Your browser doesn't support javascript.
loading
Effectiveness of a multicomponent intervention to face the COVID-19 pandemic in Rio de Janeiro's favelas: difference-in-differences analysis.
Batista-da-Silva, Amanda de Araujo; Moraes, Camila Barros; Bozza, Helena Rodrigues; Bastos, Leonardo Dos Santos Lourenço; Ranzani, Otavio T; Hamacher, Silvio; Bozza, Fernando Augusto.
Afiliação
  • Batista-da-Silva AA; Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Moraes CB; Tecgraf Institute, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Bozza HR; Associação Redes de Desenvolvimento da Maré, Rio de Janeiro, Brazil.
  • Bastos LDSL; Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
  • Ranzani OT; Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Hamacher S; Tecgraf Institute, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Bozza FA; Barcelona Institute for Global Health, Barcelona, Spain.
BMJ Glob Health ; 8(5)2023 05.
Article em En | MEDLINE | ID: mdl-37253531
INTRODUCTION: Few community-based interventions addressing the transmission control and clinical management of COVID-19 cases have been reported, especially in poor urban communities from low-income and middle-income countries. Here, we analyse the impact of a multicomponent intervention that combines community engagement, mobile surveillance, massive testing and telehealth on COVID-19 cases detection and mortality rates in a large vulnerable community (Complexo da Maré) in Rio de Janeiro, Brazil. METHODS: We performed a difference-in-differences (DID) analysis to estimate the impact of the multicomponent intervention in Maré, before (March-August 2020) and after the intervention (September 2020 to April 2021), compared with equivalent local vulnerable communities. We applied a negative binomial regression model to estimate the intervention effect in weekly cases and mortality rates in Maré. RESULTS: Before the intervention, Maré presented lower rates of reported COVID-19 cases compared with the control group (1373 vs 1579 cases/100 000 population), comparable mortality rates (309 vs 287 deaths/100 000 population) and higher case fatality rates (13.7% vs 12.2%). After the intervention, Maré displayed a 154% (95% CI 138.6% to 170.4%) relative increase in reported case rates. Relative changes in reported death rates were -60% (95% CI -69.0% to -47.9%) in Maré and -28% (95% CI -42.0% to -9.8%) in the control group. The case fatality rate was reduced by 77% (95% CI -93.1% to -21.1%) in Maré and 52% (95% CI -81.8% to -29.4%) in the control group. The DID showed a reduction of 46% (95% CI 17% to 65%) of weekly reported deaths and an increased 23% (95% CI 5% to 44%) of reported cases in Maré after intervention onset. CONCLUSION: An integrated intervention combining communication, surveillance and telehealth, with a strong community engagement component, could reduce COVID-19 mortality and increase case detection in a large vulnerable community in Rio de Janeiro. These findings show that investment in community-based interventions may reduce mortality and improve pandemic control in poor communities from low-income and middle-income countries.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: COVID-19 Tipo de estudo: Diagnostic_studies / Prognostic_studies Aspecto: Determinantes_sociais_saude Limite: Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: BMJ Glob Health Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: COVID-19 Tipo de estudo: Diagnostic_studies / Prognostic_studies Aspecto: Determinantes_sociais_saude Limite: Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: BMJ Glob Health Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido