Universidade Federal do Amazonas, Escola de Enfermagem de Manaus, Programa de Pós-Graduação em Enfermagem, Manaus, AM, Brazil.
Universidade Federal do Amazonas, Escola de Enfermagem de Manaus, Departamento de Enfermagem, Manaus, AM, Brazil.
Rev Esc Enferm USP. 2024 Oct 7;58:e20240431. doi: 10.1590/1980-220X-REEUSP-2023-0431en. eCollection 2024.
To identify vulnerability factors associated with unsuccessful tuberculosis treatment outcomes between 2011 and 2021 in Manaus, Amazonas.
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.
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).
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.
确定 2011 年至 2021 年在亚马逊州玛瑙斯导致结核病治疗失败的脆弱因素。
使用 2011 年至 2021 年可报告疾病信息系统的结核病病例报告数据进行生态研究,该数据来自玛瑙斯的居民。这些变量根据理论模型涉及治疗结果和患者脆弱性:个体、方案和社会。分析测试了脆弱性与结核病治疗失败之间的关联,治疗失败的衡量标准是死亡、失访或治疗中断的发生。根据分层模型,通过逻辑回归获得具有置信区间的优势比估计值。
以下因素更有可能导致结核病治疗失败:个体脆弱性(20 至 29 岁和 60 岁以上年龄组、土著种族、艾滋病毒阳性、药物使用);方案脆弱性(未进行艾滋病毒检测);社会脆弱性(特殊人群)。
个体脆弱性与治疗失败的相关性更强。需要采取干预措施,以探索个体最脆弱的方面,从而能够采取有效行动,防止结核病治疗失败。