Time until tuberculosis recurrence and associated factors in Brazil: a population-based retrospective cohort study using a linked database

Pelissari, Daniele Maria; Lima, Lucas Vinícius de; Pavinati, Gabriel; Magnabosco, Gabriela Tavares; Silva Júnior, José Nildo de Barros; Bartholomay, Patricia; Johansen, Fernanda Dockhorn Costa

doi:10.1590/1980-549720240016

Daniele Maria Pelissari

conceptualization

formal analysis

investigation

methodology

resources

supervision

visualization

writing – original draft

writing – review & editing

Ministério da Saúde, Coordenação-Geral de Vigilância da Tuberculose, Endemic Mycoses and Non-Tuberculous Mycobacteria – Brasília (DF), Brazil.

http://orcid.org/0000-0002-0760-1875

Lucas Vinícius de Lima CORRESPONDING AUTHOR: Lucas Vinícius de Lima. Av. Colombo, 5.790, Bloco 2, Zona 7, Campus Universitário, CEP: 87020-900, Maringá (PR), Brasil. E-mail: lvl.vinicius@gmail.com.

conceptualization

funding acquisition

investigation

methodology

visualization

writing – original draft

writing – review & editing

Universidade Estadual de Maringá, Postgraduate Nursing Program – Maringá (PR), Brazil.

http://orcid.org/0000-0002-9582-9641

Gabriel Pavinati

conceptualization

funding acquisition

investigation

methodology

visualization

writing – original draft

writing – review & editing

Universidade Estadual de Maringá, Postgraduate Nursing Program – Maringá (PR), Brazil.

http://orcid.org/0000-0002-0289-8219

Gabriela Tavares Magnabosco

conceptualization

investigation

methodology

supervision

visualization

writing – original draft

writing – review & editing

Universidade Estadual de Maringá, Postgraduate Nursing Program – Maringá (PR), Brazil.

http://orcid.org/0000-0003-3318-6748

José Nildo de Barros Silva Júnior

conceptualization

formal analysis

investigation

methodology

resources

visualization

writing – review & editing

Ministério da Saúde, Coordenação-Geral de Vigilância da Tuberculose, Endemic Mycoses and Non-Tuberculous Mycobacteria – Brasília (DF), Brazil.

http://orcid.org/0000-0001-9958-8462

Patricia Bartholomay

conceptualization

investigation

resources

visualization

writing – review & editing

Ministério da Saúde, Department of HIV/Aids, Tuberculosis, Viral Hepatitis and Sexually Transmitted Infections – Brasília (DF), Brazil.

http://orcid.org/0000-0002-4881-0630

Fernanda Dockhorn Costa Johansen

conceptualization

investigation

resources

visualization

writing – review & editing.

Ministério da Saúde, Coordenação-Geral de Vigilância da Tuberculose, Endemic Mycoses and Non-Tuberculous Mycobacteria – Brasília (DF), Brazil.

http://orcid.org/0000-0002-1762-9484

CORRESPONDING AUTHOR: Lucas Vinícius de Lima. Av. Colombo, 5.790, Bloco 2, Zona 7, Campus Universitário, CEP: 87020-900, Maringá (PR), Brasil. E-mail: lvl.vinicius@gmail.com.

CONFLICT OF INTERESTS: nothing to declare.

