Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil

Pelissari, Daniele Maria; Bartholomay, Patrícia; Jacobs, Marina Gasino; Arakaki-Sanchéz, Denise; Anjos, Davllyn Santos Oliveira dos; Costa, Mara Lucia dos Santos; Cavalcanti, Pauline; Díaz-Quijano, Fredi Alexander

doi:10.11606/s1518-8787.2018052000131

Cited by 22 publications

(23 citation statements)

References 20 publications

(26 reference statements)

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“…Being close to the primary care unit, waiting time for consultation, bonding with the health team, provision of supplies and human resources, and the presence of a Family Health Strategy team are factors that are positively associated with the detection of TB cases. 36 In addition, a study 36 conducted in Brazil found an inverse association between BAC and the TB detection rate, corroborating the results of the present study, which may indicate the effect that primary care has on TB control through the identification and early-onset treatment.…”

Section: Discussionsupporting

confidence: 91%

Social determinants of deaths from pneumonia and tuberculosis in children in Brazil: an ecological study

et al. 2020

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ObjectiveTo identify the risk areas of deaths due to unspecified pneumonia and tuberculosis (TB) in children, and to identify if there is a relationship between these events with higher TB incidence and social determinants.MethodsEcological study carried out in Brazil. All cases of TB or unspecified pneumonia deaths in children under 5 years of age reported between 2006 and 2016 were included and collected through Department of Informatics of the Unified Health System (Brazil’s electronic database). The Spatial Scan Statistics was used to identify areas at higher risk of dying from this event. The spatial association was verified through the Getis-Ord techniques. The Bivariate Moran Global Index was used to verify the spatial autocorrelation between the two events. To identify the association of TB and pneumonia deaths with endemic areas of pulmonary TB and social determinants, four explanatory statistical models were identified.ResultsA total of 21 391 cases of pneumonia and 238 cases of TB were identified. Spatial scanning analysis enabled the detection of four clusters of risk for TB (relative risk, RR, between 3.30 and 18.18) and 22 clusters for pneumonia (RR between 1.38 and 5.24). The spatial association of the events was confirmed (z-score 3.74 and 64.34) and spatial autocorrelation between events (Moran Index:0.031 (p=0.001)). The zero-inflated negative binomial distribution was chosen, and an association for both events was identified with the TB incidence rate (OR 5.3, 95% CI 2.85 to 9.84; OR 6.63, 95% CI 5.62 to 7.81), with the Gini Index (OR 1.78, 95% CI 1.12 to 2.82; OR 4.22, 95% CI 3.63 to4.92). Primary care coverage showed an inverse association for both events (OR 0.10, 95% CI 0.67 to 0.17; OR 0.18, 95% CI 0.15 to 0.21) for pneumonia). Finally, a family that benefited from the Bolsa Família Programme had an inverse association for deaths from pneumonia (OR 0.81, 95% CI 0.52 to 1.25).ConclusionsThe results do not just contribute to reduce mortality in children, but mainly contribute to prevent premature deaths through identification of critical areas in Brazil, which is crucial to qualify health surveillance services.

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Section: Discussionsupporting

confidence: 91%

Social determinants of deaths from pneumonia and tuberculosis in children in Brazil: an ecological study

et al. 2020

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“…Pelissari et al identified that requesting sputum smear microscopy was positively associated with TB case detection in Brazilian municipalities with primary health care teams evaluated by the second cycle of the Program for Improving Primary Care Access and Quality (PMAQ-AB). 20 Moreover, a study conducted in Rio de Janeiro identified that death notification was higher among TB cases with bacteriological confirmation. 21 Both studies provide evidence that mean acceptability can be used as a proxy for TB case notification.…”

Section: Discussionmentioning

confidence: 99%

Identificação de microrregiões com subnotificação de casos de tuberculose no Brasil, 2012 a 2014*

Silva¹,

Duarte²,

Cruz³

et al. 2020

Epidemiologia e Serviços de Saúde

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Objective: to identify Brazilian micro-regions with under-reported tuberculosis cases, from 2012 to 2014. Methods: this was an ecological study using data from the Notifiable Health Conditions Information System (SINAN). The indirect estimator of the proportion of notified cases (EIPCN) was calculated as the mean between the proportion of cases that adhered to treatment and the proportion of those who underwent sputum smear microscopy. Negative Binomial Regression was used to investigate evidence of under-reporting in the micro-regions selected through EIPCN. Results: under-reporting was suspected in 89 (17.5%) micro-regions with EIPCN below 83%. The EIPCN rate ratio in the regression model was 0.996 (95%CI 0.988;1.003) considering all the data and equal to 0.987 (95%CI 0.974;0.999) excluding the 89 micro-regions with suspected under-reporting. Conclusion: evidence of tuberculosis case under-reporting was found in micro-regions where basic indicators of surveillance system quality had poor performance.

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“…We observed an inverse association between the TB incidence rate and the percentage of contact investigation in the HSS, which may represent the overall effect on transmission control, possibly through identification and timely treatment. 34 Finally, in the LSS, the association with the proportion of patients with no record of TB outcome may represent failures in surveillance in collecting these data for the qualification of the information system.…”

Section: Discussionmentioning

confidence: 99%

Identifying socioeconomic, epidemiological and operational scenarios for tuberculosis control in Brazil: an ecological study

et al. 2018

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ObjectivesTo identify scenarios based on socioeconomic, epidemiological and operational healthcare factors associated with tuberculosis incidence in Brazil.DesignEcological study.SettingsThe study was based on new patients with tuberculosis and epidemiological/operational variables of the disease from the Brazilian National Information System for Notifiable Diseases and the Mortality Information System. We also analysed socioeconomic and demographic variables.ParticipantsThe units of analysis were the Brazilian municipalities, which in 2015 numbered 5570 but 5 were excluded due to the absence of socioeconomic information.Primary outcomeTuberculosis incidence rate in 2015.Data analysisWe evaluated as independent variables the socioeconomic (2010), epidemiological and operational healthcare indicators of tuberculosis (2014 or 2015) using negative binomial regression. Municipalities were clustered by the k-means method considering the variables identified in multiple regression models.ResultsWe identified two clusters according to socioeconomic variables associated with the tuberculosis incidence rate (unemployment rate and household crowding): a higher socioeconomic scenario (n=3482 municipalities) with a mean tuberculosis incidence rate of 16.3/100 000 population and a lower socioeconomic scenario (2083 municipalities) with a mean tuberculosis incidence rate of 22.1/100 000 population. In a second stage of clusterisation, we defined four subgroups in each of the socioeconomic scenarios using epidemiological and operational variables such as tuberculosis mortality rate, AIDS case detection rate and proportion of vulnerable population among patients with tuberculosis. Some of the subscenarios identified were characterised by fragility in their information systems, while others were characterised by the concentration of tuberculosis cases in key populations.ConclusionClustering municipalities in scenarios allowed us to classify them according to the socioeconomic, epidemiological and operational variables associated with tuberculosis risk. This classification can support targeted evidence-based decisions such as monitoring data quality for improving the information system or establishing integrative social protective policies for key populations.

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Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil

Cited by 22 publications

References 20 publications

Social determinants of deaths from pneumonia and tuberculosis in children in Brazil: an ecological study

Social determinants of deaths from pneumonia and tuberculosis in children in Brazil: an ecological study

Identificação de microrregiões com subnotificação de casos de tuberculose no Brasil, 2012 a 2014*

Identifying socioeconomic, epidemiological and operational scenarios for tuberculosis control in Brazil: an ecological study

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