The Porto Alegre paradox: social determinants and tuberculosis incidence

Acosta, Lisiane Morelia Weide; Bassanesi, Sérgio Luiz

doi:10.1590/1809-4503201400060008

Cited by 25 publications

(27 citation statements)

References 7 publications

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“…A study examining European countries indicated a negative prospective association between logged gross domestic product and TB rates [11]. Contrarily, a different study reported that the city of Porto Alegre exhibited a higher pulmonary TB incidence despite its higher gross national product compared with neighboring cities with a lower level of income [12]. Likewise, in the present study, the city of Istanbul was established to be the province both with the highest level of income and the highest incidence of TB.…”

Section: Discussionsupporting

confidence: 49%

Effect of human development index parameters on tuberculosis incidence in Turkish provinces

Taylan

Demir

Yılmaz

et al. 2016

J Infect Dev Ctries

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Introduction: A country's development level is measured with a quantitative parameter called the human development index (HDI). The present study researched the effects of HDI parameters (such as healthcare standards, income, and education level) on the incidence of tuberculosis. Methodology: HDI data of 36 provinces of Turkey and the tuberculosis surveillance data were obtained from the Ministry of Development and the Ministry of Health, respectively. The associations between the incidence of tuberculosis and other HDI parameters were analyzed. Results: Higher population density (n/km 2 ) (CI = 0.05 to 0.40) and higher relapse rate of tuberculosis (CI = 0.36 to 1.48) were identified to be independent predicting factors that increased the incidence of tuberculosis, whereas higher gross national product (CI = -0.06 to 0.00), the population that holds a green Medicare card (CI=-0.58 to -0.04), increased general practitioners per 100,000 people (CI=-0.66 to -0.01), female population (CI = -0.70 to -0.06), married population (CI = -1.34 to -0.03), were found to be significant negative predicting factors that were relevant to the incidence (protective against tuberculosis). Conclusions: Tuberculosis is a disease that is affected by multiple factors, including the components of HDI. Improvement of income level, facilitation of access to health services via health insurance, urbanization with lower population density strategy, and provision of enough general practitioners may be useful in reducing the incidence of TB' in provinces of developing countries such as Turkey.

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Section: Discussionsupporting

confidence: 49%

Effect of human development index parameters on tuberculosis incidence in Turkish provinces

Taylan

Demir

Yılmaz

et al. 2016

J Infect Dev Ctries

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“…A number of spatial studies have associated higher incidence rates of TB with higher housing density, poorer living conditions and lower socioeconomic factors [6, 16–18]. In the present study we evaluated the density of cases from the kernel density map and hypothesized that density, income and percentage literacy of the population could partly explain the differences observed.…”

Section: Discussionmentioning

confidence: 90%

Spatial distribution of tuberculosis from 2002 to 2012 in a midsize city in Brazil

Silva¹,

Oliveira

Neto

et al. 2016

BMC Public Health

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BackgroundTuberculosis (TB) remains a major public health problem in many developing countries. Exploratory spatial analysis is a powerful instrument in spatial health research by virtue of its capacity to map disease distribution and associated risk factors at the population level. The aim of the present study was to describe the epidemiologic characteristics and spatial distribution of new cases of TB reported during the period 2002–2012 in Divinopolis, a midsized city located in the state of Minas Gerais, southeastern Brazil.MethodsSociodemographic and clinical data relating to the study cases were retrieved from the national Brazilian database and geocoded according to residential address. Choropleth and kernel density maps were constructed and a spatial-temporal analysis was performed. Tracts defined by the 2010 national census were classified as sectors with higher or lower densities of new TB cases based on the kernel density map. Multivariate logistic analysis was used to compare the two types of sectors according to income, level of literacy and population density.ResultsA total of 326 new cases of TB were reported during the study period. Residential addresses relating to 309 (94.8 %) of these were available in the SINAN database and the locations were geocoded and mapped. The average incidence of TB during the study period was 14.5/100,000 inhabitants. Pulmonary TB was the most predominant form (73.6 %) and 74.5 % of patients had been cured. The percentage of cases was highest in males (67.8 %) and individuals aged 25–44 years (41.1 %), and lowest in children aged less than 15 years (4.6 %). The disease was spatially distributed throughout the urban district. The incidence rate among urban census tracts ranged from 0.06 to 1.1 %, and the disease occurred predominantly in the downtown area (99.3 %). Higher population density was associated significantly with increased odds of living in a sector with a “higher density of cases”, even after adjusting for income and education (odds ratio = 13.7).ConclusionsThe highest density of cases was strongly associated with higher population density but not with lower income or level of literacy.

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“…Some determinants of this scenario is the permanence of structural problems, precarious life conditions and continuous harm to the environment. 7,8 Recent studies reinforce the assumption that there is a socioeconomic gradient associated with the occurrence and distribution of TB, considered as a public health issue 9,10 . An important indicator of inequity is the difficulty to access adequate and opportune treatment 11 .…”

Section: Introductionmentioning

confidence: 91%

Desigualdades socioespaciais relacionadas à tuberculose no município de Itaboraí, Rio de Janeiro

Filho

Ribeiro

et al. 2017

Rev. bras. epidemiol.

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RESUMO: Introdução: A tuberculose ainda é um problema de saúde pública mundial e sua ocorrência e distribuição estão associadas às desigualdades sociais. Itaboraí está entre os municípios brasileiros prioritários para o controle dessa doença. Os objetivos deste estudo foram combinar indicadores sociais em um indicador sintético para mensurar as diferenças nas condições de vida da população de Itaboraí, assim como evidenciar prováveis desigualdades em saúde relacionadas à tuberculose. Métodos: Estudo ecológico, com análise espacial da tuberculose e sua relação com a situação socioeconômica e demográfica das famílias residentes. Os dados foram obtidos de indivíduos residentes, declarados no Sistema de Informação sobre Mortalidade (SIM), notificados no Sistema de Informação de Agravos de Notificação (SINAN) ou registrados no Sistema de Informação de Tratamentos Especiais de Tuberculose (SITETB), entre 2007 a 2013. Resultados: Evidências indicam associação entre desigualdades sociodemográficas e ocorrência de tuberculose na população. Achados apontam menor percentual de cura e maior percentagem de abandono e óbito em áreas com maior vulnerabilidade social, com risco relativo mais de duas vezes superior ao encontrado nas áreas de menor vulnerabilidade. Conclusão: O estudo demonstrou fortes evidências de que a influência de condições sociodemográficas desiguais tem efeitos perniciosos nas condições de saúde da população em Itaboraí.

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The Porto Alegre paradox: social determinants and tuberculosis incidence

Cited by 25 publications

References 7 publications

Effect of human development index parameters on tuberculosis incidence in Turkish provinces

Effect of human development index parameters on tuberculosis incidence in Turkish provinces

Spatial distribution of tuberculosis from 2002 to 2012 in a midsize city in Brazil

Desigualdades socioespaciais relacionadas à tuberculose no município de Itaboraí, Rio de Janeiro

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