The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil
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- Daniel J Carter
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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- Rhian Daniel
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
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- Ana W Torrens
- Tropical Medicine Department, University of Brasília, Brasília, Brazil
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- Mauro N Sanchez
- Federal University of Brasília, Brasília, Brazil
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- Ethel Leonor N Maciel
- Federal University of Espírito Santo, Vitoria, Brazil
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- Patricia Bartholomay
- National Tuberculosis Programme/Ministry of Health, Brasília, Brazil
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- Draurio C Barreira
- National Tuberculosis Programme/Ministry of Health of Brazil, Brasília, Brazil
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- Davide Rasella
- Centro de Pesquisas Gonçalo Muniz, Fundação Oswaldo Cruz, Salvador, Brazil
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- Mauricio L Barreto
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
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- Laura C Rodrigues
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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- Delia Boccia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
書誌事項
- 公開日
- 2019-01
- DOI
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- 10.1136/bmjgh-2018-001029
- 公開者
- BMJ
説明
<jats:sec> <jats:title>Background</jats:title> <jats:p>Evidence suggests that social protection policies such as Brazil’s Bolsa Família Programme (BFP), a governmental conditional cash transfer, may play a role in tuberculosis (TB) elimination. However, study limitations hamper conclusions. This paper uses a quasi-experimental approach to more rigorously evaluate the effect of BFP on TB treatment success rate.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Propensity scores were estimated from a complete-case logistic regression using covariates from a linked data set, including the Brazil’s TB notification system (SINAN), linked to the national registry of those in poverty (CadUnico) and the BFP payroll.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>The average effect of treatment on the treated was estimated as the difference in TB treatment success rate between matched groups (ie, the control and exposed patients, n=2167). Patients with TB receiving BFP showed a treatment success rate of 10.58 percentage points higher (95% CI 4.39 to 16.77) than patients with TB not receiving BFP. This association was robust to sensitivity analyses.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>This study further confirms a positive relationship between the provision of conditional cash transfers and TB treatment success rate. Further research is needed to understand how to enhance access to social protection so to optimise public health impact.</jats:p> </jats:sec>
収録刊行物
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- BMJ Global Health
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BMJ Global Health 4 (1), e001029-, 2019-01
BMJ