Lancet Reg Health Am
September 2025
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View Article and Find Full Text PDFPLoS One
August 2025
Background: Clinical trials have shown the protective efficacy of tuberculosis preventive treatment (TPT) for averting disease and death from tuberculosis among people living with HIV/AIDS (PLHIV). TPT has been recommended for PLHIV since the 1980s. However, tuberculosis is still the first cause of death in PLHIV.
View Article and Find Full Text PDFBackground: The World Health Organization recommends evaluation of all household contacts (HHC) of index tuberculosis (TB) patients for TB disease (TBD) and TB infection (TBI). Tests to identify TBI and TBD are preferred but can be skipped in persons living with HIV and children <5 years. There is equipoise on the need for these tests in other HHC.
View Article and Find Full Text PDFAdv Rheumatol
July 2025
Background: Tuberculosis (TB) remains a leading cause of infectious disease mortality globally. Although directly observed therapy (DOT) has been widely implemented to improve adherence, nonadherence continues to compromise treatment success rates, especially in real-world settings. Therefore, this study aims to assess the impact of missed doses on TB treatment outcomes.
View Article and Find Full Text PDFThis study aims to conduct a needs and preparedness assessment of public primary care units to scale up tuberculosis infection diagnosis and tuberculosis preventive treatment in 5 Brazilian capitals. This observational operational study was carried out across five Brazilian high tuberculosis-burden cities. Clinics with at least one monthly new tuberculosis case were included.
View Article and Find Full Text PDFAdv Rheumatol
March 2025
Background: The risk of tuberculosis infection (TBI) and its progression to tuberculosis disease (TBD) among persons with immune-mediated inflammatory diseases (IMID) results from a complex interplay of patient and disease characteristics, immunosuppression level, and the epidemiological context. Brazilian recommendations are unclear about TBI screening and its preventive treatment (TPT) in persons with IMID.
Objective: To provide a comprehensive and evidence-based guideline for managing TBI in persons with IMID in Brazil.
Tuberculosis is a leading cause of death globally. Given the airborne transmission of tuberculosis, anybody can be infected, but people in high-incidence settings are more exposed. Risk of progression to disease is higher in the first years after infection, and in people with undernourishment, immunosuppression, or who smoke, drink alcohol, or have diabetes.
View Article and Find Full Text PDFCad Saude Publica
May 2025
This study aimed to analyze the cost-effectiveness of three tuberculosis (TB) antigen-based skin tests (TBST) (Diaskintest, C-TST, and Cy-TB) and QFT-Plus for TB infection diagnosis compared to the current standard of care, PPD Rt-23 tuberculin skin test (TST), among healthcare workers in Brazil. A state-transition Markov model was employed, simulating a cohort of healthcare workers (five annual cycles) for testing and treating TB infection with three months of weekly doses of rifapentine and isoniazid (3HP) under the Brazilian public health system perspective. Effects (TB disease averted) and costs for screening and treating TB infection were discounted at 5%.
View Article and Find Full Text PDFEpidemiol Serv Saude
May 2025
Objective: To describe the mortality profile and analyze the spatiotemporal distribution of COVID-19 mortality among international migrants residing in Brazil from 2020 to 2022.
Methods: This is a descriptive and ecological cross-sectional study using secondary data. Absolute and relative frequencies of the sociodemographic profile and mortality coefficients (MCs) were analyzed.
Background: Globally, over one-third of pulmonary tuberculosis (TB) disease diagnoses are made based on clinical criteria after a negative bacteriological test result. There is limited information on the factors that determine clinicians' decisions to initiate TB treatment when initial bacteriological test results are negative.
Methods And Findings: We performed a systematic review and individual patient data meta-analysis using studies conducted between January 2010 and December 2022 (PROSPERO: CRD42022287613).
Tuberculosis (TB) is the leading infectious disease cause of death worldwide. In recent years, stringent measures to contain the spread of SARS-CoV-2 have led to considerable disruptions of healthcare services for TB in many countries. The extent to which these measures have affected TB testing, treatment initiation and outcomes has not been comprehensively assessed.
