Spatial analysis of the tuberculosis treatment dropout, Buenos Aires, Argentina

OBJECTIVE Identify spatial distribution patterns of the proportion of nonadherence to tuberculosis treatment and its associated factors.METHODS We conducted an ecological study based on secondary and primary data from municipalities of the metropolitan area of Buenos Aires, Argentina. An exploratory analysis of the characteristics of the area and the distributions of the cases included in the sample (proportion of nonadherence) was also carried out along with a multifactor analysis by linear regression. The variables related to the characteristics of the population, residences and families were analyzed.RESULTS Areas with higher proportion of the population without social security benefits (p = 0.007) and of households with unsatisfied basic needs had a higher risk of nonadherence (p = 0.032). In addition, the proportion of nonadherence was higher in areas with the highest proportion of households with no public transportation within 300 meters (p = 0.070).CONCLUSIONS We found a risk area for the nonadherence to treatment characterized by a population living in poverty, with precarious jobs and difficult access to public transportation.

研究目的：明确结核病治疗不依从率的空间分布特征及其相关影响因素。
研究方法：本研究以阿根廷布宜诺斯艾利斯大都市区各区县的一手与二手数据为基础开展生态学研究。同时，本研究针对研究区域特征、纳入样本的病例分布情况（即治疗不依从率）展开探索性分析，并通过线性回归开展多因素分析，对人口、居住与家庭相关特征变量开展了分析。
研究结果：未享受社会保障福利的人口占比更高的区域（p=0.007）以及基本需求未得到满足的家庭占比更高的区域，其结核病治疗不依从风险更高（p=0.032）。此外，300米范围内无公共交通的家庭占比最高的区域，治疗不依从率同样更高（p=0.070）。
研究结论：本研究发现，以贫困人群为主体、就业不稳定且公共交通可达性不佳的区域，为结核病治疗不依从的高风险区域。