Factors associated with unfavorable outcome of tuberculosis treatment in people deprived of liberty: a systematic review

Saita, Nânci Michele; Andrade, Rúbia Laine de Paula; Bossonário, Pedro Augusto; Bonfim, Rafaele Oliveira; Hino, Paula; Monroe, Aline Aparecida

doi:10.1590/1980-220x-reeusp-2020-0583

Cited by 5 publications

(5 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings are consistent with previous systematic reviews and meta-analyses [ 11 – 13 ], and point to the greater challenges of achieving successful treatment outcomes for medically fragile individuals, and for individuals with vulnerable circumstances or health behaviors that make it more difficult to complete the extended treatment regimens required for TB disease. Treatment completion was found to be higher among incarcerated patients, consistent with earlier studies [ 12 , 14 , 15 ]. However, TB treatment completion among incarcerated individuals may be negatively impacted when patients are transferred between facilities or released during treatment, as coordination of care is often challenging [ 15 ].…”

Section: Discussionsupporting

confidence: 91%

Predictors of unsuccessful tuberculosis treatment outcomes in Brazil: an analysis of 259,484 patient records

Ryuk,

Pelissari,

Alves

et al. 2024

BMC Infect Dis

View full text Add to dashboard Cite

Introduction Tuberculosis (TB) causes over 1 million deaths annually. Providing effective treatment is a key strategy for reducing TB deaths. In this study, we identified factors associated with unsuccessful treatment outcomes among individuals treated for TB in Brazil. Methods We obtained data on individuals treated for TB between 2015 and 2018 from Brazil’s National Disease Notification System (SINAN). We excluded patients with a history of prior TB disease or with diagnosed TB drug resistance. We extracted information on patient-level factors potentially associated with unsuccessful treatment, including demographic and social factors, comorbid health conditions, health-related behaviors, health system level at which care was provided, use of directly observed therapy (DOT), and clinical examination results. We categorized treatment outcomes as successful (cure, completed) or unsuccessful (death, regimen failure, loss to follow-up). We fit multivariate logistic regression models to identify factors associated with unsuccessful treatment. Results Among 259,484 individuals treated for drug susceptible TB, 19.7% experienced an unsuccessful treatment outcome (death during treatment 7.8%, regimen failure 0.1%, loss to follow-up 11.9%). The odds of unsuccessful treatment were higher with older age (adjusted odds ratio (aOR) 2.90 [95% confidence interval: 2.62–3.21] for 85-100-year-olds vs. 25-34-year-olds), male sex (aOR 1.28 [1.25–1.32], vs. female sex), Black race (aOR 1.23 [1.19–1.28], vs. White race), no education (aOR 2.03 [1.91–2.17], vs. complete high school education), HIV infection (aOR 2.72 [2.63–2.81], vs. no HIV infection), illicit drug use (aOR 1.95 [1.88–2.01], vs. no illicit drug use), alcohol consumption (aOR 1.46 [1.41–1.50], vs. no alcohol consumption), smoking (aOR 1.20 [1.16–1.23], vs. non-smoking), homelessness (aOR 3.12 [2.95–3.31], vs. no homelessness), and immigrant status (aOR 1.27 [1.11–1.45], vs. non-immigrants). Treatment was more likely to be unsuccessful for individuals treated in tertiary care (aOR 2.20 [2.14–2.27], vs. primary care), and for patients not receiving DOT (aOR 2.35 [2.29–2.41], vs. receiving DOT). Conclusion The risk of unsuccessful TB treatment varied systematically according to individual and service-related factors. Concentrating clinical attention on individuals with a high risk of poor treatment outcomes could improve the overall effectiveness of TB treatment in Brazil.

show abstract

Section: Discussionsupporting

confidence: 91%

Predictors of unsuccessful tuberculosis treatment outcomes in Brazil: an analysis of 259,484 patient records

Ryuk,

Pelissari,

Alves

et al. 2024

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…These findings are consistent with previous systematic reviews and meta-analyses [11–13], and point to the greater challenges of achieving successful treatment outcomes for medically fragile individuals, and for individuals with vulnerable circumstances or health behaviors that make it more difficult to complete the extended treatment regimens required for TB disease. Treatment completion was found to be higher among incarcerated patients, consistent with earlier studies [12, 16, 17]. However, TB treatment completion among incarcerated individuals may be eroded when patients are transferred between facilities or released during treatment, as coordination of care is often challenging [17].…”

Section: Discussionsupporting

confidence: 84%

Predictors of unsuccessful tuberculosis treatment outcomes in Brazil: an analysis of 259,484 patient records

