ABSTRACT
Objective: To analyze tuberculosis cases according to the outcome situation in Rondonópolis, Mato Grosso.
Method: Ecological and descriptive study carried out with data from the Epidemiological Surveillance database of Rondonópolis, Mato Grosso, from March 2020 to March 2023. The population was all reported cases of tuberculosis according to the outcome situation (cure, treatment abandonment and death from tuberculosis). Death from other causes, transfer and ignored and/or blank cases were excluded. Descriptive statistics used absolute and relative frequencies with the aid of the R software. Study approved by the Research Ethics Committee (Opinion: 6,130,934).
Results: A total of 233 cases of tuberculosis with outcome situation were reported (71.67% cure, 23.18% treatment abandonment and 5.15% death). The profile was male, mixed race, high school graduate, new case admission type and chest X-ray with suspicious finding. Cure was prevalent among people aged 61 to 70, while treatment abandonment and death were prevalent among people aged 31 to 40.
Research Implications: The study highlights that, despite the high cure rate, treatment abandonment is a challenge. It is essential to continue studies to monitor and improve tuberculosis control measures.
Originality/Value: The results highlight the need to propose specific interventions for vulnerable groups, in addition to the importance of complete notifications by health professionals.
Keywords: Tuberculosis, Death, Epidemiology. Pandemic.
RESUMO
Objetivo: Analisar os casos de tuberculose de acordo com a situação de encerramento em Rondonópolis, Mato Grosso.
Método: Estudo ecológico e descritivo realizado em com dados do banco de dados da Vigilância Epidemiológica de Rondonópolis, Mato Grosso, de março de 2020 a março de 2023. A população foi todos casos notificados de tuberculose de acordo com a situação de encerramento (cura, abandono do tratamento e óbito por tuberculose). Foram excluídos óbito por outras causas, transferência e os casos ignorados e/ou em branco. A estatística descritiva utilizou frequências absoluta e relativa com auxílio do software R. Estudo aprovado pelo Comitê de Ética em Pesquisa (Parecer:6.130.934).
Resultados: Foram notificados 233 casos de tuberculose com situação de encerramento (71,67% cura, 23,18% abandono de tratamento e 5,15% óbito). O perfil foi indivíduos do sexo masculino, pardos, ensino médio completo, tipo de entrada caso novo e radiografia de tórax com achado suspeito. A cura foi prevalente entre pessoas de 61 a 70 anos, enquanto o abandono de tratamento e óbito de 31 a 40 anos.
Implicações da Pesquisa: O estudo destaca que, apesar da alta taxa de cura, o abandono do tratamento é um desafio. É essencial a continuidade de estudos headnote monitorar e melhorar as medidas de controle da tuberculose.
Originalidade/Valor: Os resultados evidenciam a necessidade de se propor intervenções específicas headnote grupos vulneráveis, além da importância das notificações completas por parte dos profissionais de saúde.
Palavras-chaves: Tuberculose, Morte, Epidemiologia. Pandemia.
RESUMEN
Objetivo: Analizar los casos de tuberculosis según la situación de cierre en Rondonópolis, Mato Grosso.
Método: Estudio ecológico y descriptivo realizado con datos de la base de datos de Vigilancia Epidemiológica de Rondonópolis, Mato Grosso, de marzo de 2020 a marzo de 2023. La población fue de todos los casos notificados de tuberculosis según la situación de cierre (curación, abandono del tratamiento y muerte por tuberculosis). Se excluyeron muertes por otras causas, traslado y casos ignorados y/o en blanco. La estadística descriptiva utilizó frecuencias absolutas y relativas con ayuda del software R Estudio aprobado por el Comité de Ética en Investigación (Opinión: 6.130.934).
Resultados: Se reportaron 233 casos de tuberculosis con cierre (71,67% curación, 23,18% abandono del tratamiento y 5,15% muerte). El perfil fue masculino, mestizo, bachillerato completo, tipo de ingreso de caso nuevo y radiografía de tórax con hallazgo sospechoso. La curación prevaleció entre las personas de 61 a 70 años, mientras que el abandono del tratamiento y la muerte prevalecieron entre las personas de 31 a 40 años.