Variable		TB no recurrence	TB recurrence	Median time
Variable		n (%)	n (%)	Years (IQR)
Sex
	Female	16,015 (34.2)	716 (22.0)	2.0 (0.0–6.3)
	Male	30,752 (65.8)	2,537 (78.0)	2.2 (0.0–6.6)
	Not informed	2 (0.0)	0 (0.0)	NA
Age group (in years)
	0 to 4	622 (1.3)	13 (0.4)	4.3 (3.0–4.3)
	5 to 9	321 (0.7)	7 (0.2)	1.4 (2.3–0.5)
	10 to 14	687 (1.5)	24 (0.7)	2.7 (1.3–4.9)
	15 to 19	3,256 (7.0)	194 (6.0)	2.5 (0.1–6.0)
	20 to 29	11,222 (24.0)	870 (26.7)	2.4 (0.0–6.4)
	30 to 59	24,240 (51.8)	1,743 (53.7)	2.1 (0.0–6.5)
	60 and more	6,419 (13.7)	401 (12.3)	1.4 (0.0–6.2)
Race
	White	16,009 (34.2)	858 (26.4)	2.3 (0.0–6.4)
	Black	5,362 (11.5)	449 (13.8)	2.1 (0.0–6.1)
	Asian	338 (0.7)	27 (0.8)	2.6 (0.7–4.1)
	Mixed	20,990 (44.9)	1,602 (49.2)	2.2 (0.0–6.5)
	Indigenous	644 (1.4)	25 (0.8)	1.7 (0.3–3.4)
	Not informed	3,426 (7.3)	292 (9.0)	NA
Education level (in years)
	0 to 8	20,620 (44.0)	1,819 (55.9)	2.1 (0.0–6.5)
	9 to 11	11,253 (24.1)	501 (15.4)	2.4 (0.0–6.2)
	12 and more	3,320 (7.1)	94 (2.9)	2.3 (0.1–6.2)
	Not informed	11,576 (24.8)	839 (25.8)	NA
Beneficiary of a cash transfer program
	No	21,548 (46.1)	1,864 (57.3)	2.1 (0.0–6.4)
	Yes	2,254 (4.8)	182 (5.6)	2.3 (0.0–6.3)
	Not informed	22,967 (49.1)	1,207 (37.1)	NA
Prison population
	No	38,543 (82.4)	2,274 (69.9)	2.1 (0.0–6.5)
	Yes	3,896 (8.3)	630 (19.4)	2.5 (0.0–6.4)
	Not informed	4,330 (9.3)	349 (10.7)	NA
Homeless population
	No	41,378 (88.4)	2,766 (85.0)	2.2 (0.0–6.6)
	Yes	634 (1.4)	70 (2.2)	1.7 (0.3–5.9)
	Not informed	4,757 (10.2)	417 (12.8)	NA
Health professional
	No	41,277 (88.2)	2,820 (86.7)	2.2 (0.0–6.6)
	Yes	680 (1.5)	19 (0.6)	1.6 (0.9–3.8)
	Not informed	4,812 (10.3)	414 (12.7)	NA
Immigrant population
	No	39,718 (85.0)	2,766 (85.1)	2.2 (0.0–6.6)
	Yes	205 (0.4)	8 (0.2)	1.6 (1.2–2.0)
	Not informed	6,846 (14.6)	479 (14.7)	NA
Clinical form
	Extrapulmonary	6,473 (13.8)	225 (6.9)	2.0 (0.0–6.0)
	Pulmonary/mixed	40,296 (86.2)	3,028 (93.1)	2.2 (0.0–6.6)
	Not informed	0 (0.0)	0 (0.0)	NA
HIV status
	Negative	35,658 (76.2)	2,308 (70.9)	2.3 (0.0–6.5)
	Positive	385 (0.8)	41 (1.3)	1.6 (0.3–5.5)
	AIDS	2,744 (5.9)	320 (9.8)	1.8 (0.0–6.0)
	Unknown	7,982 (17.1)	584 (18.0)	2.2 (0.0–6.2)
Diabetes
	No	40,456 (86.5)	2,645 (81.3)	2.2 (0.0–6.5)
	Yes	3,441 (7.4)	236 (7.3)	2.1 (0.0–5.8)
	Not informed	2,872 (6.1)	372 (11.4)	NA
Tobacco use
	No	35,747 (76.4)	2,153 (66.2)	2.2 (0.0–6.5)
	Yes	7,287 (15.6)	681 (20.9)	2.2 (0.0–6.4)
	Not informed	3,735 (8.0)	419 (12.9)	NA
Alcohol use
	No	37,901 (81.0)	2,318 (71.2)	2.2 (0.0–6.5)
	Yes	6,126 (13.1)	607 (18.7)	2.1 (0.0–6.3)
	Not informed	2,742 (5.9)	328 (10.1)	NA
Illicit drug use
	No	39,175 (83.8)	2,415 (74.2)	2.1 (0.0–6.6)
	Yes	3,651 (7.8)	399 (12.3)	2.4 (0.0–6.0)
	Not informed	3,943 (8.4)	439 (13.5)	NA
DOT
	No	16,827 (36.0)	1,149 (35.3)	2.1 (0.0–6.4)
	Yes	19,532 (41.7)	1,299 (40.0)	2.2 (0.0–6.3)
	Not informed	10,410 (22.3)	805 (24.7)	NA

