Fatores associados à não adesão ao tratamento para tuberculose pulmonar

Mansour, Greyce Khoury; Ferreira, Luisa; Martins, Gabriella de Oliveira; Melo, Jessica Luanda Lemos; Freitas, Patrícia Scotini; Nascimento, Murilo César do

doi:10.11606/issn.2176-7262.rmrp.2021.172543

Cited by 8 publications

(9 citation statements)

References 65 publications

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“…[17,30,31] However, older age was also associated with factors known to improve their TB prognoses such as less IV drug use, HIV, and extra-pulmonary TB, and abandonment of treatment. [32][33][34] The distribution of risk factors for TB, therefore, can have variations across all adult age groups and identifying the high-risk profiles in the OA is important for prompt TB suspicion, diagnosis, and treatment initiation, in order to improve their prognosis. Regardless of a combination of risk and protective factors for TB in the OA in multivariable models, the highest threat to this age group was their higher odds of death of any cause during TB treatment.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico

Medrano,

Lee,

Gemeinhardt

et al. 2023

Medicine

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Older people are at high risk of developing and dying from pulmonary infections like tuberculosis (TB), but there are few studies among them, particularly in Hispanics. To address these gaps, we sought to identify host factors associated with TB and adverse treatment outcomes in older Hispanics by conducting a cross-sectional study of TB surveillance data from Tamaulipas, Mexico (2006–2013; n = 8381). Multivariable logistic regressions were assessed for older adults (OA ≥65 years) when compared to young (YA, 18–39 years) and middle-aged adults (40–64 years). We found that the OA had features associated with a less complicated TB (e.g., lower prevalence of extra-pulmonary TB and less likely to abandon treatment or have drug resistant TB), and yet, were more likely to die during TB treatment (adj-OR 3.9, 95% 2.5, 5.25). Among the OA, excess alcohol use and low body mass index increased their odds of death during TB treatment, while a higher number of reported contacts (social support) was protective. Diabetes was not associated with adverse outcomes in OA. Although older age is a predictor of death during TB disease, OA are not prioritized by the World Health Organization for latent TB infection screening and treatment during contact investigations. With safer, short-course latent TB infection treatment available, we propose the inclusion of OA as a high-risk group in latent TB management guidelines.

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Section: Discussionmentioning

confidence: 99%

Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico

Medrano,

Lee,

Gemeinhardt

et al. 2023

Medicine

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“…Abandonment of treatment contributes to adverse outcomes but we found that the ELD are less likely to abandon TB treatment [30, 48, 49]. Interestingly, we found an inverse association between the number of TB contacts and odds of abandoning treatment in all age groups, or among ELD patients only.…”

Section: Discussionmentioning

confidence: 83%

Tuberculosis presentation and outcomes in elderly Hispanics from Tamaulipas, Mexico

Medrano¹,

Lee²,

Gemeinhardt

et al. 2023

Preprint

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Old people are at high risk of developing and dying from pulmonary infections like tuberculosis (TB), but they are few studies among them, and particularly in Hispanics. To address these gaps, we sought to identify host factors associated with TB and adverse treatment outcomes in old Hispanics by conducting a secondary analysis of TB surveillance data from Tamaulipas, Mexico (2006-2013; n=8,381). Multivariable logistic regressions were assessed for the elderly (ELD, ≥65 years) when compared to young (YA, 18 to 39 years) and middle-aged adults (MAA, 40 to 64 years). We found that the ELD had features associated with a less complicated TB (e.g. less extra-pulmonary TB, abandoning of treatment or having drug resistant TB), and yet, were more likely to die (adj-OR 3.9, 95% 2.5, 5.25). Among the elderly, excess alcohol use and low BMI increased their odds of death, while diabetes and BCG vaccination were protective. These data suggest that old people share some, but not all the risk factors for adverse TB treatment outcomes, when compared with YA or MAA. Furthermore, even though old age in itself is an important predictor of death during TB, old people are not prioritized by the World Health Organization for latent TB infection screening and treatment during contact investigations. We propose the inclusion of the elderly as a high-risk group in TB management guidelines.

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“…[3][4][5][6]10 Others allude to the low level of knowledge about the disease, which can be related to socio-demographic factors, such as low education, low socioeconomic conditions, and difficulty of access, which influence the continuity of treatment, since the lower understanding of what the disease is can trigger affections such as fear, anxiety states, and other negative thoughts during the course of treatment for pulmonary TB. 7,[11][12][13][14] Of these studies, two were conducted in the North region of Brazil, [15][16][17][18] focusing on the obstacles to treatment, pointing out the little regional production, and reiterating the need for studies focused on this reality and its respective peculiarities.…”

Section: Introductionmentioning

confidence: 99%

Conceptions about treatment and diagnosis of pulmonary tuberculosis for those who experience it

et al. 2023

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Objectives to analyze the conceptions of people experiencing treatment and diagnosis of pulmonary tuberculosis. Method this is a descriptive and exploratory research with a qualitative approach, developed in a School Health Center of Belém (Pará) with 30 patients. Data was collected during the period from September 2019 to January 2020 through a semi-structured interview with the aid of a script containing six questions, as well as the observation of the information contained in the medical record and in the tuberculosis record control book. For the analysis of the results, the Content Analysis technique was used according to Bardin's perspective. Result it was identified that the reduced knowledge about the disease and the presence of negative conceptions influence, in a significant way, the search for care or the adherence to treatment, interfering in daily and work activities. Conclusion it is concluded that the need for patients to (re)mean tuberculosis during treatment persists, and it is essential that the health team knows such conceptions in order to provide care that contemplates physical and bio-psychosocial aspects before the Tuberculosis Control Program of the unit.

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Fatores associados à não adesão ao tratamento para tuberculose pulmonar

Cited by 8 publications

References 65 publications

Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico

Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico

Tuberculosis presentation and outcomes in elderly Hispanics from Tamaulipas, Mexico

Conceptions about treatment and diagnosis of pulmonary tuberculosis for those who experience it

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