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

• Published in: Journal of infection in developing countries Vol. 15; no. 11; pp. 1661 - 1669
• Main Authors: De Almeida Crispim, Juliane, Arroyo, Luiz Henrique, Zamboni Berra, Thaís, Lima dos Santos, Felipe, Limirio Souza, Ludmilla Leidianne, Alves, Yan Mathias, Vieira Ramos, Antônio Carlos, Inomata Bruce, Alexandre Tadashi, Yamamura, Mellina, Rolim Scholze, Alessandro, Pinto de Andrade, Hamilton Leandro, Meneguetti Pieri, Flávia, Carvalho Pinto, Ione, Fredemir Palha, Pedro, Arcêncio, Ricardo Alexandre
• Format: Journal Article
• Language: English
• Published: Italy Journal of Infection in Developing Countries 01.11.2021; The Journal of Infection in Developing Countries
• Subjects: Adult; Alcoholism; Brazil - epidemiology; Comorbidity; Drug resistance; Drug-Resistant Tuberculosis; Female; Humans; Male; Middle Aged; Multidrug-Resistant Tuberculosis; Prevalence; Prisoners - statistics & numerical data; Prisons; Retrospective Studies; Risk Factors; Tuberculosis; Tuberculosis Control; Tuberculosis, Multidrug-Resistant - epidemiology; Brazil; Sao Paulo Brazil; Tuberculosis Control; Drug-Resistant Tuberculosis; Multidrug-Resistant Tuberculosis; prisons
• ISSN: 1972-2680; 2036-6590; 1972-2680
• DOI: 10.3855/jidc.14843

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.