Brazil is among the 30 countries with the highest tuberculosis (TB) burden according to the WHO, and one of the challenges is treatment adherence. The COVID-19 pandemic negatively impacted disease control, especially regarding treatment adherence. This study aimed to describe the clinical and sociodemographic profile of individuals notified as re-entry after treatment abandonment for TB in the municipality of Curitiba, from 2015 to 2024. ecological, descriptive epidemiological study with secondary data from the Notifiable Diseases Information System (SINAN), obtained through DataSUS. To assess the proportion of re-entry after abandonment, patients notified as abandonment, primary abandonment, and re-entry after abandonment were included in Curitiba from 2015 to 2024. The re-entry profile was described according to: clinical form of TB (pulmonary, extrapulmonary or mixed), age, sex, education, skin color, vulnerability (alcoholism, use of psychoactive substances, homelessness), HIV infection, and smear microscopy. In the analyzed period, 4,671 confirmed TB cases were recorded in Curitiba, of which 386 (8.3%) were re-entries after abandonment. Among the notified cases, there were 545 (11.7%) treatment abandonments. It is observed that there was an increase in the number of abandonments and a reduction in re-entries in the pandemic years, with reversal in the post-pandemic period. Among re-entries, cases were concentrated in men (77%), aged 25 to 39 years (53.4%), with incomplete elementary education (55%), White (67%). Also, 57% were alcohol users, 57% illicit drug users, 41% were experiencing homelessness, and 34% were HIV seropositive. Initial smear microscopy was positive in 40.9% of cases, maintaining the transmission chain. At the end of treatment, among re-entries, only 26.4% achieved cure, while 37% had a new abandonment and 2.8% died due to TB. Curitiba showed, in the post-pandemic period, a reduction in TB treatment abandonment among new cases and growth of re-entries. The high percentage of new abandonment among those who re-entered stands out, indicating challenges of the health system in retaining these individuals. The findings reinforce the urgency to develop innovative and targeted strategies that consider the sociodemographic and comorbidity profile to improve treatment adherence among individuals who re-enter TB treatment.
Bremer et al. (Sun,) studied this question.