Ryuk,

Pelissari,

Alves

et al. 2024

Preprint

View full text Add to dashboard Cite

IntroductionTuberculosis (TB) causes over 1 million deaths annually. Providing effective treatment is a key strategy for reducing TB deaths. In this study, we identified factors associated with unsuccessful treatment outcomes among individuals treated for TB in Brazil.MethodsWe obtained data on individuals treated for TB between 2015 and 2018 from Brazil’s National Disease Notification System (SINAN). We excluded patients with a history of prior TB disease or with diagnosed TB drug resistance. We extracted information on patient-level factors potentially associated with successful treatment, including demographic and social factors, comorbid health conditions, health-related behaviors, health system level at which care was provided, use of directly observed therapy (DOT), and clinical examination results. We categorized treatment outcomes as successful (cure, completed) or unsuccessful (death, regimen failure, loss to follow-up). We fit multivariate logistic regression models to identify factors associated with unsuccessful treatment outcome.ResultsAmong 259,484 individuals treated for drug susceptible TB, 19.7% experienced an unsuccessful treatment outcome (death during treatment 7.8%, regimen failure 0.1%, loss to follow-up 11.9%). The odds of unsuccessful outcome were higher with older age (adjusted odds ratio (aOR) 2.90 [95% confidence interval: 2.62–3.21] for 85-100-year-olds vs. 25-34-year-olds), male sex (aOR 1.28 [1.25– 1.32], vs. female sex), Black race (aOR 1.23 [1.19–1.28], vs. White race), no education (aOR 2.03 [1.91– 2.17], vs. complete high school education), HIV infection (aOR 2.72 [2.63–2.81], vs. no HIV infection), illicit drug use (aOR 1.95 [1.88–2.01], vs. no illicit drug use), alcohol consumption (aOR 1.46 [1.41– 1.50], vs. no alcohol consumption), smoking (aOR 1.20 [1.16–1.23], vs. non-smoking), homelessness (aOR 3.12 [2.95–3.31], vs. no homelessness), and immigrant status (aOR 1.27 [1.11–1.45], vs. non-immigrants). Treatment was more likely to be unsuccessful for individuals treated in tertiary care (aOR 2.20 [2.14–2.27], vs. primary care), and for patients not receiving DOT (aOR 2.35 [2.29–2.41], vs. receiving DOT).ConclusionThe risk of unsuccessful TB treatment varied systematically according to individual and service-related factors. Concentrating clinical attention on individuals with a high risk of poor treatment outcomes could improve the overall effectiveness of TB treatment in Brazil.

show abstract

“…A relação da TB com o sistema prisional não é uma realidade recente. Esse contexto está diretamente associado às condições que o ambiente prisional oferta: superlotação, pouca ventilação e iluminação, hábitos de vida dos detentos na prisão e ausência de Equipes de Atenção Primária Prisional -EAPP (SAITA et al, 2021).…”

Section: Discussionunclassified

Busca Ativa De Tuberculose Pulmonar Em Pessoas Privadas De Liberdade Em Araripina - Pe

CABRAL,

MACHADO,

BANDEIRA

et al. 2023

Anais Do IV Congresso Nacional De Inovações Em Saúde

View full text Add to dashboard Cite

6 . RESUMO INTRODUÇÃO:A População Privada de Liberdade (PPL) possui risco 28 vezes maior de adoecer por Tuberculose (TB) pulmonar, devido ao contexto social que estão inseridos, o qual favorece uma maior probabilidade de transmissão da doença e de adoecimento por ela. OBJETIVO: Relatar a experiência de graduandos de medicina na busca ativa de casos positivos de TB pulmonar em PPL da cadeia pública de Araripina-PE. MÉTODOS: Estudo descritivo, do tipo relato de experiência, vivenciado por graduandos do 5º período de Medicina de uma IES no interior de Pernambuco, PE, no período de abril a junho de 2023. RESULTADOS: Realizou-se uma triagem para detecção dos detentos com sintomas respiratórios (como tosse há 3 semanas ou mais) para realização da baciloscopia neles, e todos se mostraram dispostos e compreenderam a necessidade desses procedimentos por parte da equipe de saúde. Considerando a análise da baciloscopia colhida entre as PPL do estudo, todas negativaram para TB. Não foi obtido o resultado dos exames de imagem mediante a dificuldade de logística para tal realização. DISCUSSÃO: A relação da TB com o sistema prisional se associa às condições que o ambiente prisional oferta. Estudos sugerem que os empecilhos para contenção da TB nos presídios podem ser superados a partir do momento em que se realiza maior rastreio e busca ativa da doença entre os detentos com sintomas respiratórios. CONCLUSÃO: Em síntese, as ações de busca ativa de TB pulmonar nas PPL se mostram relevantes diante da vulnerabilidade biopsicossocial na qual esses indivíduos se encontram, pois lhes oferece o acesso aos seus direitos à saúde e corroboram para um maior controle da TB nesses ambientes. Além disso, este é um importante instrumento para o aumento da detecção de casos, diagnóstico e tratamento precoce de TB pulmonar. Palavras-chave: População privada de liberdade; Saúde coletiva; Tuberculose pulmonar.

show abstract

Factors associated with unfavorable outcome of tuberculosis treatment in people deprived of liberty: a systematic review

Cited by 5 publications

References 49 publications

Predictors of unsuccessful tuberculosis treatment outcomes in Brazil: an analysis of 259,484 patient records

Predictors of unsuccessful tuberculosis treatment outcomes in Brazil: an analysis of 259,484 patient records

Predictors of unsuccessful tuberculosis treatment outcomes in Brazil: an analysis of 259,484 patient records

Busca Ativa De Tuberculose Pulmonar Em Pessoas Privadas De Liberdade Em Araripina - Pe

Contact Info

Product

Resources

About