Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2017-10-01
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| Series: | Infectious Diseases of Poverty |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40249-017-0348-5 |
| _version_ | 1811220233428402176 |
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| author | Mellina YAMAMURA Marcelino SANTOS NETO Francisco CHIARAVALLOTI NETO Luiz Henrique ARROYO Antônio Carlos Vieira RAMOS Ana Angélica Rêgo de QUEIROZ Aylana de Souza BELCHIOR Danielle Talita dos SANTOS Juliane de Almeida CRISPIM Ione Carvalho PINTO Severina Alice da Costa UCHÔA Regina Célia FIORATI Ricardo Alexandre ARCÊNCIO |
| author_facet | Mellina YAMAMURA Marcelino SANTOS NETO Francisco CHIARAVALLOTI NETO Luiz Henrique ARROYO Antônio Carlos Vieira RAMOS Ana Angélica Rêgo de QUEIROZ Aylana de Souza BELCHIOR Danielle Talita dos SANTOS Juliane de Almeida CRISPIM Ione Carvalho PINTO Severina Alice da Costa UCHÔA Regina Célia FIORATI Ricardo Alexandre ARCÊNCIO |
| author_sort | Mellina YAMAMURA |
| collection | DOAJ |
| description | Abstract 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 R2 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. |
| first_indexed | 2024-04-12T07:38:19Z |
| format | Article |
| id | doaj.art-bdc2683c6b60415caba976ee4f5fca06 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-04-12T07:38:19Z |
| publishDate | 2017-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-bdc2683c6b60415caba976ee4f5fca062022-12-22T03:41:53ZengBMCInfectious Diseases of Poverty2049-99572017-10-016111110.1186/s40249-017-0348-5Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast BrazilMellina YAMAMURA0Marcelino SANTOS NETO1Francisco CHIARAVALLOTI NETO2Luiz Henrique ARROYO3Antônio Carlos Vieira RAMOS4Ana Angélica Rêgo de QUEIROZ5Aylana de Souza BELCHIOR6Danielle Talita dos SANTOS7Juliane de Almeida CRISPIM8Ione Carvalho PINTO9Severina Alice da Costa UCHÔA10Regina Célia FIORATI11Ricardo Alexandre ARCÊNCIO12School of Nursing of the University of São Paulo, Ribeirão Preto Campus (EERP/USP)Federal University of Maranhão (UFMA)School of Public Health of the University of São Paulo (FSP/USP)School of Nursing of the University of São Paulo, Ribeirão Preto Campus (EERP/USP)School of Nursing of the University of São Paulo, Ribeirão Preto Campus (EERP/USP)School of Nursing of the University of São Paulo, Ribeirão Preto Campus (EERP/USP)School of Nursing of the University of São Paulo, Ribeirão Preto Campus (EERP/USP)School of Nursing of the University of São Paulo, Ribeirão Preto Campus (EERP/USP)School of Nursing of the University of São Paulo, Ribeirão Preto Campus (EERP/USP)School of Nursing of the University of São Paulo, Ribeirão Preto Campus (EERP/USP)Federal University of Rio Grande do Norte (UFRN)School of Medicine of the University of São Paulo, Ribeirão Preto Campus (FMRP/USP)School of Nursing of the University of São Paulo, Ribeirão Preto Campus (EERP/USP)Abstract 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 R2 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.http://link.springer.com/article/10.1186/s40249-017-0348-5TuberculosisSpatial analysisMortalityCause of death |
| spellingShingle | Mellina YAMAMURA Marcelino SANTOS NETO Francisco CHIARAVALLOTI NETO Luiz Henrique ARROYO Antônio Carlos Vieira RAMOS Ana Angélica Rêgo de QUEIROZ Aylana de Souza BELCHIOR Danielle Talita dos SANTOS Juliane de Almeida CRISPIM Ione Carvalho PINTO Severina Alice da Costa UCHÔA Regina Célia FIORATI Ricardo Alexandre ARCÊNCIO Areas with evidence of equity and their progress on mortality from tuberculosis in an endemic municipality of southeast Brazil Infectious Diseases of Poverty Tuberculosis Spatial analysis Mortality Cause of death |
| 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 | Tuberculosis Spatial analysis Mortality Cause of death |
| url | http://link.springer.com/article/10.1186/s40249-017-0348-5 |
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