[Magnitude of social determinants in the risk of death from tuberculosis in Central-west Brazil]

Abstract

Objective: To evaluate the magnitude of social determinants in areas of risk of mortality due to tuberculosis in a high incidence city.

Method: Ecological study, which recruited the cases of tuberculosis deaths registered between 2006 and 2016 in the capital of Mato Grosso-Brazil. The social determinants were obtained from the Human Development Units. Sweep statistics were used to identify areas of risk of mortality due to tuberculosis. Principal component analysis was carried out to identify dimensions of social determinants. Multiple logistic regression was applied to verify associations between the dimensions of social determinants and the risk of mortality from tuberculosis. A 5% error was fixed. The standard error was established at 5% for all statistical tests.

Results: A total of 225 deaths due to tuberculosis were registered in the period, distributed heterogeneously in the space. A cluster of risk for tuberculosis mortality was identified, with RR=2.09 (95%CI: 1.48-2.94; p=0.04). Social determinants, low educational level and poverty were associated with the risk of mortality due to tuberculosis (OR: 2.92; 95%CI: 1.17-7.28). Income had a negative association with the risk of mortality due to tuberculosis (OR: 0.05; 95%CI: 0.00-0.70). The value of the ROC curve of the model was 92.1%.

Conclusions: The results confirmed that the risk of mortality due to tuberculosis is a problem associated with social determinants. Health policies and social protection programmes can collaborate to address this problem.

Keywords: Brasil; Brazil; Determinantes sociales en salud; Mortalidad; Mortality; Mycobacterium tuberculosis; Social determinants of health; Tuberculosis.