巴西有条件现金转移支付计划对结核病发病率的影响。
Effect of Brazil's conditional cash transfer programme on tuberculosis incidence.
作者信息
Nery J S, Rodrigues L C, Rasella D, Aquino R, Barreira D, Torrens A W, Boccia D, Penna G O, Penna M L F, Barreto M L, Pereira S M
机构信息
Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil.
Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
出版信息
Int J Tuberc Lung Dis. 2017 Jul 1;21(7):790-796. doi: 10.5588/ijtld.16.0599.
Abstract
OBJECTIVE
To evaluate the impact of the Brazilian cash transfer programme (Bolsa Família Programme, BFP) on tuberculosis (TB) incidence in Brazil from 2004 to 2012.
DESIGN
We studied tuberculosis surveillance data using a combination of an ecological multiple-group and time-trend design covering 2458 Brazilian municipalities. The main independent variable was BFP coverage and the outcome was the TB incidence rate. All study variables were obtained from national databases. We used fixed-effects negative binomial models for panel data adjusted for selected covariates and a variable representing time.
RESULTS
After controlling for covariates, TB incidence rates were significantly reduced in municipalities with high BFP coverage compared with those with low and intermediate coverage (in a model with a time variable incidence rate ratio = 0.96, 95%CI 0.93-0.99).
CONCLUSION
This was the first evidence of a statistically significant association between the increase in cash transfer programme coverage and a reduction in TB incidence rate. Our findings provide support for social protection interventions for tackling TB worldwide.
摘要
目的
评估巴西现金转移计划（家庭补助金计划，BFP）对2004年至2012年巴西结核病（TB）发病率的影响。
设计
我们采用生态多组和时间趋势设计相结合的方法，研究了覆盖巴西2458个市的结核病监测数据。主要自变量是BFP覆盖率，结果变量是结核病发病率。所有研究变量均来自国家数据库。我们使用固定效应负二项模型对面板数据进行分析，并对选定的协变量和一个代表时间的变量进行了调整。
结果
在控制协变量后，与低覆盖率和中等覆盖率的市相比，BFP高覆盖率市的结核病发病率显著降低（在一个包含时间变量的模型中，发病率比=0.96，95%可信区间0.93-0.99）。
结论
这是现金转移计划覆盖率增加与结核病发病率降低之间存在统计学显著关联的首个证据。我们的研究结果为全球应对结核病的社会保护干预措施提供了支持。
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