On March 24, World Tuberculosis Day is celebrated. According to data from the Bahia State Department of Health (Sesab), 4,750 cases of the disease were recorded in 2018, with 295 deaths throughout the state. Despite the still significant number, there is a gradual fall of the disease in recent years. In 2006, there were 5,972 registered cases, which means a reduction of more than 20% since then. According to studies conducted by the UFBA Institute of Collective Health, the decrease in incidence and mortality rates, identified throughout the country, may be related to the direct performance of the Bolsa Família Program among the poorest families.
New Case Drop
The first survey points to a 15.8% decrease in the incidence of tuberculosis between 2004 and 2012. For this result, 2,458 municipalities were analyzed, responsible for more than 93% of tuberculosis cases diagnosed in Brazil. Thus, the study took into consideration the initial nine years of the Bolsa Família Program, introduced in the country in 2004.
“Our results suggest that the Bolsa Familia Program, although not designed to control tuberculosis, may have contributed at least in part to this reduction,” explains Joilda Nery, a professor at UFBA’s Collective Health Institute who led the program. study.
Also according to the researcher, the program focuses on poor families, which consequently are at high risk of tuberculosis. For her, there is significant evidence to suggest that the program has reduced extreme poverty and alleviated social and economic inequalities, improving nutritional status and other health benefits among the most deprived individuals.
“Bolsa Família is an inclusive public policy that has a positive impact, particularly with regard to poverty-related diseases. Future research should evaluate the effectiveness of these interventions and how they can contribute to tuberculosis control worldwide. ”
Fall in mortality
The second study by the UFBA Institute of Collective Health, published in 2018, evaluated the mortality rates for tuberculosis in Brazil between 2001 and 2012. The research covers the joint effect of the Family Health Strategy, which began in 1994, and the Bolsa Família Program, implemented in 2004.
According to data collected in 1,614 municipalities, primary health care coverage contributed to a reduction in tuberculosis mortality by 16 to 20%, while higher Bolsa Familia coverage contributed to a 12% reduction in mortality. .
Throughout the period evaluated, the number of deaths from the disease fell by 30% in the country. A total of 5,249 deaths from all forms of tuberculosis were recorded in 2001, falling to 4,316 in 2012.
For the researcher responsible for the study, Ramon Andrade de Souza, the performance of the Bolsa Família Program is associated with socioeconomic factors such as housing, food, education and access to health services, resulting in improvements in social conditions. “Direct income transfer can also contribute to better adherence to treatment, increased cure rates and, consequently, a reduction in the number of deaths.”, Explains the researcher.
For him, the study points to the need to strengthen investment in the universal implementation of health policies. “Other studies need to be conducted to increase knowledge about the mechanisms involved in tuberculosis mortality and to establish new associations.”
Both works were developed through the Integrated Program in Epidemiology and Population Health Impact Assessment of ISC / UFBA, in the research line in Tuberculosis Epidemiology. The studies, consisting of doctoral thesis and master’s thesis, respectively, were funded by the Ministry of Health, under the coordination of Professor Susan Martins Pereira.