Tuberculosis Burden and Determinants of Treatment Outcomes According to Age in Brazil: A Nationwide Study of 896,314 Cases Reported Between 2010 and 2019

Abstract:  

Methods: We analyzed data from the Brazilian National Notifiable Diseases Information System (SINAN) for 896,314 TB cases reported between 2010 and 2019. Patients were stratified into four age groups: children (<10 years), young (10–24 years), adults (25–64 years), and elderly (≥65 years). Multivariable logistic regression identified factors associated with unfavorable outcomes (treatment failure, loss to follow-up, relapse, or death).

Results: TB incidence was highest among adult males, but young males showed the highest growth rate during the period. Directly observed therapy (DOT) was associated with protection against unfavorable outcomes in all age groups. Risk factors for unfavorable outcomes varied by age: prior TB, lack of DOT, and pulmonary-extrapulmonary TB were significant in children , while HIV infection, illicit drug use, and smoking were also prominent in young people and adults. Mortality was highest among the elderly (18.6%).

Conclusions: Determinants of TB outcomes are age-specific in Brazil. The findings support the universal implementation of DOT and highlight young and adult males as priority groups for prevention efforts.

Keywords: tuberculosis; age; outcomes; pulmonary TB; extrapulmonary TB.

Clique aqui

• Data de Publicação: 27/07/2021
• Autores: Beatriz Barreto-Duarte1,2,3,4†, Mariana Araújo-Pereira1,2,5†, Betânia M. F. Nogueira1,2,6,7 , Luciana Sobral 8,9, Moreno M. S. Rodrigues 10, Artur T. L. Queiroz 2,11, Michael S. Rocha2,6 , Vanessa Nascimento2,6,9, Alexandra B. Souza12,13, Marcelo Cordeiro-Santos 12,13,14 , Afrânio L. Kritski 4,15, Timothy R. Sterling16, María B. Arriaga1,2,5† and Bruno B. Andrade1,2,3,4,5,7,8,9,16