Busca de casos de tuberculose pulmonar: abreugrafia em sintomáticos respiratórios, seguida de exames bacteriológicos nos suspeitos Case-finding for pulmonary tuberculosis through photofluorography and sputum examination of symptomatic persons

• Main Authors: Gilberto Ribeiro Arantes (Author), Antonio Ruffino-Netto (Author)
• Format: Book
• Published: Universidade de São Paulo, 1980-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1590/S0034-89101980000200004; 0034-8910; 1518-8787
• Keywords: Tuberculose; Tuberculose pulmonar; Escarro; Fluoroscopia; Tuberculosis; Tuberculosis, pulmonary; Sputum; Fluoroscopy; Public aspects of medicine; RA1-1270
• Source: Revista de Saúde Pública, Vol 14, Iss 2, Pp 185-193 (1980)

Todos os 32.225 adultos matriculados durante um ano no Centro de Saúde de Ribeirão Preto, Estado de São Paulo, Brasil, foram interrogados quanto à presença de sintomas respiratórios e abreugrafados. Aos sintomáticos foi dada orientação para a colheita de escarro com vistas à baciloscopia e à cultura para bacilo da tuberculose. O exame abreugráfico selecionou 230 portadores de sombras anormais (0,75%) entre os 30.846 assintomáticos e 328 (23,8%) entre os 1.379 sintomáticos. Dos 90 doentes descobertos, 57 eram sintomóticos bacilíferos, 28 sintomáticos não-bacilíferos e 5 assintomáticos. Se a busca de casos tivesse sido realizada somente nos sintomáticos respiratórios, sem utilização da abreugrafia, 33 doentes deixariam de ser descobertos. Por sua vez a pesquisa apenas em sintomáticos portadores de sombras anormais teria economizado 30.846 abreugrafias deixando de descobrir só 5 casos assintomáticos, ou seja, clinicamente inexpressivos. Foi qualificado o potencial epidemiológíco desse tipo de caso concluindo-se que o mesmo é desprezível.<br>To determine the best pattern for the use of radiology in tuberculosis case-finding, all registrants aged 15 and over at the Public Health Center of Ribeirão Preto, SP (Brazil) were questioned for respiratory symptoms and had a 70mm chest photofluorogram taken. This program was carried on for a year. Each symptomatic sputum specimen was examined through microscopy and culture. Each registrant with an abnormal X-ray and negative sputum specimen was submitted to clinical procedure until final diagnosis could be reached. X-rays showed abnormal shadws in 558 people. One thousand three hundred and seventy-nine people were found to have respiratory symptoms. A total 90 active cases were found; 57 of these were bacillary and 33, abacillary (5 of them asymptomatic). Of the 30,846 persons screened by X-ray, 230 (0.75%) were found to be radiologically abnormal, and 5.6%, that is, 5 out of 90, active cases. That 5 remaining, clinically inimportant, asymptomatic and abacillary cases would have been missed. A mathematical estimate of the potential danger of this type of case suggests that it is irrelevant to the well-being of a community.