Social and environmental factors associated with the hospitalization of tuberculosis patients

Abstract

OBJECTIVE: to identify social and environmental factors associated with hospitalization of tuberculosis (TB) patients in Manaus, Amazonas, during 2010. METHODS: this is a quantitative cross-sectional epidemiological study, with primary data collection and analysis of human immunodeficiency virus (HIV), based on seropositive status. RESULTS: Among social factors for TB-HIV co-infection, the association between alcohol use and dependence was significant for employed workers; among non-co-infections, the association between income less than one minimum wage (U.S. $200) and retired people, Bolsa Família Program [Family Allowance]/other social benefits was significant. Regarding environmental factors, the association was significant for TB-HIV co-infection among those not having their own house, having masonry housing and daily garbage collection; and among non-co-infection, owning their own house, no masonry housing and lack of daily garbage collection was significant. CONCLUSION: The findings indicated that not only social factors, but also environmental ones are associated with hospitalization of tuberculosis patients, and such associations differ according to TB-HIV co-infection. Findings revealed that the non-biological factors associated with hospitalization of tuberculosis patients should be considered when caring patients with this disease.

Sociodemographic and health profile of TB/HIV co-infection in Brazil: a systematic review

“…The Southeast region accounted for four studies, two in São José do Rio Preto (14)(15) , one in Ribeirão Preto (16) and one in an administrative district of São Paulo (17) . Next, four studies that covered the entire national territory were identified (5,(18)(19)(20) , and finally, two articles in the Northern region, one in the state of Amazonas (21) and one in the capital Manaus (22) . No studies conducted in the Southern and Central-Western regions of Brazil were found.…”

“…As for the studies' design, all are observational, and six are of the cross-sectional type (5,17,(19)(20)(21)22) . Five cohort studies (9,10,(12)(13)(14) , three ecological studies (15)(16)18) and one control case (11) were identified.…”

“…The epidemiological profile of the Northern region for patients co-infected with TB/HIV (21)(22) showed prevalence of males aged from 20 to 39 years old, with four to 10 years of education (22) , mixed race, heterosexual, residing in the capital and with low socioeconomic level. The clinical characteristics revealed prevalence of the pulmonary form of TB (21) and relationship with the use of alcohol corresponding to 50.8% (22) . Mortality rate was 30.9% (21)…”

Hospitalizations and re-hospitalizations due to tuberculosis: economic costs and spatial distribution analysis in an endemic Northeastern city, Brazil

“…In this context, studies reveal that men have a 1.6 times higher chance of being hospitalized than women [33,34], which can be explained by the lesser frequency at which they visit health services, in combination with other factors knowingly linked to TB that are more prevalent among men, such as HIV infection; alcoholism and drugs abuse [14,35]. In addition, the hospitalization enhances the family and social damage the disease causes, as men of economically active age become unproductive during the hospitalization, which can compromise the family and professional activities and cause a high economic and social impact, especially in developing countries [26]. With respect to the reason for leaving the hospital, a larger proportion of cases were discharged, despite the important percentage of hospital deaths and re-hospitalizations.…”

Internações e reinternações por tuberculose: análise dos custos e da distribuição espacial no município de Natal/Rio Grande do Norte, Brasil

“…As regiões para as quais não foram observadas associações significativas, sob o ponto de vista estatístico, apontam setores censitários e bairros para os quais não se pode afirmar se há autocorrelação espacial.O estudo objetivou analisar o perfil sociodemográfico e clínico dos indivíduos que demandaram internação e reinternação evitáveis devido a TB, seus custos para o sistema de saúde e desenvolver uma análise espacial desses eventos em um município endêmico Além disso, a forma clínica pulmonar da TB é predominante entre os casos.Embora as populações das áreas estudadas sejam predominantemente femininas, pardas e na faixa etária produtiva, os casos de internação e reinternação por TB ocorrem principalmente entre os homens. Nesse contexto, estudos revelam que os homens possuem 1,6 vezes mais chances de serem internados do que as mulheres(HARGREAVES et al, 2011;OLIVEIRA et al, 2013), o que pode ser explicado pela menor frequência de procura pelos serviços de saúde aliada a outros fatores reconhecidamente associados à TB e mais prevalentes nos indivíduos desse sexo, tais como infecção pelo HIV, alcoolismo e uso abusivo de drogasTHOMAS et al, 2010).Apesar de esses pacientes já terem sido diagnosticados pelo serviço de saúde e já apresentarem histórico de internação hospitalar, o acompanhamento e o tratamento integral desses casos tanto pelos serviços de saúde de atenção primária quanto hospitalares são FERNANDES et al, 2009; CENTERS FOR DISEASE CONTROL AND PREVENTION., 2013). Ademais, sabe-se que esses recursos nem sempre são alocados de forma eficiente, universal e equitativa entre as populações e regiões.…”