A propósito del artículo “Características y frecuencia de tuberculosis antes y durante la pandemia por COVID-19 en adultos atendidos en un centro de atención primaria, Lima-Perú, 2019-2020” Translated title: About the article entitled "Characteristics and frequency of tuberculosis before and during the COVID-19 pandemic among adults treated in a primary healthcare center in Lima, Peru, 2019-2020"

Background Peru is one of the countries with the highest burden of tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB) in the Latin American region and globally. Health education provided by nurses reinforces social support and the quality of patient care allows a greater impact on adherence to TB treatment. Purpose This study evaluated the mediating effect of treatment education between social support, quality of care, and treatment adherence in TB patients. Methods A cross-sectional study was carried out considering 162 adult TB patients from four health centers of the public sector located in the center of the city of Lima, Peru. Data were collected on variables, such as social support, quality of care, health education, and adherence to TB treatment. SmartPLS was used for data analysis. Results The results showed that social support and quality of care significantly influence health education. Likewise, health education mediates social support and quality of care for better adherence to treatment. Conclusion It is recommended that hospitals take initiatives to provide better health education on TB treatment to ensure better adherence to treatment.

RESUMEN Objetivo: Determinar las características y la frecuencia de pacientes con tuberculosis (TBC), mayores de 18 años, en prepandemia (2019) y durante la pandemia por COVID-19 (2020), en un centro de salud (CS) de Lima-Perú. Materiales y métodos: Estudio descriptivo, retrospectivo, que incluyó historias clínicas de 100 pacientes >18 años adscritos al programa de TBC en el CS Los Libertadores (SMP-Lima, Perú), durante el período 2019-2020. Se analizaron variables sociodemográficas (sexo, lugar de procedencia, edad), clínicas (condición de ingreso/egreso, índice de masa corporal, comorbilidades, localización de tuberculosis, tipo de resistencia, esquema de tratamiento) y laboratoriales (baciloscopia, cultivo, métodos de prueba de sensibilidad). Se excluyó a pacientes que no contaban con todas las variables. Se elaboró una base de datos en Excel y se realizó un análisis estadístico descriptivo en SPSS de las variables cualitativas, expresadas en frecuencias, y de las variables cuantitativas, en medidas de tendencia central (media) y desviación estándar. Se determinó la prevalencia de TBC por año, de acuerdo con la población adscrita al centro de salud; dicha información fue obtenida por medio del Sistema de Información Gerencial de Tuberculosis (SIGTB). Resultados: En 2019, la prevalencia de tuberculosis fue de 0,0015 % (49 pacientes); en el 2020, 0,075 % (51 pacientes). En ambos años, predominó el sexo masculino y el grupo etario de 18 a 29 años; la localización predominante fue pulmonar. El 2020 se observó un aumento de la comorbilidad asociada a VIH y de la tasa de mortalidad (0,074), así como más casos positivos en la baciloscopia. Conclusiones: La prevalencia de TBC fue mayor en el 2020, primer año de la pandemia del COVID-19, debido a un menor abordaje de los programas de TBC por la situación que impuso la pandemia. Además del aumento de las tasas de mortalidad de TBC en ese mismo año, probablemente, por la tasa de abandono del tratamiento o una mayor comorbilidad con VIH y la diabetes.

Objective is to determine the risk factors associated with developing tuberculosis in household contacts of patients with pulmonary tuberculosis in the epidemiological context of the Covid 19 pandemic Methods It is descriptive, analytical and cross-sectional, the population of index cases with tuberculosis is 53, and a sample of 59 household contacts of a health center of the Ministry of Health, in Lima, in the months of September and October 2021, two pre-established surveys were applied, one applied in the index case, and another to household contacts; for the association of risk factors, the Mantel and Haenszel Chi-square test was used Results in the sociodemographic risk, shared housing, with a significance of 0.000; family support, with a significance of 0.006, considered P values <0.05. Clinical factor, 27.5% (11) of the index cases have type 2 diabetes mellitus, and 7.5% (3) have malnutrition, and 7.5% have alcoholism, 5% have HIV/AIDS, arterial hypertension, and lack of application of isoniazid preventive therapy (IPT) are associated with a significance level of 0.001, (P <0.05). Environmental risk, home lighting, hygiene and ventilation are associated with a significance level of 0.017, 0.002 and 0.011 respectively, with P<0.05. index cases, more than 28 % were infected, 69.8 % were vaccinated; in contacts more than 13 % were infected, and vaccinated more than 47 % Conclusion shared housing, family support, associated diseases, lack of implementation of isoniazid preventive therapy (PTZ), home lighting, hygiene and ventilation were the most relevant associated with the development of tuberculosis. Tuberculosis is a global health crisis, attention should focus on controlling tuberculosis in areas where it continues to develop. Given that migration factors are a prevalent condition in the Americas, the focus must address health risk factors to improve health outcomes and care for TB patients in Peru.