Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates.
<h4>Introduction</h4>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 bei...
Main Authors: | , , , , , , , , , , |
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Format: | Article |
Language: | English |
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Public Library of Science (PLoS)
2019-01-01
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Series: | PLoS ONE |
Online Access: | https://doi.org/10.1371/journal.pone.0212617 |
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author | Barbara Reis-Santos Priya Shete Adelmo Bertolde Carolina M Sales Mauro N Sanchez Denise Arakaki-Sanchez Kleydson B Andrade M Gabriela M Gomes Delia Boccia Christian Lienhardt Ethel L Maciel |
author_facet | Barbara Reis-Santos Priya Shete Adelmo Bertolde Carolina M Sales Mauro N Sanchez Denise Arakaki-Sanchez Kleydson B Andrade M Gabriela M Gomes Delia Boccia Christian Lienhardt Ethel L Maciel |
author_sort | Barbara Reis-Santos |
collection | DOAJ |
description | <h4>Introduction</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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].<h4>Conclusion</h4>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. |
first_indexed | 2024-04-11T19:34:44Z |
format | Article |
id | doaj.art-077254c1c9834990b7026ab6b2deee6c |
institution | Directory Open Access Journal |
issn | 1932-6203 |
language | English |
last_indexed | 2024-04-11T19:34:44Z |
publishDate | 2019-01-01 |
publisher | Public Library of Science (PLoS) |
record_format | Article |
series | PLoS ONE |
spelling | doaj.art-077254c1c9834990b7026ab6b2deee6c2022-12-22T04:06:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01142e021261710.1371/journal.pone.0212617Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates.Barbara Reis-SantosPriya SheteAdelmo BertoldeCarolina M SalesMauro N SanchezDenise Arakaki-SanchezKleydson B AndradeM Gabriela M GomesDelia BocciaChristian LienhardtEthel L Maciel<h4>Introduction</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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].<h4>Conclusion</h4>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.https://doi.org/10.1371/journal.pone.0212617 |
spellingShingle | Barbara Reis-Santos Priya Shete Adelmo Bertolde Carolina M Sales Mauro N Sanchez Denise Arakaki-Sanchez Kleydson B Andrade M Gabriela M Gomes Delia Boccia Christian Lienhardt Ethel L Maciel Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates. PLoS ONE |
title | Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates. |
title_full | Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates. |
title_fullStr | Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates. |
title_full_unstemmed | Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates. |
title_short | Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates. |
title_sort | tuberculosis in brazil and cash transfer programs a longitudinal database study of the effect of cash transfer on cure rates |
url | https://doi.org/10.1371/journal.pone.0212617 |
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