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Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates.
Reis-Santos, Barbara; Shete, Priya; Bertolde, Adelmo; Sales, Carolina M; Sanchez, Mauro N; Arakaki-Sanchez, Denise; Andrade, Kleydson B; Gomes, M Gabriela M; Boccia, Delia; Lienhardt, Christian; Maciel, Ethel L.
Afiliação
  • Reis-Santos B; Laboratory of Epidemiology of Federal University of Espírito Santo, Vitória/ES, Brazil.
  • Shete P; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, CA, United States of America.
  • Bertolde A; Departamento de Estatística, Universidade Federal do Espírito Santo, Vitória/ES, Brazil.
  • Sales CM; Laboratory of Epidemiology of Federal University of Espírito Santo, Vitória/ES, Brazil.
  • Sanchez MN; Departamento de Saúde Coletiva, Universidade de Brasília: Asa Norte, Brasília/DF, Brazil.
  • Arakaki-Sanchez D; Programa Nacional de Controle da Tuberculose-Ministério da Saúde, Brasília/DF, Brazil.
  • Andrade KB; Programa Nacional de Controle da Tuberculose-Ministério da Saúde, Brasília/DF, Brazil.
  • Gomes MGM; Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
  • Boccia D; CIBIO-InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Vairão, Portugal.
  • Lienhardt C; London School of Hygiene and Tropical Medicine: Keppel St., Bloomsbury, London, United Kingdom.
  • Maciel EL; Global TB Programme, World Health Organisation, Geneva, Switzerland.
PLoS One ; 14(2): e0212617, 2019.
Article em En | MEDLINE | ID: mdl-30794615
INTRODUCTION: Tuberculosis incidence is disproportionately high among people in poverty. Cash transfer programs have become an important strategy in Brazil fight inequalities as part of comprehensive poverty alleviation policies. This study was aimed at assessing the effect of being a beneficiary of a governmental cash transfer program on tuberculosis (TB) treatment cure rates. METHODS: We conducted a longitudinal database study including people ≥18 years old with confirmed incident TB in Brazil in 2015. We treated missing data with multiple imputation. Poisson regression models with robust variance were carried out to assess the effect of TB determinants on cure rates. The average effect of being beneficiary of cash transfer was estimated by propensity-score matching. RESULTS: In 2015, 25,084 women and men diagnosed as new tuberculosis case, of whom 1,714 (6.8%) were beneficiaries of a national cash transfer. Among the total population with pulmonary tuberculosis several determinants were associated with cure rates. However, among the cash transfer group, this association was vanished in males, blacks, region of residence, and people not deprived of their freedom and who smoke tobacco. The average treatment effect of cash transfers on TB cure rates, based on propensity score matching, found that being beneficiary of cash transfer improved TB cure rates by 8% [Coefficient 0.08 (95% confidence interval 0.06-0.11) in subjects with pulmonary TB]. CONCLUSION: Our study suggests that, in Brazil, the effect of cash transfer on the outcome of TB treatment may be achieved by the indirect effect of other determinants. Also, these results suggest the direct effect of being beneficiary of cash transfer on improving TB cure rates.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pobreza / Tuberculose Pulmonar / Bases de Dados Factuais / Programas Governamentais Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pobreza / Tuberculose Pulmonar / Bases de Dados Factuais / Programas Governamentais Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos