Banca de DEFESA: MARÍLIA SANTOS DOS ANJOS

Childhood tuberculosis: sociodemographic inequalities and drug resistance.

Childhood tuberculosis; Social determinants; Associated factors; Epidemiology.

Objective: To analyze the factors associated with the outcomes of childhood tuberculosis treatment in Brazil, emphasizing the inequalities related to age group, sex, race/ethnicity, and geographic region, in the period from 2008 to 2019. Methods: A retrospective cohort study was conducted. The study population included all cases of tuberculosis in under-15s from the whole of Brazil reported in the National Disease Notification System. The relative risks (RRs) and their confidence intervals (95%CIs) were estimated using Poisson regression with robust variance. This project was approved by the research ethics committee under protocol number 5,075,877. Results: Black, brown, and indigenous children had a higher risk of having unfavorable outcomes compared with white children (24%, 29%, and 29%, respectively). Children under one year old had a RR of 1.80 (95%CI: 1.61-2.00) and children aged 1 to 4 had a RR of 1.19 (95%CI: 1.06-1.33), forming the age groups with the highest risk of having some unfavorable outcome. Children with a positive HIV test presented an almost three times higher risk of unfavorable outcomes than those with a negative HIV result [RR: 2.61; 95%CI: 2.33-2.94)]. Conclusion: The study revealed an accentuated disparity and higher risk of some unfavorable outcome of TB in black, brown, and indigenous children and adolescents, as well as showing that children under five years old need special attention, as they had a higher risk of having unfavorable outcomes.