title: Treatment outcomes of tuberculosis patients in Brazilian prisons: a polytomous regression analysis.
abstract: METHODS
  Tuberculosis (TB) is a major public health problem and an important cause of infectious disease-related death in young adults. TB rates are higher in vulnerable populations, including prisoners.
  
  
  OBJECTIVE
  To describe the clinical and epidemiological characteristics associated with anti-tuberculosis treatment outcomes in the Brazilian prison population.
  
  
  METHODS
  The study population consisted of prisoners diagnosed with TB identified through the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) between January 2007 and December 2011. Pearson's χ(2) test was used to compare the proportions and covariates associated with the outcome of interest. These variables were further analysed using the polytomous regression model.
  
  
  RESULTS
  Compared to those who completed anti-tuberculosis treatment, prisoners who defaulted from treatment were younger (P < 0.001), less educated (P < 0.001) and more likely to be alcoholic (P < 0.001); they were more likely to have recurrent or relapse TB (P < 0.001) and they were not under directly observed treatment (P < 0.001). Those who died from TB tended to be older (P < 0.001) and alcoholic (P < 0.001); they were also more likely to have received treatment of unknown type (P < 0.001) and to have both pulmonary and extra-pulmonary TB (EPTB). Prisoners who developed multidrug-resistant TB were more likely to experience TB recurrence, return to treatment after default, change treatment centres and have EPTB.
  
  
  CONCLUSIONS
  Our results highlight the need to improve TB control and policies in correctional facilities. Improving treatment outcomes of prisoners will also prevent transmission to other prisoners, their family members, and health professionals.
authors.affiliation: Post-Graduate Programme in Doenças Infecciosas, and Laboratory of Epidemiology, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Ribeiro Macedo
authors.forename: B
authors.initials: B
authors.lastname: Reis-Santos
authors.forename: L W
authors.initials: LW
authors.lastname: Riley
authors.forename: E L
authors.initials: EL
authors.lastname: Maciel
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000401:mortality; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D016009:Chi-Square Distribution; D015897:Comorbidity; D023801:Directly Observed Therapy; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D016017:Odds Ratio; D015995:Prevalence; D011329:Prisoners; D011330:Prisons; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000635:transmission; D035862:Vulnerable Populations; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents