Idioma:

Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil

Harling, Guy ; Lima Neto, Antonio S ; Sousa, Geziel S ; Machado, Marcia M T ; Castro, Marcia C

BMC public health, 2017-05, Vol.17 (1), p.508-508, Article 508 [Revista revisada por pares]

England: BioMed Central

Texto completo disponible

Citas Citado por

Acciones

Título:
Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil
Autor: Harling, Guy ; Lima Neto, Antonio S ; Sousa, Geziel S ; Machado, Marcia M T ; Castro, Marcia C
Materias: Abandonment ; Adolescent ; Adult ; Aged ; Brazil ; Brazil - epidemiology ; Child ; Cities ; City centres ; Clustering ; Contact tracing ; Directly Observed Therapy - utilization ; Disease ; Female ; Fortaleza ; Homicide ; Humans ; Incidence ; Information systems ; Low income areas ; Male ; Middle Aged ; Mortality ; Murders & murder attempts ; Population ; Poverty Areas ; Primary care ; Public health ; Regression analysis ; Regression models ; Residence Characteristics - statistics & numerical data ; Risk Factors ; Sewage ; Sewerage ; Social Determinants of Health ; Socioeconomic Factors ; Socioeconomics ; Spatial Analysis ; Treatment ; Treatment failure ; Treatment Refusal - statistics & numerical data ; Tuberculosis ; Tuberculosis - epidemiology ; Tuberculosis - therapy ; Tuberculosis - transmission ; Young Adult
Es parte de: BMC public health, 2017-05, Vol.17 (1), p.508-508, Article 508
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Descripción: Tuberculosis (TB) remains a public health problem, despite recent achievements in reducing incidence and mortality rates. In Brazil, these achievements were above the worldwide average, but marked by large regional heterogeneities. In Fortaleza (5th largest city in Brazil), the tuberculosis cure rate has been declining and treatment abandonment has been increasing in the past decade, despite a reduction in incidence and an increase in directly observed therapy (DOT). These trends put efforts to eliminate tuberculosis at risk. We therefore sought to determine social and programmatic determinants of tuberculosis incidence and treatment abandonment in Fortaleza. We analyzed sociodemographic and clinical data for all new tuberculosis cases notified in the Notifiable Diseases Information System (SINAN) from Fortaleza between 2007 and 2014. We calculated incidence rates for 117 neighborhoods in Fortaleza, assessed their spatial clustering, and used spatial regression models to quantify associations between neighborhood-level covariates and incidence rates. We used hierarchical logistic regression models to evaluate how individual- and neighborhood-level covariates predicted tuberculosis treatment abandonment. There were 12,338 new cases reported during the study period. Case rates across neighborhoods were significantly positively clustered in two low-income areas close to the city center. In an adjusted model, tuberculosis rates were significantly higher in neighborhoods with lower literacy, higher sewerage access and homicide rates, and a greater proportion of self-reported black residents. Treatment was abandoned in 1901 cases (15.4%), a rate that rose by 71% between 2007 and 2014. Abandonment was significantly associated with many individual sociodemographic and clinical factors. Notably, being recommended for DOT was protective for those who completed DOT, but associated with abandonment for those who did not. Low socioeconomic status areas have higher tuberculosis rates, and low socioeconomic individuals have higher risk of treatment abandonment, in Fortaleza. Treatment abandonment rates are growing despite the advent of universal DOT recommendations in Brazil. Proactive social policies, and active contact tracing to find missed cases, may help reduce the tuberculosis burden in this setting.
Editor: England: BioMed Central
Idioma: Inglés

Enlaces

View this record in MEDLINE/PubMed

Volver a la lista de resultados

Anterior Resultado 4 Siguiente Ir a la siguiente página

Realización: Logos de Redes Sociales:

Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil

Harling, Guy ; Lima Neto, Antonio S ; Sousa, Geziel S ; Machado, Marcia M T ; Castro, Marcia C

England: BioMed Central

Buscando en bases de datos remotas, por favor espere