View Article and Find Full Text PDFCad Saude Publica
June 2024
The economic, social, and health crisis in Venezuela has resulted in the largest forced migration in recent Latin American history. The general scenario in host countries influence migrants' self-perception of quality of life, which can be understood as an indicator of their level of integration. The COVID-19 pandemic has exacerbated socioeconomic and health vulnerabilities, especially for forced migrants.
View Article and Find Full Text PDFBrazil was heavily affected by COVID-19 both with death toll and economically, with absence of a centralized Federal Government response. Tuberculosis (TB) notifications decreased in 2020 but partial recovery was observed in 2021. We have previously shown a sharp (93%) reduction in TB preventive treatment notifications among five Brazilian cities with more than 1,000 notifications in 2021.
View Article and Find Full Text PDFBackground: Globally, over one-third of pulmonary tuberculosis (TB) disease diagnoses are made based on clinical criteria after a negative diagnostic test result. Understanding factors associated with clinicians' decisions to initiate treatment for individuals with negative test results is critical for predicting the potential impact of new diagnostics.
Methods: We performed a systematic review and individual patient data meta-analysis using studies conducted between January/2010 and December/2022 (PROSPERO: CRD42022287613).
Background: The duration of the protective effect of tuberculosis preventive therapy (TPT) is controversial. Some studies have found that the protective effect of TPT is lost after cessation of therapy among people with human immunodeficiency virus (HIV) in settings with very high tuberculosis incidence, but others have found long-term protection in low-incidence settings.
Methods: We estimated the incidence rate (IR) of new tuberculosis disease for up to 12 years after randomization to 4 months of rifampin or 9 months of isoniazid, among 991 Brazilian participants in a TPT trial in the state of Rio de Janeiro, with an incidence of 68.
Front Med (Lausanne)
January 2024
Introduction: The recommendation of rifampin-based shorter - and safer - regimens for tuberculosis preventive treatment (TPT) is progressively replacing monotherapy with isoniazid by different countries. The Brazilian Ministry of Health (MoH) approved the incorporation of the Rifapentine + isoniazid regimen (3HP) at the end of 2020, with free distribution in the Brazilian Unified Health System (SUS) started from the last quarter of 2021. The objectives were to describe the implementation of the IL-TB System (Information System of TPT Notification) and uptake of Rifapentine + isoniazid (3HP) and Isoniazid (6H or 9H) in Brazil.
View Article and Find Full Text PDFBackground: Indicators of extensive disease-acid fast bacilli (AFB) smear positivity and lung cavitation-have been inconsistently associated with clinical rifampin-resistant/multidrug-resistant tuberculosis (RR/MDR-TB) outcomes. We evaluated the association of these indicators with end-of-treatment outcomes.
Methods: We did an individual participant data meta-analysis of people treated for RR/MDR-TB with longer regimens with documented AFB smear and chest radiography findings.
BMJ Glob Health
December 2023
Introduction: Mental health inequalities across racial and ethnic groups are large and unjust in many countries, yet these inequalities remain under-researched, particularly in low-income and middle-income countries such as Brazil. This study investigates racial and socioeconomic inequalities in primary healthcare usage, hospitalisation and mortality for mental health disorders in Rio de Janeiro, Brazil.
Methods: A cohort of 1.
Tuberculosis (TB) is the leading cause of pleural exudative effusions. Inflammatory markers, such as IFNγ and ADA, have been used as proxies for its diagnosis. We evaluated ex vivo levels of several cytokines in 83 pleural effusion specimens from patients with TB (including 10 with HIV co-infection) and 26 patients with other pleuritis using multiplex and ELISA assays.
View Article and Find Full Text PDFCad Saude Publica
September 2023
From 2011 to 2022, 348,067 people applied for a refugee status in Brazil. The reasons that resulted in their migration, the risks during their journey, and the cultural transition upon arrival may be associated with different health problems. This study aimed to analyze the self-reported health conditions of asylum seekers in the municipality of Rio de Janeiro from 2010 to 2017.
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