Risk Factors Associated With Interruption of Tuberculosis Treatment in the State of Paraná

Interruption of tuberculosis (TB) treatment remains one of the greatest challenges for TB control in Brazil. This study aims to describe the epidemiological profile of treatment interruption cases and associated conditions. Descriptive study based on TB notifications in the National Notifiable Diseases Information System, in the state of Paraná, between 2022 and 2024. Samples were analyzed using simple frequency and cross-tabulation (Pearson’s chi-square). The following variables were analyzed: age group, sex, area of residence, municipality size, education level, clinical form of the disease, type of entry, and comorbidities. CAAE 38855820.6.0000.5231. A total of 10,804 TB cases were reported, of which 731 were treatment interruptions. Regarding temporal distribution, 41.9% occurred in 2022, 25.4% in 2023, and 32.7% in 2024. Most cases were adults aged 19 to 59 years, with a mean age of 36.06 years (92.9%). There was a predominance of males (78.5%). Regarding residence, 92.9% lived in urban areas, and 78.5% in large municipalities. The East (46.6%) and North (26.9%) macro-regions concentrated most cases, especially the Curitiba (33.9%) and Londrina (21.5%) regional health areas. Pulmonary TB was the most common form (87.6%), followed by extrapulmonary (9.4%). Among associated conditions, the most frequent were alcoholism (37.6%), smoking (49.7%), illicit drug use (46.4%), AIDS (15.9%), mental disorders (4.1%), and diabetes mellitus (3.4%). Other conditions with lower frequency included syphilis, epilepsy, systemic arterial hypertension, chronic obstructive pulmonary disease, and neoplasms. In the analysis, mental disorders and illicit drug use showed a significant association with interruption of directly observed TB treatment, according to the chi-square test (p=0.025 and p=0.036, respectively). The most frequent type of entry was new cases (57.5%), followed by re-entry after treatment interruption (24.1%). The association of mental disorders and illicit drug use with treatment interruption is highlighted. It reinforces the need to strengthen Directly Observed Treatment, expand active tracing of missed appointments, and implement strategies focused on mental health and harm reduction to improve TB control.