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Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil

Overview of attention for article published in BMC Public Health, May 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (75th percentile)
  • High Attention Score compared to outputs of the same age and source (81st percentile)

Mentioned by

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12 tweeters

Citations

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10 Dimensions

Readers on

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116 Mendeley
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Title
Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil
Published in
BMC Public Health, May 2017
DOI 10.1186/s12889-017-4435-0
Pubmed ID
Authors

Guy Harling, Antonio S. Lima Neto, Geziel S. Sousa, Marcia M. T. Machado, Marcia C. Castro

Abstract

Tuberculosis (TB) remains a public health problem, despite recent achievements in reducing incidence and mortality rates. In Brazil, these achievements were above the worldwide average, but marked by large regional heterogeneities. In Fortaleza (5th largest city in Brazil), the tuberculosis cure rate has been declining and treatment abandonment has been increasing in the past decade, despite a reduction in incidence and an increase in directly observed therapy (DOT). These trends put efforts to eliminate tuberculosis at risk. We therefore sought to determine social and programmatic determinants of tuberculosis incidence and treatment abandonment in Fortaleza. We analyzed sociodemographic and clinical data for all new tuberculosis cases notified in the Notifiable Diseases Information System (SINAN) from Fortaleza between 2007 and 2014. We calculated incidence rates for 117 neighborhoods in Fortaleza, assessed their spatial clustering, and used spatial regression models to quantify associations between neighborhood-level covariates and incidence rates. We used hierarchical logistic regression models to evaluate how individual- and neighborhood-level covariates predicted tuberculosis treatment abandonment. There were 12,338 new cases reported during the study period. Case rates across neighborhoods were significantly positively clustered in two low-income areas close to the city center. In an adjusted model, tuberculosis rates were significantly higher in neighborhoods with lower literacy, higher sewerage access and homicide rates, and a greater proportion of self-reported black residents. Treatment was abandoned in 1901 cases (15.4%), a rate that rose by 71% between 2007 and 2014. Abandonment was significantly associated with many individual sociodemographic and clinical factors. Notably, being recommended for DOT was protective for those who completed DOT, but associated with abandonment for those who did not. Low socioeconomic status areas have higher tuberculosis rates, and low socioeconomic individuals have higher risk of treatment abandonment, in Fortaleza. Treatment abandonment rates are growing despite the advent of universal DOT recommendations in Brazil. Proactive social policies, and active contact tracing to find missed cases, may help reduce the tuberculosis burden in this setting.

Twitter Demographics

The data shown below were collected from the profiles of 12 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 116 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 116 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 26 22%
Researcher 12 10%
Student > Bachelor 11 9%
Student > Ph. D. Student 11 9%
Student > Doctoral Student 6 5%
Other 24 21%
Unknown 26 22%
Readers by discipline Count As %
Medicine and Dentistry 25 22%
Nursing and Health Professions 15 13%
Social Sciences 9 8%
Computer Science 6 5%
Pharmacology, Toxicology and Pharmaceutical Science 4 3%
Other 21 18%
Unknown 36 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 7. 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 29 October 2019.
All research outputs
#2,721,992
of 14,731,479 outputs
Outputs from BMC Public Health
#3,207
of 10,299 outputs
Outputs of similar age
#66,439
of 267,616 outputs
Outputs of similar age from BMC Public Health
#4
of 27 outputs
Altmetric has tracked 14,731,479 research outputs across all sources so far. Compared to these this one has done well and is in the 81st percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,299 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.7. This one has gotten more attention than average, scoring higher than 68% of its peers.
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 267,616 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 75% of its contemporaries.
We're also able to compare this research output to 27 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 81% of its contemporaries.