社会不平等作为巴西结核病例积极发现策略的效果修饰者:一项生态研究
José Mário Nunes da Silva1, Fredi Alexander Diaz-Quijano2
1Postgraduate Program in Epidemiology, School of Public Health, University of São Paulo, Av. Dr Arnaldo, 715, São Paulo, SP 01246-904, Brazil.
Transactions of the Royal Society of Tropical Medicine and Hygiene
|September 8, 2025
概括
巴西的社会不平等影响了结核病 (TB) 检测率. 积极案例寻找 (ACF) 策略在人类发展较高的地区效率较低,但在社会脆弱性较高的地区更有效.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康 公平 卫生 公平
背景情况:
- 社会不平等显著影响结核病 (TB) 发病率.
- 在结核病检测中,社会不平等作为积极病例发现 (ACF) 策略的效果修饰者的作用需要进行调查.
研究的目的:
- 估计ACF策略与结核病检测率之间的关联.
- 评估这些协会因社会不平等而改变的效果. 在巴西的市政当局.
主要方法:
- 包括5033个报告结核病病例的市镇.
- 定义的结核病检测率作为结果.
- 报告社区ACF和家庭接触调查 (HCI) 作为暴露的初级保健团队 (PCT) 的使用比例.
- 评估市政人力发展指数 (MHDI) 和社会脆弱性指数 (SVI) 作为影响修饰因素.
主要成果:
- 结核病检测率与社区ACF和HCI积极相关.
- 协会随着MHDI的增加而减弱 (ACF IRR为0.95;HCI IRR为0.93).
- 与较高的SVI (ACF IRR 1.11; HCI IRR 1.17) 加强的关联.
结论:
- 巴西市区的社会不平等改变了ACF在结核病检测策略的有效性.
- ACF策略对结核病检测的影响受社会经济因素的影响.
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