The impact of the stratification by degree of clinical severity and abandonment risk of tuberculosis treatment

Navarro, Pedro Daibert de; Haddad, João Paulo Amaral; Rabelo, Juliana Veiga Costa; Silva, Claudia Hermínia de Lima e; Almeida, Isabela Neves de; Carvalho, Wânia da Silva; Miranda, Silvana Spíndola de

doi:10.36416/1806-3756/e20210018

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…El fortalecer la adherencia al tratamiento tiene mejor impacto que otras estrategias, siendo mucho mayor en países en desarrollo, y otras se dirigen a las necesidades del paciente y la identificación de barreras para el acceso al tratamiento, siendo el primer nivel de atención el más adecuado para este manejo (Navarro et al, 2021). Sistemas precarios de salud, personas agrupadas y ambientes con poca ventilación se vinculan con la diseminación de la tuberculosis, pero el abandono al tratamiento se relaciona con la resistencia a los medicamentos del tratamiento para tuberculosis por lo que es importante identificar pacientes que tengan mayor posibilidad de dejar el tratamiento para una intervención oportuna y disminuir la mortalidad por esta enfermedad (Da Frota et al, 2020).…”

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Factores asociados al abandono del tratamiento de pacientes con tuberculosis de la red de salud Tacna

2023

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El objetivo general fue determinar los factores asociados al abandono del tratamiento de pacientes con Tuberculosis de la Red de Salud Tacna. Es un estudio observacional, de casos y controles, retrospectivo, transversal, se acudió a los establecimientos que tenían casos de abandono que para el 2018 fueron 13 pacientes considerados como casos y se seleccionó por muestreo no aleatorio por conveniencia los 117 pacientes que terminaron el tratamiento como controles, la población estaba conformada por 367 pacientes con diagnóstico de tuberculosis y la muestra de 130 pacientes que cumplieron los criterios de inclusión y exclusión. La evaluación médico-enfermera-nutricionista,evaluación-médico-enfermera-nutricionista-psicóloga-asistenta social, irregularidad al tratamiento fase uno y dos, días de inasistencia en fase uno y dos, días transcurridos entre la inasistencia y la primera visita, número de visitas en la fase uno y dos, se asociaron al abandono del tratamiento de tuberculosis en los pacientes mencionados.

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Factores asociados al abandono del tratamiento de pacientes con tuberculosis de la red de salud Tacna

2023

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High risk of unsuccessful treatment outcome in migrant population with tuberculosis: Data from three Italian hospitals

Gennaro

Cotugno²,

Fasano³

et al. 2023

Front. Public Health

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IntroductionTuberculosis (TB) remains an unresolved global health problem and vulnerable groups such as migrants remain the most affected with a higher risk of worse outcomes. The aim of this study was to evaluate clinical features, outcomes, and adverse events in migrant and native Italian patients admitted to three Italian hospitals in Southern Italy in order to assess differences and targeted strategies.MethodsWe performed a retrospective study on TB patients admitted between January 1, 2013, and December 31, 2021, in three Apulia hospitals. Two logistic regression models were used, with the dependent variables being (I) unsuccessful treatment (died, loss to follow-up, and failed treatment) and (II) adverse events.ResultsWe enrolled 543 consecutive patients admitted at three Italian hospitals with a diagnosis of TB during the study period, of them 323 (59.5%) were migrants and 220 Italian patients. The treatment success rate in the migrant group was 44.9% (137/305), while in the non-migrant group was 97.1% (203/209). Independent factors of unsuccess treatment (death, failure or loss to follow up) were: migrant status (O.R. = 11.31; 95% CI 9.72–14.23), being male (O.R. = 4.63; 95% CI 2.16–6.10), homelessness (O.R. = 3.23; 95% CI 2.58–4.54), having a MDR (Multidrug-resistant) (O.R = 6.44; 95% CI 4.74–8.23), diagnostic delay (O.R. = 3.55; 95% CI 1.98–5.67), and length of hospitalization (O.R. = 3.43; 95% CI 1.88–5.87). While, age >65 ys (O.R. = 3.11; 95% CI 1.42–4.76), presence of extrapulmonary TB (O.R. = 1.51; 95% CI 1.31–2.18), monoresistance (O.R. = 1.45; 95% CI 1.25–3.14) and MDR pattern (O.R. = 2.44; 95% CI 1.74–5.03) resulted associated with adverse events.ConclusionMigrant population is at high risk of unsuccessful treatment (death, loss to follow-up, and treatment failure). Policies targeted specifically to this group are needed to really impact and improve their health status and also to contain the TB burden.

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Factors Associated with Tuberculosis Outcome in a Hyperendemic City in the North of Brazil

et al. 2023

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Ananindeua city, State of Pará, North of Brazil, is a hyperendemic area for tuberculosis (TB), with a cure rate below the recommendation by the Brazilian Ministry of Health. We aimed to describe: (I) the TB incidence coefficient of Ananindeua municipality comparatively against Brazilian data; (II) TB treatment outcomes; (III) to compare the socioeconomic and epidemiological characteristics of abandonment versus cure outcome; and (IV) to evaluate the risk factors associated with TB treatment abandonment in Ananindeua city, from 2017 to 2021. This is a retrospective, descriptive, and cross-sectional epidemiological study which used secondary TB entries. Data were analyzed by linear regression, descriptive statistics, and associations were made using the Chi-square test and G-test, followed by univariate and multivariate logistic regression analyses. Cure rates ranged from 28.7% to 70.1%, abandonment between 7.3% and 11.8%, deaths from the disease ranged from 0% to 1.6%, and drug-resistant tuberculosis (TB-DR) rates had frequencies from 0% to 0.9%. Patient transfer rates to other municipalities were between 4.9% and 12.5%. The multivariate analysis showed that alcohol is almost 2 times more likely to lead an individual to abandon treatment and use of illicit drugs was almost 3 times more likely. Individuals between 20 and 59 years of age were also more likely to abandon treatment almost twice as often. Finally, data obtained in the present report is of great relevance to strengthen epidemiological surveillance and minimize possible discrepancies between the information systems and the reality of public health in high endemicity areas.

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The impact of the stratification by degree of clinical severity and abandonment risk of tuberculosis treatment

Cited by 3 publications

References 29 publications

Factores asociados al abandono del tratamiento de pacientes con tuberculosis de la red de salud Tacna

Factores asociados al abandono del tratamiento de pacientes con tuberculosis de la red de salud Tacna

High risk of unsuccessful treatment outcome in migrant population with tuberculosis: Data from three Italian hospitals

Factors Associated with Tuberculosis Outcome in a Hyperendemic City in the North of Brazil

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