Fatores associados à morte precoce por tuberculose no Espírito Santo: um estudo transversal

Abstract

Introduction: TB cases that end in death represent a challenge to be faced as they reflect failures in the health service. Early death is defined by deaths that occur within 60 days of starting treatment. The main reasons for studying early death from TB are associated with the need to know characteristics that allow establishing strategies to reduce mortality from TB. Objective: To analyze the factors associated with early death from tuberculosis, in Espírito Santo, from 2015 to 2019. Methodology: Cross-sectional study conducted using linkage between the Sinan and SIM databases. Pearson's chi-square test was performed to determine the proportions of variables in the cure and early death groups and a hierarchical logistic regression model was performed to determine the determinants associated with them. All analyzes were performed in Stata 14.0 and the results were stored in tables in Excel 16. Results: 229 individuals (77.1% of total deaths) died prematurely from TB. Individuals aged 60 or over (OR: 7.08; 95%CI 2.74 - 18.28), alcoholics (OR: 2.64; 95%CI 1.65 - 4.21), people with diabetes (OR: 1 .97; 95%CI 1.18 - 3.30), mental illness (OR: 2.63; 95%CI 1.08 - 6.42), individuals who did not undergo HIV serology (OR: 7.83; 95%CI 4 .33 - 14.14) and individuals who did not undergo sputum culture (OR: 3.18 95% CI 1.45 - 6.98) had a higher chance of early death from TB when compared to individuals who achieved a cure. Conclusions: The analysis of the sociodemographic and clinical characteristics of deaths allowed us to establish a profile of cases of early death due to TB. The results of this analysis reinforce the need for investment in in-depth studies that aim to develop strategies to improve the infrastructure of the health service offered and equitable access to it. With this, advances will be made in the context of preventing and controlling TB, as well as its complications and deaths.