Tuberculosis and its associated factors in a city in the metropolitan region of Rio de Janeiro

ABSTRACT: Introduction: The occurrence of tuberculosis has been related to the spatial organization and improvement of the living conditions of the population. However, this relationship is not directly related and tuberculosis illness involves processes at different levels of organization. Method: An ecological study analyzing the relationship between living conditions and tuberculosis in the city of Niteroi, Brazil. Two indicators, socio-environmental and programmatic, were created by factor analysis and analyzed by regression in the period of 2008 to 2012. Thematic maps were constructed to examine the distribution pattern of the incidence rate and indicators in the city. Results: The results showed a direct and significant association of the two indicators with the incidence rate of tuberculosis. A one-unit higher the programmatic indicator was associated with a 7% higher incidence rate. The socio-environmental indicator was associated with a 27% higher tuberculosis rate. Discussion: The results of the present study were consistent with the direct relationship between tuberculosis and living conditions in the city of Niteroi. Conclusion: We can conclude that the dynamics of tuberculosis transmission in Niteroi can be explained by the occurrence of the disease in areas of consolidated social periphery and by the social vulnerability of specific groups.

摘要：
研究背景：结核病的发生与人群居住环境的空间布局及居住条件改善存在关联，但二者并非直接因果关系，结核病的发病涉及不同组织层级的病理过程。
研究方法：本研究为生态学研究，以巴西尼特罗伊市（Niteroi）为研究区域，分析当地居住条件与结核病发病的关联。研究通过因子分析构建社会环境与防控项目两类指标，并以2008年至2012年为研究时段，采用回归分析对指标进行检验；同时绘制专题地图，以探究该市结核病发病率及各项指标的空间分布格局。
研究结果：两类指标均与结核病发病率存在显著的正向关联。防控项目类指标每提升1个单位，结核病发病率升高7%；社会环境类指标则对应27%的结核病发病率增幅。
讨论：本研究结果与“尼特罗伊市结核病发病与居住条件存在正向关联”的结论相符。
结论：综上，尼特罗伊市结核病传播的动态特征可通过疾病在已成型的社会边缘区域的发生情况，以及特定群体的社会脆弱性特征加以阐释。