Variable		uRR (95%CI)
Sex^* * p≤0.20;
	Female	Reference
	Male	1.8 (1.6–1.9)^† † p≤0.05.
Age group (in years)^* * p≤0.20;
	0 to 4	Reference
	5 to 9	1.0 (0.4–2.6)
	10 to 14	1.6 (0.8–3.2)
	15 to 19	2.7 (1.6–4.8)^† † p≤0.05.
	20 to 29	3.5 (2.0–6.0)^† † p≤0.05.
	30 to 59	3.3 (1.9–5.6)^† † p≤0.05.
60 and more		2.9 (1.7–5.0)^† † p≤0.05.
	Race^* * p≤0.20;
	White	Reference
	Black	1.5 (1.4–1.7)^† † p≤0.05.
	Asian	1.5 (1.0–2.1)^† † p≤0.05.
	Mixed	1.4 (1.3–1.5)^† † p≤0.05.
	Indigenous	0.7 (0.5–1.1)
Education level (in years)^* * p≤0.20;
	0 to 8	Reference
	9 to 11	0.5 (0.5–0.6)^† † p≤0.05.
	12 and more	0.3 (0.3–0.4)^† † p≤0.05.
	Not informed	0.8 (0.8–0.9)^† † p≤0.05.
Beneficiary of a cash transfer program
	No	Reference
	Yes	0.9 (0.8–1.1)
	Not informed	0.6 (0.6–0.7)^† † p≤0.05.
Prison population^* * p≤0.20;
	No	Reference
	Yes	2.5 (2.3–2.7)^† † p≤0.05.
	Not informed	1.3 (1.2–1.5)^† † p≤0.05.
Homeless population^* * p≤0.20;
	No	Reference
	Yes	1.6 (1.3–2.0)^† † p≤0.05.
	Not informed	1.3 (1.2–1.4)^† † p≤0.05.
Health professional^* * p≤0.20;
	No	Reference
	Yes	0.4 (0.3–0.7)^† † p≤0.05.
	Not informed	1.2 (1.1–1.4)^† † p≤0.05.
Immigrant population
	No	Reference
	Yes	0.6 (0.3–1.1)
	Not informed	1.0 (0.9–1.1)
Clinical form^* * p≤0.20;
	Extrapulmonary	Reference
	Pulmonary/mixed	2.1 (1.8–2.4)^† † p≤0.05.
HIV status^* * p≤0.20;
	Negative	Reference
	Positive	1.6 (1.2–2.1)^† † p≤0.05.
	AIDS	1.7 (1.5–1.9)^† † p≤0.05.
	Unknown	1.1 (1.0–1.2)
Diabetes
	No	Reference
	Yes	1.0 (0.9–1.2)
	Not informed	1.9 (1.7–2.1)^† † p≤0.05.
Tobacco use^* * p≤0.20;
	No	Reference
	Yes	1.5 (1.4–1.6)^† † p≤0.05.
	Not informed	1.8 (1.6–2.0)^† † p≤0.05.
Alcohol use^* * p≤0.20;
	No	Reference
	Yes	1.6 (1.4–1.7)^† † p≤0.05.
	Not informed	1.9 (1.7–2.1)^† † p≤0.05.
Illicit drug use^* * p≤0.20;
	No	Reference
	Yes	1.7 (1.5–1.9)^† † p≤0.05.
	Not informed	1.7 (1.6–1.9)^† † p≤0.05.
DOT^* * p≤0.20;
	No	Reference
	Yes	1.0 (0.9–1.1)
	Not informed	1.1 (1.0–1.2)

