OBJETIVO: Tracar o perfil epidemiologico dos casos notificados de tuberculose entre os profissionais de saude no Programa de Controle da Tuberculose do Hospital Universitario Cassiano Antonio de Moraes, em Vitoria (ES) Brasil. METODOS: Realizou-se um estudo descritivo e retrospectivo de dados secundarios no periodo de 2002 a 2006. RESULTADOS: Foram notificados 25 casos de profissionais de saude com tuberculose: 8 tecnicos de enfermagem (32%); 4 medicos (16%); 3 enfermeiros (12%); 2 tecnicos em radiologia (8%) e 8 profissionais pertencentes a outras categorias (32%); 14 do sexo masculino (56%) e 11 do sexo feminino (44%). A faixa etaria com maior incidencia foi a de 35-39 anos. A forma clinica predominante foi a extrapulmonar com 12 casos (48%), seguido da pulmonar com 11 casos (44%), e 2 casos (8%) apresentaram ambas as manifestacoes. Entre os agravos associados, AIDS, etilismo e tabagismo apresentaram a mesma proporcao entre a populacao do estudo: 33,3%. Quanto ao desfecho, houve 22 casos de cura (88%), 2 transferencias (8%) e 1 obito (4%). A proporcao de profissionais de saude com diagnostico de tuberculose no periodo estudado foi de 2,53%. CONCLUSOES: Os resultados deste estudo apontam a necessidade de os profissionais de saude que trabalham nos programas de controle da tuberculose preencherem o campo "ocupacao profissional" nas fichas de notificacao do Sistema de Informacao de Agravos de Notificacao. Alem disso, apontam para a necessidade da implementacao de um programa de controle de tuberculose ocupacional.

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Epidemiological Profile of Tuberculosis Cases Reported Among Health Care Workers at the University Hospital in Vitoria, Brazil

The objective of this review was to contribute to the debate on the nosocomial transmission of TB among health professionals in a country where TB is endemic Prior to 1900, there was no reason to believe that health professionals interacting with TB patients were more susceptible to becoming infected with the bacillus than was the general population Between 1920 and 1930, various studies showed significant findings regarding the rates of positive tuberculin skin tests among students in the area of health care However, most clinicians remained skeptical about the susceptibility of health professionals to becoming infected with TB In the various locales where the treatment of patients with TB has been implemented, health professionals have been described as an especially predisposed population to becoming infected with and developing active TB It is urgent that the scientific community and health professionals become mobilized, recognizing themselves as a population at risk of developing TB, and that actions be taken in order to minimize the potential risks of acquiring the disease at locales where patients with TB are treated

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Tuberculose em profissionais de saúde: um novo olhar sobre um antigo problema

Objective: To describe the epidemiological profile of tuberculosis cases reported among health care workers in the Tuberculosis Control Program of the Cassiano Antnio de Moraes University Hospital in Vitoria, Brazil. Methods: A retrospective descriptive study of secondary data was conducted between 2002 and 2006. Results: Twenty-five cases of health care workers with tuberculosis were reported: 8 in nursing technicians (32%); 4 in doctors (16%); 3 in nurses (12%); 2 in radiology technicians (8%) and 8 in professionals from other categories (32%). Of those 25 health care workers, 14 (56%) were male and 11 (44%) were female. The incidence of the disease was highest among those from 35 to 39 years of age. The predominant clinical presentation was extrapulmonary (12 cases, 48%), followed by pulmonary (11 cases, 44%) and a combination of the two (2 cases, 8%). Regarding comorbidities, AIDS, alcoholism and smoking, respectively, were present in 33.3% of the study population. Outcomes were as follows: 22 cases of cure (88%); 2 transfers (8%); and 1 death (4%). The proportion of health care workers diagnosed with tuberculosis in the period studied was 2.53%. Conclusions: The results show the need for heath care workers who work in the tuberculosis control program to fill out the field ‘professional occupation’ on the tuberculosis case registry database reporting forms. In addition, this situation draws attention to the need to implement an occupational tuberculosis control program.