Implicaciones de la investigación: El estudio destaca que, a pesar de la alta tasa de curación, abandonar el tratamiento es un desafío. Es fundamental continuar los estudios headnote monitorear y mejorar las medidas de control de la tuberculosis.
Originalidad/Valor: Los resultados resaltan la necesidad de proponer intervenciones específicas headnote grupos vulnerables, además de la importancia de las notificaciones completas por parte de los profesionales de la salud.
Palabras clave: Tuberculosis, Muerte, Epidemiología. Pandemia.
1 INTRODUCTION
Tuberculosis (TB) is a communicable disease that has significant implications for public health, standing out as one of the main causes of global morbidity and mortality. Prior to the coronavirus pandemic in 2020, tuberculosis was the main cause of death resulting from a single infectious agent. Its etiology lies in the bacillus Mycobacterium tuberculosis , which spreads when individuals expel bacteria into the environment. Although it has its primary manifestation in the lungs, its incidence can affect other organs and systems (WHO, 2021).
TB is diagnosed using clinical, bacteriological, radiological and histopathological methods. In clinical diagnosis, symptoms such as fever, weakness, weight loss, night sweats and specific symptoms of the affected area are observed; bacteriological diagnosis is performed through sputum smear microscopy, mycobacterial culture and molecular tests to detect bacilli DNA. Radiological diagnosis is mainly performed by chest X-ray and computed tomography (Brazil, 2019).
TB is susceptible to effective treatment and is preventable. Approximately 85% of individuals who develop the disease can be treated through a six-month therapeutic regimen. This therapy highlights the feasibility of effective control and management of the disease, contributing to reducing its impact on public health (WHO, 2021). TB treatment is essential both for curing the patient and for preventing its spread in the community. It is essential to start treatment immediately, especially in patients with a high suspicion of TB or in severe conditions ( Nahid et al., 2016).
During the COVID-19 pandemic, there was a significant reduction in the number of tuberculosis diagnoses. After an increase observed between 2017 and 2019, there was an 18% decrease between 2019 and 2020, from 7.1 million to 5.8 million diagnosed cases worldwide. Notably, the Southeast Asia and Western Pacific regions led the global reduction (84%). In the European region, there was an interruption in the decreasing trend in notifications, suggesting that case detection was adversely impacted by the pandemic. This epidemiological dynamic highlights the influence of the pandemic context on the surveillance and effective response to tuberculosis cases (WHO, 2021).
In 2020 and 2021, there was a decrease in the incidence of tuberculosis compared to pre-pandemic periods in Brazil. In 2021, 59,735 new cases of pulmonary tuberculosis were recorded. In 2020, 83,741 cases were reported and in 2021 there were 82,680 (Brazil, 2022).
Regarding the situation of TB closure cases in Brazil in the Notifiable Diseases Information System (SINAN), it is defined according to the following criteria: cure (patients undergoing tuberculosis treatment and obtaining negative results in two bacilloscopy tests or who complete treatment without showing signs of failure and are released based on clinical and radiological evaluations), treatment abandonment (interruption by the patient who used the medication for 30 days or more and interrupted treatment for a consecutive period of 30 days or more) and death (the fundamental cause of death is attributed to tuberculosis) (Brazil, 2019).
In 2020, Brazil saw significant progress in the cure rate among new cases of pulmonary tuberculosis (68.4%), surpassing the cure rates for the Central-West (60.3%), South (63.2%) and Northeast (66.8%) regions. This trend was reflected in several states, including Mato Grosso. On the other hand, 12.9% of new cases resulted in treatment abandonment, a rate 2.6 times higher than the 5% limit recommended by the World Health Organization (WHO). In the Central-West (14.2%) and Southeast (14.1%) regions, as well as in Mato Grosso, abandonment rates were higher compared to the national average (11.9%) (Brazil, 2022).
