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      Estratégias assistenciais para o controle da tuberculose drogarresistente: revisão integrativa da literatura Translated title: Estrategias asistenciales para el control de la tuberculosis farmacoresistente: revisión integradora de la literatura Translated title: Care strategies for controlling drug-resistant tuberculosis: integrative literature review

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          Abstract

          RESUMO Objetivo identificar, na literatura científica, estratégias assistenciais para o controle da tuberculose drogarresistente. Método revisão integrativa da literatura, com análise de pesquisas relevantes sobre a questão nortedora: Quais são as evidências científicas sobre as estratégias assistenciais para o controle da tuberculose drogarresistente? Busca realizada nas bases Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis, Índice Bibliográfico Espanhol em Ciências da Saúde e Banco de Dados em Enfermagem, entre janeiro e março de 2020. Foram incluídos dez artigos para discussão dos resultados que responderam à questão da pesquisa, atendendo aos critérios de inclusão e exclusão. Resultados nos estudos publicados nos últimos cinco anos, 80% abordaram estratégias assistenciais para o controle da tuberculose drogarresistente e 20% evidenciaram falhas na assistência aos portadores da doença. Conclusão a revisão da literatura identificou várias estratégias assistenciais para o controle da tuberculose drogarresistente, com destaque para a descentralização do diagnóstico e tratamento compartilhado, possibilitando uma atenção ampliada e integral aos pacientes.

          Translated abstract

          RESUMEN Objetivo identificar, en la literatura científica, estrategias de asistencia para el control de la tuberculosis farmacorresistente. Método se trata de una revisión integradora de la literatura, con análisis de investigaciones relevantes sobre la cuestión rectora: ¿Cuáles son las evidencias científicas sobre las estrategias de asistencia para el control de la tuberculosis farmacorresistente? La búsqueda fue realizada en las bases Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Medical Literature Analysis, Índice Bibliográfico Español en Ciencias de la Salud y Banco de Datos en Enfermería, de enero a marzo de 2020. Se incluyeron diez artículos para discutir los resultados que respondieron a la pregunta de la investigación, cumpliendo con los criterios de inclusión y exclusión. Resultados en los estudios publicados en los últimos cinco años, el 80% abordó estrategias de atención para el control de la tuberculosis farmacorresistente y el 20% mostró fallas en la atención de los pacientes con la enfermedad. Conclusión la revisión de la literatura identificó varias estrategias asistenciales para el control de la tuberculosis farmacorresistente, con énfasis en la descentralización del diagnóstico y tratamiento compartido, permitiendo una atención ampliada e integral a los pacientes.

          Translated abstract

          ABSTRACT Objective from the scientific literature, to identify care strategies for controlling drug-resistant tuberculosis. Method this integrative literature review examined relevant research on the research question – What is the scientific evidence on care strategies for controlling drug-resistant tuberculosis? – by searching Latin American and Caribbean Health Sciences Information, Medical Literature Analysis, Índice Bibliográfico Español en Ciencias de la Salud and Banco de Dados em Enfermagem, between January and March 2020. Ten articles were included in order to discuss findings that answered the research question, after meeting the inclusion and exclusion criteria. Results of studies published in the past five years, 80% addressed care strategies for controlling drug-resistant tuberculosis and 20% revealed shortcomings in care for patients with the disease. Conclusion the literature review identified several care strategies for controlling drug-resistant tuberculosis, particularly by decentralized diagnosis and shared treatment, allowing expanded, comprehensive patient care.

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          Principais itens para relatar Revisões sistemáticas e Meta-análises: A recomendação PRISMA

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            Tuberculosis care strategies and their economic consequences for patients: the missing link to end tuberculosis

            Background While investment in the development of Tuberculosis (TB) treatment strategies is essential, it cannot be assumed that the strategies are affordable for TB patients living in countries with high economic constraints. This study aimed to determine the economic consequences of directly observed therapy for TB patients. Methods A cross-sectional cost-of-illness analysis was conducted between September to November 2015 among 576 randomly selected adult TB patients who were on directly observed treatment in 27 public health facilities in Addis Ababa, Ethiopia. Data were collected using interviewer-administered questionnaire adapted from the Tool to Estimate Patients’ Costs. Mean and median costs, reduction of productivity, and household expenditure of TB patients were calculated and ways of coping costs captured. Eta (η), Odds ratio and p values were used to measure association between variables. Results Of the total 576 TB patients enrolled, 43 % were smear-positive pulmonary TB (PTB), 17 % smear-negative PTB, 37 % Extra-PTB and 3 % multi-drug resistant TB cases. Direct (Out-of-Pocket) mean and median costs of TB illness to patients were $123.0 (SD = 58.8) and $125.78 (R = 338.12), respectively, and indirect (loss income) mean and median costs were $54.26 (SD = 43.5) and $44.61 (R = 215.6), respectively. Mean and median total cost of TB illness to patient were $177.3 (SD = 78.7) and $177.1 (R = 461.8), respectively. The total cost had significant association with patient’s household income, residence, need for additional food, and primary income (P <0.05). Direct costs were catastrophic for 63 % of TB patients, regardless of significant difference between gender (P = 0.92) and type of TB cases (P = 0.37). TB patients mean productivity and income reduced by 37 and 10 %, respectively, compared with pre-treatment level, while mean household expenditure increased by 33 % and working hours reduced by 78 % due to TB illness. Income quartile categories were directly correlated with catastrophic costs (η = 0.684). Conclusion Despite the availability of free-of-charge anti-TB drugs, TB patients were suffering from out-of-pocket payments with catastrophic consequences, which in turn were hampering the efforts to end TB. TB patients in resource-limited countries deserve integrated patient-centered care with comprehensive health insurance coverage, financial incentives, and nutrition support to reduce catastrophic costs and retain them in care. Such countries should induce home-based directly observed therapy programs to reduce costs due to attending health facilities, intensify home treatment of critically-ill patients with impaired mobility, and reduce the spread of TB due to patients traveling to seek care. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0187-9) contains supplementary material, which is available to authorized users.
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              O método da revisão integrativa nos estudos organizacionais

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                Author and article information

                Journal
                reuerj
                Revista Enfermagem UERJ
                Rev. enferm. UERJ
                Universidade do Estado do Rio de Janeiro (Rio de Janeiro, RJ, Brazil )
                0104-3552
                2021
                : 29
                : e52508
                Affiliations
                [1] Amazonas orgnameUniversidade Federal do Amazonas Brazil
                Article
                S0104-35522021000100402 S0104-3552(21)02900000402
                10.12957/reuerj.2021.52508
                b99814b0-a95c-4532-a264-2d5c9348f41e

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 May 2021
                : 07 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 0
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigos de Revisão

                Grupo de Atención al Paciente,Promoción de la Salud,Tuberculose Resistente a Múltiplos Medicamentos,Equipe de Assistência ao Paciente,Promoção da Saúde,Tuberculosis, Multidrug-Resistant,Patient-Centered Care,Patient Care Team,Health Promotion,Assistência Centrada no Paciente,Tuberculosis Resistente a Múltiples Medicamentos,Atención Dirigida al Paciente

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