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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Determinants of multidrug-resistant tuberculosis in Sao Paulo-Brazil: a multilevel Bayesian analysis of factors associated with individual, community and access to health services

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Arroyo, Luiz Henrique [1] ; Yamamura, Mellina [2] ; Ramos, Antonio Carlos Vieira [1] ; Campoy, Laura Terenciani [1] ; Crispim, Juliane de Almeida [1] ; Berra, Thais Zamboni [1] ; Alves, Luana Seles [1] ; Alves, Yan Mathias [1] ; Santos, Felipe Lima [1] ; Souza, Ludmilla Leidianne Limirio [1] ; Bruce, Alexandre Tadashi Inomata [1] ; de Andrade, Hamilton Leandro Pinto [1] ; Bollela, Valdes Roberto [3] ; Krainski, Elias Teixeira [4] ; Nunes, Carla [5] ; Arcencio, Ricardo Alexandre [1]
Total Authors: 16
[1] Univ Sao Paulo, Ribeirao Preto Coll Nursing, Ribeirao Preto - Brazil
[2] Univ Fed Sao Carlos, Dept Nursing, Sao Carlos - Brazil
[3] Univ Sao Paulo, Ribeirao Preto Med Sch, Sao Paulo - Brazil
[4] Univ Fed Parana, Dept Stat, Curitiba, Parana - Brazil
[5] Nova Univ Lisbon, Natl Sch Publ Hlth, Lisbon - Portugal
Total Affiliations: 5
Document type: Journal article
Web of Science Citations: 0

Objective Multidrug-resistant tuberculosis (MDR-TB) remains a serious public health problem worldwide. Accordingly, this study sought to identify individual, community and access to health services risk factors for MDR-TB. Methods Retrospective cohort of all TB cases diagnosed between 2006 and 2016 in the state of Sao Paulo. A Bayesian spatial hierarchical analysis with a multilevel design was carried out. Results It was identified that the history of previous TB treatment (Odds Ratios {[}OR]:13.86, 95% credibility interval {[}95% CI]:12.06-15.93), positive sputum culture test (OR: 5.26, 95% CI: 4.44-6.23), diabetes mellitus (OR: 2.34, 95% CI: 1.87-2.91), residing at a standard address (OR: 2.62, 95% CI: 1.91-3.60), positive sputum smear microscopy (OR: 1.74, 95% CI: 1.44-2.12), cavitary pulmonary TB (OR: 1.35, 95% CI: 1.14-1.60) and diagnosis performed due to spontaneous request (OR: 1.26; 95% CI: 1.10-1.46) were associated with MDR-TB. Furthermore, municipalities that performed HIV tests in less than 42.65% of patients with TB (OR: 1.50, 95% CI: 1.25-1.79), that diagnosed TB cases only after death (OR: 1.50, 95% CI: 1.17-1.93) and that had more than 20.16% of their population with income between 1/4 and 1/2 of one minimum wage (OR: 1.56, 95% CI: 1.30-1.87) were also related to the MDR-TB. Conclusions Knowledge of these predictive factors may help to develop more comprehensive disease prevention strategies for MDR-TB, avoiding the risks expressed regarding drug resistance expansion. (AU)

FAPESP's process: 18/14337-0 - Mixed study of the determinants of multidrug-resistant tuberculosis in the state of São Paulo: From the Bayesian approach to the perception of health professionals and patients
Grantee:Ricardo Alexandre Arcêncio
Support type: Regular Research Grants