The simultaneous coexistence of COVID-19 and TB can induce more serious closure situations, attributable to the interaction between these two conditions in the pathophysiological aspects of the respiratory system, as well as immune suppression, acute inflammatory response and additional challenges in clinical management. Individuals with this co-infection may be more likely to require intensive care and ventilatory assistance, as well as longer hospitalization periods and a higher mortality rate compared to patients who only have COVID-19 (Sousa et al., 2023).
TB management and control strategies were weakened during the COVID-19 pandemic. The reorganization of health services to meet emergency demands and patients' fear of contracting SARS-CoV-2 infection resulted in inconsistency and discontinuity in care followup. This hampered the effective implementation of intervention and treatment measures essential for TB control (Xavier et al., 2022). In addition, the similarity between the symptoms of the infections made diagnosis difficult, creating the possibility of misclassifying a case of tuberculosis as COVID-19 (Nascimento et al., 2023).
The persistence of tuberculosis as a public health challenge and the difficulties faced in preventing and controlling the disease, the significant impacts associated with treatment abandonment and the need to reduce it, highlight the importance of conducting studies that consider the temporal aspect of the disease. Such assessments are important for understanding the outcome situation and for developing and implementing strategic public policies and control measures that are contextualized and effective.
Brazil has set targets for tuberculosis control, with the aim of reducing the incidence rate to less than 10 cases per 100,000 inhabitants, limiting the number of annual deaths to less than 230, and eradicating the catastrophic costs faced by people affected by the disease (Brazil, 2021). In addition, epidemiological studies can propose actions that will contribute to target 3.3 of the World Health Organization's (WHO) Sustainable Development Goal (SDG), which aims to end the tuberculosis epidemic.
The scarcity of studies addressing tuberculosis outcomes in the southeastern region of Mato Grosso highlights the need for such analyses. During the pandemic period, there was an intensification of tuberculosis underreporting due to the restrictive measures implemented, which made it difficult for the population to access health services.
These results are expected to provide information about the characteristics of these tuberculosis cases and the influence of the COVID-19 pandemic on tuberculosis case outcomes. Therefore, this research aims to analyze tuberculosis cases according to the closure situation in the municipality of Rondonópolis, Mato Grosso between March 2020 and March 2023.
2 METHODOLOGY
Ecological and descriptive study of reported cases of tuberculosis closure from March 2020 to March 2023 in the municipality of Rondonópolis, Mato Grosso, Brazil. Carried out using secondary data on reported cases of tuberculosis from the municipality's Epidemiological Surveillance.
The municipality of Rondonópolis is located in the state of Mato Grosso, in the southeast region, comprising a territorial area equivalent to 4,824.020 km2. The estimated resident population is 244,911 individuals and the demographic density is 47.00 inhab./km2 (IBGE, 2022).
Data were collected from notifications made in the following health services registered in the National Registry of Health Establishments (CNES) of the municipality: basic health units, tuberculosis reference center, specialized HIV/AIDS care service, private hospital, public hospital, philanthropic hospital, public emergency care unit and prison unit outpatient clinic.
It is important to highlight that in health establishments where users with respiratory symptoms have been diagnosed as having TB, health professionals or those responsible for the respective health establishments, public or private, must compulsorily notify the health problem to Epidemiological Surveillance (Brazil, 2014).
The network of services that works on the identification, notification and treatment of TB in the municipality, is composed of 64 Family Health Strategy units in Primary Health Care, 3 of which are located in the Rural Area, 4 health centers, 2 polyclinics and 2 health posts. In secondary care, there is 1 reference center for leprosy and tuberculosis and 1 Specialized Care Service (SAE). The health care network also includes 1 central laboratory, 2 municipal hospitals for adults, 1 children's hospital, 1 UPA, 1 regional hospital, 1 outpatient clinic at the Mata Grande prison unit (CNES, 2024).
