Ricardo Gadelha de Abreu1, Lúcia Santana Rolim2, Artur Iuri Alves de Sousa3, Maria Regina Fernandes de Oliveira4,5. 1. Ministério da Saúde, Secretaria de Atenção Primária à Saúde - Brasília (DF), Brasil. 2. Ministério da Saúde, Secretaria de Vigilância Sanitária - Brasília (DF), Brasil. 3. Ministério da Saúde, Agência Nacional de Vigilância Sanitária - Brasília (DF), Brasil. 4. Universidade de Brasília, Núcleo de Medicina Tropical - Brasília (DF), Brasil. 5. Instituto de Avaliação de Tecnologias em Saúde, Conselho Nacional de Desenvolvimento Científico e Tecnológico - Porto Alegre (UF), Brasil.
Abstract
INTRODUCTION: Tuberculosis and diabetes comorbidity remains a challenge for global public health. OBJECTIVE: To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. METHODS: This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. RESULTS: We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). CONCLUSION: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.
INTRODUCTION: Tuberculosis and diabetes comorbidity remains a challenge for global public health. OBJECTIVE: To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. METHODS: This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. RESULTS: We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). CONCLUSION: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.
Authors: María B Arriaga; Mariana Araújo-Pereira; Beatriz Barreto-Duarte; Caio Sales; João Pedro Miguez-Pinto; Evelyn B Nogueira; Betânia M F Nogueira; Michael S Rocha; Alexandra B Souza; Aline Benjamin; Jamile G de Oliveira; Adriana S R Moreira; Artur T L Queiroz; Moreno M S Rodrigues; Renata Spener-Gomes; Marina C Figueiredo; Betina Durovni; Solange Cavalcante; José R Lapa-E-Silva; Afrânio L Kristki; Marcelo Cordeiro-Santos; Timothy R Sterling; Valeria C Rolla; Bruno B Andrade Journal: Front Med (Lausanne) Date: 2022-01-21