Castro Daniel Barros de, Pinto Rosemary Costa, Albuquerque Bernardino Cláudio de, Sadahiro Megumi, Braga José Ueleres
Health Surveillance Foundation of Amazonas State, Manaus, Brazil.
Sergio Arouca National School of Public Health, FIOCRUZ, Rio de Janeiro, Brazil.
PLoS One. 2016 Jun 30;11(6):e0158574. doi: 10.1371/journal.pone.0158574. eCollection 2016.
Despite the availability of tuberculosis prevention and control services throughout Amazonas, high rates of morbidity and mortality from tuberculosis remain in the region. Knowledge of the social determinants of tuberculosis in Amazonas is important for the establishment of public policies and the planning of effective preventive and control measures for the disease. To analyze the relationship of the spatial distribution of the incidence of tuberculosis in municipalities and regions of Amazonas to the socioeconomic factors and indigenous tuberculosis component, from 2007 to 2013. An ecological study was conducted based on secondary data from the epidemiological surveillance of tuberculosis. A linear regression model was used to analyze the relationship of the annual incidence of tuberculosis to the socioeconomic factors, performance indicators of health services, and indigenous tuberculosis component. The distribution of the incidence of tuberculosis in the municipalities of Amazonas was positively associated with the Gini index and the population attributable fraction of tuberculosis in the indigenous peoples, but negatively associated with the proportion of the poor and the unemployment rate. The spatial distribution of tuberculosis in the different regions of Amazonas was heterogeneous and closely related with the socioeconomic factors and indigenous component of tuberculosis.
尽管亚马孙州各地都有结核病预防和控制服务，但该地区结核病的发病率和死亡率仍然很高。了解亚马孙州结核病的社会决定因素对于制定公共政策以及规划针对该疾病的有效预防和控制措施至关重要。为了分析2007年至2013年亚马孙州各市和各地区结核病发病率的空间分布与社会经济因素及土著结核病构成部分之间的关系。基于结核病流行病学监测的二手数据进行了一项生态研究。使用线性回归模型分析结核病年发病率与社会经济因素、卫生服务绩效指标以及土著结核病构成部分之间的关系。亚马孙州各市结核病发病率的分布与基尼指数以及土著居民中结核病的人群归因分数呈正相关，但与贫困人口比例和失业率呈负相关。亚马孙州不同地区结核病的空间分布是异质的，并且与结核病的社会经济因素和土著构成部分密切相关。
