Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/42846

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CONDITIONAL CASH TRANSFER PROGRAM AND LEPROSY INCIDENCE: ANALYSIS OF 12.9 MILLION FAMILIES FROM THE 100 MILLION BRAZILIAN COHORT (PREPRINT)
Pescarini, Julia Moreira et al. | Date Issued: 2020
Author
Pescarini, Julia Moreira
Williamson, Elizabeth
Ichihara, Maria Y.
Fiaccone, Rosemeire L.
Forastiere, Laura
Ramond, Anna
Nery, Joilda Silva
Penna, Maria Lucia F.
Strina, Agostino
Reis, Sandra
Smeeth, Liam
Rodrigues, Laura C.
Brickley, Elizabeth B.
Penna, Gerson Oliveira
Barreto, Mauricio Lima
Affilliation
Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
London School of Hygiene & Tropical Medicine. Department of Medical Statistics. London, United Kingdom.
Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Institute of Mathematics and Statistics. Salvador, BA, Brasil.
Yale University. Yale Institute for Network Science. New Haven, USA.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, United Kingdom.
Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
Universidade Federal Fluminense. Instituto de Saúde da Comunidade. Niterói, RJ, Brasil.
Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
London School of Hygiene & Tropical Medicine. Department of Non-Communicable Disease Epidemiology. London, United Kingdom.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, United Kingdom.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, United Kingdom.
Fundação Oswaldo Cruz. Escola Fiocruz de Governo. Brasília, DF, Brasil / Universidade de Brasília. Núcleo de Medicina Tropical. Brasília, DF, Brasil.
Fundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
Abstract
Leprosy is a neglected tropical disease predominately affecting poor and marginalized populations. To test the hypothesis that poverty-alleviating policies may be associated with reduced leprosy incidence, we evaluated the association between the Brazilian Bolsa Familia conditional cash transfer Program (BFP) and new leprosy case detection using linked records from 12,949,730 families in the 100 Million Brazilian Cohort (2007-2014). After propensity score matching BFP beneficiary to non-beneficiary families, we used Mantel-Haenszel tests and Poisson regressions to estimate incidence rate ratios (IRRs) for new leprosy case detection and secondary endpoints related to operational classification and leprosy-associated disabilities at diagnosis. Overall, cumulative leprosy incidence was 17.4/100,000 pyr (95%CI: 17.1, 17.7), and markedly higher in "priority" (high-burden) versus "non-priority" (low-burden) municipalities (22.8/100,000 pyr, 95%CI: 22.2, 23.3 versus 14.3/100,000, 95%CI: 14.0, 14.7). After matching, BFP participation was not associated with leprosy incidence overall (IRRPoisson 0.97, 95%CI: 0.90, 1.04) but was associated with lower leprosy incidence when restricted to families living in high-burden municipalities (IRRPoisson 0.86, 95%CI: 0.77, 0.96). In high-burden municipalities, the association was particularly pronounced for paucibacillary cases (IRRPoisson 0.82, 95%CI: 0.68, 0.98) and cases with leprosy-associated disabilities (IRRPoisson 0.79, 95%CI: 0.65, 0.97). These findings provide policy-relevant evidence that social policies may contribute to on-going leprosy control efforts in high-burden communities.
Keywords in Portuguese
Programa Bolsa Família
Renda
Pobreza
Desigualdade
Doenças infecciosas
Hanseníase
 
Keywords
Bolsa Familia Program
Cash transfers
Poverty
Inequality
Infectious diseases
Hansen’s disease
 
Publisher
Bloomberg School of Public Health
Later version
https://www.arca.fiocruz.br/handle/icict/45505
Citation
PESCARINI, Julia Moreira et al. Conditional Cash Transfer Program and Leprosy Incidence: Analysis of 12.9 Million Families From the 100 Million Brazilian Cohort. American Journal of Epidemiology, p. 1-25, 2020.
DOI
10.1093/aje/kwaa127
ISSN
0002-9262