Tuberculosis (TB) is a preventable and a curable disease. In Brazil, TB treatment outcomes are particularly worse among homeless populations who are either of black race, malnourished or living with HIV/AIDS and other comorbidities. This study therefore evaluated factors associated with unsuccessful TB treatment among homeless population (HP) compared to those with shelter. The study population was composed of 284,874 people diagnosed with TB in Brazil between 2015 and 2020 and reported in the Information System for Notifiable Diseases (SINAN), among which 7,749 (2.72%) were homeless and 277,125 (97.28%) were sheltered. Cox regression analysis was performed with both populations to identify factors associated with unsuccessful TB treatment, and significant predictors of TB treatment outcomes. Results show that HP are more susceptible to unfavorable outcomes when compared to sheltered people (Hazard Ratio (HR): 2.04, 95% CI 1.82–2.28). Among the HP, illicit drug use (HR: 1.38, 95% CI 1.09–1.74), mental disorders (HR: 2.12, 95% CI 1.08–4.15) and not receiving directed observed treatment (DOT) (HR: 18.37, 95% CI 12.23–27.58) are significant predictors of poor treatment outcomes. The use of illicit drugs (HR: 1.53, 95% CI 1.21–1.93) and lack of DOT (HR: 17.97, 95% CI 11.71–27.59) are associated with loss to follow-up, while lack of DOT (HR: 15.66, 95% CI 4.79–51.15) was associated with mortality among TB patients. Homeless population living in Brazil are twice at risk of having an unsuccessful treatment, compared to those who are sheltered, with illicit drugs use, mental disorders and lack of DOT as risk factors for unsuccessful TB outcomes. Our findings reinforce the arguments for an intersectoral and integral approach to address these determinants of health among the vulnerable homeless populations. Tuberculosis is one of the world’s most deadly disease and is responsible for 4,000 deaths daily. People living in impoverished conditions, especially those who are homeless are among the worst affected. In Brazil, the population of homeless persons is rising. This population is affected by socioeconomic issues such as worst jobs, structural racism, lack of civil rights, limited access to health care service and stigmatization. Our study therefore investigated the reasons why tuberculosis treatments are unsuccessful among homeless people in Brazil in comparison to populations with shelter. We found out that homeless population living in Brazil are twice at risk of having an unsuccessful treatment, compared to those who are with shelter. In addition, we found that homeless population who use illicit drugs and had mental illness were the most affected. Also, the non-implementation of directly observed treatment is a major reason why most patients do not complete their treatment, and a major predictor of death among these homeless populations. Since tuberculosis is a preventable and curable disease and diagnosis and treatment are freely available in the Unified Health System (SUS, Sistema Único de Saúde) of Brazil, it therefore becomes important to understand and address these barriers that have limited the access of homeless populations to existing health services.

Background: Malnutrition is a public health problem that affects physical and psychosocial well-being. It manifests as a rapid deterioration in nutritional status and bilateral edema due to inadequate food intake or illness. Methods: This study is a retrospective cohort of 1208 children with severe acute malnutrition (SAM) in Sofala Province from 2018 to 2022. It includes hospitalized children aged 6–59 months with SAM and related complications. The dependent variable is recovery, and the independent variables include age, sex of the child, vomiting, dehydration, hypoglycemia, nutritional edema and anthropometry. Survival curves were plotted using the Kaplan–Meier method, and bivariable and multivariable Cox regression analyses were performed. Results: The crude analysis revealed significant factors for nutritional recovery in children with SAM, including age, weight, height, malaria, diarrhea and dehydration. Children under 24 months had a 28% lower likelihood of recovery. Weight below 6.16 kg decreased the likelihood by 2%, and height above 71.1 cm decreased it by 20%. Conversely, malaria, diarrhea and dehydration increased the likelihood of recovery. However, after adjustment, only diarrhea remained a significant predictor of nutritional recovery. Conclusion: This study found that diarrhea is a predictor of nutritional recovery in children with SAM.

A comida e os hábitos culturais provenientes do continente africano foram e continuam sendo importantes para a composição da cultura alimentar brasileira, oferecendo uma riqueza que vai desde alimentos in natura ou minimamente processados até comidas e preparações carregadas de história e significados, que garantem a qualidade nutricional, saúde e conexão com a terra. Este ensaio buscou demonstrar, através de uma metodologia qualitativa descritiva e da bibliografia de referência, como a valorização dos alimentos in natura ou minimamente processados, presentes em preparações de matriz africana e na cultura alimentar afrodiaspórica brasileira, pode fortalecer o elo entre as regiões, além de promover a Educação Alimentar e Nutricional. Tal valorização constitui uma forma de resistência ao avanço da produção e do consumo de alimentos ultraprocessados, os quais contribuem para o apagamento da soberania alimentar.