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Clinical and epidemiological characteristics associated with unfavorable tuberculosis treatment outcomes in TB-HIV co-infected patients in Brazil: a hierarchical polytomous analysis

Overview of attention for article published in Brazilian Journal of Infectious Diseases, December 2016
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Title
Clinical and epidemiological characteristics associated with unfavorable tuberculosis treatment outcomes in TB-HIV co-infected patients in Brazil: a hierarchical polytomous analysis
Published in
Brazilian Journal of Infectious Diseases, December 2016
DOI 10.1016/j.bjid.2016.11.006
Pubmed ID
Authors

Thiago Nascimento do Prado, Jayant V. Rajan, Angélica Espinosa Miranda, Elias dos Santos Dias, Lorrayne Beliqui Cosme, Lia Gonçalves Possuelo, Mauro N. Sanchez, Jonathan E. Golub, Lee W. Riley, Ethel Leonor Maciel

Abstract

TB patients co-infected with HIV have worse treatment outcomes than non-coinfected patients. How clinical characteristics of TB and socioeconomic characteristics influence these outcomes is poorly understood. Here, we use polytomous regression analysis to identify clinical and epidemiological characteristics associated with unfavorable treatment outcomes among TB-HIV co-infected patients in Brazil. TB-HIV cases reported in the Brazilian information system (SINAN) between January 1, 2001 and December 31, 2011 were identified and categorized by TB treatment outcome (cure, default, death, and development of MDR TB). We modeled treatment outcome as a function of clinical characteristics of TB and patient socioeconomic characteristics by polytomous regression analysis. For each treatment outcome, we used cure as the reference outcome. Between 2001 and 2011, 990,017 cases of TB were reported in SINAN, of which 93,147 (9.4%) were HIV co-infected. Patients aged 15-19 (OR=2.86; 95% CI: 2.09-3.91) and 20-39 years old (OR=2.30; 95% CI: 1.81-2.92) were more likely to default on TB treatment than those aged 0-14 years old. In contrast, patients aged ≥60 years were more likely to die from TB (OR=2.22; 95% CI: 1.43-3.44) or other causes (OR=2.86; 95% CI: 2.14-3.83). Black patients were more likely to default on TB treatment (OR=1.33; 95% CI: 1.22-1.44) and die from TB (OR=1.50; 95% CI: 1.29-1.74). Finally, alcoholism was associated with all unfavorable outcomes: default (OR=1.94; 95% CI: 1.73-2.17), death due to TB (OR=1.46; 95% CI: 1.25-1.71), death due to other causes (OR=1.38; 95% CI: 1.21-1.57) and MDR-TB (OR=2.29; 95% CI: 1.46-3.58). Socio-economic vulnerability has a significant effect on treatment outcomes among TB-HIV co-infected patients in Brazil. Enhancing social support, incorporation of alcohol abuse screening and counseling into current TB surveillance programs and targeting interventions to specific age groups are interventions that could improve treatment outcomes.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 200 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Unknown 199 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 33 17%
Student > Bachelor 22 11%
Student > Ph. D. Student 20 10%
Researcher 18 9%
Student > Postgraduate 14 7%
Other 41 21%
Unknown 52 26%
Readers by discipline Count As %
Medicine and Dentistry 63 32%
Nursing and Health Professions 35 18%
Social Sciences 8 4%
Immunology and Microbiology 6 3%
Psychology 6 3%
Other 24 12%
Unknown 58 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 December 2016.
All research outputs
#20,537,408
of 26,106,397 outputs
Outputs from Brazilian Journal of Infectious Diseases
#513
of 823 outputs
Outputs of similar age
#306,333
of 424,510 outputs
Outputs of similar age from Brazilian Journal of Infectious Diseases
#9
of 17 outputs
Altmetric has tracked 26,106,397 research outputs across all sources so far. This one is in the 18th percentile – i.e., 18% of other outputs scored the same or lower than it.
So far Altmetric has tracked 823 research outputs from this source. They receive a mean Attention Score of 3.5. This one is in the 32nd percentile – i.e., 32% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 424,510 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 24th percentile – i.e., 24% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 17 others from the same source and published within six weeks on either side of this one. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.