The sample consisted of all reported cases of tuberculosis and registered in the Epidemiological Surveillance database according to the closure situation in the period from March 2020 to March 2023. All cases with the definition of the International Statistical Classification of Diseases and Related Health Problems notified with ICD-10 A16.9 - Respiratory tuberculosis, unspecified, without mention of bacteriological or histological confirmation were considered. For the closure situation of the cases, cure, abandonment of treatment and death from tuberculosis were considered. The exclusion criteria were the closure situations of death from other causes, transfer and ignored cases, cases reported with duplication and notifications of user residing in another municipality.
Data collection was carried out in April 2024 in the Epidemiological Surveillance database of Rondonópolis (MT).
The variables included were:
* Number of cases of tuberculosis reported per month in the municipality under study;
* Ending situation (cure, treatment abandonment and death from tuberculosis);
* Sociodemographic characteristics: sex (male and female), race (yellow, white, indigenous, brown, black and unknown), age group (in years), education (illiterate, incomplete 1st to 4th grade, complete 4th grade, incomplete 5th to 8th grade, complete elementary school, incomplete high school, complete high school, complete higher education, not applicable and unknown) and health professional (yes, no and unknown).
* Clinical characteristics: type of admission (new case, relapse, re-admission after abandonment, transfer and ignored), sputum smear microscopy (positive, negative, not performed and ignored), rapid molecular TB test (detectable resistant to rifampicin, detectable sensitive to rifampicin, not detectable, inconclusive, not performed and ignored), culture test (positive, negative and not performed), sensitivity test (sensitive, not performed, in progress and ignored), histopathology (suggestive of TB, not suggestive of TB, AFB positive, in progress, not performed) and chest X-ray (suspicious, normal, not performed, ignored).
* Vulnerable population and health problems: population deprived of liberty (PPL) (yes, no and ignored), homeless population (PSR) (yes, no and ignored), immigrant (yes and no), beneficiary of government income program (PPR) (yes, no and ignored), health problems (HIV, AIDS, alcoholism, diabetes mellitus, mental illness, illicit drugs and smoking).
Descriptive statistics were performed on tuberculosis cases according to the closure situation, using absolute and relative frequencies. This analysis was aided by the R software (R Core Team, 2024).
This study, despite being secondary data, respects all ethical aspects in research, in accordance with Resolution No. 466, of December 12, 2012 (Brazil, 2012), and was approved by the Research Ethics Committee of the Federal University of Rondonópolis (UFR) (CAAE: 69006223.8.0000.0126 and Opinion: 6,130,934).
3 RESULTS
The total number of reported cases of tuberculosis during the study period was 326. Of these, 93 cases were excluded, including double notification (n= 10, 3.06%), users residing in another municipality (n=1; 0.30% ) deaths from other causes (n=25;7.66%), transfer (n=16;4.90%) and ignored and/or blank cases (n=41;12.57%).
The population of this study was 233 cases. The closure situations were: cure/discharge 167 cases (71.67%), treatment abandonment 54 cases (23.18%) and death from tuberculosis 12 cases (5.15%). The highest number of cure cases was recorded in March 2021 (n=10; 5.98%), while in February 2023 there were no reports of cases. Regarding treatment abandonment, March 2022 prevailed (n=6; 11.11%), while February 2020 there were no cases recorded. The highest prevalence of deaths occurred in October 2022 and January 2023 (n=2; 16.66%), respectively, and February 2020 recorded no deaths (Figure 1).
The sociodemographic characteristics of tuberculosis cases according to the closure status were:
Cure/discharge: male (n=108; 68.78%), brown race (n=94; 56.29%), age group 61 to 70 years (n=30; 17.96%), completed high school (n=34; 20.36%) and health professionals (n=3; 1.8%);
Treatment abandonment: male (n=43; 79.63%), brown race (n=35; 64.81%), age group 31 to 40 years (n=13; 24%), complete high school (n=13; 24.07%) and health professionals (n=2; 3.7%); and
Deaths from tuberculosis: male (n=9;75%), brown race (n=8;66.67%), age group 31 to 40 years (n=4;33.34%), completed high school (n=3;25.01%) and there were no records of deaths among health professionals (Table 1).
