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Title: Ethnic and racial inequalities in notified cases of Tuberculosis in Brazil
Authors: Viana, Paulo Victor de Sousa
Gonçalves, Maria Jacirema Ferreira
Basta, Paulo Cesar
Affilliation: Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Centro de Referência Professor Hélio Fraga. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brasil / Universidade Federal do Amazonas. Escola de Enfermagem de Manaus. Manaus, AM, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Abstract: Objective: This study analysed clinical and sociodemographic aspects and follow-up for notified cases of tuberculosis (TB) and explored inequalities in incidence rates and outcome by colour or race and the geographic macro-regions of Brazil. Methods: This paper reports the results of a population-based descriptive epidemiological study of all notified cases of TB in Brazil during the period from 01/01/2008 to 31/12/2011. We analysed sociodemographic and clinical variables according to colour or race (white, black, Asian, mixed, and indigenous) and geographic macro-regions of the country (North, Northeast, Central-West, South, and Southeast). Results: During the study period, the average incidence of TB in Brazil was 36.7 cases per 100,000 inhabitants, with the highest rates occurring in the North and Southeast regions. The analysis of TB notifications by colour or race revealed that the indigenous population presented the highest incidence rates in all macro-regions except the South, where higher rates were reported in black patients. ‘Cured’ was the most frequently reported treatment outcome for all skin colour categories. The highest cure rate occurred among the indigenous population (76.8%), while the lowest cure rate occurred among the black population (70.7%). Rates of treatment default were highest among blacks (10.5%) and lowest among the indigenous population (6.9%). However, the fatality rate was similar across race categories, varying between 2.8% and 3.8% for whites and the indigenous population, respectively. The lowest cure rates were observed when follow-up was inadequate (58.3%), and the highest was observed when the follow-up was classified as excellent (96.8%). Conclusions: This study revealed that—apart from the heterogeneous distribution of TB among the Brazilian macro-regions—ethnic-racial inequalities exist in terms of clinical-epidemiological characteristics and incidence rates as well as follow-up for cases undergoing treatment. The highest rates of TB occurred among the indigenous people.
Keywords: Tuberculosis
Indigenous populations
Virus testing
Ethnic epidemiology
Keywords: Doenças Infecciosas
Região Norte
Região Sudeste
DeCS: Brasil
Índios Sul-Americanos
Saúde de Populações Indígenas
Doenças Transmissíveis
Tuberculose / diagnóstico
Issue Date: 2016
Publisher: Public Library of Science
Citation: VIANA, Paulo Victor de Sousa; GONÇALVES, Maria Jacirema Ferreira; BASTA, Paulo Cesar. Ethnic and racial inequalities in notified cases of Tuberculosis in Brazil. PLoS ONE, v. 11, n. 5, p. 1-16, 13 May 2016.
metadata.dc.identifier.doi: 10.1371/journal.pone.0154658
ISSN: 1932-6203
Copyright: open access
Appears in Collections:DIP - Artigos de Periódicos

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