Analysis and comparison of tuberculosis treatment outcomes in the homeless population and in the general population of Brazil

Santos, Andresa Cristine Estrella dos; Brunfentrinker, Camila; Pena, Larissa da Silva; Saraiva, Suélen dos Santos; Boing, Antonio Fernando

doi:10.36416/1806-3756/e20200178

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BRIEF COMMUNICATION • J. bras. pneumol. 47 (02) • 2021 • https://doi.org/10.36416/1806-3756/e20200178 copy

Analysis and comparison of tuberculosis treatment outcomes in the homeless population and in the general population of Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Tuberculosis remains a major public health problem deeply influenced by inequality. The present study used data from the Brazilian Tuberculosis Case Registry Database in order to compare the rates of tuberculosis treatment success, loss to follow-up, and tuberculosis mortality between the homeless population and the general population of Brazil. The likelihood of tuberculosis treatment success was reduced by approximately 50% in the homeless population. In addition, the rate of loss to follow-up was 2.9 times higher in the homeless population than in the general population, and the rate of tuberculosis mortality was 2.5 times higher in the former.

Keywords:
Tuberculosis; Homeless persons; Health information systems; Health policy

Population	Outcome									p*
	Treatment success			Loss to follow-up			Tuberculosis mortality
	%	95% CI	IR^a	%	95% CI	IR^a	%	95% CI	IR^a
Brazil										< 0.001
Homeless (n = 1,530)	39.0	(36.5-41.4)	0.5	28.8	(26.6-31.1)	2.9	8.1	(6.8-9.6)	2.5
General (n = 54,608)	71.9	(71.6-72.3)	0.5	9.9	(9.6-10.1)	2.9	3.3	(3.1-3.4)	2.5
Northern region										< 0.001
Homeless (n = 83)	44.6	(34.1-55.6)	0.6	24.7	(16.0-34.7)	2.5	9.6	(4.8-18.3)	3.8
General (n = 6,318)	72.4	(71.3-73.5)	0.6	11.0	(10.2-11.8)	2.5	2.6	(2.2-3.0)	3.8
Northeastern region										< 0.001
Homeless (n = 243)	33.7	(28.0-40.0)	0.5	30.0	(24.6-36.1)	3.5	7.0	(4.4-11.0)	1.8
General (n = 12,997)	68.2	(67.4-69.0)	0.5	8.5	(8.0-9.0)	3.5	3.8	(3.5-4.1)	1.8
Southeastern region										< 0.001
Homeless (n = 1,869)	41.7	(38.4-45.0)	0.5	31.1	(28.1-34.2)	2.9	7.7	(6.1-9.7)	2.5
General (n = 26,212)	75.9	(75.3-76.4)	0.5	10.6	(10.2-10.9)	2.9	3.1	(2.8-3.3)	2.5
Southern region										< 0.001
Homeless (n = 248)	33.5	(27.8-39.6)	0.5	21.8	(17.0-27.4)	2.5	8.1	(5.2-12.2)	2.1
General (n = 6,674)	66.6	(65.6-67.7)	0.5	8.6	(8.0-9.3)	2.5	3.9	(3.4-4.4)	2.1
Central-west region										< 0.001
Homeless (n = 87)	36.8	(27.2-47.6)	0.6	27.6	(19.1-38.1)	2.7	13.8	(7.9-23.0)	4.6
General (n = 2,407)	62.9	(61.0-64.9)	0.6	10.2	(9.1-11.5)	2.7	3.0	(2.4-3.8)	4.6

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[1] Correspondence to: Suélen Saraiva. Rua Mauro Ramos, 950, CEP 88075-010, Florianópolis, SC, Brasil. Tel.: 55 48 3211-6079. E-mail: suelen.saraiva@ifsc.edu.br