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Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates

Author

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  • Barbara Reis-Santos
  • Priya Shete
  • Adelmo Bertolde
  • Carolina M Sales
  • Mauro N Sanchez
  • Denise Arakaki-Sanchez
  • Kleydson B Andrade
  • M Gabriela M Gomes
  • Delia Boccia
  • Christian Lienhardt
  • Ethel L Maciel

Abstract

Introduction: Tuberculosis incidence is disproportionately high among people in poverty. Cash transfer programs have become an important strategy in Brazil fight inequalities as part of comprehensive poverty alleviation policies. This study was aimed at assessing the effect of being a beneficiary of a governmental cash transfer program on tuberculosis (TB) treatment cure rates. Methods: We conducted a longitudinal database study including people ≥18 years old with confirmed incident TB in Brazil in 2015. We treated missing data with multiple imputation. Poisson regression models with robust variance were carried out to assess the effect of TB determinants on cure rates. The average effect of being beneficiary of cash transfer was estimated by propensity-score matching. Results: In 2015, 25,084 women and men diagnosed as new tuberculosis case, of whom 1,714 (6.8%) were beneficiaries of a national cash transfer. Among the total population with pulmonary tuberculosis several determinants were associated with cure rates. However, among the cash transfer group, this association was vanished in males, blacks, region of residence, and people not deprived of their freedom and who smoke tobacco. The average treatment effect of cash transfers on TB cure rates, based on propensity score matching, found that being beneficiary of cash transfer improved TB cure rates by 8% [Coefficient 0.08 (95% confidence interval 0.06–0.11) in subjects with pulmonary TB]. Conclusion: Our study suggests that, in Brazil, the effect of cash transfer on the outcome of TB treatment may be achieved by the indirect effect of other determinants. Also, these results suggest the direct effect of being beneficiary of cash transfer on improving TB cure rates.

Suggested Citation

  • Barbara Reis-Santos & Priya Shete & Adelmo Bertolde & Carolina M Sales & Mauro N Sanchez & Denise Arakaki-Sanchez & Kleydson B Andrade & M Gabriela M Gomes & Delia Boccia & Christian Lienhardt & Ethel, 2019. "Tuberculosis in Brazil and cash transfer programs: A longitudinal database study of the effect of cash transfer on cure rates," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-18, February.
    • Handle: RePEc:plo:pone00:0212617
    DOI: 10.1371/journal.pone.0212617
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    References listed on IDEAS

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    5. Glewwe, Paul & Kassouf, Ana Lucia, 2012. "The impact of the Bolsa Escola/Familia conditional cash transfer program on enrollment, dropout rates and grade promotion in Brazil," Journal of Development Economics, Elsevier, vol. 97(2), pages 505-517.
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    1. Dalila Camêlo Aguiar & Ramón Gutiérrez Sánchez & Edwirde Luiz Silva Camêlo, 2020. "Hierarchical Clustering with Spatial Constraints and Standardized Incidence Ratio in Tuberculosis Data," Mathematics, MDPI, vol. 8(9), pages 1-12, September.

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