Determinants of tuberculosis in countries of Latin America and the Caribbean
Date
2016-02Metadata
Show full item recordAbstract
Objectives. To explore the relationships among social, economic, environmental, and health
services determinants of tuberculosis (TB) morbidity and mortality, and to identify the mechanisms
that mediate such associations in countries of Latin America and the Caribbean (LAC).
Methods. This was an ecological study of 26 LAC countries that had accurate data available
on 38 selected variables for the year 2010. The countries represented 99% of the TB burden in
LAC. Multivariate linear regression was used to identify associations among determinants of
health and TB morbidity and mortality.
Results. TB-HIV coinfection and multidrug resistant TB (MDR-TB) in previously
treated
cases were found to be positively associated to TB morbidity and negatively associated to improved
basic sanitation and water coverage—pointing to an increase of TB morbidity in the first two
variables and a decrease of TB morbidity in the last two. Regarding TB mortality, indigenous
people and MDR-TB in previously
treated cases were positively associated. In contrast, literacy
among women, basic sanitation,
water coverage, and nutritional status were negatively associated
to mortality, denoting that improvements in these areas could reduce TB mortality.
Conclusions. The study findings support intersectoral actions that address social, economic,
environmental, and health services determinants within the Stop TB strategy. The
mechanisms by which social determinants of health affect current trend outcomes extend
beyond medical interventions to control TB, but more research is needed to understand how
and to develop actionable recommendations.
Translated title
Determinantes de la tuberculosis en los países de América Latina y el Caribe
Subject
Citation
Bergonzoli G, Castellanos LG, Rodríguez R, Garcia LM. Determinants of tuberculosis in countries of Latin America and the Caribbean. Rev Panam Salud Publica. 2016;39(2):101–5.
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