Spatial analysis of cases of Tuberculosis with Mental Disorders in São Paulo

Arroyo, Luíz Henrique; Arcoverde, Marcos Augusto Moraes; Alves, Josilene Dália; Fuentealba-Torres, Miguel; Scholze, Alessandro Rolim; Ramos, Antônio Carlos Vieira; Arcêncio, Ricardo Alexandre

doi:10.1590/0034-7167-2017-0949

Cited by 7 publications

(8 citation statements)

References 32 publications

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“…Mental disorders were not a significant factor in unfavorable TB treatment outcomes. However, a study identifies that PDLs have a high prevalence and a strong relationship with this condition, which can lead to worse outcomes in TB treatment and deteriorated mental disorders 37 and points to the need to review the care for individuals with mental disorders and the practice of leaving them in overcrowded cells, without psychological monitoring to guarantee their protection 15 .…”

Section: Discussionmentioning

confidence: 99%

Social determinants of health and unfavourable outcome of tuberculosis treatment in the prison system

Ferreira

Andrade

Bossonário

et al. 2022

Ciênc. saúde coletiva

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This article aims to analyze the unfavorable outcome of tuberculosis treatment among the population deprived of liberty by social determinants of health. This retrospective cohort was conducted in the states of Rondônia and São Paulo, Brazil, with inmates with tuberculosis notified between 2008 and 2017. Data were collected from SINAN and TB-WEB and analyzed by relative risk (RR) and confidence intervals (95%CI), which tested the association between the dependent variable (unfavorable outcome (deaths from tuberculosis and other causes, and primary and non-primary lost to follow-up) vs. favorable outcome (cure)) and the structural and intermediary determinants of health. One hundred fifty-eight unfavorable outcomes were registered in Rondônia and 2,227 in São Paulo. For Rondônia, this outcome was associated with gender (RR 3.09; 95%CI 1.03-9.27) and AIDS (RR 2.46; 95%CI 1.63-3.71). In São Paulo, aged over 30 years (RR 1.36; 95%CI 1.26-1.47), AIDS (RR 3.08; 95%CI 2.81-3.38), alcohol abuse (RR 1.54; 95%CI 1.35-1.76), diabetes (RR 1.70; 95%CI 1.27-2.28) and self-administered treatment (RR 2.55; 95%CI 2.27-2.86) were risk factors for the unfavorable outcome. The study contributes with elements to the risk stratification of people with tuberculosis in prison units and, thus, improves health care towards a favorable outcome.

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Section: Discussionmentioning

confidence: 99%

Social determinants of health and unfavourable outcome of tuberculosis treatment in the prison system

Ferreira

Andrade

Bossonário

et al. 2022

Ciênc. saúde coletiva

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“…Transtornos mentais não foram um fator preponderante na ocorrência de desfechos desfavo-ráveis do tratamento da TB, embora um estudo identifique que a PPL apresenta alta prevalência e forte relação com essa condição, o que pode levar a piores desfechos no tratamento da TB e ao agravamento dos transtornos mentais 37 . Isso aponta para a necessidade de rever a atenção aos indivíduos portadores de transtorno mental e a prática de deixá-los em celas superlotadas, sem acompanhamento psicológico que garanta sua proteção 15 .…”

Section: Discussionunclassified

Determinantes sociais da saúde e desfecho desfavorável do tratamento da tuberculose no sistema prisional

