ArticleBMC infectious diseases2016
Risk factors for differential outcome following directly observed treatment (DOT) of slum and non-slum tuberculosis patients: a retrospective cohort study.
Article in BMC infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 4 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 4 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Tuberculosis in the South America's homeless: a systematic review of social determinants, control strategies and health equity.Revista da Escola de Enfermagem da U S P · 2026Pooled it
- Factors Associated with the Abandonment of Tuberculosis Treatment in Brazil: A Systematic Review.Revista da Sociedade Brasileira de Medicina Tropical · 2023Pooled it
- Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis.PloS one · 2019Pooled it
- Adherence interventions and outcomes of tuberculosis treatment: A systematic review and meta-analysis of trials and observational studies.PLoS medicine · 2018Pooled it
- The impact of the stratification by degree of clinical severity and abandonment risk of tuberculosis treatment.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2021Trial
- "They tossed me up like a ball": informal settlement residents' experiences in accessing healthcare in Kampala, Uganda.BMC public health · 2025Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundBrazil's National Tuberculosis Control Program seeks to improve tuberculosis (TB) treatment in vulnerable populations. Slum residents are more vulnerable to TB due to a variety of factors, including their overcrowded living conditions, substandard infrastructure, and limited access to healthcare compared to their non-slum dwelling counterparts. Directly observed treatment (DOT) has been suggested to improve TB treatment outcomes among vulnerable populations, but the program's differential effectiveness among urban slum and non-slum residents is not known.
methodsWe retrospectively compared the impact of DOT on TB treatment outcome in residents of slum and non-slum census tracts in Rio de Janeiro reported to the Brazilian Notifiable Disease Database in 2010. Patient residential addresses were geocoded to census tracts from the 2010 Brazilian Census, which were identified as slum (aglomerados subnormais -AGSN) and non-slum (non-AGSN) by the Census Bureau. Homeless and incarcerated cases as well as those geocoded outside the city's limits were excluded from analysis.
resultsIn 2010, 6,601 TB cases were geocoded within Rio de Janeiro; 1,874 (27.4 %) were residents of AGSN, and 4,794 (72.6 %) did not reside in an AGSN area. DOT coverage among AGSN cases was 35.2 % (n = 638), while the coverage in non-AGSN cases was 26.2 % (n = 1,234). Clinical characteristics, treatment, follow-up, cure, death and abandonment were similar in both AGSN and non-AGSN TB patients. After adjusting for covariates, AGSN TB cases on DOT had 1.67 (95 % CI: 1.17, 2.4) times the risk of cure, 0.61 (95 % CI: 0.41, 0.90) times the risk of abandonment, and 0.1 (95 % CI: 0.01, 0.77) times the risk of death from TB compared to non-AGSN TB cases not on DOT.
conclusionWhile DOT coverage was low among TB cases in both AGSN and non-AGSN communities, it had a greater impact on TB cure rate in AGSN than in non-AGSN populations in the city of Rio de Janeiro.
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