Social determinants of health and unfavourable outcome of tuberculosis treatment in the prison system

This article aims to analyze the unfa-vorable outcome of tuberculosis treatment among the population deprived of liberty by social deter-minants of health. This retrospective cohort was conducted in the states of Rondonia and Silo Pau-lo, Brazil, with inmates with tuberculosis notified between 2008 and 2017. Data were collected from SINAN and TB-WEB and analyzed by relative risk (RR) and confidence intervals (95%CI), which test -ed the association between the dependent variable (unfavorable outcome (deaths from tuberculosis and other causes, and primary and non-primary lost to follow-up) vs. favorable outcome (cure)) and the structural and intermediary determinants of health. One hundred fifty-eight unfavorable out-comes were registered in Rondonia and 2,227 in Silo Paulo. For Rondonia, this outcome was associ-ated with gender (RR 3.09; 95%CI 1.03-9.27) and AIDS (RR 2.46; 95%CI 1.63-3.71). In Silo Paulo, aged over 30 years (RR 1.36; 95%CI 1.26-1.47), AIDS (RR 3.08; 95%CI 2.81-3.38), alcohol abuse (RR 1.54; 95%CI 1.35-1.76), diabetes (RR 1.70; 95%CI 1.27-2.28) and self-administered treatment (RR 2.55; 95%CI 2.27-2.86) were risk factors for the unfavorable outcome. The study contributes with elements to the risk stratification of people with tuberculosis in prison units and, thus, im-proves health care towards a favorable outcome.