. Programa Acadêmico de Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil.
. Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro (RJ) Brasil.
J Bras Pneumol. 2020 Nov 18;46(5):e20200015. doi: 10.36416/1806-3756/e20200015. eCollection 2020.
The epidemiological relevance of tuberculosis is directly related to the socioeconomic profile of a given country. Vulnerability to tuberculosis is influenced by biological factors (e.g., malnutrition, HIV infection, and age) and social factors (e.g., unhealthy housing, high population density, inappropriate working conditions, and lack of access to health services). In many cases, multiple vulnerabilities occur in conjunction. We propose here a reflection on tuberculosis from the point of view of the social determinants of health, as well as the costs associated with its diagnosis and treatment in Brazil, based not only on data in the international literature but also on evidence related to the national context. Given the magnitude of tuberculosis as a socially mediated disease, there is an evident need for greater involvement of health professionals and of the scientific community to implement relevant operational and research measures to understand the social conditions influencing the health-illness continuum for tuberculosis patients. Although the recent economic crisis in Brazil has contributed to increased mortality from all causes, including tuberculosis, health and social protection expenditures have mitigated detrimental health effects. The evidence presented here underscores the importance of public social protection policies for minimizing the effects of tuberculosis indicators, with the aim of eliminating tuberculosis in Brazil.
结核病的流行病学相关性与特定国家的社会经济状况直接相关。结核病的易感性受到生物因素（如营养不良、HIV 感染和年龄）和社会因素（如不健康的住房、人口密度高、工作条件不当以及缺乏获得卫生服务的机会）的影响。在许多情况下，多种脆弱性同时发生。本文从健康的社会决定因素的角度出发，对结核病进行了反思，同时还考虑了巴西在诊断和治疗结核病方面的相关成本，不仅基于国际文献中的数据，还基于与国家背景相关的证据。鉴于结核病作为一种社会媒介疾病的重要性，显然需要更多卫生专业人员和科学界的参与，以实施相关的操作和研究措施，以了解影响结核病患者健康-疾病连续体的社会条件。尽管巴西最近的经济危机导致包括结核病在内的所有原因导致的死亡率上升，但卫生和社会保护支出减轻了对健康的不利影响。本文提供的证据强调了公共社会保护政策的重要性，以最大限度地减少结核病指标的影响，从而在巴西消除结核病。