The clinical characteristics of tuberculosis cases according to the closure situations were:
Cure/Discharge: type of entry new case (n=141; 84.43%), positive sputum smear microscopy (n=74; 44.31%), rapid molecular test for TB not performed (n=106; 63.47%), culture not performed (n=152; 91.01%), sensitivity test not performed (n=153; 91.62%), histopathology not performed (n=157; 94.01%) and chest X-ray with suspicious finding (n=143; 85.63%);
Treatment abandonment: type of entry new case (n=44;81.48%), positive sputum smear microscopy not performed (n=19;35.19%), rapid molecular test for TB not performed (n=44;81.48%), culture not performed (n=51;94.44%), sensitivity test not performed (n=51;94.45%), histopathology not performed (n=49;90.74%) and chest X-ray with suspicious finding (n=46;85.19%); and
Deaths from tuberculosis: type of entry new case (n=9;75%), positive sputum smear microscopy (n=6;49.9%), rapid molecular test for TB not performed (n=10;83.33%), culture not performed (n=11;91.67%), sensitivity test not performed (n=11;91.67%), histopathology not performed (n=7;58.33%) and chest X-ray suspicious finding (n=10;83.33%) (Table 2).
The characteristics of the vulnerable population and associated complications related to the outcome of tuberculosis cases predominated:
Cure/discharge: PPL (n=29;17.36%), PPS (n=2;1.18%), immigrants (n=2;1.20%), PPR (n=8;4.8% ); HIV positive (n=17;10.18%), AIDS (n=17;10.18%), alcoholism (n=9;5.39%), diabetes mellitus (n=17;10.18%), mental (n=11; 6.59%), illicit drugs (n=12; 7.19%) and smoking (n=49; 29.34%);
Treatment abandonment: PPL (n=2;3.70%), PPS (n=4;7.4%), PPR (n=3;5.56%); HIV positive (n=8;14.81%), AIDS (n=8;14.81%), alcoholism (n=12;22.23%), diabetes mellitus (n=4; 7.4%), illicit drugs (n=14;25.93%) and smoking (n=17;31.48%). There was no treatment abandonment among immigrants or among people with mental disorders; and
Deaths from tuberculosis: PPL (n=2; 16.77%), PPS (n=1; 8.34%), immigrants (n=1; 8.34%), PPR (n=1; 8.34%); HIV positive (n=1; 8.34%), AIDS (n=1; 8.34%), alcoholism (n=4; 33.34%), mental illness (n=1; 8.34%), illicit drugs (n=4; 33.34%) and smoking (n=5; 41.66%). There were no cases of deaths from tuberculosis with diabetes mellitus ( Table 3).
4 DISCUSSIONS
A study carried out between 2020 and 2023 in Brazil, in which the number of tuberculosis notifications increased significantly (26.58%) (Ribeiro et al., 2024). In contrast, in a study that analyzed the tuberculosis scenario in Brazil, between 2020 and 2021, a decrease in notifications of the disease was recorded, probably influenced by the direct and indirect effects of the COVID-19 pandemic (Silva et al., 2022).
In this study, the highest number of cure cases was recorded in March 2021 (5.98%), treatment abandonment in March 2022 (11.11%) and deaths in October 2022 and January 2023 (16.66%, respectively).
In this sense, it is important to highlight that tuberculosis continues to be a significant public health challenge, especially in areas with disadvantaged socioeconomic conditions. There has been a continuous reduction in the standardized mortality rate from tuberculosis throughout Brazil and in the various regions of the country. This suggests an inverse relationship between the level of development and the mortality rate from tuberculosis (Queiroz et al., 2023).
Regarding the outcome situations in this study, there was a 71.67% cure/discharge rate, 23.18% treatment abandonment, and 5.15% death rate. Other states presented similar prevalence rates of cure situations, such as in Ipatinga (MG), between 2005 and 2018, of the 108 cases of extrapulmonary tuberculosis, there was a 77.78% cure, 6.48% abandonment, and 1.85% death rate (Figueiredo et al., 2021). Furthermore, from 23,120 confirmed cases of tuberculosis in Maranhão, between 2009 and 2018, there was a cure outcome situation (65.58%), treatment abandonment (11.04%), and deaths (3.24%) (Passarinho Neto et al., 2020). In Rio Grande do Sul, between 2018 and 2022, 52.69% were cured, 17.10% abandoned treatment and 4.52% died (Carraro et al., 2024).
