1921
image of Unfavorable Outcomes in Tuberculosis: Multidimensional Factors among Adolescents in Rio de Janeiro, Brazil
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645
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Abstract

Since 2018, adolescents have been included as a target group for tuberculosis (TB) surveillance by the WHO. However, they are considered a neglected population, as there are considerable gaps in information about them. We aimed to analyze the risk factors for unfavorable TB treatment outcomes among adolescents in Rio de Janeiro, a Brazilian city with a high burden of TB. This is a retrospective study of adolescents (10–18 years) with TB notified in Rio de Janeiro, from four national database systems, covering 2014–2016. “Extreme vulnerability” was defined as adolescents who presented one of the following characteristics: homelessness, incarceration, tobacco use, illicit drug use, or alcohol abuse. Logistic regression analysis was used to identify factors associated with favorable (cure/completed treatment) and unfavorable outcomes (lost to follow-up, death, and treatment failure). A total of 725 adolescents with TB were included: 610 (84.1%) were cured, 94 (13%) were lost to follow-up, six (0.8%) died because of TB, 13 (1.8%) died because of other causes, and two (0.3%) failed treatment. Unfavorable outcomes were associated with retreatment (adjusted odds ratio [aOR]: 4.51; 95% CI: 2.23–9.17), TB–HIV coinfection (aOR: 10.15; 95% CI: 4.15–25.34), extreme vulnerability (aOR: 3.01; 95% CI: 1.70–5.33), and living in the two districts (3.1 and 3.3) with worst conditions: large population and rates of homicides and shantytowns (aOR: 4.11; 95% CI: 1.79–9.46 and aOR: 5.35; 95% CI: 2.20–13.03, respectively). Our findings underscore the need for strengthening early identification and interventions for adolescents at high risk of unfavorable outcomes, especially those living in shantytowns.

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/content/journals/10.4269/ajtmh.20-0209
2020-09-21
2020-11-26
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http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.20-0209
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  • Received : 23 Mar 2020
  • Accepted : 17 Aug 2020
  • Published online : 21 Sep 2020
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