Sociodemographic and Digital Access Factors Associated with Tuberculosis Treatment Supervision Strategies in Brazilian Municipalities
1
Maternal-Infant and Public Health Nursing Department, University of São Paulo College of Nursing at Ribeirão Preto, São Paulo/Ribeirão Preto, Brazil
2
Federal University of Mato Grosso, Mato Grosso/Barra do Garça, Brazil
3
State University of Londrina, Paraná/Londrina, Brazil
4
Federal University of Tocantins, Tocantins/Palmas, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A618
ABSTRACT
BACKGROUND:
Tuberculosis (TB) remains a disease of high magnitude and social relevance, particularly affecting low- and middle-income countries. Despite global efforts toward ending TB, challenges related to treatment adherence persist. Video Directly Observed Treatment (VDOT) has emerged as an innovative telemonitoring strategy; however, its implementation may be influenced by social and digital inequalities. This study aimed to analyze sociodemographic and digital access factors associated with TB treatment supervision strategies in Brazilian municipalities.
METHODS:
A prospective cohort study was conducted between October 2024 and December 2025 across the five macro-regions of Brazil. Individuals aged ≥18 years, diagnosed with TB within 30 days of treatment initiation, who consented to participate and completed questionnaires were included. Participants receiving conventional TB treatment (Self-Administered Treatment/Directly Observed Treatment – SAT/DOT) were compared with those receiving Video Directly Observed Treatment (VDOT). Pearson’s chi-square test, Student’s t test, and multivariable logistic regression were performed using JASP software (version 0.15.0.0).
RESULTS:
A total of 209 participants were included, of whom 128 (61.2%) were followed under SAT/DOT and 81 (38.8%) under VDOT. No differences were observed between groups regarding sex (p=0.898). Ownership of a mobile phone and internet access were not significantly different between groups (p=0.174). Significant associations were identified between the supervision strategy and race/skin color (p=0.037), educational level (p=0.031), family income (p=0.007), and age (p=0.011). In the multivariable analysis, age and family income remained significantly associated with the supervision strategy.
CONCLUSIONS:
VDOT supervision was associated with sociodemographic characteristics, highlighting social inequalities relevant to the organization of TB care. Although access to mobile phones and the internet did not differ significantly between groups, SAT/DOT concentrated individuals in more vulnerable conditions. These findings underscore the importance of Primary Health Care–oriented implementation of VDOT to promote equity in tuberculosis care.
Tuberculosis (TB) remains a disease of high magnitude and social relevance, particularly affecting low- and middle-income countries. Despite global efforts toward ending TB, challenges related to treatment adherence persist. Video Directly Observed Treatment (VDOT) has emerged as an innovative telemonitoring strategy; however, its implementation may be influenced by social and digital inequalities. This study aimed to analyze sociodemographic and digital access factors associated with TB treatment supervision strategies in Brazilian municipalities.
METHODS:
A prospective cohort study was conducted between October 2024 and December 2025 across the five macro-regions of Brazil. Individuals aged ≥18 years, diagnosed with TB within 30 days of treatment initiation, who consented to participate and completed questionnaires were included. Participants receiving conventional TB treatment (Self-Administered Treatment/Directly Observed Treatment – SAT/DOT) were compared with those receiving Video Directly Observed Treatment (VDOT). Pearson’s chi-square test, Student’s t test, and multivariable logistic regression were performed using JASP software (version 0.15.0.0).
RESULTS:
A total of 209 participants were included, of whom 128 (61.2%) were followed under SAT/DOT and 81 (38.8%) under VDOT. No differences were observed between groups regarding sex (p=0.898). Ownership of a mobile phone and internet access were not significantly different between groups (p=0.174). Significant associations were identified between the supervision strategy and race/skin color (p=0.037), educational level (p=0.031), family income (p=0.007), and age (p=0.011). In the multivariable analysis, age and family income remained significantly associated with the supervision strategy.
CONCLUSIONS:
VDOT supervision was associated with sociodemographic characteristics, highlighting social inequalities relevant to the organization of TB care. Although access to mobile phones and the internet did not differ significantly between groups, SAT/DOT concentrated individuals in more vulnerable conditions. These findings underscore the importance of Primary Health Care–oriented implementation of VDOT to promote equity in tuberculosis care.
| eISSN: | 2654-1459 |
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