Factors associated with unsuccessful tuberculosis treatment in Manaus, Amazonas, from 2011 to 2021.

Revista da Escola de Enfermagem da U S P Pub Date : 2024-10-07 eCollection Date: 2024-01-01 DOI:10.1590/1980-220X-REEUSP-2023-0431en
Felipe Alves de Almeida, Maria Jacirema Ferreira Gonçalves
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Abstract

Objective: To identify vulnerability factors associated with unsuccessful tuberculosis treatment outcomes between 2011 and 2021 in Manaus, Amazonas.

Method: Ecological study using tuberculosis case notification data from the Notifiable Diseases Information System, from 2011 to 2021, of residents in Manaus. The variables refer to treatment outcomes and patient vulnerability, according to the theoretical model: individual, programmatic and social. The analysis tested the association between vulnerability and tuberculosis treatment non-success, measured by the occurrence of death, loss to follow-up or treatment default. The Odds Ratio estimate with confidence interval was obtained by logistic regression, according to a hierarchical model.

Results: The following factors were more likely to lead to unsuccessful tuberculosis treatment: individual vulnerability (age group 20 to 29 years and over 60 years, indigenous race, HIV+, drug use); programmatic vulnerability (not having an HIV test), social vulnerability (special population).

Conclusion: Individual vulnerability was more strongly associated with non-success. Intervention is needed to explore the points of greatest individual vulnerability, enabling effective action to prevent unsuccessful tuberculosis treatment.

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2011 年至 2021 年亚马孙州马瑙斯市肺结核治疗不成功的相关因素。
目的确定 2011 年至 2021 年亚马孙州马瑙斯市与结核病治疗失败相关的脆弱性因素:方法:利用 2011 年至 2021 年间马瑙斯居民结核病病例通报信息系统中的结核病病例通报数据进行生态学研究。根据个人、计划和社会理论模型,变量涉及治疗结果和患者的脆弱性。分析检验了脆弱性与结核病治疗不成功之间的关联,以死亡、失去随访或治疗违约的发生率来衡量。结果显示,以下因素更有可能导致治疗不成功:以下因素更有可能导致肺结核治疗失败:个人脆弱性(20 至 29 岁年龄组和 60 岁以上年龄组、土著种族、HIV 感染者、吸毒);项目脆弱性(未进行 HIV 检测);社会脆弱性(特殊人群):结论:个人脆弱性与不成功的关系更为密切。需要采取干预措施,探索个人最易受伤害的地方,从而采取有效行动,防止结核病治疗失败。
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