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Tuberculosis Burden and Determinants of Treatment Outcomes According to Age in Brazil: A Nationwide Study of 896,314 Cases Reported Between 2010 and 2019
Approximately 1.4 million people die annually worldwide from tuberculosis. Large epidemiologic studies can identify determinants of unfavorable clinical outcomes according to age, which can guide public health policy implementation and clinical management to improve outcomes. We obtained data from t...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354381/ https://www.ncbi.nlm.nih.gov/pubmed/34386510 http://dx.doi.org/10.3389/fmed.2021.706689 |
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author | Barreto-Duarte, Beatriz Araújo-Pereira, Mariana Nogueira, Betânia M. F. Sobral, Luciana Rodrigues, Moreno M. S. Queiroz, Artur T. L. Rocha, Michael S. Nascimento, Vanessa Souza, Alexandra B. Cordeiro-Santos, Marcelo Kritski, Afrânio L. Sterling, Timothy R. Arriaga, María B. Andrade, Bruno B. |
author_facet | Barreto-Duarte, Beatriz Araújo-Pereira, Mariana Nogueira, Betânia M. F. Sobral, Luciana Rodrigues, Moreno M. S. Queiroz, Artur T. L. Rocha, Michael S. Nascimento, Vanessa Souza, Alexandra B. Cordeiro-Santos, Marcelo Kritski, Afrânio L. Sterling, Timothy R. Arriaga, María B. Andrade, Bruno B. |
author_sort | Barreto-Duarte, Beatriz |
collection | PubMed |
description | Approximately 1.4 million people die annually worldwide from tuberculosis. Large epidemiologic studies can identify determinants of unfavorable clinical outcomes according to age, which can guide public health policy implementation and clinical management to improve outcomes. We obtained data from the national tuberculosis case registry; data were reported to the Brazilian National Program (SINAN) between 2010 and 2019. Clinical and epidemiologic variables were compared between age groups (child: <10 years, young: 10–24years, adult: 25–64years, and elderly: ≥65years). Univariate comparisons were performed together with second-generation p-values. We applied a backward stepwise multivariable logistic regression model to identify characteristics in each age group associated with unfavorable TB treatment outcomes. There were 896,314 tuberculosis cases reported during the period. Tuberculosis incidence was highest among adult males, but the young males presented the highest growth rate during the period. Directly observed therapy (DOT) was associated with protection against unfavorable outcomes in all age groups. The use of alcohol, illicit drugs, and smoking, as well as occurrence of comorbidities, were significantly different between age groups. Lack of DOT, previous tuberculosis, race, location of tuberculosis disease, and HIV infection were independent risk factors for unfavorable outcome depending on the age group. The clinical and epidemiological risk factors for unfavorable tuberculosis treatment outcomes varied according to age in Brazil. DOT was associated with improved outcomes in all age groups. Incidence according to age and sex identified adults and young males as the groups that need prevention efforts. This supports implementation of DOT in all populations to improve tuberculosis outcomes. |
format | Online Article Text |
id | pubmed-8354381 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83543812021-08-11 Tuberculosis Burden and Determinants of Treatment Outcomes According to Age in Brazil: A Nationwide Study of 896,314 Cases Reported Between 2010 and 2019 Barreto-Duarte, Beatriz Araújo-Pereira, Mariana Nogueira, Betânia M. F. Sobral, Luciana Rodrigues, Moreno M. S. Queiroz, Artur T. L. Rocha, Michael S. Nascimento, Vanessa Souza, Alexandra B. Cordeiro-Santos, Marcelo Kritski, Afrânio L. Sterling, Timothy R. Arriaga, María B. Andrade, Bruno B. Front Med (Lausanne) Medicine Approximately 1.4 million people die annually worldwide from tuberculosis. Large epidemiologic studies can identify determinants of unfavorable clinical outcomes according to age, which can guide public health policy implementation and clinical management to improve outcomes. We obtained data from the national tuberculosis case registry; data were reported to the Brazilian National Program (SINAN) between 2010 and 2019. Clinical and epidemiologic variables were compared between age groups (child: <10 years, young: 10–24years, adult: 25–64years, and elderly: ≥65years). Univariate comparisons were performed together with second-generation p-values. We applied a backward stepwise multivariable logistic regression model to identify characteristics in each age group associated with unfavorable TB treatment outcomes. There were 896,314 tuberculosis cases reported during the period. Tuberculosis incidence was highest among adult males, but the young males presented the highest growth rate during the period. Directly observed therapy (DOT) was associated with protection against unfavorable outcomes in all age groups. The use of alcohol, illicit drugs, and smoking, as well as occurrence of comorbidities, were significantly different between age groups. Lack of DOT, previous tuberculosis, race, location of tuberculosis disease, and HIV infection were independent risk factors for unfavorable outcome depending on the age group. The clinical and epidemiological risk factors for unfavorable tuberculosis treatment outcomes varied according to age in Brazil. DOT was associated with improved outcomes in all age groups. Incidence according to age and sex identified adults and young males as the groups that need prevention efforts. This supports implementation of DOT in all populations to improve tuberculosis outcomes. Frontiers Media S.A. 2021-07-27 /pmc/articles/PMC8354381/ /pubmed/34386510 http://dx.doi.org/10.3389/fmed.2021.706689 Text en Copyright © 2021 Barreto-Duarte, Araújo-Pereira, Nogueira, Sobral, Rodrigues, Queiroz, Rocha, Nascimento, Souza, Cordeiro-Santos, Kritski, Sterling, Arriaga and Andrade. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Barreto-Duarte, Beatriz Araújo-Pereira, Mariana Nogueira, Betânia M. F. Sobral, Luciana Rodrigues, Moreno M. S. Queiroz, Artur T. L. Rocha, Michael S. Nascimento, Vanessa Souza, Alexandra B. Cordeiro-Santos, Marcelo Kritski, Afrânio L. Sterling, Timothy R. Arriaga, María B. Andrade, Bruno B. Tuberculosis Burden and Determinants of Treatment Outcomes According to Age in Brazil: A Nationwide Study of 896,314 Cases Reported Between 2010 and 2019 |
title | Tuberculosis Burden and Determinants of Treatment Outcomes According to Age in Brazil: A Nationwide Study of 896,314 Cases Reported Between 2010 and 2019 |
title_full | Tuberculosis Burden and Determinants of Treatment Outcomes According to Age in Brazil: A Nationwide Study of 896,314 Cases Reported Between 2010 and 2019 |
title_fullStr | Tuberculosis Burden and Determinants of Treatment Outcomes According to Age in Brazil: A Nationwide Study of 896,314 Cases Reported Between 2010 and 2019 |
title_full_unstemmed | Tuberculosis Burden and Determinants of Treatment Outcomes According to Age in Brazil: A Nationwide Study of 896,314 Cases Reported Between 2010 and 2019 |
title_short | Tuberculosis Burden and Determinants of Treatment Outcomes According to Age in Brazil: A Nationwide Study of 896,314 Cases Reported Between 2010 and 2019 |
title_sort | tuberculosis burden and determinants of treatment outcomes according to age in brazil: a nationwide study of 896,314 cases reported between 2010 and 2019 |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354381/ https://www.ncbi.nlm.nih.gov/pubmed/34386510 http://dx.doi.org/10.3389/fmed.2021.706689 |
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