Background Social determinants influence health and the development of tuberculosis (TB). However, a paucity of data is available considering the relationship of social determinants influencing therapy failure and multi drug resistance (MDR). We conducted a review investigating the relationship of common social determinants on therapy failure and MDR in people with TB. Methods PubMed and SCOPUS were searched without language restrictions until February 02, 2016 for studies reporting the association between socioeconomic factors (income, education and alcohol abuse) and therapy failure or MDR-TB. The association between social determinants and outcomes was explored by pooling data with a random effects model and calculating crude and adjusted odds ratios (ORs) ±95% confidence intervals (CIs). Results Fifty studies with 407,555 participants with TB were included. Analysis demonstrated that low income (unadjusted OR = 2.00 (95% CI: 1.69–2.38; I2 = 88%; 33 studies, adjusted OR 1.77, p < 0.0001), low education (unadjusted OR 2.11, 95% CI 1.55–2.86, 26 studies, adjusted OR 1.69, p < 0.0001) and alcohol abuse (unadjusted OR = 2.43 (95% CI: 1.56–3.80, 16 studies, adjusted OR 2.13, p < 0.0001) were associated with therapy failure. Similarly, low income (unadjusted OR = 1.67; 95% CI: 1.12–2.41, p = 0.006; 14 studies, adjusted OR 2.16, p < 0.0001) and alcohol abuse (unadjusted OR = 1.88; 95% CI: 1.18–3.00, 7 studies, adjusted OR 1.43, p = 0.06) were associated with MDR-TB. Increasing age of the population was able to explain a consistent part of the heterogeneity found.

Social determinants of therapy failure and multi drug resistance among people with tuberculosis: A review

Di Gennaro, Francesco;MONNO, Laura;SARACINO, ANNALISA;
2017-01-01

Abstract

Background Social determinants influence health and the development of tuberculosis (TB). However, a paucity of data is available considering the relationship of social determinants influencing therapy failure and multi drug resistance (MDR). We conducted a review investigating the relationship of common social determinants on therapy failure and MDR in people with TB. Methods PubMed and SCOPUS were searched without language restrictions until February 02, 2016 for studies reporting the association between socioeconomic factors (income, education and alcohol abuse) and therapy failure or MDR-TB. The association between social determinants and outcomes was explored by pooling data with a random effects model and calculating crude and adjusted odds ratios (ORs) ±95% confidence intervals (CIs). Results Fifty studies with 407,555 participants with TB were included. Analysis demonstrated that low income (unadjusted OR = 2.00 (95% CI: 1.69–2.38; I2 = 88%; 33 studies, adjusted OR 1.77, p < 0.0001), low education (unadjusted OR 2.11, 95% CI 1.55–2.86, 26 studies, adjusted OR 1.69, p < 0.0001) and alcohol abuse (unadjusted OR = 2.43 (95% CI: 1.56–3.80, 16 studies, adjusted OR 2.13, p < 0.0001) were associated with therapy failure. Similarly, low income (unadjusted OR = 1.67; 95% CI: 1.12–2.41, p = 0.006; 14 studies, adjusted OR 2.16, p < 0.0001) and alcohol abuse (unadjusted OR = 1.88; 95% CI: 1.18–3.00, 7 studies, adjusted OR 1.43, p = 0.06) were associated with MDR-TB. Increasing age of the population was able to explain a consistent part of the heterogeneity found.
File in questo prodotto:
File Dimensione Formato  
Di gennaro, Tuberculosis 2017 (proof).pdf

non disponibili

Tipologia: Documento in Post-print
Licenza: NON PUBBLICO - Accesso privato/ristretto
Dimensione 854.15 kB
Formato Adobe PDF
854.15 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11586/180795
Citazioni
  • ???jsp.display-item.citation.pmc??? 43
  • Scopus 50
  • ???jsp.display-item.citation.isi??? 49
social impact