title: Unemployment in TB patients - ten-year observation at regional center of pulmonology in Bydgoszcz, Poland.
abstract: BACKGROUND
  Tuberculosis (TB) affects the poorest of the poor and is an example of a disease that can contribute to the "disease-poverty trap". The variable epidemiological situation is associated with social risk factors, such as unemployment, which may favor the occurrence of this disease. The aim of this study was to analyze unemployment as a factor that can influence the incidence and course of the disease.
  
  
  METHODS
  We analyzed TB patients with confirmed status of employment or unemployment admitted to the Regional Center of Pulmonology in Bydgoszcz in during the years 2001 to 2010. Out of 1130 patients, 604 were unemployed and the other confirmed their employment.
  
  
  RESULTS
  The unemployed patients were mostly single men over age 40, with a low level of education, and living in a city. We observed that the proportions of smokers and alcohol abusers were significantly higher among the unemployed patients. The advanced radiological lesions, smear-positive pulmonary TB, and extra-pulmonary sites were diagnosed significantly more often in this group. The rate of death in the course of hospitalization was significantly higher in the group of unemployed patients.
  
  
  CONCLUSIONS
  Unemployment among TB patients is a serious problem. We found that more advanced radiological lesions were associated with more frequent treatment interruptions and a higher rate of death in the course of hospitalization. Increased efforts are needed to reduce and eliminate the problem of unemployment among patients with TB. This may, indirectly, contribute to a decrease in notifications of TB cases and improve treatment outcomes.
authors.affiliation: Department of Pulmonary Diseases and Tuberculosis, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Przybylski
authors.affiliation: Department of Theoretical Foundations of Biomedical Sciences and Medical Informatics, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
authors.forename: Anita
authors.initials: A
authors.lastname: Dabrowska
authors.affiliation: Department of Pulmonary Diseases and Tuberculosis, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Pilaczyńska-Cemel
authors.affiliation: Department of Microbiology, Regional Center of Pulmonology in Bydgoszcz, Bydgoszcz, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Krawiecka
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology; D014478:Unemployment; D055815:Young Adult