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Resistencia a los medicamentos antituberculosos y vigilancia anónima del VIH en pacientes con tuberculosis en
L J Nelson1, E A Talbot, M J Mwasekaga
1Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA. LBN9@CDC.GOV
Lancet (London, England)
|August 9, 2005
Resumen
La resistencia a los medicamentos para la tuberculosis en Botswana aumentó significativamente de 1995 a 2002, coincidiendo con la alta prevalencia del VIH. Se necesitan intervenciones urgentes de control de la tuberculosis para combatir la creciente resistencia a los medicamentos.
Área de la Ciencia:
- Salud Pública La salud pública.
- Enfermedades infecciosas Enfermedades infecciosas.
- Epidemiología La epidemiología.
Sus antecedentes:
- Botswana experimentó un aumento de tres veces en la tuberculosis (TB) desde 1989.
- Encuestas anteriores en la década de 1990 indicaron bajas tasas de resistencia a los medicamentos antituberculosos.
Objetivo del estudio:
- Evaluar las tendencias en la resistencia a los medicamentos de la tuberculosis y la prevalencia del VIH en Botswana entre 1995 y 2002.
- Determinar el impacto del VIH en la epidemiología de la tuberculosis en Botswana.
Principales métodos:
- Una encuesta nacional se llevó a cabo en 2002, recolectando muestras de esputo de pacientes con tuberculosis.
- Se realizó una prueba anónima y rápida de VIH (Oraquick) en los pacientes participantes.
- Se analizaron los patrones de resistencia a los medicamentos para los casos de tuberculosis nuevos y tratados previamente.
Principales resultados:
- La prevalencia del VIH entre los pacientes con tuberculosis fue alta, con un 60% (1457 de 2200 casos positivos en frotis y 219 casos recurrentes) infectados con el VIH.
- La resistencia a los fármacos antituberculosos en pacientes nuevos aumentó significativamente del 3,7% en 1995 al 10,4% en 2002 (p<0,0001).
Conclusiones:
- En Botswana ha surgido un aumento sustancial de la tuberculosis resistente a los medicamentos.
- La alta prevalencia del VIH es un factor significativo en la epidemia de tuberculosis.
- Se necesitan urgentemente intervenciones urgentes y efectivas para el control de la tuberculosis en Botsuana para frenar una mayor resistencia a los medicamentos.
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