[Effectiveness of a community strategy for the treatment of tuberculosis in vulnerable contexts in the city of Buenos AiresEfetividade de uma estratégia de base comunitária para o tratamento da tuberculose em contextos vulneráveis da Cidade de Buenos Aires].

Abstract

Objective: To evaluate the effectiveness of the strategy implemented by Casa Masantonio for the treatment of tuberculosis and to analyze the associated factors in vulnerable populations in the City of Buenos Aires between 2019 and 2023.

Methods: A retrospective cohort study (2019-2023) was conducted using data from the National Health Surveillance System. We compared treatment success among patients at Casa Masantonio (n=145) with the usual treatment strategies in the Buenos Aires Metropolitan Area (n=17 965). Sociodemographic, clinical, and treatment variables were analyzed. Crude and adjusted risk ratios (RR) were estimated by Poisson regression.

Results: The success rate was significantly higher in Casa Masantonio (93.8%) compared to the general population (70.2%) (RRa 1.48; CI 95%: 1.24-1.74), and loss to follow-up was substantially lower (2.1% vs. 19.9%). Likewise, mortality was lower at Casa Masantonio (4.1% vs. 9.7%); RRa 0.40; CI 95%: 0.16-0.82). This center served a highly vulnerable population, 55% homeless and 77% with problematic substance use.

Conclusion: The results highlight the effectiveness of a comprehensive, person-centered approach adapted to the social and health conditions of each patient. This model not only improves clinical outcomes but also demonstrates that in order to achieve success in the treatment of diseases such as tuberculosis, it is essential to integrate social, territorial, and community support.