Regarding the profile of cases in the closure situations, males and brown race predominated in this study. A similar fact was observed in Juiz de Fora (MG), between 2015 and 2019, with the majority of male cases in the cure (68.95%) and abandonment of tuberculosis (71.97%) (Morato Filho et al., 2023) and in Alagoas, from 2019 to 2023, where the majority were male (62.98%) and brown race (65.20%) (Muniz et al., 2024). In addition, black and brown people and those in situations of social vulnerability have a greater chance of having TB (Mendonça et al., 2021).
In Goiás (GO), between 2016 and 2020, of the 212 cases of tuberculosis reported in males, 63.20% were cured, 25% abandoned treatment and 11.79% died (Vilela et al., 2021). In Itumbiara (GO), between 2010 and 2022, 153 cases of tuberculosis were registered, the majority were male (66.01%) and the cases ended in 64.05% cure, 7.19% abandoned treatment and 5.23% deaths (Graça Junior et al., 2023).
Regarding age group, the most common cases of tuberculosis cure were elderly people (61 to 70 years old), while treatment abandonment and deaths were adults (31 to 40 years old). The incidence of the disease is strongly associated with several socioeconomic factors. These include age group, type of housing, location in urban areas, per capita income, unemployment rate, educational level, access to health services, quality of food, basic sanitation conditions and presence of pre-existing diseases.
In this study, the prevalence of cases of treatment abandonment was with complete high school education. This was different in Ceará, between 2001 and 2017, where 74,006 cases of tuberculosis were reported, the majority of which had incomplete elementary education (13.53%) (Sousa et al., 2021). Generally, low education contributes to tuberculosis treatment failures, which did not occur in this study.
The majority of the prison population was cured, while the homeless population was more likely to abandon tuberculosis treatment. Similarly, a study carried out in all Brazilian states in 2020 identified 86,166 people with tuberculosis, of which 12% were PDL, 4% were homeless, and 0.68% were immigrants. Of these, 34% of the total population were cured, while for PDL, immigrants, and the homeless population it was 41.8%, 30.4%, and 15.8%, respectively. Deaths in the total population were 3.2%, with PDL 0.6%, immigrants 3.9%, and the homeless population 5.9%. Treatment abandonment in total was 8.8%, with 0.4% PDL, 10.2% immigrants, and 24.6% in the homeless population (Santo et al., 2022).
Between 2007 and 2016, data from the Paraíba State Health Department showed that, for women in the prison population, the tuberculosis cure rate was 82.80% and the treatment abandonment rate was 17.20% (Alves et al., 2020).
Furthermore, in this study, regarding the complications related to the termination situation, cases of alcoholism and illicit drug use prevailed in treatment abandonment, while HIV, AIDS, diabetes mellitus, smoking and mental illness, cure. Treatment evasion can be strongly influenced by factors including HIV co-infection, alcohol and drug use, conditions of social vulnerability and a low educational level (Brazil, 2019).
At the same time, in a study carried out in Pará, between 2010 and 2019, the health conditions in the situations of cure were AIDS (14%), alcoholism (33.1%), diabetes mellitus (20.70%) and smoking (27.70%) (Figueiredo & Pires, 2023). On the other hand, in Maranhão, between 2025 and 2019, the cure and death due to tuberculosis totaled in diabetes mellitus (86.40% and 13.60%), alcoholism (90.42% and 9.57%) and HIV-positive (97.56% and 2.43%), respectively (Vasco et al., 2023). For cases of TB associated with HIV, 71.40% were cured and 28.60% abandoned treatment (Alves et al., 2020).
