Risk factors associated with drug-resistant tuberculosis in prisons in Sāo Paulo State, Brazil (2006-2016)

  • Juliane de Almeida Crispim College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Luiz Henrique Arroyo College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Thaís Zamboni Berra College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Felipe Lima dos Santos College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Ludmilla Leidianne Limirio Souza College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Yan Mathias Alves College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Antônio Carlos Vieira Ramos College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Alexandre Tadashi Inomata Bruce College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Mellina Yamamura Federal University of São Carlos, São Carlos, São Paulo, Brazil
  • Alessandro Rolim Scholze College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Hamilton Leandro Pinto de Andrade College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Flávia Meneguetti Pieri Londrina State University, Londrina, Paraná, Brazil
  • Ione Carvalho Pinto College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Pedro Fredemir Palha College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  • Ricardo Alexandre Arcêncio College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
Keywords: Drug-Resistant Tuberculosis, Multidrug-Resistant Tuberculosis, Prisons, Tuberculosis Control

Abstract

Introduction: Prisons are high-risk settings for drug-resistant tuberculosis because the prevalence of the tuberculosis (TB) is much higher than in the general population. This study to investigated the factors associated with drug-resistant tuberculosis in prisons in the state of São Paulo, Brazil.

Methodology: Retrospective cohort of drug-resistant TB cases for incarcerated people in São Paulo state, reported in the Tuberculosis Patient Control System between 2006 and 2016. To analyze the factors associated with drug-resistant TB, the backward method (likelihood ratio) was used, determining the adjusted odds ratio and respective 95%CI coefficients. Multiple models were proposed to adjust for potential confusion and interaction. The best fit model was selected based on the lowest Akaike information criterion coefficient.

Results: In total, 473 drug-resistant tuberculosis cases were reported in the prison population of Sāo Paulo state, the majority were male. The cases that presented negative results for sputum smear and sputum culture had, respectively, an aOR=0.6 and aOR=0.16 for drug-resistant tuberculosis in relation to the cases with positive results. The cases where the patient had AIDS and reported alcoholism, respectively, an aOR=1.47 and aOR=1.60 for drug-resistant TB. Individuals with a background treatment history for TB presented a stronger association with drug-resistant tuberculosis, aOR=35.08.

Conclusions: Sputum spear, sputum culture, chest X-ray, AIDS, alcoholism and background treatment history for TB were factors associated with resistance to antituberculosis drugs among prisoners. This is useful for the implementation of disease control measures related to the detection and monitoring of cases in the prison system.

Published
2021-11-30
How to Cite
1.
de Almeida Crispim J, Arroyo LH, Zamboni Berra T, Lima dos Santos F, Limirio Souza LL, Alves YM, Vieira Ramos AC, Inomata Bruce AT, Yamamura M, Rolim Scholze A, Pinto de Andrade HL, Meneguetti Pieri F, Carvalho Pinto I, Fredemir Palha P, Arcêncio RA (2021) Risk factors associated with drug-resistant tuberculosis in prisons in Sāo Paulo State, Brazil (2006-2016). J Infect Dev Ctries 15:1661-1669. doi: 10.3855/jidc.14843
Section
Original Articles