AVANÇOS E BARREIRAS NO CONTROLE DA TUBERCULOSE MULTIRRESISTENTE NO SUS: DIAGNÓSTICO, TRATAMENTO E ADESÃO

• DOI: https://doi.org/10.22533/at.ed.2511225270115

• Palavras-chave: Tuberculose; Monitoramento epidemiológico; Vigilância epidemiológica; Coinfecção TB-HIV.

• Keywords: Tuberculosis; Epidemiological monitoring; Epidemiological surveillance; TB-HIV coinfection.

• Abstract: Tuberculosis, caused by Mycobacterium tuberculosis, is an old disease that still represents a serious public health problem in several countries, with approximately 10 million new cases and more than one million deaths each year. In Brazil, approximately 80,000 new cases and 5,500 deaths are recorded annually. The treatment offered by the Unified Health System (SUS) lasts at least six months and includes four main drugs, such as rifampicin and isoniazid. However, in recent years, the effectiveness of this treatment has been compromised by the increase in antimicrobial resistance. In addition, difficulties in accessing health services and social barriers, such as poverty and stigma, make tuberculosis control and prevention even more challenging. Therefore, the objective of this study was to conduct a study on the challenges in controlling M. tuberculosis resistance in the SUS. For this purpose, an integrative literature review was conducted. Articles published in Portuguese in the Google Scholar, Scientific Direct and PubMed databases between January 2012 and August 2024 were selected. The following descriptors were used: “Mycobacterium tuberculosis”, “Unified Health System”, “Antimicrobial Resistance”, “Diagnosis”, “Coinfection”, “Treatment”. The results indicate that multidrug-resistant tuberculosis (MDR-TB) is becoming a growing problem in Brazil, facing treatment challenges due to antibiotic resistance and difficulty in accessing new therapies. Factors such as late diagnosis and treatment abandonment contribute significantly to the increase in M. tuberculosis resistance. Early diagnosis and the use of molecular methods, such as GeneXpert, are essential for controlling this disease. TB-HIV co- infection further aggravates the situation, making clinical management more complex. The incorporation of drugs such as pretomanid by the SUS represents an advance, and may improve treatment adherence and reduce its duration. Therefore, it is essential to implement social and financial support programs to address MDR- TB. In addition, strengthening epidemiological surveillance and expanding education about the disease are key strategies to contain the spread of drug-resistant tuberculosis.