Social determinants of health and unfavourable outcome of tuberculosis treatment in the prison system

Ciencia e Saude Coletiva

article

Ferreira, Melisane Regina Lima¹  Andrade, Rubia Laine de Paula¹  Bossonario, Pedro Augusto¹  Fiorati, Regina Célia¹  Arcêncio, Ricardo Alexandre¹  Rezende, Carlos Eduardo Menezes de²  Orfão, Nathalia Halax³  Monroe, Aline Aparecida¹ 

[1]Universidade de São Paulo

[2]Ministério da Saúde

[3]Universidade Federal de Rondônia

关键词: Tuberculosis;    Prisons;    Treatment outcome;    Social determinants of health;    Health policy;   

DOI  :  10.1590/1413-812320222712.08632022EN

学科分类：社会科学、人文和艺术（综合）

来源: Associacao Brasileira de Pos - Graduacao em Saude Coletiva

【 摘 要 】

This article aims to analyze the unfavorable outcome of tuberculosis treatment among the population deprived of liberty by social determinants of health. This retrospective cohort was conducted in the states of Rondônia and São Paulo, Brazil, with inmates with tuberculosis notified between 2008 and 2017. Data were collected from SINAN and TB-WEB and analyzed by relative risk (RR) and confidence intervals (95%CI), which tested the association between the dependent variable (unfavorable outcome (deaths from tuberculosis and other causes, and primary and non-primary lost to follow-up) vs. favorable outcome (cure)) and the structural and intermediary determinants of health. One hundred fifty-eight unfavorable outcomes were registered in Rondônia and 2,227 in São Paulo. For Rondônia, this outcome was associated with gender (RR 3.09; 95%CI 1.03-9.27) and AIDS (RR 2.46; 95%CI 1.63-3.71). In São Paulo, aged over 30 years (RR 1.36; 95%CI 1.26-1.47), AIDS (RR 3.08; 95%CI 2.81-3.38), alcohol abuse (RR 1.54; 95%CI 1.35-1.76), diabetes (RR 1.70; 95%CI 1.27-2.28) and self-administered treatment (RR 2.55; 95%CI 2.27-2.86) were risk factors for the unfavorable outcome. The study contributes with elements to the risk stratification of people with tuberculosis in prison units and, thus, improves health care towards a favorable outcome.

【 授权许可】

CC BY