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儿童和青少年结核病:患病率及与治疗中断相关的因素

[Tuberculosis in childhood and adolescence: prevalence and factors associated with treatment abandonment].

作者信息

Soledade Mariana Pereira da, Yamauti Sueli Miyuki, Aguiar Andressa Simões, Sucupira Carolina, Crozatti Márcia Teresinha Lonardoni

机构信息

Hospital Infantil Cândido Fontoura, São Paulo, Brasil.

Universidade Federal de São Paulo, São Paulo, Brasil.

出版信息

Cad Saude Publica. 2024 Sep 16;40(9):e00158323. doi: 10.1590/0102-311XPT158323. eCollection 2024.

Abstract

Tuberculosis (TB) is an infectious disease that remains a serious public health problem worldwide. In the pediatric population, the knowledge about the factors that lead to the abandonment of TB treatment is limited, especially in regions with a high prevalence of the disease. This study aimed to identify the prevalence and risk factors associated with TB treatment abandonment in children and adolescents. A cross-sectional study was carried out using data obtained from TB notifications from the São Paulo State Tuberculosis Patient Control System, Brazil, for individuals aged between 0 and 18 years, from January 2009 to December 2019. The crude and adjusted prevalence ratios were estimated with a 95% confidence interval, using the Poisson regression model to identify associations between the outcome of treatment abandonment and the sociodemographic, clinical-epidemiological, diagnostic and therapeutic factors of TB cases with complete information. Of the 12,256 cases analyzed, 941 individuals abandoned treatment. The highest prevalence rate of treatment abandonment occurs among Black or brown adolescents, those over 11 years of age and those deprived of their liberty. Other characteristics associated with treatment abandonment include: being a person living with HIV/AIDS, having a history of previous TB treatment, using illicit substances and using a self-administered TB treatment regimen. Knowing the profile of the patient most likely to abandon TB treatment makes it possible to devise more effective strategies focused on adherence to drug treatment.

摘要

结核病(TB)是一种传染病,在全球范围内仍然是一个严重的公共卫生问题。在儿童群体中,关于导致结核病治疗中断因素的了解有限,尤其是在该疾病高发地区。本研究旨在确定儿童和青少年结核病治疗中断的患病率及相关危险因素。采用横断面研究方法,使用从巴西圣保罗州结核病患者控制系统的结核病通报中获取的数据,研究对象为2009年1月至2019年12月期间年龄在0至18岁之间的个体。使用泊松回归模型估计粗患病率和调整患病率,并给出95%置信区间,以确定治疗中断结局与具有完整信息的结核病病例的社会人口学、临床流行病学、诊断和治疗因素之间的关联。在分析的12256例病例中,有941人中断治疗。治疗中断患病率最高的是黑人或棕色青少年、11岁以上青少年以及被剥夺自由者。与治疗中断相关的其他特征包括:感染艾滋病毒/艾滋病、既往有结核病治疗史、使用非法药物以及采用自我管理的结核病治疗方案。了解最有可能中断结核病治疗的患者特征有助于制定更有效的策略,以提高药物治疗的依从性。

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Tuberculosis in childhood and adolescence: a view from different perspectives.儿童和青少年结核病:不同视角的观察。
J Pediatr (Rio J). 2020 Mar-Apr;96 Suppl 1(Suppl 1):99-110. doi: 10.1016/j.jped.2019.11.002. Epub 2019 Dec 18.

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