Profile of re-entry cases after abandonment of treatment of tuberculosis in Salvador, Bahia, Brazil

Abstract Background Tuberculosis is still a major public health problem and has been worrying health authorities. Tuberculosis is directly related to social determinants, a fact that has been involving governments with intersectoral actions to reduce the vulnerability of the population to health. Objective To describe the profile of re-entry cases after abandonment of tuberculosis treatment in the city of Salvador, Bahia, from 2006 to 2015, comprising sociodemographic, clinical and behavioral factors of the individuals. Method This is a descriptive and exploratory spatio-temporal ecological study performed through secondary data available in the Brazilian Notifiable Diseases Information System. The data obtained were stored and consolidated for calculation of the absolute and relative frequency variables, re-entry incidence rate after abandonment, and Spearman correlation. Then, the information obtained was used to make graphs and tables. Results There were 1,611 re-entry cases with predominance of males, 30 to 49 years old, self-declared brown skin color, and the level of complete fundamental education, with tuberculosis presenting as pulmonary and HIV negative. The health districts of Cabula/Beiru, Subúrbio Ferroviário, and São Caetano/Valéria presented higher incidence rates. Conclusion The profile found is consistent with the individuals with the highest incidence rates of the disease, as well as higher rates of tuberculosis mortality throughout the country. The education level of the individual was presented as a crucial factor for greater re-entry to treatment.

**背景**：结核病仍是威胁全球公共卫生的重大问题，长期困扰各国卫生主管部门。结核病与社会决定因素直接相关，这一认知促使各国政府开展跨部门行动，以降低人群的健康易感性。
**目的**：描述2006年至2015年巴西巴伊亚州萨尔瓦多市结核病治疗中断后复归病例的特征，涵盖研究对象的社会人口学、临床及行为学相关因素。
**方法**：本研究为描述性探索性时空生态研究，数据来源于巴西法定传染病信息系统（Brazilian Notifiable Diseases Information System）公开的二手资料。研究对获取的数据进行存储与整合，用于计算绝对频率与相对频率变量、治疗中断后复归发病率以及斯皮尔曼（Spearman）相关性系数，随后基于分析所得信息绘制图表。
**结果**：本研究共纳入1611例复归病例，主要特征为男性、年龄30~49岁、自报棕肤色、完成初等教育，所患结核病为肺结核且HIV检测呈阴性。卡布拉/贝鲁、铁路郊区以及圣卡埃塔诺/瓦莱里亚等卫生区的复归发病率更高。
**结论**：本研究发现的病例特征与巴西全国结核病发病率及死亡率较高的人群特征相符，个体受教育程度是影响治疗中断后复归治疗的关键因素。