Social determinants and inequalities in tuberculosis incidence in Latin America and the Caribbean / Determinantes sociales y desigualdades en la incidencia de tuberculosis en América Latina y el Caribe
Rev Panam Salud Publica
; 38(3),sept. 2015
Artigo
em Inglês
| PAHO-IRIS
| ID: phr-10071
Biblioteca responsável:
US1.1
ABSTRACT
Objective. To identify key social determinants of tuberculosis (TB) incidence among countries in Latin America and the Caribbean (LAC), a geographic area regarded as one of the most socioeconomically unequal in the world. Methods. An ecological study was conducted at the country level. Data were obtained from several institutional-based sources. Random-effects regression modeling was used to explore the relationship between several social determinants indicators and TB incidence rates in 20 LAC countries in 1995–2012. Standard gap and gradient metrics of social inequality in TB incidence among countries in 2000, 2005, and 2010 were then calculated. Results. TB incidence rate trends were significantly associated with health expenditure per capita and access to improved sanitation facilities, as well as with life expectancy at birth and TB detection rate, after adjusting for other socioeconomic, demographic, and health services variables. Absolute and relative inequality in TB incidence remained mostly unchanged countries at the bottom 20% of both health expenditure and sanitation coverage distributions concentrated up to 40% of all TB incident cases, despite a considerable decline in the overall TB incidence mean rate during the period assessed. Conclusions. Along with the intensity of TB control (reflected by TB detection rate), both access to sanitation (as a proxy of quality of living conditions) and health expenditure per capita (either as an indicator of the level of resources and/or commitment to health care) appear to be key determinants of TB incidence trends in LAC countries. Inequalities in both health expenditure per capita and access to sanitation seem to define profound and persistent inverse gradients in TB incidence among LAC countries.
Texto completo:
Disponível
Coleções:
Bases de dados de organismos internacionais
Contexto em Saúde:
ODS3 - Meta 3.8 Atingir a cobertura universal de saúde
/
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
/
Doenças Negligenciadas
Problema de saúde:
Coordenação Multissetorial
/
Objetivo 1: Acesso equitativo aos serviços de saúde
/
Meta 3.8 Atingir a cobertura universal de saúde
/
Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
/
Meta 3.9: Reduzir o número de mortes por produtos químicos perigosos e contaminação do ar e água do solo
/
Doenças Negligenciadas
/
Tuberculose
Base de dados:
PAHO-IRIS
Assunto principal:
Fatores Socioeconômicos
/
Tuberculose
/
Região do Caribe
/
Equidade em Saúde
/
Determinantes Sociais da Saúde
/
América Latina
Tipo de estudo:
Ensaio clínico controlado
/
Estudo de incidência
/
Estudo prognóstico
/
Fatores de risco
/
Estudo de rastreamento
Aspecto:
Determinantes sociais da saúde
/
Equidade e iniquidade
Idioma:
Inglês
Ano de publicação:
2015
Tipo de documento:
Artigo