Bayesian spatio-temporal models for mapping TB mortality risk and its relationship with social inequities in a region from Brazilian Legal Amazon

Reducing TB mortality is a great challenge in Brazil due to its territorial extension, cultural variations and economic and political crises, which impact the health system. This study aimed to estimate in space and time the risk of TB mortality and test its relationship with social inequities. This...

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Bibliographic Details
Published in:	Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 114; no. 5; pp. 323 - 331
Main Authors:	Alves, Josilene D, Chiaravalloti-Neto, Francisco, Arroyo, Luiz H, Arcoverde, Marcos A M, Santos, Danielle T, Berra, Thaís Z, Alves, Luana S, Ramos, Antônio C V, Campoy, Laura T, Belchior, Aylana S, Assis, Ivaneliza S, Nunes, Carla, Forati, Regina C, Serrano-Gallardo, Pilar, Arcêncio, Ricardo A
Format:	Journal Article
Language:	English
Published:	England 07-05-2020
Subjects:	Bayesian inference Mortality Public health TB
Online Access:	Get full text
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Summary:	Reducing TB mortality is a great challenge in Brazil due to its territorial extension, cultural variations and economic and political crises, which impact the health system. This study aimed to estimate in space and time the risk of TB mortality and test its relationship with social inequities. This was an ecological study that included deaths from TB between 2006 and 2016 in Cuiabá, Brazilian Legal Amazon. Bayesian models based on the integrated nested Laplace approximation approach were used to estimate spatio-temporal RRs. RRs for TB mortality were obtained according to the covariables representative of social inequities. The risk of TB mortality was stable between 2006 and 2016 and high-risk areas were identified throughout the municipality studied. Regarding social inequities, income was an important factor associated with TB mortality risk, as an increase of 1 SD in income resulted in a 35.4% (RR 0.646; CI 95% 0.476 to 0.837) decrease in risk. The results provided evidence of areas with higher TB mortality risks that have persisted over time and are related to social inequities. Advancing social policies and protections in these areas will contribute to achieving the WHO's End TB strategy.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0035-9203 1878-3503
DOI:	10.1093/trstmh/traa008