Resumo em Espanhol:

OBJETIVO: Identificar factores de pronóstico del abandono del tratamiento antituberculoso en la provincia de Ica, Perú. MÉTODOS: Entre 1998 y 2000 se llevó a cabo un estudio de casos y testigos (razón numérica de 1:1) en la provincia de Ica. Se identificaron 55 casos de abandono del tratamiento antituberculoso. Los factores evaluados se seleccionaron a partir del modelo del campo de la salud de Lalonde. Las respectivas razones de posibilidades se calcularon por medio de análisis unifactorial y multifactorial. RESULTADOS: Se identificaron como factores pronósticos del abandono del tratamiento anti-tuberculoso los siguientes: considerar insuficiente la información proporcionada por el personal de salud sobre el tratamiento (razón de posibilidades [odds ratio, OR]: 4,20; intervalo de confianza de 95% [IC95%]: 1,77 a 10,02), considerar inadecuados los horarios para recibir el tratamiento (OR: 9,95; IC95%: 1,97 a 50,21) y consumir drogas ilícitas (OR: 7,15; IC95%: 1,69 a 30,23). CONCLUSIONES: Para mejorar el cumplimiento del régimen antituberculoso es necesario brindar a los pacientes información personalizada sobre la enfermedad y su tratamiento, además de ofrecerles horarios flexibles y apropiados para recibirlo. El consumo de drogas es el factor de riesgo más alto de abandono, por lo que resultan cruciales su identificación y seguimiento.

Resumo em Inglês:

OBJECTIVE: To identify factors that predict noncompliance with tuberculosis treatment in the province of Ica, Peru. METHODS: Between 1998 and 2000 a case-control study (1:1 ratio) was conducted in the province of Ica, with 55 cases (persons who dropped out of treatment) being identified. The factors evaluated were chosen from Lalonde's model of the field of health. The respective odds ratios were calculated by means of univariate analysis and multivariate analysis. RESULTS: The following factors were identified as being predictive of noncompliance with tuberculosis treatment: thinking that the information that health workers provided on treatment was insufficient (odds ratio (OR) = 4.20; 95% confidence interval (95% CI), 1.77-10.02), thinking that the office hours for receiving treatment were inadequate (OR = 9.95; 95% CI, 1.97-50.21), and consuming illegal drugs (OR = 7.15; 95% CI, 1.69-30.23). CONCLUSIONS: To improve compliance with tuberculosis treatment, it is necessary to provide patients with personalized information on the disease and its treatment, and to offer them flexible, appropriate times to receive treatment. Drug consumption is the most serious risk factor for noncompliance, and identifying and following up with drug users is crucial.

Resumo em Espanhol:

OBJETIVOS: Determinar la prevalencia de algunos defectos eritrocíticos y evaluar su relación con la densidad de la parasitemia en personas con diagnóstico de malaria (paludismo) por Plasmodium falciparum en una población del Pacífico colombiano. MÉTODOS: Se realizó un estudio de prevalencia en 242 personas con malaria por P. falciparum que consultaron al Programa de Enfermedades Tropicales en la ciudad de Buenaventura, Colombia. Se midieron los niveles de parasitemia y se determinó la presencia de defectos eritrocíticos congénitos (deficiencia de glucosa-6-fosfato deshidrogenasa [G6PD] y presencia de hemoglobinas anormales y de talasemias) y de otros factores potencialmente relacionados con los niveles de parasitemia. RESULTADOS: La prevalencia obtenida de defectos eritrocíticos fue de 26,4% (IC95% 21,0 a 32,5), similar a la hallada en estudios realizados antes en la misma zona. En los modelos de regresión múltiple, las personas con drepanocitosis o deficiencia total de la G6PD presentaron una menor densidad de parasitemia que las personas sin defecto, y el riesgo de parasitemias altas fue menor en estas personas después de ajustes respecto a otras variables de interés (razón de posibilidades [odds ratio, RP]: 0,30 y 0,72, respectivamente). CONCLUSIONES: Los resultados confirman una alta prevalencia de defectos eritrocíticos en el Pacífico colombiano, en una población con características étnicas similares a las de algunas poblaciones del África Occidental, y aportan información en favor de la existencia de resistencia innata a la malaria en personas portadoras de hemoglobina AS o con deficiencia de la G6PD.

Resumo em Inglês:

OBJECTIVES: To determine the prevalence of some erythrocyte defects and to evaluate the relation that that has with parasitemia density in individuals diagnosed with Plasmodium falciparum malaria in a population in the Pacific coastal region of Colombia. METHODS: This prevalence study was carried out with 242 persons with P. falciparum malaria who had gone for consultation at the Program of Tropical Diseases diagnostic center in the city of Buenaventura, Colombia. The parasitemia levels were measured, and also determined was the presence of congenital erythrocyte defects (glucose-6-phosphate dehydrogenase (G6PD) deficiency, abnormal hemoglobins, and thalassemias) and of other factors possibly related to parasitemia levels. RESULTS: The prevalence of erythrocyte defects was 26.4% (95% confidence interval, 21.0%-32.5%), which was similar to what had been found in previous studies in the same area of Colombia. In the multiple regression models, individuals with sickle cell anemia or a complete deficiency of G6PD had a lower density of parasitemia than did persons without any erythrocyte defect. After adjusting for other variables of interest, the risk of high parasitemias was lower in persons with sickle cell anemia (odds ratio = 0.30) and individuals with a complete deficiency of G6PD (odds ratio = 0.72). CONCLUSIONS: Our results confirm the high prevalence of erythrocyte defects in Colombia's Pacific coastal region, in a population with ethnic characteristics that are similar to those of some populations in West Africa. Our results also lend support for the existence of innate resistance to malaria among carriers of hemoglobin AS and in persons with G6PD deficiency.