Family Health Strategy and determinants of directly observed treatment for tuberculosis in Brazil: A cross-sectional study with surveillance system data, 2014-2016

Abstract

Objective: To assess the association between tuberculosis determinants and performance of directly observed treatment (DOT) under different levels of Family Health Strategy (FHS) coverage in Brazil. Methods: This was a cross-sectional study using data on tuberculosis cases notified between 2014 and 2016 on the Notifiable Health Conditions Information System, as well as data on FHS coverage in the municipality of residence. Logistic regression was used. Results: 177,626 individuals were included; being an alcohol user (odds ratio (OR) 1.09 - 95% confidence interval % [95%CI] 1.03;1.16), being deprived of liberty (OR=1.21 - 95%CI 1.12;1.32) and positive sputum smear microscopy (OR=1.15 - 95%CI 1.10;1.21) increased the chances of DOT being performed . When stratified by FHS coverage, these associations became weak in the highest stratum of coverage. Conclusion: DOT being performed was associated with determinants of tuberculosis. However, association was not confirmed among residents in municipalities with higher FHS coverage.