Objectives: To describe the profile of tuberculosis reported cases and analyze the factors associated with treatment nonadherence in the state of Parana. Methods: Ecological study that presented the TB cases reported between 2006 and 2010, using descriptive statistics and binary logistic regression, with significance level of 5%. Results: During this period, 15,077 cases were reported, of which 84.2% were new cases. The majority of patients were male, skin color/ ethnicity white, and more than half were less than 40 years old with low education. Incidence rates and treatment nonadherence were higher than national rates. Less than half had directly observed therapy. Young, alcoholics, unemployed individuals with low education and previous treatment nonadherence were more likely not to adhere to treatment. Conclusion: The knowledge of these aspects can support a more effective strategy in combating tuberculosis treatment nonadherence. Keywords: Tuberculosis/epidemiology; Treatment refusal; Public heallth ReSumoObjetivos: Descrever o perfil epidemiológico e clínico dos casos de tuberculose notificados no Estado do Paraná e identificar fatores associados ao abandono do tratamento. Métodos: O estudo do tipo ecológico que levantou os casos de tuberculose notificados no período entre 2006 e 2010, com uso da estatística descritiva e regressão logística binária, com nível de significância de 5%. Resultados: Nesse período, foram notificados 15.077 casos, dos quais 84,2% eram novos. A maioria dos doentes era do gênero masculino, de cor/etnia/etnia branca, e mais da metade tinha menos de 40 anos e baixa escolaridade. As taxas de incidência e de abandono do tratamento foram maiores que as taxas nacionais. Menos da metade fez tratamento diretamente observado. Indivíduos jovens, etilistas, desempregados, de baixa escolaridade e com abandono do tratamento anterior tiveram mais chances de abandonar o tratamento. Conclusão: O conhecimento desses aspectos pode subsidiar uma atuação mais efetiva no combate ao abandono do tratamento da tuberculose. Descritores: Tuberculose/epidemiologia; Recusa do paciente ao tratamento; Saúde pública ReSumenObjetivos: Describir el perfil epidemiológico y clínico de los casos de tuberculosis notificados en el Estado de Paraná e identificar factores asociados al abandono del tratamiento. Métodos: Se trata de un estudio de tipo ecológico en el que se levantó los casos de tuberculosis notificados en el período comprendido entre 2006 y 2010 y usó la estadística descriptiva y regresión logística binaria, con nivel de significancia del 5%. Resultados: En este período, fueron notificados 15.077 casos, de los cuales el 84,2% eran nuevos. La mayoría de los enfermos era del género masculino, de color/etnia/etnia blanca, y más de la mitad tenía menos de 40 años y baja escolaridad. Las tasas de incidencia y de abandono del tratamiento fueron mayores que las tasas nacionales. Menos de la mitad hizo tratamiento directamente observado. Individuos jóvenes, etílicos, desempleados, de baja escolaridad y con a...

To know the profile of adults who died by tuberculosis as the main cause, the time interval between the diagnosis and death, associated comorbidities and vulnerabilities. Method: Observational study of secondary data regarding deaths by tuberculosis that occurred in the State of Paraná, Brazil, from 2008 to 2015. A linkage between the databases of mortality and tuberculosis notification system was conducted for data enrichment. Frequency tables, Exact Fisher test and Z test have identified statistical associations. Results: Linkage points out 12.1% (115/944) of under-reporting in the 944 deaths identified. Early deaths accounted for 74.6% (705/944). The male sex (75.8%) was associated with the early death group. Almost half of the deaths reported in notification system (414/829) had one or more vulnerabilities. Early death were associated with respiratory system diseases and symptoms (p = 0.0001) and mental and behavioral disorders (p = 0.0001). Conclusion: High number of early deaths due TB indicate the need to seek out the respiratory symptomatic and use faster diagnostic methods. Strategies for treatment adherence, adequate monitoring of comorbidities and multisectorial support may prevent early and late death. The presence of vulnerabilities indicates that efforts beyond the health sector are needed in order to eliminate tuberculosis as public health problem.

The detection of the contacts of index cases constitutes an epidemiological and public health strategy for the surveillance and control of TB. The health professionals who promote patient adherence to treatment and the involvement of their families in the fight against TB achieve better results regarding the identification of contacts of index cases, adherence to treatment, and cure.

No abstract

No abstract