Original Article Epidemiological profile of tuberculosis cases reported among health care workers at the University Hospital in Vitoria, Brazil*

Objective: To describe the epidemiological profile of tuberculosis cases reported among health care workers in the Tuberculosis Control Program of the Cassiano Antonio of Moraes University Hospital in Vitoria, Brazil. Methods: A retrospective descriptive study of secondary data was conducted between 2002 and 2006. Results: Twenty-five cases of health care workers with tuberculosis were reported: 8 in nursing technicians (32%); 4 in doctors (16%); 3 in nurses (12%); 2 in radiology technicians (8%) and 8 in professionals from other categories (32%). Of those 25 health care workers, 14 (56%) were male and 11 (44%) were female. The incidence of the disease was highest among those from 35 to 39 years of age. The predominant clinical presentation was extrapulmonary (12 cases, 48%), followed by pulmonary (11 cases, 44%) and a combination of the two (2 cases, 8%). Regarding comorbidities, AIDS, alcoholism and smoking, respectively, were present in 33.3% of the study population. Outcomes were as follows: 22 cases of cure (88%); 2 transfers (8%); and 1 death (4%). The proportion of health care workers diagnosed with tuberculosis in the period studied was 2.53%. Conclusions: The results show the need for heath care workers who work in the tuberculosis control program to fill out the field “professional occupation” on the tuberculosis case registry database reporting forms. In addition, this situation draws attention to the need to implement an occupational tuberculosis control program.

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Artigo Original Perfil epidemiológico dos casos notificados de tuberculose entre os profissionais de saúde no Hospital Universitário em Vitória (ES) Brasil

Several studies have demonstrated an elevated prevalence amongst professionals of mycobacterium tuberculosis, both in the rate of infections and illness. This study was carried out in a School Hospital in Campo Grande, MS, Brazil, aiming to establish the prevalence of infection with Mycobacterium tuberculosis. The results of the analysis of 194 subjects showed an overall positivity for the tuberculin test of 38.7%. There was a correlation with smoking (p=0.01, RP=1. 72 (1.20-2.45- Yates’s correction). The conclusion is that the establishment of a program of tuberculin screening jointly with the implementation of interventions is necessary in order to reduce the risk of nosocomial transmission.

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Prevalence of mycobacterium tuberculosis among professionals in a university hospital, Mato Grosso do Sul, 2004

INTRODUCAO:O Hospital Ferreira Machado, utilizado em parte das atividades de treinamento clinico dos alunos da graduacao da Faculdade de Medicina de Campos, admitiu 65 pacientes com tuberculose em 2001 OBJETIVO: Quantificar a resposta cutânea ao PPD e descrever a prova tuberculinica (PT) positiva entre os alunos Identificar e analisar os fatores associados a PT positiva Comparar as taxas de PT positiva, incluindo o efeito booster e estimar a prevalencia da PT positiva nos diferentes periodos da graduacao METODO: Estudo transversal de 500 alunos de medicina matriculados no primeiro semestre de 2002 Informacoes sobre caracteristicas socio-demograficas, vacinacao pelo BCG e exposicoes potenciais a TB foram obtidas por meio de questionario padronizado e validado A PT foi feita por profissional habilitado pelo Ministerio da Saude, usando-se PPD Rt23 atraves da tecnica de Mantoux feita em dois tempos RESULTADOS: Dos 500 alunos elegiveis, 316 (63,2%) foram incluidos A analise mostrou taxas crescentes de positividade a PT feita em dois tempos, de acordo com o progredir das atividades praticas (4,0%, 6,4% e 13,1%) e uma tendencia de associacao entre o periodo profissional e a PT positiva O maior percentual de PT positiva foi encontrado durante os anos de treinamento clinico, o que corresponde ao maior tempo de exposicao a pacientes (1000 horas) CONCLUSAO: A prevalencia da primeira PT positiva foi de 1,4% (5/345) Apos o segundo teste, a proporcao de PT positiva foi elevada (7,9%); 3) O periodo profissional (maior tempo de exposicao a pacientes) mostrou tendencia de associacao com a PT positiva A pesquisa do efeito booster mostrou-se altamente recomendavel pois reduz a PT falso-negativa

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Luiz Clovis Parente Soares

Papers

Prevalência da prova tuberculínica positiva entre alunos da Faculdade de Medicina de Campos (RJ)