Socio-spatial inequalities related to tuberculosis in the city of Itaboraí, Rio de Janeiro

ABSTRACT: Introduction: Tuberculosis remains as a global public health problem and its occurrence and distribution is associated with social inequalities. Itaboraí is among the priority Brazilian municipalities for tuberculosis control. The study aimed to combine social indicators into a composite indicator to measure differences in living conditions of the population in Itaboraí, as well as evidence of health inequalities related to tuberculosis. Methods: An ecological study, with spatial analysis of tuberculosis and its relation to socioeconomic and demographic status of households. Data were obtained from individuals declared in the Mortality Information System (SIM), notified in the Notification of Injury Information System - SINAN or Tuberculosis Special Treatment Information System - SITETB from 2007 to 2013. Results: Evidence indicates association between sociodemographic inequalities and occurrence of tuberculosis in the population. Findings point to a lower percentage of healing and a higher percentage of abandonment and death in areas with high social vulnerability, with a relative risk over twice as high than that found in areas of lower vulnerability. Conclusion: The study showed strong evidence that the influence of unequal sociodemographic conditions have a negative impact on health conditions of the population in Itaboraí.

摘要：
引言：结核病仍是全球性公共卫生难题，其发生与分布与社会不平等密切相关。伊塔波阿伊（Itaboraí）是巴西结核病防控重点市政辖区之一。本研究旨在将社会指标整合为综合指标，以衡量伊塔波阿伊市居民生活条件的差异，并探究与结核病相关的健康不平等现象。
方法：本研究为生态学研究，开展结核病空间分析，并探讨其与家庭社会经济及人口学特征的关联。研究数据来源于2007年至2013年间，在死亡信息系统（Mortality Information System，SIM）、伤害通报信息系统（Notification of Injury Information System，SINAN）或结核病特殊治疗信息系统（Tuberculosis Special Treatment Information System，SITETB）中申报的个体信息。
结果：研究结果显示，人群中社会人口学不平等与结核病的发生存在关联。研究发现，在社会脆弱性较高的区域，患者治愈率更低，失访率与死亡率更高，相对风险是低脆弱性区域的两倍以上。
结论：本研究提供了强有力的证据，表明不平等的社会人口学条件对伊塔波阿伊市居民的健康状况存在负面影响。