Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil
BACKGROUND: In Brazil, people still fall ill and die from tuberculosis (TB), and this can be explained by the significant impasse in the equity of distribution of therapeutic resources to the population as a whole. The aim was to identify geographical areas which have shown progress in terms of equi...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637336/ https://www.ncbi.nlm.nih.gov/pubmed/29020981 http://dx.doi.org/10.1186/s40249-017-0348-5 |
_version_ | 1783270605216284672 |
---|---|
author | YAMAMURA, Mellina SANTOS NETO, Marcelino CHIARAVALLOTI NETO, Francisco ARROYO, Luiz Henrique RAMOS, Antônio Carlos Vieira de QUEIROZ, Ana Angélica Rêgo BELCHIOR, Aylana de Souza dos SANTOS, Danielle Talita CRISPIM, Juliane de Almeida PINTO, Ione Carvalho UCHÔA, Severina Alice da Costa FIORATI, Regina Célia ARCÊNCIO, Ricardo Alexandre |
author_facet | YAMAMURA, Mellina SANTOS NETO, Marcelino CHIARAVALLOTI NETO, Francisco ARROYO, Luiz Henrique RAMOS, Antônio Carlos Vieira de QUEIROZ, Ana Angélica Rêgo BELCHIOR, Aylana de Souza dos SANTOS, Danielle Talita CRISPIM, Juliane de Almeida PINTO, Ione Carvalho UCHÔA, Severina Alice da Costa FIORATI, Regina Célia ARCÊNCIO, Ricardo Alexandre |
author_sort | YAMAMURA, Mellina |
collection | PubMed |
description | BACKGROUND: In Brazil, people still fall ill and die from tuberculosis (TB), and this can be explained by the significant impasse in the equity of distribution of therapeutic resources to the population as a whole. The aim was to identify geographical areas which have shown progress in terms of equity (of income, schooling and urban occupancy) and test its effect on mortality from TB in a municipality of southeast Brazil. METHODS: It is an ecological study considering TB as the basic cause for deaths registered between 2006 and 2013 on the Mortality Information System and other variables obtained through the Demographic Census of the Brazilian Institute of Geography and Statistics (2010). The geographical area for analysis comprised the areas of coverage of the health services. Social indicators have been constructed through the Principal Component Analysis (PCA). The cases were geocoded and the annual mortality rate from TB was calculated with smoothing using the local empirical Bayesian method. Multiple linear regression was then performed. There was confirmation of the existence of spatial dependence of residue through the application of the Global Moran I test, and application of the Models with Global Spatial Effects, to identify the best standard of spatial regression. RESULTS: The mortality rates ranged from 0.00 to 2.8 deaths per 100,000 people, per year. In the PCA, three indicators were constructed, and designated as indicators of income, social inequality, and social equity. In multiple linear regression, the indicator of social equity was statistically significant (P < 0.0001) but had a negative association, an adjusted R(2) of 28.36% and with spatial dependence (Moran I = 0.21, P = 0.003455). The best model to deal with existing spatial dependence was the Spatial Lag Model. CONCLUSIONS: The better social conditions have shown progress in reducing mortality from TB, thereby reinforcing the achievement of Sustainable Development Goals. In addition, cartography was also applied, which can be replicated in other scenarios throughout the world, using a scope distinct from that of works traditionally produced in that it places the emphasis on social equity. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40249-017-0348-5) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5637336 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-56373362017-10-18 Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil YAMAMURA, Mellina SANTOS NETO, Marcelino CHIARAVALLOTI NETO, Francisco ARROYO, Luiz Henrique RAMOS, Antônio Carlos Vieira de QUEIROZ, Ana Angélica Rêgo BELCHIOR, Aylana de Souza dos SANTOS, Danielle Talita CRISPIM, Juliane de Almeida PINTO, Ione Carvalho UCHÔA, Severina Alice da Costa FIORATI, Regina Célia ARCÊNCIO, Ricardo Alexandre Infect Dis Poverty Research Article BACKGROUND: In Brazil, people still fall ill and die from tuberculosis (TB), and this can be explained by the significant impasse in the equity of distribution of therapeutic resources to the population as a whole. The aim was to identify geographical areas which have shown progress in terms of equity (of income, schooling and urban occupancy) and test its effect on mortality from TB in a municipality of southeast Brazil. METHODS: It is an ecological study considering TB as the basic cause for deaths registered between 2006 and 2013 on the Mortality Information System and other variables obtained through the Demographic Census of the Brazilian Institute of Geography and Statistics (2010). The geographical area for analysis comprised the areas of coverage of the health services. Social indicators have been constructed through the Principal Component Analysis (PCA). The cases were geocoded and the annual mortality rate from TB was calculated with smoothing using the local empirical Bayesian method. Multiple linear regression was then performed. There was confirmation of the existence of spatial dependence of residue through the application of the Global Moran I test, and application of the Models with Global Spatial Effects, to identify the best standard of spatial regression. RESULTS: The mortality rates ranged from 0.00 to 2.8 deaths per 100,000 people, per year. In the PCA, three indicators were constructed, and designated as indicators of income, social inequality, and social equity. In multiple linear regression, the indicator of social equity was statistically significant (P < 0.0001) but had a negative association, an adjusted R(2) of 28.36% and with spatial dependence (Moran I = 0.21, P = 0.003455). The best model to deal with existing spatial dependence was the Spatial Lag Model. CONCLUSIONS: The better social conditions have shown progress in reducing mortality from TB, thereby reinforcing the achievement of Sustainable Development Goals. In addition, cartography was also applied, which can be replicated in other scenarios throughout the world, using a scope distinct from that of works traditionally produced in that it places the emphasis on social equity. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40249-017-0348-5) contains supplementary material, which is available to authorized users. BioMed Central 2017-10-12 /pmc/articles/PMC5637336/ /pubmed/29020981 http://dx.doi.org/10.1186/s40249-017-0348-5 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article YAMAMURA, Mellina SANTOS NETO, Marcelino CHIARAVALLOTI NETO, Francisco ARROYO, Luiz Henrique RAMOS, Antônio Carlos Vieira de QUEIROZ, Ana Angélica Rêgo BELCHIOR, Aylana de Souza dos SANTOS, Danielle Talita CRISPIM, Juliane de Almeida PINTO, Ione Carvalho UCHÔA, Severina Alice da Costa FIORATI, Regina Célia ARCÊNCIO, Ricardo Alexandre Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil |
title | Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil |
title_full | Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil |
title_fullStr | Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil |
title_full_unstemmed | Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil |
title_short | Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil |
title_sort | areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast brazil |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637336/ https://www.ncbi.nlm.nih.gov/pubmed/29020981 http://dx.doi.org/10.1186/s40249-017-0348-5 |
work_keys_str_mv | AT yamamuramellina areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT santosnetomarcelino areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT chiaravallotinetofrancisco areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT arroyoluizhenrique areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT ramosantoniocarlosvieira areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT dequeirozanaangelicarego areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT belchioraylanadesouza areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT dossantosdanielletalita areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT crispimjulianedealmeida areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT pintoionecarvalho areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT uchoaseverinaalicedacosta areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT fioratireginacelia areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil AT arcencioricardoalexandre areaswithevidenceofequityandtheirprogressonmortalityfromtuberculosisinanendemicmunicipalityofsoutheastbrazil |