rends and factors associated with tuberculosis treatment default in Brazil

Abstract

Objective: To analyze temporal trends and factors associated with tuberculosis treatment abandonment in Brazil. Methods: An ecological time-series study was conducted using data from the Notifiable Diseases Information System. Treatment abandonment trends were assessed using annual proportions from 2002-2022, analyzed through control charts. Factors associated with treatment abandonment were evaluated, period 2016–2022 by estimating odds ratios (ORs), 95% confidence interval and 5% significance level, considering sociodemographic, social vulnerability, and clinical-behavioral variables. Results: Treatment abandonment rates increased from 11.21 per 100 new cases in 2002 to 16.45 in 2022. Individuals under 65 years had a higher likelihood of abandonment, particularly those aged 25–34 years (22.4%). Male sex was associated with a higher probability of abandonment (OR = 1.49). Higher proportions were observed among individuals with lower educational levels and among those of Black race/color (24.0%). The Northeast region showed a lower likelihood of abandonment. Homelessness was strongly associated with abandonment (57.7%), whereas incarcerated individuals had a lower probability (14.5%). Individuals with AIDS, mental illness, illicit drug use, and tobacco use were more likely to abandon treatment. Conclusion: Tuberculosis treatment abandonment is strongly associated with social and clinical vulnerabilities, underscoring the need for targeted strategies to improve treatment adherence.