In the state of Paraná, 386 people living with HIV/AIDS were identified undergoing treatment for tuberculosis between 2019 and 2020. Regarding the outcomes, 61.4% were cured after completing treatment, while 10.4% abandoned the regimen ( Murugara et al., 2023).
In the context of the clinical characteristics of these cases, new cases from different closure situations prevailed. In another scenario, in Ceará, in relation to clinical-laboratory characteristics, the most common types of admission were relapse (14.48%) and postabandonment readmission (39.80%) (Sousa et al., 2021). Between 2020 and 2022, in the state of Pará, the distribution of admission types and deaths showed significant variations. Regarding new cases, the observed proportion was 82.48% in 2020, 81.82% in 2021 and 78.56% in 2022 (Corrêa et al., 2024).
Finally, regarding diagnostic tests for tuberculosis, sputum smear microscopy and chest X-ray were the most frequently performed tests in cases of closure. A similar fact occurred in Rondônia, where most cases resulted in cure (47.49%). Among the main diagnostic tests used, sputum smear microscopy (31.33%) and chest X-ray (33.69%) stand out. Although sputum culture is also a diagnostic option, it was less frequently performed (35.27%) (Silva et al., 2019).
Limitations of this study include the use of secondary data from notification registries, which may be subject to underreporting or inconsistencies, especially in more vulnerable groups. Furthermore, the COVID-19 pandemic may have influenced the data collected, making it difficult to accurately assess closure situations.
5 CONCLUSION
This study revealed that, although the cure rate was relatively high, treatment abandonment continues to be a worrying factor, contributing to the maintenance of the disease.
The profile of tuberculosis cases indicated a higher prevalence among men, mixed race individuals and those with a high school education for the outcome situations (cure, treatment abandonment and death). Cure was more prevalent among the elderly and treatment abandonment and deaths among young people. Among vulnerable populations, the highest cure rate was observed in the prison population, while the homeless population had the highest abandonment rate. The prison population also had the highest death rate among vulnerable groups.
It is worth noting that despite efforts in treatment and prevention, tuberculosis still remains a significant public health challenge, especially in vulnerable populations, such as people deprived of liberty and homeless people. Thus, the findings of this study reinforce the need for targeted interventions for these populations and control of treatment abandonment, factors essential to combat tuberculosis.
Finally, it is essential to continue studies to monitor and improve tuberculosis control measures, in addition to the need for specific interventions for vulnerable groups, such as expanding access to health services, educational campaigns focused on adherence to treatment and the integration of comprehensive care strategies for this population. Furthermore, it is necessary to present the profile of users with TB so that health professionals can develop strategies aimed at the most susceptible population, improving the quality of notifications and disease management.
ACKNOWLEDGMENTS
Result of research funded by the National Council for Scientific and Technological Development - CNPq Call No. 21/2023 - Transdisciplinary Studies in Public Health.
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Abstract
Objective: To analyze tuberculosis cases according to the outcome situation in Rondonópolis, Mato Grosso. Method: Ecological and descriptive study carried out with data from the Epidemiological Surveillance database of Rondonópolis, Mato Grosso, from March 2020 to March 2023. The population was all reported cases of tuberculosis according to the outcome situation (cure, treatment abandonment and death from tuberculosis). Death from other causes, transfer and ignored and/or blank cases were excluded. Descriptive statistics used absolute and relative frequencies with the aid of the R software. Study approved by the Research Ethics Committee (Opinion: 6,130,934). Results: A total of 233 cases of tuberculosis with outcome situation were reported (71.67% cure, 23.18% treatment abandonment and 5.15% death). The profile was male, mixed race, high school graduate, new case admission type and chest X-ray with suspicious finding. Cure was prevalent among people aged 61 to 70, while treatment abandonment and death were prevalent among people aged 31 to 40. Research Implications: The study highlights that, despite the high cure rate, treatment abandonment is a challenge. It is essential to continue studies to monitor and improve tuberculosis control measures. Originality/Value: The results highlight the need to propose specific interventions for vulnerable groups, in addition to the importance of complete notifications by health professionals.