Social inequalities associated with the onset of tuberculosis in disease-prone territories in a city from northeastern Brazil

  • Hamilton Leandro Pinto de Andrade University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
  • Luiz Henrique Arroyo University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
  • Melina Yamamura University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
  • Antônio Carlos Vieira Ramos University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
  • Juliane de Almeida Crispim University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
  • Thaís Zamboni Berra University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
  • Marcelino Santos Neto Federal University of Maranhão, Imperatriz, Maranhão, Brazil
  • Ione Carvalho Pinto University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
  • Pedro Fredemir Palha University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
  • Aline Aparecida Monroe University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
  • Kamila Anise Alexander Johns Hopkins School of Nursing, Baltimore, Maryland, United States
  • Ricardo Alexandre Arcêncio University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
Keywords: Tuberculosis, Public health, Social Determinants of Health, social inequality

Abstract

Introduction: Tuberculosis remains a major health problem worldwide, killing thousand adults and children every year mainly in developing countries as Brazil. The disease is socially determined, caused mainly by inequalities as overcrowding, bad conditions of housing, unemployment, and limited access to health care. The aim of this study was to identify the social inequalities associated with the onset of tuberculosis in disease-prone territories in a city from the Northeast.

Methodology: This was an ecological study, which has gathered patients diagnosed with tuberculosis through secondary data source in a city from the northeast of Brazil. The GAMLSS statistical model has been applied considering as response variable the count of Tuberculosis cases and the independent variable, the social conditions. The double Poisson distribution was considered in the analysis. The best model fitted was selected according the Akaike information criterion value. For all tests, the p value < 0.05 was considered as statistically significant.

Results: 460 patients with diagnosis of tuberculosis were identified, which represents an incidence of 36.3 cases/100,000 in males and 20.7 cases/100,000 in females. Regarding social inequality associated with tuberculosis, income (households with per capita income between 1/8 and 3 minimum wages), gender and age (Proportion of males under 15 years of age) were associated with the disease. 

Conclusions: The findings evidenced the social determinants associated with tuberculosis, with a greater occurrence of the disease in areas with mostly male children and low-income families, these issues must be managed within and beyond the health sector, which is mandatory for the Tuberculosis elimination.

Published
2021-10-31
How to Cite
1.
de Andrade HLP, Arroyo LH, Yamamura M, Ramos ACV, Crispim J de A, Berra TZ, Neto MS, Pinto IC, Palha PF, Monroe AA, Alexander KA, Arcêncio RA (2021) Social inequalities associated with the onset of tuberculosis in disease-prone territories in a city from northeastern Brazil. J Infect Dev Ctries 15:1443-1452. doi: 10.3855/jidc.13143
Section
Original Articles