Family Health Strategy and determinants of directly observed treatment for tuberculosis in Brazil: a cross-sectional study with surveillance system data, 2014-2016.

João Paulo Cola, Thiago Nascimento do Prado, Carolina Maia Martins Sales, Ethel Leonor Noia Maciel
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引用次数: 2

Abstract

Objective: To assess the association between tuberculosis determinants and performance of directly observed treatment (DOT) under different levels of Family Health Strategy (FHS) coverage in Brazil.

Methods: This was a cross-sectional study using data on tuberculosis cases notified between 2014 and 2016 on the Notifiable Health Conditions Information System, as well as data on FHS coverage in the municipality of residence. Logistic regression was used.

Results: 177,626 individuals were included; being an alcohol user (odds ratio (OR) 1.09 - 95% confidence interval % [95%CI] 1.03;1.16), being deprived of liberty (OR=1.21 - 95%CI 1.12;1.32) and positive sputum smear microscopy (OR=1.15 - 95%CI 1.10;1.21) increased the chances of DOT being performed . When stratified by FHS coverage, these associations became weak in the highest stratum of coverage.

Conclusion: DOT being performed was associated with determinants of tuberculosis. However, association was not confirmed among residents in municipalities with higher FHS coverage.

巴西家庭卫生战略和直接观察治疗结核病的决定因素:2014-2016年监测系统数据的横断面研究
目的:评估巴西不同家庭健康战略(FHS)覆盖水平下结核病决定因素与直接观察治疗(DOT)绩效之间的关系。方法:这是一项横断面研究,使用了2014年至2016年在应通报健康状况信息系统上报告的结核病病例数据,以及居住城市的FHS覆盖数据。采用Logistic回归分析。结果:共纳入177626人;酗酒者(比值比(OR) 1.09 - 95%可信区间% [95% ci] 1.03;1.16)、被剥夺自由(OR=1.21 - 95% ci 1.12;1.32)和痰涂片镜检阳性(OR=1.15 - 95% ci 1.10;1.21)增加了行DOT检查的机会。当按FHS覆盖率分层时,这些关联在覆盖率最高的阶层中变得较弱。结论:行DOT检查与结核病的决定因素有关。然而,在住房和家庭服务部覆盖率较高的城市居民中,这种联系尚未得到证实。
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