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Who are the patients that default tuberculosis treatment? – Space matters!

2017-01Journal article Restricted access
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dc.contributor.authorNunes, C.
dc.contributor.authorDuarte, R.
dc.contributor.authorVeiga, Ana Costa
dc.contributor.authorTaylor, B.
dc.date.accessioned2017-03-07T16:41:32Z
dc.date.available2017-03-07T16:41:32Z
dc.date.issued2017-01
dc.description.abstractThe goals of this article are: (i) to understand how individual characteristics affect the likelihood of patients defaulting their pulmonary tuberculosis (PTB) treatment regimens; (ii) to quantify the predictive capacity of these risk factors; and (iii) to quantify and map spatial variation in the risk of defaulting. We used logistic regression models and generalized additive models with a spatial component to determine the odds of default across continental Portugal. We focused on new PTB cases, diagnosed between 2000 and 2013, and included some individual information (sex, age, residence area, alcohol abuse, intravenous drug use, homelessness, HIV, imprisonment status). We found that the global default rate was 4·88%, higher in individuals with well-known risk profiles (males, immigrants, HIV positive, homeless, prisoners, alcohol and drug users). Of specific epidemiological interest was that our geographical analysis found that Portugal's main urban areas (the two biggest cities) and one tourist region have higher default rates compared to the rest of the country, after adjusting for the previously mentioneded risk factors. The challenge of treatment defaulting, either due to other individual non-measured characteristics, healthcare system failure or patient recalcitrance requires further analysis in the spatio-temporal domain. Our findings suggest the presence of significant within-country variation in the risk of defaulting that cannot be explained by these classical individual risk factors alone. The methods we advocate are simple to implement and could easily be applied to other diseases.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationNunes C, Duarte R, Costa-Veiga A, Taylor B. Who are the patients that default tuberculosis treatment? Space matters! Epidemiology Infection. 2017;145(6):1130-4.pt_PT
dc.identifier.doi10.1017/S0950268816003307pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/6845
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherCambridge University Presspt_PT
dc.relation.publisherversionhttps://www.cambridge.org/core/journals/epidemiology-and-infection/article/div-classtitlewho-are-the-patients-that-default-tuberculosis-treatment-space-mattersdiv/817AF3A078F00DBD488DA78AC71F389Fpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectPharmacologypt_PT
dc.subjectNoncompliancept_PT
dc.subjectPulmonary tuberculosispt_PT
dc.subjectRisk factorpt_PT
dc.subjectSpatial patternpt_PT
dc.subjectTreatmentpt_PT
dc.titleWho are the patients that default tuberculosis treatment? – Space matters!pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1134pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage1130pt_PT
oaire.citation.titleEpidemiology and Infectionpt_PT
oaire.citation.volume145pt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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