Factors associated with non-completion of TB preventive treatment in Brazil

BACKGROUND: Among Brazilian initiatives to scale up TB preventive therapy (TPT) are the adoption of the 3HP regimen (12 weekly doses of rifapentine and isoniazid [INH]) in 2021 and the implementation in 2018 of the TPT surveillance information system. Since then, 63% of the 76,000 eligible individuals notified completed TPT. Recommended regimens in this period were 6H, 9H (6 or 9 months of INH) and 4R (4 months of rifampicin). OBJECTIVE: To analyse the factors associated with TPT non-completion. METHODS: We analysed the cohort of TPT notifications from 2018 to 2020. Robust variance Poisson regression model was used to verify the association of TPT non-completion with sociodemographic, clinical and epidemiological variables. RESULTS: Of the 39,973 TPT notified in the study period, 8,534 (21.5%) were non-completed, of which 7,858 (92.1%) were lost to follow-up. Age 15–60 years (relative risk [RR] 1.27, 95% confidence interval [95% CI] 1.20–1.35), TPT with isoniazid (RR 1.40, 95% CI 1.19–1.64) and Black/mixed race (RR 1.17, 95% CI 1.09–1.25) were associated with a higher risk of non-completion. CONCLUSION: Individuals in situations of social and financial vulnerability such as being Black/ pardo race, younger and on longer TPT regimens were more likely to be associated with TPT incompletion.