Factors associated with recovery and the abandonment of tuberculosis treatment in the incarcerated population

Alves, Kelle Karolina Ariane Ferreira; Borralho, Lívia Menezes; Araújo, Aguinaldo José de; Bernardino, Ítalo de Macedo; Figueiredo, Tânia Maria Ribeiro Monteiro de

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Revista Brasileira de Epidemiologia

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ORIGINAL ARTICLE • Rev. bras. epidemiol. 23 • 2020 • https://doi.org/10.1590/1980-549720200079 copy

Factors associated with recovery and the abandonment of tuberculosis treatment in the incarcerated population

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Objective:

This study aimed to investigate the factors associated with the outcomes of recovery and abandonment in the incarcerated population with tuberculosis.

Methods:

A quantitative and observational analytical study was performed with data from the Notification Disease Information System (Sinan), tuberculosis data from the incarcerated population in the state of Paraiba from 2007 to 2016; Notifications of individuals over the age of 18, reported as “new cases” and the outcome, “recovery” or “abandonment” status were included. Those people who until December 2016 had no outcome information were excluded. Analyses were performed using bivariate and multivariate statistics from the Poisson regression.

Results:

Of the 614 notifications, most were male (93.8%). In the bivariate analysis, there was a statistically relevant association of outcomes with Acquired Immunodeficiency Syndrome (p = 0.044), Human Immunodeficiency Virus (HIV) serology (p = 0.048) and lack of completion of follow-up bacilloscopy (p = 0.001). In the adjusted multivariate analysis, Acquired Immunodeficiency Syndrome (RR = 1.998; 95%CI 1.078 - 3.704; p = 0.028) and lack of completion of follow-up bacilloscopy (RR = 5.251; 95%CI 2.158 - 12.583; p <0.001*) remained significantly associated with the dropout outcome.

Conclusion:

Recovery and abandonment outcomes were mainly associated with whether the follow-up bacilloscopy was performed or not and Acquired Immunodeficiency Syndrome.

Keywords:
Tuberculosis; Prisoners; Therapeutics; Treatment; Risk factors

Variables	n	%
Sex [614]
Male	576	93.8
Female	38	6.2
Age [614]
Average (SD): 31,18 (10,26)
Median (IIQ) 29,00 (24,00-36,00)
Race [601]
White	98	16.3
Black	57	9.5
Yellow	6	1.0
Brown	437	72.7
Indigenous	3	0.5
Education [443]
≤ 8 years of study	400	90.3
> 8 years of study	43	9.7

Variables	n	%
Chest X-ray [394]
Suspect	385	97.7
Normal	8	2
Another pathology	1	0.3
Tuberculin test [88]
Non-reactor	19	21.6
Weak reactor	9	10.2
Strong reactor	60	68.2
Form [614]
Pulmonary	580	94.5
Extrapulmonary	31	5
Pulmonary + Extrapulmonary	3	0.5
(AIDS) [451]
Yes	24	5.3
No	427	94.7
(HIV) [448]
Positive	28	6.3
Negative	384	85.7
In Progress	36	8
Bacilloscopy (diagnosis) [548]
Positive	474	86.5
Negative	74	13.5
Bacilloscopy (monitoring) [614]
Performed as recommended	184	30
Not performed	430	70
DOT [546]
Yes	250	45.8
No	296	54.2
Closed [614]
Recovered	510	83.1
Abandoned	104	16.9

Variables	Outcome
	Recovered		Abandoned		Total		p
	N	%	n	%	n	%	p
Sex
Male	477	82.8	99	17.2	576	100.0	0.521^a
Female	33	86.8	5	13.2	38	100.0	0.521^a
Age
≤ 29 years	283	83.0	58	17.0	341	100.0	0.958^a
> 29 years	227	83.2	46	16.8	273	100.0	0.958^a
Education level
≤ 8 years of study	330	82.5	70	17.5	400	100.0	0.329^a
> 8 years of study	38	88.4	5	11.6	43	100.0	0.329^a
Tuberculin test
Non-reactor	14	73.7	5	26.3	19	100.0	0.339^b
Weak reactor	7	77.8	2	22.2	9	100.0
Strong reactor	52	86.7	8	13.3	60	100.0
Form
Pulmonary	481	82.9	99	17.1	580	100.0	0.999^b
Extrapulmonary	26	83.9	5	16.1	31	100.0
Pulmonary + Extrapulmonary	3	100.0	0	0.0	3	100.0
AP (AIDS)
Yes	16	66.7	8	33.3	24	100.0	0.044^a*
No	354	82.9	73	17.1	427	100.0	0.044^a*
AP (Diabetes)
Yes	12	80.0	3	20.0	15	100.0	0.727^b
No	421	83.2	85	16.8	506	100.0	0.727^b
Sputum culture
Positive	58	92.1	5	7.9	63	100.0	0.080^b
Negative	6	66.7	3	33.3	9	100.0
In Progress	25	86.2	4	13.8	29	100.0
HIV
Positive	20	71.4	8	28.6	28	100.0	0.048^b*
Negative	318	82.8	66	17.2	384	100.0
In Progress	34	94.4	2	5.6	36	100.0
Bacilloscopy diagnosis
Positive	391	82.5	83	17.5	474	100.0	0.574^a
Negative	63	85.1	11	14.9	74	100.0	0.574^a
Bacilloscopy monitoring
Carried out	171	92.9	13	7.1	184	100.0	<0.001^a*
Not carried out	339	78.8	91	21.2	430	100.0	<0.001^a*
DOT
Yes	210	84.0	40	16.0	250	100.0	0.861^a
No	247	83.4	49	16.6	296	100.0	0.861^a

Variables	Multivariate model
Variables	RR _Adjusted (95%CI)	p
Sex
Male	2.283 (0.686 - 7.603)	0.179
Female	1	0.179
Age
≤ 29 years	0.774 (0.514 - 1.164)	0.219
> 29 years	1	0.219
AP (AIDS)
Yes	1.998 (1.078 - 3.704)	0.028*
No	1	0.028*
Bacilloscopy diagnosis
Positive	1.665 (0.898 - 3.086)	0.105
Negative	1	0.105
Bacilloscopy monitoring
Carried out	1	< 0.001*
Not carried out	5.211 (2.158 - 12.583)	< 0.001*

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[1] Corresponding author: Kelle Karolina Ariane Ferreira Alves. Rua Eliezer Dourado, 355, Coopirecê, CEP: 4990-000, Irecê, BA, Brazil. E-mail: kellekarolina@hotmail.com