In this cross-sectional study, mycobacteria specimens from 189 tuberculosis (TB) patients living in an urban area in Brazil were characterised from 2008-2010 using phenotypic and molecular speciation methods (pncA gene and oxyR pseudogene analysis). Of these samples, 174 isolates simultaneously grew on Löwenstein-Jensen (LJ) and Stonebrink (SB)-containing media and presented phenotypic and molecular profiles of Mycobacterium tuberculosis, whereas 12 had molecular profiles of M. tuberculosis based on the DNA analysis of formalin-fixed paraffin wax-embedded tissue samples (paraffin blocks). One patient produced two sputum isolates, the first of which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, and the second of which only grew on SB media and presented phenotypic profiles of Mycobacterium bovis. One patient provided a bronchial lavage isolate, which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, but had molecular profiles of M. bovis from paraffin block DNA analysis, and one sample had molecular profiles of M. tuberculosis and M. bovis identified from two distinct paraffin blocks. Moreover, we found a low prevalence (1.6%) of M. bovis among these isolates, which suggests that local health service procedures likely underestimate its real frequency and that it deserves more attention from public health officials.

Apesar de ilegal no Brasil, cerca de 31% das gestações terminam em aborto. A maioria dos abortamentos provocados é realizada por pessoas não capacitadas, e em condições inseguras, resultando em aumento da mortalidade feminina. O presente estudo utilizou dados de uma amostra representativa de 3.047 puérperas, de 1999-2000, de corte transversal, parte de estudo multicêntrico nacional sobre soroprevalência de sífilis no Brasil. Destas, foram analisadas 1.838 puérperas com pelo menos uma gravidez anterior à gravidez de referência. Os desfechos estudados foram perdas fetais prévias (voluntária e espontânea) e ausência de perda fetal prévia. A análise foi conduzida por meio de regressão logística multinomial. Os resultados indicaram alto número de perdas fetais por mulher (até seis) e 31% das perdas foram voluntárias. A ausência de pré-natal, a história de DST na gravidez de referência e a ausência de filhos vivos aumentaram a ocorrência de perdas fetais. Para as perdas voluntárias, a raça/cor não branca, mais de um parceiro no ano anterior e idade precoce à primeira relação sexual também concorreram para o aumento da ocorrência. Características de vulnerabilidade destas mulheres devem ser consideradas em programas de planejamento familiar e de aconselhamento de mulheres, focalizando aquelas que já tiveram abortos, para a redução do número e consequências deste procedimento.

Despite its illegality in Brazil, about 31% of all pregnancies end in abortion. Most abortions are performed by unskilled personnel and under unsafe conditions, resulting in increased female mortality. This study used data from a cross-sectional representative sample of 3,047 puerperal women, in 1999-2000, part of a national multicenter study on the prevalence of syphilis in Brazil. Of these, 1,838 women with at least one previous pregnancy before the reference pregnancy were included in the analysis. The outcomes studied were voluntary prior fetal loss, spontaneous prior fetal loss, and no prior fetal loss. The analysis was carried out using multinomial logistic regression. The results indicated a high number of fetal losses per woman (up to six); and 31% of the losses were voluntary. The absence of prenatal care, history of STD in the reference pregnancy, and absence of living children were factors that increased the odds of fetal loss. For voluntary fetal loss, being non-white, having more than one partner in the previous year, and an early age at first sexual intercourse also increased the odds of fetal loss. These data confirm the public health relevance of abortion in Brazil. Characteristics related to women´s vulnerability should be considered in family planning programs in order to reduce the number of abortions and their consequences. Counseling must also be provided, targeting women with a previous abortion.