Ferreira

Andrade

Bossonário

et al. 2022

Ciênc. saúde coletiva

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Resumo O objetivo deste artigo é analisar o desfecho desfavorável do tratamento da tuberculose entre a população privada de liberdade segundo os determinantes sociais de saúde. Coorte retrospectiva realizada nos estados de Rondônia e São Paulo, Brasil, com detentos com tuberculose notificados entre 2008 e 2017. Os dados foram coletados do SINAN e do TB-WEB e analisados pelo risco relativo (RR), com intervalos de confiança (IC95%), testando a associação entre a variável dependente [desfecho desfavorável (óbitos por tuberculose e outras causas, assim como os abandonos, primários ou não) x favorável (cura)] e os determinantes estruturais e intermediários da saúde. Foram registrados 158 desfechos desfavoráveis em Rondônia e 2.227 em São Paulo. Para Rondônia, tal desfecho esteve associado a sexo masculino (RR 3,09; IC95% 1,03-9,27) e Aids (RR 2,46; IC95% 1,63-3,71). Em São Paulo, idade superior a 30 anos (RR 1,36; IC95% 1,26-1,47), Aids (RR 3,08; IC95% 2,81-3,38), alcoolismo (RR 1,54; IC95% 1,35-1,76), diabetes (RR 1,70; IC95% 1,27-2,28) e tratamento autoadministrado (RR 2,55; IC95% 2,27-2,86) constituíram fatores de risco para o desfecho desfavorável. O estudo contribui com elementos para a estratificação de risco das pessoas com tuberculose nas unidades de saúde prisionais, fornecendo subsídios para qualificar a assistência para o desfecho favorável dos casos.

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“…However, the impact of the COVID-19 pandemic on TB rates may have altered the spatial distribution pattern of the disease, considering the vast dimensions of the country, its diverse regional realities, and the increase in unfavorable outcomes. In the literature, there are few studies [ 15 , 16 ] on unfavorable treatment outcomes, especially in the post-pandemic period. Generally, studies in Brazil have conducted analyses by region or territories, but not at the national level.…”

Section: Introductionmentioning

confidence: 99%

Unsuccessful tuberculosis treatment outcomes across Brazil's geographical landscape before and during the COVID-19 pandemic: are we truly advancing toward the sustainable development/end TB goal?

Tavares,

Berra,

Alves

et al. 2024

Infect Dis Poverty

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Background Tuberculosis is one of the most significant infectious diseases for global public health. The reallocation of healthcare resources and the restrictions imposed by the COVID-19 pandemic have hindered access to TB diagnosis and treatment. Increases in unfavorable outcomes of the disease have been observed in Brazil. The objective of this study was to analyze the spatial distribution of unfavorable TB treatment outcomes in Brazil before and during the pandemic. Methods An ecological study with spatial analysis was conducted with all 5569 municipalities in Brazil. All reported cases of tuberculosis between January 2010 and December 2021, as well as reported cases of COVID-19 from February 2020 to December 2021, were included. The outcomes studied encompass loss to follow-up, drug-resistant tuberculosis, and death. The Getis Ord GI* technique was employed to assess spatial association, and the Kernel density estimator was used to identify areas with concentrated increases or decreases in outcomes. Bivariate Local Moran's I was used to examine the spatial association between outcomes and COVID-19 incidence. The study was approved by the Research Ethics Committee of Ribeirão Preto Nursing School, University of São Paulo. Results There were 134,394 cases of loss to follow-up, 10,270 cases of drug resistance, and 37,863 deaths. Clusters of high and low values were identified for all three outcomes, indicating significant changes in the spatial distribution patterns. Increases in concentrations were observed for lost to follow-up cases in the Southeast, while reductions occurred in the Northeast, South, and Midwest. Drug-resistant tuberculosis experienced an increase in the Southern and Southeastern regions and a decrease in the Northeast and South. TB-related deaths showed notable concentrations in the Midwest, Northeast, South, and Southeast. There was an increase in high occurrence clusters for deaths after 2020 and 2021 in the Northeast. Conclusions The pandemic has brought additional challenges, emphasizing the importance of enhancing efforts and disease control strategies, prioritizing early identification, treatment adherence, and follow-up. This commitment is vital for achieving the goal of tuberculosis elimination.

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Spatial analysis of cases of Tuberculosis with Mental Disorders in São Paulo

Cited by 7 publications

References 32 publications

Social determinants of health and unfavourable outcome of tuberculosis treatment in the prison system

Social determinants of health and unfavourable outcome of tuberculosis treatment in the prison system

Determinantes sociais da saúde e desfecho desfavorável do tratamento da tuberculose no sistema prisional

Unsuccessful tuberculosis treatment outcomes across Brazil's geographical landscape before and during the COVID-19 pandemic: are we truly advancing toward the sustainable development/end TB goal?

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