Reis-Santos Barbara, Locatelli Rodrigo, Oliosi Janaína, Sales Carolina M, do Prado Thiago Nascimento, Shete Priya B, Riley Lee W, Maciel Ethel L
Laboratory of Epidemiology of Federal University of Espírito Santo, Maruípe, Vitória, Espírito Santo, Brazil.
Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, San Francisco, California.
Am J Trop Med Hyg. 2022 Nov 14;107(6):1281-1287. doi: 10.4269/ajtmh.21-1074. Print 2022 Dec 14.
We assessed the effectiveness of food vouchers as a social protection strategy to enhance the adherence to tuberculosis treatment in health-care facilities in Brazil between 2014 and 2017. A cluster-randomized controlled trial was performed in four Brazilian capital cities. A total of 774 adults with newly diagnosed pulmonary tuberculosis were included in this study. Eligible participants initiated standard tuberculosis treatment per National Tuberculosis Program guidelines. Health clinics were assigned randomly to intervention groups (food voucher or standard treatment). The food voucher was provided by researchers, which could be used by subjects only for buying food. Most people with tuberculosis were poor, did receive benefits of the Bolsa Familia Program, and were unemployed. By Poisson regression analysis, with the total number of subjects included in the study, we found that individuals with tuberculosis who received food vouchers had a 1.13 greater risk of cure (95% CI, 1.03-1.21) compared with those who did not receive food vouchers. The provision of food vouchers improved outcomes of tuberculosis treatment and it should be enhanced even further as social protection for people with tuberculosis.
我们评估了食品券作为一种社会保护策略，在2014年至2017年期间对巴西医疗机构中提高结核病治疗依从性的有效性。在巴西四个首都城市进行了一项整群随机对照试验。本研究共纳入774例新诊断的成年肺结核患者。符合条件的参与者按照国家结核病项目指南开始标准的结核病治疗。健康诊所被随机分配到干预组（食品券组或标准治疗组）。食品券由研究人员提供，受试者只能用其购买食品。大多数结核病患者贫困，确实领取了家庭补助金计划的福利，且处于失业状态。通过泊松回归分析，以纳入研究的受试者总数计算，我们发现与未领取食品券的结核病患者相比，领取食品券的结核病患者治愈风险高1.13倍（95%CI，1.03 - 1.21）。提供食品券改善了结核病治疗结果，作为对结核病患者的社会保护，应进一步加强这一措施。