Variable		Rate	aRR (95%CI)	PAF/PPF (95%CI)
Sex
	Female	22.0	Reference	Reference
	Male	78.0	1.4 (1.3–1.5)^* * p≤0.05.	22.9 (18.1–27.8)^* * p≤0.05.
Age group (in years)
	0 to 4	0.4	Reference	Reference
	5 to 9	0.2	1.4 (0.6–3.8)	0.1 (-0.1–0.2)
	10 to 14	0.7	2.0 (1.0–4.1)	0.4 (0.1–0.6)
	15 to 19	6.0	3.2 (1.7–6.1)^* * p≤0.05.	4.1 (3.0–5.3)^* * p≤0.05.
	20 to 29	26.7	3.1 (1.7–5.8)^* * p≤0.05.	18.1 (12.8–23.5)^* * p≤0.05.
	30 to 59	53.6	3.0 (1.6–5.7)^* * p≤0.05.	36.0 (25.1–46.9)^* * p≤0.05.
	60 and more	12.3	2.9 (1.6–5.5)^* * p≤0.05.	8.1 (5.5–10.7)^* * p≤0.05.
Race
	White	26.4	Reference	Reference
	Black	13.8	1.3 (1.2–1.5)^* * p≤0.05.	3.5 (2.3–4.6)^* * p≤0.05.
	Asian	0.8	1.4 (1.0–2.1)	0.3 (0.0–0.5)
	Mixed	49.2	1.3 (1.2–1.4)^* * p≤0.05.	10.6 (7.5–13.8)^* * p≤0.05.
	Indigenous	0.8	0.9 (0.6–1.3)	-0.1 (-0.5–0.2)
Education level (in years)
	0 to 8	55.9	Reference	Reference
	9 to 11	15.4	0.6 (0.5–0.6)^* * p≤0.05.	10.1 (7.8–12.2)^* * p≤0.05.
	12 and more	2.9	0.5 (0.4–0.6)^* * p≤0.05.	3.3 (2.1–4.6)^* * p≤0.05.
	Not informed	25.8	0.8 (0.8–0.9)^* * p≤0.05.	5.2 (2.6–7.6)^* * p≤0.05.
Prison population
	No	69.9	Reference	Reference
	Yes	19.4	1.9 (1.7–2.1)^* * p≤0.05.	9.1 (8.1–10.1)^* * p≤0.05.
	Not informed	10.7	1.1 (1.0–1.3)	1.2 (0.1–2.4)
Clinical form
	Extrapulmonary	6.9	Reference	Reference
	Pulmonary/mixed	93.1	1.7 (1.4–1.9)^* * p≤0.05.	37.1 (29.4–44.8)^* * p≤0.05.
HIV status
	Negative	70.9	Reference	Reference
	Positive	1.3	1.5 (1.1–2.0)^* * p≤0.05.	0.4 (0.2–0.7)^* * p≤0.05.
	AIDS	9.8	1.8 (1.6–2.0)^* * p≤0.05.	4.3 (3.6–4.9)^* * p≤0.05.
	Unknown	18.0	1.0 (0.9–1.1)	0.7 (-1.0–2.3)
Tobacco use
	No	66.2	Reference	Reference
	Yes	20.9	1.2 (1.0–1.3)	2.7 (1.0–4.5)
	Not informed	12.9	1.2 (0.9–1.5)	2.0 (-0.6–4.6)
Alcohol use
	No	71.3	Reference	Reference
	Yes	18.7	1.2 (1.1–1.3)^* * p≤0.05.	2.9 (1.3–4.5)^* * p≤0.05.
	Not informed	10.1	1.1 (0.9–1.3)	1.1 (-0.5–2.7)
Illicit drug use
	No	74.2	Reference	Reference
	Yes	12.3	1.1 (1.0–1.3)	1.4 (0.1–2.6)
	Not informed	13.5	1.1 (0.9–1.4)	1.0 (-1.9–4.0)
DOT
	No	35.3	Reference	Reference
	Yes	39.9	0.9 (0.8–0.9)^* * p≤0.05.	4.4 (1.1–7.6)^* * p≤0.05.
	Not informed	24.7	1.0 (0.9–1.1)	0.3 (-2.0–2.5)

