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Costa GF, Garcez JCD, Marcos W, Ferreira ALDS, Andrade JAA, Rodrigues YC, Lima LNGC, Conceição EC, Lima KVB. Factors Associated with Tuberculosis Outcome in a Hyperendemic City in the North of Brazil. Healthcare (Basel) 2023; 11:healthcare11040508. [PMID: 36833042 PMCID: PMC9957009 DOI: 10.3390/healthcare11040508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 02/11/2023] Open
Abstract
Ananindeua city, State of Pará, North of Brazil, is a hyperendemic area for tuberculosis (TB), with a cure rate below the recommendation by the Brazilian Ministry of Health. We aimed to describe: (I) the TB incidence coefficient of Ananindeua municipality comparatively against Brazilian data; (II) TB treatment outcomes; (III) to compare the socioeconomic and epidemiological characteristics of abandonment versus cure outcome; and (IV) to evaluate the risk factors associated with TB treatment abandonment in Ananindeua city, from 2017 to 2021. This is a retrospective, descriptive, and cross-sectional epidemiological study which used secondary TB entries. Data were analyzed by linear regression, descriptive statistics, and associations were made using the Chi-square test and G-test, followed by univariate and multivariate logistic regression analyses. Cure rates ranged from 28.7% to 70.1%, abandonment between 7.3% and 11.8%, deaths from the disease ranged from 0% to 1.6%, and drug-resistant tuberculosis (TB-DR) rates had frequencies from 0% to 0.9%. Patient transfer rates to other municipalities were between 4.9% and 12.5%. The multivariate analysis showed that alcohol is almost 2 times more likely to lead an individual to abandon treatment and use of illicit drugs was almost 3 times more likely. Individuals between 20 and 59 years of age were also more likely to abandon treatment almost twice as often. Finally, data obtained in the present report is of great relevance to strengthen epidemiological surveillance and minimize possible discrepancies between the information systems and the reality of public health in high endemicity areas.
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Affiliation(s)
- Gabriel Fazzi Costa
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
- Correspondence: (G.F.C.); (K.V.B.L.); Tel.: +55-91-3214-2116 (K.V.B.L.)
| | - Juliana Conceição Dias Garcez
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
| | - Weber Marcos
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
| | - Ana Lúcia da Silva Ferreira
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
| | | | - Yan Corrêa Rodrigues
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ananindeua 67030-000, PA, Brazil
| | - Luana Nepomuceno Gondim Costa Lima
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health of Brazil, Ananindeua 67030-000, PA, Brazil
| | - Emilyn Costa Conceição
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7602, South Africa
| | - Karla Valéria Batista Lima
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health of Brazil, Ananindeua 67030-000, PA, Brazil
- Correspondence: (G.F.C.); (K.V.B.L.); Tel.: +55-91-3214-2116 (K.V.B.L.)
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