Betina Durovni1,2, Valeria Saraceni1, Mariana Soares Puppin1,3, Wagner Tassinari4, Oswaldo G Cruz1,5, Solange Cavalcante1,6, Claudia Medina Coeli3, Anete Trajman7,8. 1. Secretaria Municipal de Saúde, Rio de Janeiro, Brazil. 2. Centro de Estudos Estratégicos, Fundação Oswaldo Cruz, CEE, Rio de Janeiro, Brazil. 3. Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. 4. Departamento de Matemática, Universidade Federal Rural do Rio de Janeiro, Rio de Janeiro, Brazil. 5. Programa de Computação Científica (PROCC) Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. 6. Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. 7. Global Health Department, McGill University, Montreal, Quebec, Canada. 8. Rua São Francisco Xavier 524, Maracanã, Bloco E, 7º andar, UERJ, Rio de Janeiro, RJ, Brazil.
Abstract
Background: Unsuccessful tuberculosis outcomes are frequent; bold policies are needed to end the tuberculosis (TB) epidemic to attain the third Sustainable Development Goal (SDG) by 2030. We examined the effect of the Family Health Strategy (FHS) and its interactions with the conditional cash transfer programme (CTP) on TB outcomes in Rio de Janeiro, Brazil. Methods: We performed individual-based analyses of a database resulting from deterministic and probabilistic linkages of the TB information system, FHS registries and CTP payrolls. Patients ≥15 years old treated with the standard RHZE regimen were included. The rates of successful outcomes were analysed according to coverage by FHS. Effects from the CTP and its interactions with the FHS were examined among the poorest. Results: FHS coverage increased the likelihood for successful outcomes by 14% (12-17%) among 13 482 new cases, and by 35% (25-47%) among 1880 retreatment cases. The CTP had an independent effect but no interaction with the FHS among the poorest. Conclusions: This is the first individual-based study to show a relevant protection of poor urban communities regarding patient-important health outcomes by the Brazilian FHS and CTP. These findings support strategies of universal health coverage, primary care strengthening and social protection to achieve a major SDG.
Background: Unsuccessful tuberculosis outcomes are frequent; bold policies are needed to end the tuberculosis (TB) epidemic to attain the third Sustainable Development Goal (SDG) by 2030. We examined the effect of the Family Health Strategy (FHS) and its interactions with the conditional cash transfer programme (CTP) on TB outcomes in Rio de Janeiro, Brazil. Methods: We performed individual-based analyses of a database resulting from deterministic and probabilistic linkages of the TB information system, FHS registries and CTP payrolls. Patients ≥15 years old treated with the standard RHZE regimen were included. The rates of successful outcomes were analysed according to coverage by FHS. Effects from the CTP and its interactions with the FHS were examined among the poorest. Results: FHS coverage increased the likelihood for successful outcomes by 14% (12-17%) among 13 482 new cases, and by 35% (25-47%) among 1880 retreatment cases. The CTP had an independent effect but no interaction with the FHS among the poorest. Conclusions: This is the first individual-based study to show a relevant protection of poor urban communities regarding patient-important health outcomes by the Brazilian FHS and CTP. These findings support strategies of universal health coverage, primary care strengthening and social protection to achieve a major SDG.
Authors: Daniel J Carter; Rhian Daniel; Ana W Torrens; Mauro N Sanchez; Ethel Leonor N Maciel; Patricia Bartholomay; Draurio C Barreira; Davide Rasella; Mauricio L Barreto; Laura C Rodrigues; Delia Boccia Journal: BMJ Glob Health Date: 2019-01-24
Authors: Jasper Nidoi; Winters Muttamba; Simon Walusimbi; Joseph F Imoko; Peter Lochoro; Jerry Ictho; Levicatus Mugenyi; Rogers Sekibira; Stavia Turyahabwe; Raymond Byaruhanga; Giovanni Putoto; Simone Villa; Mario C Raviglione; Bruce Kirenga Journal: BMC Public Health Date: 2021-11-26 Impact factor: 3.295
Authors: M L Barreto; M Y Ichihara; B A Almeida; M E Barreto; L Cabral; R L Fiaccone; R P Carreiro; Cas Teles; R Pitta; G O Penna; M Barral-Netto; M S Ali; G Barbosa; S Denaxas; L C Rodrigues; L Smeeth Journal: Int J Popul Data Sci Date: 2019-11-20