Social determinants of non adherence to tuberculosis treatment in selected municipalities of Buenos Aires, Argentina.

HERRERO MB; BRAGA JU

Conferencia; 47th Union World Conference on Lung Health; 2016

The International Union Against Tuberculosis

Background: The aim of this study was to identify the social determinants of adherence to tuberculosis treatment, at different levels in selected municipalities of Buenos Aires, Argentina. Methods: An ecological study was conducted in selected municipalities, to identify spatial distribution patterns of the proportion of nonadherence (analysis of spatial correlation); and a crosssectional study with a model of hierarchical analysis, conducted in Buenos Aires, Argentina. Data was collected through a questionnaire and the characteristics of the area based on National Population Census were analyzed. The social determinants´ analysis was performed using multiple logistic regression (2level hierarchical model). Results: The final results of the ecological study show higher incidence rates of nonadherenceto treatment in areas with a lower proportion of the population that does not make pension contributions, in areas with a higher proportion of households with UBN as subsistence capacity and in areas with a higher proportion of households that do not have public transport within 300 meters. The final model of the hierarchical analysis shows that at the individual level male patients had 3 times higher risk of nonadherence to treatment. Not having water supply at home increased 4 times the risk of nonadherence, compared with homes that have water supply. In households where the head of household had no health coverage, the risk of nonadherence to treatment increased almost 6 times. Patients who used more than one means of transport to attend the health service had nearly 7 times the risk of nonadherence to treatment than those who used only one mean of transport. At the area level, areas with a higher proportion of households with UBN as subsistence capacity presented more than triple risk of nonadherence. Areas with higher proportion of households without natural gas network had a lower risk of nonadherence. Finally not having flush toilet increased more than 5 times the risk of nonadherence. Conclusions: In conclusion, adherence to tuberculosis treatment is part of a complex multidimensional process. The results show that there is an influence of social and economic variables for nonadherence to tuberculosis treatment, both individually and geographically (area).