Variable		uRR (95%CI)	aRR (95%CI)
Sex
	Female	Reference	Reference
	Male	1.8 (1.6–1.9)^* * p≤0.05.	1.4 (1.3–1.5)^* * p≤0.05.
Age group (in years)
	0 to 4	Reference	Reference
	5 to 9	0.8 (0.3–2.1)	0.8 (0.3–2.2)
	10 to 14	1.6 (0.8–3.0)	1.4 (0.7–3.1)
	15 to 19	2.6 (1.5–4.4)^* * p≤0.05.	2.3 (1.2–4.4)^* * p≤0.05.
	20 to 29	3.3 (1.9–5.5)^* * p≤0.05.	2.3 (1.2–4.4)^* * p≤0.05.
	30 to 59	3.0 (1.8–5.1)^* * p≤0.05.	2.2 (1.1–4.2)^* * p≤0.05.
	60 and more	2.7 (1.6–4.5)^* * p≤0.05.	2.1 (1.1–4.0)^* * p≤0.05.
Race
	White	Reference	Reference
	Black	1.4 (1.3–1.6)^* * p≤0.05.	1.3 (1.1–1.4)^* * p≤0.05.
	Asian	1.4 (1.0–1.9)	1.3 (1.0–1.8)
	Mixed	1.3 (1.2–1.5)^* * p≤0.05.	1.2 (1.2–1.3)^* * p≤0.05.
	Indigenous	1.0 (0.7–1.3)	1.1 (0.8–1.4)
Education level (in years)
	0 to 8	Reference	Reference
	9 to 11	0.6 (0.6–0.7)^* * p≤0.05.	0.7 (0.6–0.7)^* * p≤0.05.
	12 and more	0.5 (0.4–0.6)^* * p≤0.05.	0.6 (0.5–0.7)^* * p≤0.05.
Prison population
	No	Reference	Reference
	Yes	2.2 (2.1–2.4)^* * p≤0.05.	1.8 (1.7–2.0)^* * p≤0.05.
Clinical form
	Extrapulmonary	Reference	Reference
	Pulmonary/mixed	2.1 (1.8–2.4)^* * p≤0.05.	1.7 (1.5–2.0)^* * p≤0.05.
HIV status
	Negative	Reference	Reference
	Positive	1.4 (1.2–1.8)^* * p≤0.05.	1.4 (1.1–1.7)^* * p≤0.05.
	AIDS	1.5 (1.4–1.7)^* * p≤0.05.	1.6 (1.4–1.7)^* * p≤0.05.
Tobacco use
	No	Reference	Reference
	Yes	1.5 (1.4–1.6)^* * p≤0.05.	1.2 (1.1–1.3)^* * p≤0.05.
Alcohol use
	No	Reference	Reference
	Yes	1.5 (1.4–1.6)^* * p≤0.05.	1.2 (1.1–1.3)^* * p≤0.05.
Illicit drug use
	No	Reference	Reference
	Yes	1.6 (1.5–1.8)^* * p≤0.05.	1.1 (1.0–1.2)
DOT
	No	Reference	Reference
	Yes	1.0 (0.9–1.1)	0.9 (0.9–1.0)

[1] CORRESPONDING AUTHOR: Lucas Vinícius de Lima. Av. Colombo, 5.790, Bloco 2, Zona 7, Campus Universitário, CEP: 87020-900, Maringá (PR), Brasil. E-mail: lvl.vinicius@gmail.com.

Brasil

Brasil

Time until tuberculosis recurrence and associated factors in Brazil: a population-based retrospective cohort study using a linked database

Tempo até a recorrência da tuberculose e fatores associados no Brasil: um estudo de coorte retrospectiva de base populacional usando dados de linkage

ABSTRACT

Objective:

Methods:

Results:

Conclusion: