Factors associated with unsuccessful tuberculosis treatment in Manaus, Amazonas, from 2011 to 2021.
Felipe Alves de Almeida, Maria Jacirema Ferreira Gonçalves
PMID 39378167WHAT IT FOUND
HIV, substance use, younger adults and older adults, male sex, non-white race, missed HIV testing, DOT or diagnostic tests, and special-population or cash-transfer status were associated with unsuccessful TB treatment.
Diabetes was associated with less unsuccessful treatment.
Key findings
01Male sex, age 15 to 49 or 60 and over, non-white race, HIV-positive status and substance use were associated with higher odds of unsuccessful treatment.
02Not being tested for HIV, not undergoing DOT and not undergoing diagnostic testing were associated with higher odds of unsuccessful treatment.
03Diabetes was associated with lower odds of unsuccessful treatment in all three models.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used routine notification data, so missing or ignored entries and unclear death certificates could have classified outcomes incorrectly. It showed associations among recorded factors and treatment outcomes, not that any factor caused unsuccessful treatment or that adding DOT, HIV testing or diagnostic testing would change outcomes. Education was not included in the multivariable model because of data-quality concerns, so social factors may be incompletely captured. The vulnerability blocks were a chosen grouping, and other factors relevant to vulnerability were not available in the notification data. Cases included deaths from other causes and grouped low-frequency outcomes, which may blur the reasons for unsuccessful treatment.
Declared interests
The work was funded by CAPES, FAPEAM and UFAM. The supplied text does not report commercial sponsorship, author conflicts of interest, or that the funders designed or wrote the study.
The easy way to misread this
Do not conclude that DOT, HIV testing or diagnostic testing caused better TB outcomes. This was a retrospective registry analysis, so these factors were associated with unsuccessful treatment among people already recorded in the system.