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Free Content Effect of Brazil's conditional cash transfer programme on tuberculosis incidence

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OBJECTIVE: To evaluate the impact of the Brazilian cash transfer programme (Bolsa Família Programme, BFP) on tuberculosis (TB) incidence in Brazil from 2004 to 2012.

DESIGN: We studied tuberculosis surveillance data using a combination of an ecological multiple-group and time-trend design covering 2458 Brazilian municipalities. The main independent variable was BFP coverage and the outcome was the TB incidence rate. All study variables were obtained from national databases. We used fixed-effects negative binomial models for panel data adjusted for selected covariates and a variable representing time.

RESULTS: After controlling for covariates, TB incidence rates were significantly reduced in municipalities with high BFP coverage compared with those with low and intermediate coverage (in a model with a time variable incidence rate ratio = 0.96, 95%CI 0.93–0.99).

CONCLUSION: This was the first evidence of a statistically significant association between the increase in cash transfer programme coverage and a reduction in TB incidence rate. Our findings provide support for social protection interventions for tackling TB worldwide.
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Keywords: Bolsa Família Programme; Brazil; TB

Document Type: Research Article

Affiliations: 1: Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil 2: Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK 3: National Program of Tuberculosis Control, Brazilian Health Ministry, Brasília, Distrito Federal 4: Tropical Medicine Center, University of Brasília, Brasília, Distrito Federal 5: Health Sciences Center, Institute of Community Health, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil

Publication date: 2017-07-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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