Infecção latente por tuberculose entre trabalhadores de instalação correcional: prevalência e fatores associados.

Abstract

Tuberculosis (TB) is an infectious bacterial disease caused by Mycobacterium tuberculosis (MTB) or Koch's Bacillus (BK), which mainly affects the lungs. People carrying the active and untreated tuberculosis bacillus transmit the bacteria to other individuals when talking, sneezing or coughing, as they eliminate droplets containing the pathogen in the environment. Depending on the immunity of the host individual, it may initiate the development of the disease or remain in a latent form for many years, or even never develop the disease. Considering that criminal police officers and the entire staff of penitentiary employees develop their activities within a vulnerable environment, with a significant increase in tuberculosis cases, they are classified as a population at high risk of contact with MTB. Thus, the objective of the investigation was to estimate the prevalence and factors associated with latent tuberculosis infection (LTBI) in criminal police officers in Paraná. Cross-sectional, prospective study carried out with 71 criminal police officers from the State Penitentiary of Francisco Beltrão PR. Participants were invited to answer a self-administered questionnaire that had questions about sociodemographic and clinical-epidemiological data. Subsequently, a blood sample was collected, used to assess whether the participant had already had contact with MTB, through the IGRA method (Interferon - Gamma Release Assay), by the QuantiFERON-TB Gold In-Tube test (QFT-GIT) . The descriptive analysis was carried out, according to the selected characteristics, stratified by sex, through frequency distribution, as well as measures of central tendency and dispersion for the listed characteristics. Student's t test was used to compare mean differences for continuous variables, and Pearson's chi-square test to compare proportions of categorical variables. The IBM SPSS Statistics program, version 24.0 (IBM Corp., Armonk, NY, USA) was used for statistical analysis, and data were organized in tables. Regarding LTBI, a prevalence of 22.5% of positive results was identified (n=16; CI:95%;12.8-32.3). With reactive outcome in the QFT-GIT exam. The logistic regression model was significant (p = 0.004) and explained 26% of the outcome (Nagelkerke's R2). Age over 43 years (OR = 4.20) and who knew someone with tuberculosis (OR = 5.38) had significantly higher chances of having a positive test result. Variables with values of p ≤ 0.25 in the Wald test in the univariate analysis were manually selected to start the multivariate model. The significance level required for the inclusion of the selected variables in the final model was 0.05 to better adjust potential confounding factors. It is concluded that due to the high risk that criminal police officers have of being infected and falling ill with tuberculosis, indicating a 2.12 times greater chance than the rest of the population, it is essential to carry out actions to promote occupational health aimed at this group, that are capable of identifying signs and symptoms of the disease in persons deprived of their liberty (PDL), with an early diagnosis of LTBI, only then will it be possible to control transmission and, consequently, worldwide mortality.