Fatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomial

Detalhes bibliográficos
Autor(a) principal: Rodrigues, Leticia do Nascimento
Data de Publicação: 2023
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
Texto Completo: http://repositorio.ufes.br/handle/10/12396
Resumo: Introduction: Tuberculosis (TB), despite being a treatable and curable ancient disease, still represents a significant public health problem globally. Among the groups with higher vulnerability to developing TB are the elderly, who have a higher mortality rate compared to non-elderly individuals. Objective: To identify, within the three vulnerability axes, the factors associated with unfavorable outcomes of loss to follow-up, TB-related death, and death from other causes among the elderly in Brazil during the period from 2015 to 2019. Methods: This is a cross-sectional study using secondary data from the Notifiable Diseases Information System (SINAN) of TB cases reported between January 1, 2015, and December 31, 2019, in people aged 60 years or older. The dependent variable was the treatment outcome, and co-variables associated with the outcome of interest (p ≤ 0.20) were included in a multinomial logistic regression model, using the cure category as the reference. Results: Elderly individuals who self-identified as Black and Brown, were homeless, had mental health disorders, lived with HIV, and used licit and illicit drugs had a higher likelihood of treatment loss to follow-up. Meanwhile, elderly individuals who were homeless, had mental health disorders, used licit and illicit drugs, and did not undergo bacilloscopy had higher chances of death due to TB. For the outcome of death from other causes, individuals living with diabetes mellitus (DM) and HIV, and those using licit and illicit drugs had higher chances of this outcome. On the other hand, those living with DM and those with positive bacilloscopy results had lower chances of treatment loss to follow-up. Those with higher levels of education and those who did not undergo bacilloscopy had lower chances of death from other causes. Also, individuals with higher levels of education had lower chances of death from TB. Conclusion:The results of this study indicate that characteristics related to vulnerability are significantly associated with unfavorable tuberculosis outcomes in the elderly. Finally, specific strategies and a comprehensive approach, considering medical, social, and psychosocial aspects, are crucial to address the complex challenges related to tuberculosis and achieve better treatment outcomes for TB in the elderly and the occurrence of a favorable outcome.
id UFES_3e7bdcd15eaaf4751eb0c5714b33aa8d
oai_identifier_str oai:repositorio.ufes.br:10/12396
network_acronym_str UFES
network_name_str Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
repository_id_str 2108
spelling Prado, Thiago Nascimento Dohttps://orcid.org/0000000181326288http://lattes.cnpq.br/6388559394015871Rodrigues, Leticia do Nascimentohttps://orcid.org/0000-0002-1218-1465http://lattes.cnpq.br/0819645694118435Sales, Carolina Maia Martinshttp://lattes.cnpq.br/3613476296412930Possuelo, Lia Gonçalves2024-05-29T20:55:13Z2024-05-29T20:55:13Z2023-08-21Introduction: Tuberculosis (TB), despite being a treatable and curable ancient disease, still represents a significant public health problem globally. Among the groups with higher vulnerability to developing TB are the elderly, who have a higher mortality rate compared to non-elderly individuals. Objective: To identify, within the three vulnerability axes, the factors associated with unfavorable outcomes of loss to follow-up, TB-related death, and death from other causes among the elderly in Brazil during the period from 2015 to 2019. Methods: This is a cross-sectional study using secondary data from the Notifiable Diseases Information System (SINAN) of TB cases reported between January 1, 2015, and December 31, 2019, in people aged 60 years or older. The dependent variable was the treatment outcome, and co-variables associated with the outcome of interest (p ≤ 0.20) were included in a multinomial logistic regression model, using the cure category as the reference. Results: Elderly individuals who self-identified as Black and Brown, were homeless, had mental health disorders, lived with HIV, and used licit and illicit drugs had a higher likelihood of treatment loss to follow-up. Meanwhile, elderly individuals who were homeless, had mental health disorders, used licit and illicit drugs, and did not undergo bacilloscopy had higher chances of death due to TB. For the outcome of death from other causes, individuals living with diabetes mellitus (DM) and HIV, and those using licit and illicit drugs had higher chances of this outcome. On the other hand, those living with DM and those with positive bacilloscopy results had lower chances of treatment loss to follow-up. Those with higher levels of