Temporal pattern of tuberculosis cure, mortality, and treatment abandonment in Brazilian capitals.
George Jó Bezerra Sousa, Thiago Santos Garces, Maria Lúcia Duarte Pereira and 2 others
PMID 31826160WHAT IT FOUND
TB cure rates did not change much, treatment abandonment increased in many capitals, and TB mortality decreased.
Key findings
01Of the 27 cities reporting 542,656 TB cases from 2001 to 2014, 17 capitals had a stationary cure trend.
02Of the 26 capitals analyzed for treatment abandonment, 13 significantly increased the abandonment rate and 1 decreased it.
0311 of the 25 capitals analyzed for TB mortality significantly reduced their mortality trend, and none had a significant increase.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is an ecological study of city-level records, so it cannot show what happened to individual TB patients or why they abandoned treatment. Drug resistance, transfer, failure, and primary abandonment were left out because of missing data or because the forms did not capture them for the whole period. The cure and abandonment series stopped in 2014 because of incomplete records, and the notification and follow-up form changed in 2014. The study used public data, so it cannot confirm whether care quality, DOT coverage, or other local factors caused the trends.
The easy way to misread this
Do not read these capital-level trends as proof that a nursing intervention caused the changes in cure, abandonment, or mortality. The study used routine records and cannot separate the effects of individual patient factors, services, or DOT coverage.