Factors associated with deaths by tuberculosis in the state of Mato Grosso, 2011-2020: retrospective cohort study

Epidemiol Serv Saude. 2024 Nov 11:33:e20231402. doi: 10.1590/S2237-96222024V33E20231402.EN. eCollection 2024.
[Article in English, Portuguese]

Abstract
in English, Spanish

Objective: To investigate factors associated with tuberculosis deaths in Mato Grosso state, Brazil, from 2011 to 2020.

Methods: Retrospective cohort study with data obtained from the Notifiable Health Conditions Information System and the Mortality Information System. Deaths were qualified using probabilistic linkage and analyzed using Poisson regression.

Results: 12,331 cases and 525 deaths were identified over 10 years. The factors associated with death were: age ≥60 years (RR: 7.70; 95%CI 1.91;31.04), incomplete elementary and high school education (RR: 3.66; 95%CI 1.34;9.96), illiteracy (RR: 4.50; 95%CI 1.60;12.66), homeless population (RR: 2.41; 95%CI 1.34;4.35), alcohol use (RR: 1.45; 95%CI 1.04;2.02), male sex (RR: 1.48; 95%CI 1.04;2.09) and tobacco use (RR: 1.32; 95%CI 0.98;1.77). Laboratory confirmation was a protective factor.

Conclusion: Risk of death was higher in men over 60 years old, with low education levels, in vulnerable situations, and who used alcohol/tobacco.

Objetivo:: Investigar los factores asociados a la mortalidad por tuberculosis en Mato Grosso, entre 2011/2020.

Métodos:: Cohorte retrospectivo con datos obtenidos del Sistema de Información de Enfermedades de Declaración Obligatoria y Sistema de Información de Mortalidad. Las muertes se calificaron mediante relación probabilística y se analizaron por regresión de Poisson.

Resultados:: En 10 años se identificaron 12.331 casos y 525 muertes. Los factores asociados a muertes fueron: edad ≥ 60 años (RR: 7,70; IC95% 1,91;31,04), educación primaria/secundaria incompleta (RR: 3,66; IC95% 1,34;9,96), analfabetismo (RR: 4. 50 IC95% 1.60;12.66), población sin hogar (RR: 2.41; IC95% 1.34;4.35), alcohol (RR: 1.45; IC95% 1.04;2.02), sexo masculino (RR: 1.48; IC95% 1.04 ;2,09), tabaco (RR: 1,32; IC95% 0,98;1,77). La confirmación de laboratorio fue un factor protector (RR: 0,68; IC95% 0,52;0,93).

Conclusión:: Hubo mayor riesgo de muerte en hombres mayores de 60 años, con baja escolaridad, en situación de vulnerabilidad, que consumen alcohol/tabaco.

Plain language summary

Main results: Risk of death was higher in the elderly, males, people with low education levels, homeless people, alcohol and tobacco users. Laboratory confirmation was a protective factor.

Implications for services: Raising awareness of health professionals regarding risk factors, especially regarding risk behaviors and laboratory confirmation of tuberculosis, to which efforts should be targeted.

Perspectives: It would be strategic to study survival in order to assimilate the effect of time and to study people with drug-resistant tuberculosis in order to update treatment recommendations. Health service managers need to define public policies aimed at the determinants found.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Alcohol Drinking / epidemiology
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Educational Status*
  • Female
  • Humans
  • Ill-Housed Persons / statistics & numerical data
  • Infant
  • Literacy / statistics & numerical data
  • Male
  • Middle Aged
  • Protective Factors
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Tobacco Use / epidemiology
  • Tuberculosis* / epidemiology
  • Tuberculosis* / mortality
  • Young Adult

Grants and funding

Vanessa da Silva Lopes receives a scientific initiation grant from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), File No. 122597/2022-2.