education and those who did not undergo bacilloscopy had lower chances of death from other causes. Also, individuals with higher levels of education had lower chances of death from TB. Conclusion:The results of this study indicate that characteristics related to vulnerability are significantly associated with unfavorable tuberculosis outcomes in the elderly. Finally, specific strategies and a comprehensive approach, considering medical, social, and psychosocial aspects, are crucial to address the complex challenges related to tuberculosis and achieve better treatment outcomes for TB in the elderly and the occurrence of a favorable outcome.Introdução: A tuberculose (TB), apesar de ser uma doença milenar tratável e curável, representa ainda um importante problema de saúde pública a nível global e dentre os grupos com maior vulnerabilidade para o desenvolvimento de TB encontram-se os idosos, que apresentam maior taxa de mortalidade quando comparados com pessoas não-idosas. Objetivo: identificar, dentro dos três eixos de vulnerabilidades, os fatores que estão associados aos desfechos desfavoráveis de perda de seguimento, óbito por TB e óbito por outras causas entre os idosos no Brasil no período entre 2015 e 2019. Métodos: trata-se de um estudo transversal com dados secundários provenientes do Sistema de Informação de Agravos de Notificação (SINAN) dos casos de TB notificados entre 1º de janeiro de 2015 e 31 de dezembro de 2019, em pessoas com idade igual ou maior que 60 anos. A variável dependente foi a situação de encerramento e as co-variáveis associadas com o desfecho de interesse (p ≤ 0,20) foram incluídas em um modelo de regressão logística multinomial, utilizando a categoria cura como referência. Resultados: idosos autodeclarados pretos e pardos, em situação de rua, com transtorno de saúde mental, que vivem com HIV, que utilizam drogas lícitas e ilícitas tiveram maiores chances de perda de seguimento. Enquanto que idosos em situação de rua, com transtorno de saúde mental, que utilizam drogas lícitas e ilícitas e que não realizaram baciloscopia, apresentaram maiores chances para ocorrência de óbito por TB. Para o desfecho óbito por outras causas, pessoas que vivem com diabetes mellitus (DM) e com HIV, que utilizam drogas lícitas e ilícitas tiveram maiores chances para ocorrência desse desfecho. Por outro lado, aqueles que vivem com DM e que tiveram a baciloscopia positiva apresentaram menores chance de perda de seguimento; aqueles com maior grau de escolaridade e que não realizaram baciloscopia tiveram menores chances de óbito por outras causas; e aqueles com maior grau de escolaridade tiveram menor chances de óbito por TB. Conclusão: Os resultados deste estudo indicam que as características relacionadas à vulnerabilidade estão significativamente associadas aos desfechos desfavoráveis da tuberculose em idosos. Por fim, estratégias específicas e uma abordagem abrangente, considerando aspectos médicos, sociais e psicossociais, são fundamentais para enfrentar os desafios complexos relacionados à tuberculose e alcançar melhores resultados no tratamento de TB em idosos e a ocorrência de um desfecho favorável.Fundação Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Texthttp://repositorio.ufes.br/handle/10/12396porUniversidade Federal do Espírito SantoMestrado em Saúde ColetivaPrograma de Pós-Graduação em Saúde ColetivaUFESBRCentro de Ciências da SaúdeSaúde ColetivaTuberculoseIdososMedidas de associaçãoExposiçãoRisco ou desfechoFatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)instname:Universidade Federal do Espírito Santo (UFES)instacron:UFESORIGINALLeticiaNascimentoRodrigues-2023-Trabalho.pdfapplication/pdf3112196http://repositorio.ufes.br/bitstreams/c623188f-9f82-4404-a0e1-6559ff8f15f0/download8ac55b266b2bd3da09cdd63112c7e798MD5110/123962024-09-13 14:31:24.897oai:repositorio.ufes.br:10/12396http://repositorio.ufes.brRepositório InstitucionalPUBhttp://repositorio.ufes.br/oai/requestopendoar:21082024-10-15T17:52:22.038589Repositório Institucional da Universidade Federal do Espírito Santo (riUfes) - Universidade Federal do Espírito Santo (UFES)false
dc.title.none.fl_str_mv Fatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomial
title Fatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomial
spellingShingle Fatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomial
Rodrigues, Leticia do Nascimento
Saúde Coletiva
Tuberculose
Idosos
Medidas de associação
Exposição
Risco ou desfecho
title_short Fatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomial
title_full Fatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomial
title_fullStr Fatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomial
title_full_unstemmed Fatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomial
title_sort Fatores associados aos desfechos desfavoráveis de tuberculose em idosos no Brasil: análise multinomial
author Rodrigues, Leticia do Nascimento
author_facet Rodrigues, Leticia do Nascimento
author_role author
dc.contributor.authorID.none.fl_str_mv https://orcid.org/0000-0002-1218-1465
dc.contributor.authorLattes.none.fl_str_mv http://lattes.cnpq.br/0819645694118435
dc.contributor.advisor1.fl_str_mv Prado, Thiago Nascimento Do
dc.contributor.advisor1ID.fl_str_mv https://orcid.org/0000000181326288
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/6388559394015871
dc.contributor.author.fl_str_mv Rodrigues, Leticia do Nascimento
dc.contributor.referee1.fl_str_mv Sales, Carolina Maia Martins
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/3613476296412930
dc.contributor.referee2.fl_str_mv Possuelo, Lia Gonçalves
contributor_str_mv Prado, Thiago Nascimento Do
Sales, Carolina Maia Martins
Possuelo, Lia Gonçalves
dc.subject.cnpq.fl_str_mv Saúde Coletiva
topic Saúde Coletiva
Tuberculose
Idosos
Medidas de associação
Exposição
Risco ou desfecho
dc.subject.por.fl_str_mv Tuberculose
Idosos
Medidas de associação
Exposição
Risco ou desfecho
description Introduction: Tuberculosis (TB), despite being a treatable and curable ancient disease, still represents a significant public health problem globally. Among the groups with higher vulnerability to developing TB are the elderly, who have a higher mortality rate compared to non-elderly individuals. Objective: To identify, within the three vulnerability axes, the factors associated with unfavorable outcomes of loss to follow-up, TB-related death, and death from other causes among the elderly in Brazil during the period from 2015 to 2019. Methods: This is a cross-sectional study using secondary data from the Notifiable Diseases Information System (SINAN) of TB cases reported between January 1, 2015, and December 31, 2019, in people aged 60 years or older. The dependent variable was the treatment outcome, and co-variables associated with the outcome of interest (p ≤ 0.20) were included in a multinomial logistic regression model, using the cure category as the reference. Results: Elderly individuals who self-identified as Black and Brown, were homeless, had mental health disorders, lived with HIV, and used licit and illicit drugs had a higher likelihood of treatment loss to follow-up. Meanwhile, elderly individuals who were homeless, had mental health disorders, used licit and illicit drugs, and did not undergo bacilloscopy had higher chances of death due to TB. For the outcome of death from other causes, individuals living with diabetes mellitus (DM) and HIV, and those using licit and illicit drugs had higher chances of this outcome. On the other hand, those living with DM and those with positive bacilloscopy results had lower chances of treatment loss to follow-up. Those with higher levels of education and those who did not undergo bacilloscopy had lower chances of death from other causes. Also, individuals with higher levels of education had lower chances of death from TB. Conclusion:The results of this study indicate that characteristics related to vulnerability are significantly associated with unfavorable tuberculosis outcomes in the elderly. Finally, specific strategies and a comprehensive approach, considering medical, social, and psychosocial aspects, are crucial to address the complex challenges related to tuberculosis and achieve better treatment outcomes for TB in the elderly and the occurrence of a favorable outcome.
publishDate 2023
dc.date.issued.fl_str_mv 2023-08-21
dc.date.accessioned.fl_str_mv 2024-05-29T20:55:13Z
dc.date.available.fl_str_mv 2024-05-29T20:55:13Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://repositorio.ufes.br/handle/10/12396
url http://repositorio.ufes.br/handle/10/12396
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv Text
dc.publisher.none.fl_str_mv Universidade Federal do Espírito Santo
Mestrado em Saúde Coletiva
dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Saúde Coletiva
dc.publisher.initials.fl_str_mv UFES
dc.publisher.country.fl_str_mv BR
dc.publisher.department.fl_str_mv Centro de Ciências da Saúde
publisher.none.fl_str_mv Universidade Federal do Espírito Santo
Mestrado em Saúde Coletiva
dc.source.none.fl_str_mv reponame:Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
instname:Universidade Federal do Espírito Santo (UFES)
instacron:UFES
instname_str Universidade Federal do Espírito Santo (UFES)
instacron_str UFES
institution UFES
reponame_str Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
collection Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
bitstream.url.fl_str_mv http://repositorio.ufes.br/bitstreams/c623188f-9f82-4404-a0e1-6559ff8f15f0/download
bitstream.checksum.fl_str_mv 8ac55b266b2bd3da09cdd63112c7e798
bitstream.checksumAlgorithm.fl_str_mv MD5
repository.name.fl_str_mv Repositório Institucional da Universidade Federal do Espírito Santo (riUfes) - Universidade Federal do Espírito Santo (UFES)
repository.mail.fl_str_mv
_version_ 1813022506767876096