performed for low, intermediate and high TB incidence countries and a pooled estimate for each area was calculated using a random effects model. Among 3280 studies screened, we included 88 studies from 36 countries with 41 IGRA (n=67 167) and 67 TST estimates (n=284 644). The global prevalence of LTBI was 24.8% (95% CI 19.7–30.0%) and 21.2% (95% CI 17.9–24.4%), based on IGRA and a 10-mm TST cut-off, respectively. The prevalence estimates correlated well to WHO incidence rates (Rs=0.70, p In the first study of the global prevalence of LTBI derived from both IGRA and TST surveys, we found that one-fourth of the world9s population is infected. This is of relevance, as both tests, although imperfect, are used to identify individuals eligible for preventive therapy. Enhanced efforts are needed targeting the large pool of latently infected individuals, as this constitutes an enormous source of potential active tuberculosis.

Sex bias in infectious disease epidemiology: patterns and processes.

Abstract: Background Infectious disease incidence is often male-biased. Two main hypotheses have been proposed to explain this observation. The physiological hypothesis (PH) emphasizes differences in sex hormones and genetic architecture, while the behavioral hypothesis (BH) stresses gender-related differences in exposure. Surprisingly, the population-level predictions of these hypotheses are yet to be thoroughly tested in humans. Methods and Findings For ten major pathogens, we tested PH and BH predictions about incidence and exposure-prevalence patterns. Compulsory-notification records (Brazil, 2006–2009) were used to estimate age-stratified ♂:♀ incidence rate ratios for the general population and across selected sociological contrasts. Exposure-prevalence odds ratios were derived from 82 published surveys. We estimated summary effect-size measures using random-effects models; our analyses encompass ∼0.5 million cases of disease or exposure. We found that, after puberty, disease incidence is male-biased in cutaneous and visceral leishmaniasis, schistosomiasis, pulmonary tuberculosis, leptospirosis, meningococcal meningitis, and hepatitis A. Severe dengue is female-biased, and no clear pattern is evident for typhoid fever. In leprosy, milder tuberculoid forms are female-biased, whereas more severe lepromatous forms are male-biased. For most diseases, male bias emerges also during infancy, when behavior is unbiased but sex steroid levels transiently rise. Behavioral factors likely modulate male–female differences in some diseases (the leishmaniases, tuberculosis, leptospirosis, or schistosomiasis) and age classes; however, average exposure-prevalence is significantly sex-biased only for Schistosoma and Leptospira. Conclusions Our results closely match some key PH predictions and contradict some crucial BH predictions, suggesting that gender-specific behavior plays an overall secondary role in generating sex bias. Physiological differences, including the crosstalk between sex hormones and immune effectors, thus emerge as the main candidate drivers of gender differences in infectious disease susceptibility.

Treatment outcome of smear-positive pulmonary tuberculosis patients in Tigray Region, Northern Ethiopia.

Abstract: Monitoring the outcome of tuberculosis treatment and understanding the specific reasons for unsuccessful treatment outcome are important in evaluating the effectiveness of tuberculosis control program. This study investigated tuberculosis treatment outcomes and predictors for unsuccessful treatment outcome in the Tigray region of Ethiopia. Medical records of smear-positive pulmonary tuberculosis (PTB) patients registered from September 2009 to June 2011 in 15 districts of Tigray region, Northern Ethiopia, were reviewed. Additional data were collected using a structured questionnaire administered through house-to-house visits by trained nurses. Tuberculosis treatment outcomes were assessed according to WHO guidelines. The association of unsuccessful treatment outcome with socio-demographic and clinical factors was analyzed using logistic regression model. Out of the 407 PTB patients (221 males and 186 females) aged 15 years and above, 89.2% had successful and 10.8% had unsuccessful treatment outcome. In the final multivariate logistic model, the odds of unsuccessful treatment outcome was higher among patients older than 40 years of age (adj. OR = 2.50, 95% CI: 1.12-5.59), family size greater than 5 persons (adj. OR = 3.26, 95% CI: 1.43-7.44), unemployed (adj. OR = 3.10, 95% CI: 1.33-7.24) and among retreatment cases (adj. OR = 2.00, 95% CI: 1.37-2.92) as compared to their respective comparison groups. Treatment outcome among smear-positive PTB patients was satisfactory in the Tigray region of Ethiopia. Nonetheless, those patients at high risk of an unfavorable treatment outcome should be identified early and given additional follow-up and social support.

Tuberculose e indicadores socioeconômicos: revisão sistemática da literatura

Abstract: OBJETIVO: Analisar a literatura para verificar a existencia de associacao entre fatores socioeconomicos (individuais e coletivos) e a ocorrencia de tuberculose. METODOS: Realizou-se uma revisao sistematica da literatura mediante busca nas bases de dados SciELO, Lilacs, Medline e Scopus utilizando os termos "pobreza, indicadores sociais, fatores socioeconomicos" e "tuberculose" (em portugues, ingles e espanhol). Os estudos de nivel individual foram classificados segundo o desenho de estudo e a variavel dependente; os estudos ecologicos, quanto aos diferentes niveis de agregacao espacial dos dados e a variavel dependente. Para cada artigo foram registradas informacoes concernentes ao titulo do estudo, pais de origem, ano de desenvolvimento, autor, idioma, objetivos, nivel de agregacao espacial dos dados e indicadores utilizados na analise. RESULTADOS: Para estudos de nivel individual, observou-se associacao estatistica direta entre tuberculose e alcoolismo, coinfeccao com HIV, baixa escolaridade, estado civil, baixo rendimento monetario, carencia alimentar, imigracao e contato previo com pacientes de tuberculose. Em nivel coletivo, uma associacao indireta foi verificada com variaveis referentes ao produto interno bruto per capita, indice de desenvolvimento humano e acesso a saneamento basico em nivel de paises. Indicadores relativos ao numero medio de pessoas por comodo, densidade de pobres, escolaridade, declinio da renda familiar e domicilios com ajuda monetaria governamental associaram-se diretamente a tuberculose em diferentes niveis de agregacao espacial. CONCLUSOES: Os estudos analisados apontam para a persistencia da relacao entre indicadores socioeconomicos e a producao da tuberculose tanto em nivel individual quanto coletivo. A associacao entre tuberculose e indicadores socioeconomicos parece ser influenciada tanto pelo nivel de agregacao espacial quanto pelas caracteristicas particulares das areas geograficas.