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2012年巴西里约热内卢市结核病治愈率与家庭健康单位的覆盖情况、设立时间以及社会经济和人口因素的比较。

Cure rates for tuberculosis in the municipality of Rio de Janeiro, Brazil, in 2012 compared with coverage by, and time of establishment of, Family Health units, and socio-economic and demographic factors.

作者信息

Prado Junior José Carlos, Virgilio Thiago Costa, Medronho Roberto de Andrade

机构信息

Secretaria Municipal de Saúde do Rio de Janeiro, Prefeitura da Cidade do Rio de Janeiro, Rio de Janeiro, RJ, Brasil,

Faculdade de Medicina, UFRJ, Rio de Janeiro, RJ, Brasil.

出版信息

Cien Saude Colet. 2016 May;21(5):1491-8. doi: 10.1590/1413-81232015215.03912016.

Abstract

Tuberculosis (TB) has high prevalence and is considered a world emergency by the World Health Organization (WHO), being the greatest cause of death from infectious diseases in adults. It is directly associated with access to health services and socio-economic factors. A reform of Primary Care in the municipality of Rio de Janeiro began in 2010, with coverage increasing from 7% in that year to 48.2% in 2014. This article compares the proportion of cures of TB, coverage by the Family Health Strategy (FHS), how long it has been in place, and socio-economic and demographic factors in the municipality of Rio, based on new cases notified in the year 2012. An association was found between cure of TB and the variable gender, being 40% greater in females - odds ratio 1.4 (CI95% 1.21-1.62); and with residence in favelas - OR 0.86 (CI95% 0.73-1.02), but there was no association with coverage of the FHS (OR 1.06; CI95% 0.92-1.22), nor with the time for which the teams had been in place. FHS coverage in the municipality of Rio was put in place as priority in areas of greater vulnerability; at the time of this study, more than 91% of the teams had been in place for less than five years before the date of diagnosis. These factors probably contributed to it not being possible to detect better results in the cure of tuberculosis in areas covered by the FHS in the year 2012.

摘要

结核病(TB)患病率很高,世界卫生组织(WHO)将其视为全球紧急情况,是成年人传染病死亡的主要原因。它与获得医疗服务的机会以及社会经济因素直接相关。里约热内卢市的初级保健改革始于2010年,覆盖率从当年的7%增至2014年的48.2%。本文基于2012年报告的新病例,比较了里约市结核病治愈比例、家庭健康战略(FHS)的覆盖率、实施时长以及社会经济和人口因素。研究发现结核病治愈情况与性别变量之间存在关联,女性治愈率高出40%——优势比为1.4(95%置信区间为1.21 - 1.62);与居住在贫民窟有关——优势比为0.86(95%置信区间为0.73 - 1.02),但与FHS的覆盖率无关(优势比为1.06;95%置信区间为0.92 - 1.22),也与团队成立时长无关。里约市的FHS覆盖率优先在更脆弱的地区实施;在本研究开展时,超过91%的团队在诊断日期前成立不到五年。这些因素可能导致在2012年FHS覆盖地区的结核病治愈方面未能发现更好的效果。

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