Multidrug-resistant tuberculosis in the Amazonas State, Brazil, 2000-2011

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Tuberculosis (TB) control in Amazonas faces challenges with nearly 3000 cases annually.
• Multidrug-resistant TB (MDR-TB) threatens the effectiveness of TB control programs.

Purpose of the Study:

• To determine the incidence of MDR-TB cases in Amazonas.
• To refine estimates of the overall TB burden in the region.

Main Methods:

• Data on MDR-TB cases from 2000 to 2011 were extracted from the Brazilian National Mandatory Disease Reporting System (SINAN) and the Brazilian Epidemiological Surveillance System of Multidrug Resistance (TBMR).

Main Results:

• Eighty-one MDR-TB cases were reported.
• Acquired MDR-TB constituted 82.7% of cases, with primary and initial rates at 3.8% and 13.7%, respectively.
• Treatment outcomes showed a 45.7% cure rate and a 25.9% death rate among MDR-TB patients. Contact tracing was insufficient, with only 35% of reported contacts examined.

Conclusions:

• The identified number of MDR-TB cases appears low relative to the high TB prevalence in Amazonas.
• A significant gap exists in patient awareness of TB exposure, with most unaware of contact with infectious individuals.
• The findings underscore the necessity of enhancing resistance surveillance for all TB cases in Amazonas.