0145/2022 - Determinantes sociais da saúde e desfecho desfavorável do tratamento da tuberculose no sistema prisional Social determinants of health and unfavourable outcome of tuberculosis treatment in the prison system
Objetivo: Analisar o desfecho desfavorável do tratamento da tuberculose entre a população privada de liberdade segundo os determinantes sociais de saúde. Métodos: Coorte retrospectiva realizada nos estados de Rondônia e São Paulo, Brasil, com detentos com tuberculose notificados entre 2008 e 2017. Os dados foram coletados do SINAN e TB-WEB e analisados pelo risco relativo (RR) e intervalos de confiança (IC95%), o qual testou a associação entre a variável dependente (desfecho desfavorável (óbitos por tuberculose e outras causas, assim como os abandonos, primários ou não) x favorável (cura)) e os determinantes estruturais e intermediários da saúde. Resultados: Foram registrados 158 desfechos desfavoráveis em Rondônia e 2.227 em São Paulo. Para Rondônia, tal desfecho esteve associado ao sexo masculino (RR 3,09; IC95% 1,03-9,27) e aids (RR 2,46; IC95% 1,63-3,71). Em São Paulo, idade superior a 30 anos (RR 1,36; IC95% 1,26-1,47), aids (RR 3,08; IC95% 2,81-3,38), alcoolismo (RR 1,54; IC95% 1,35-1,76), diabetes (RR 1,70; IC95% 1,27-2,28) e tratamento autoadministrado (RR 2,55; IC95% 2,27-2,86) constituíram fatores de risco para o desfecho desfavorável. Conclusões: O estudo contribui com elementos para a estratificação de risco das pessoas com tuberculose nas unidades de saúde prisionais e, assim, qualificar a assistência para o desfecho favorável dos casos.
Palavras-chave:
Tuberculose. Prisões. Resultado do Tratamento. Determinantes Sociais da Saúde. Política de Saúde.
Abstract:
Objective: To analyze the unfavourable outcome of tuberculosis treatment among the population deprived of liberty according to social determinants of health. Methods: Retrospective cohort carried out in the states of Rondônia and São Paulo, Brazil, with inmates with tuberculosis notified between 2008 and 2017. Data were collectedSINAN and TB-WEB and analyzed by relative risk (RR) and confidence intervals (95%CI), which tested the association between the dependent variable (unfavourable vs favourable outcome) and the structural and intermediary determinants of health. Results: 158 unfavourable outcomes were registered in Rondônia and 2,227 in São Paulo. For Rondônia, this outcome was associated with the male gender (RR 3.09; 95%CI 1.03-9.27) and AIDS (RR 2.46; 95%CI 1.63-3.71). In São Paulo, aged over 30 years (RR 1.36; 95%CI 1.26-1.47), AIDS (RR 3.08; 95%CI 2.81-3.38), alcoholism (RR 1.54; 95%CI 1.35-1.76), diabetes (RR 1.70; 95%CI 1.27-2.28) and self-administered treatment (RR 2.55; 95%CI 2.27-2.86) were risk factors for the unfavourable outcome. Conclusions: The study contributes with elements to the risk stratification of people with tuberculosis in prison units and, thus, to improve health care towards favorable outcome.
Keywords:
Tuberculosis. Prisons. Treatment Outcome. Social Determinants of Health. Health Policy.
Social determinants of health and unfavourable outcome of tuberculosis treatment in the prison system
Resumo (abstract):
Objective: To analyze the unfavourable outcome of tuberculosis treatment among the population deprived of liberty according to social determinants of health. Methods: Retrospective cohort carried out in the states of Rondônia and São Paulo, Brazil, with inmates with tuberculosis notified between 2008 and 2017. Data were collectedSINAN and TB-WEB and analyzed by relative risk (RR) and confidence intervals (95%CI), which tested the association between the dependent variable (unfavourable vs favourable outcome) and the structural and intermediary determinants of health. Results: 158 unfavourable outcomes were registered in Rondônia and 2,227 in São Paulo. For Rondônia, this outcome was associated with the male gender (RR 3.09; 95%CI 1.03-9.27) and AIDS (RR 2.46; 95%CI 1.63-3.71). In São Paulo, aged over 30 years (RR 1.36; 95%CI 1.26-1.47), AIDS (RR 3.08; 95%CI 2.81-3.38), alcoholism (RR 1.54; 95%CI 1.35-1.76), diabetes (RR 1.70; 95%CI 1.27-2.28) and self-administered treatment (RR 2.55; 95%CI 2.27-2.86) were risk factors for the unfavourable outcome. Conclusions: The study contributes with elements to the risk stratification of people with tuberculosis in prison units and, thus, to improve health care towards favorable outcome.
Palavras-chave (keywords):
Tuberculosis. Prisons. Treatment Outcome. Social Determinants of Health. Health Policy.
Ferreira, M. R. L., Andrade, R.L.P., Bossonario, P. A., Fiorati, R. C., Arcêncio, R. A., Rezende, C. E. M., Orfão, N. H., Monroe, A. A.. Determinantes sociais da saúde e desfecho desfavorável do tratamento da tuberculose no sistema prisional. Cien Saude Colet [periódico na internet] (2022/jun). [Citado em 24/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/determinantes-sociais-da-saude-e-desfecho-desfavoravel-do-tratamento-da-tuberculose-no-sistema-prisional/18401?id=18401&id=18401