Estudo do papel da intervenção de Serviço de Assistência Domiciliar para pacientes co-infectados por vírus da Imunodeficiência Humana e Tuberculose recém desospitalizados de hospital referência em Belo Horizonte MG sobre a interrupção das terapias anti-retroviral e tuberculostática Belo Horizonte 2006

Abstract

The effectiveness of tuberculosis treatment delivered by a home-based care programme to patients co-infected with HIV was compared with that of a service provided by outpatient departments. A retrospective study was made of a cohort of co-infected patients discharged from hospital between January 1998 and December 2002 who had been followed-up for one year within one of these programmes. Two-hundred-and-forty patients who met the inclusion criteria were grouped according to their treatment programme (group 1 received home-based care with 57 patients; group 2 attended outpatient departments with 183patients). In group 1, 73,7% of patients attained successful tuberculosis treatment compared with 72,7% of those in group 2 ( = 0.882 CI=-0,14-0,12). Treatment was abandoned by 28,1% of patients in group 1 and by 42,1% of those in group 2 ( = 0.129 Relative Hazzard(RH) = 0,65 CI = 0,37-1,13). In multivariate analysis for group 1, patients more younger than 35 years old was risk factor to abandoning treatment with p=0,030 and RH= 4,19. For group 2, use illicit drugs (p=0,001 RH=2,52), gender female (p=0,003 RH=2,37), negative growth in culture for Mycobacterium sp (p=0,015 RH=2,01), less than eight years in theschool (p=0,026 RH=3,82), younger than 35 years old (p=0,041 RH=1,77) and not introduction of HAART throughout hospitalization (p=0,045 RH=1,73) were risk factors for abandonment therapy.Although both programmes achieved a similar success rate in the treatment of tuberculosis, they need improvement their rates. The importance of assigning patients at-risk of abandoning treatment to a home-based care programme after discharge from hospital is emphasised.