Fernando Andrés Hilal1, María Belén Herrero2,3, Elvira Maria Godinho de Seixas Maciel1, Jose Ueleres Braga1,4. 1. Departamento de Epidemiologia e Métodos Quantitativos em Saúde,Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brazil. 2. Departamento de Relaciones Internacionales, Facultad Latinoamericana de Ciencias Sociales - Buenos Aires, Argentina. 3. Consejo Nacional de Investigaciones Científicas y Técnicas - Buenos Aires, Argentina. 4. Departamento de Epidemiologia,Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil.
Abstract
BACKGROUND: In Argentina, approximately 9,000 new cases of tuberculosis (TB) are recorded every year, representing an incidence rate of 22 cases per 100,000 inhabitants. There are no reported studies in Argentina examining the factors that influence the unequal distribution of the disease. The aim of the study was to identify the relationship between the distribution of social and economic factors and TB in Argentina between 2008 and 2012. METHOD: An ecologic study involving 525 departmental jurisdictions was conducted. Simple linear regression analysis was performed, followed by multiple linear regression for each group of determinants. A final model of determinants of TB's incidence was constructed from a model of multiple linear regression. RESULTS: The following determinants explain 43% of the variability of TB's incidence rate among different jurisdictions: overcrowding, proportion of households with a sewage network, proportion of examined patients with respiratory symptoms and proportion of patients who discontinued treatment. DISCUSSION: This study makes an important contribution to a better understanding of the factors influencing the TB occurrence in Argentina, which is the result of a multidimensional and complex process. Thesefactors make part of this disease's social determination. CONCLUSION: TB incidence is associated with different determinants, from multiple levels. Inequalities in its distribution in Argentina are driven by the unequal distribution of key social determinants.
BACKGROUND: In Argentina, approximately 9,000 new cases of tuberculosis (TB) are recorded every year, representing an incidence rate of 22 cases per 100,000 inhabitants. There are no reported studies in Argentina examining the factors that influence the unequal distribution of the disease. The aim of the study was to identify the relationship between the distribution of social and economic factors and TB in Argentina between 2008 and 2012. METHOD: An ecologic study involving 525 departmental jurisdictions was conducted. Simple linear regression analysis was performed, followed by multiple linear regression for each group of determinants. A final model of determinants of TB's incidence was constructed from a model of multiple linear regression. RESULTS: The following determinants explain 43% of the variability of TB's incidence rate among different jurisdictions: overcrowding, proportion of households with a sewage network, proportion of examined patients with respiratory symptoms and proportion of patients who discontinued treatment. DISCUSSION: This study makes an important contribution to a better understanding of the factors influencing the TB occurrence in Argentina, which is the result of a multidimensional and complex process. Thesefactors make part of this disease's social determination. CONCLUSION: TB incidence is associated with different determinants, from multiple levels. Inequalities in its distribution in Argentina are driven by the unequal distribution of key social determinants.
Authors: Oscar Bernal; Rafael López; Ernesto Montoro; Pedro Avedillo; Keisha Westby; Massimo Ghidinelli Journal: Rev Panam Salud Publica Date: 2020-12-18