Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/59117
Type
ArticleCopyright
Open access
Sustainable Development Goals
03 Saúde e Bem-EstarCollections
- INI - Artigos de Periódicos [3646]
Metadata
Show full item record
EFFECTIVENESS OF A MULTICOMPONENT INTERVENTION TO FACE THE COVID-19 PANDEMIC IN RIO DE JANEIRO'S FAVELAS: DIFFERENCE-IN-DIFFERENCES ANALYSIS
Control Strategies
Infections
Diseases
Disorders
Injuries
Intervention Study
Public Health
Ethics approval This study involves human participants and was approved by National Research Ethics Committee (IRB/CONEP) (CAAE - 44180921.5.0000.5249 and 44180821.1.0000.5249).
Author
Affilliation
Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil / Pontifical Catholic University of Rio de Janeiro. Tecgraf Institute. Rio de Janeiro, RJ, Brazil.
Associação Redes de Desenvolvimento da Maré. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.
Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil / Pontifical Catholic University of Rio de Janeiro. Tecgraf Institute. Rio de Janeiro, RJ, Brazil.
Barcelona Institute for Global Health. Barcelona, Spain / University of São Paulo Hospital of Clinics. São Paulo, SP, Brazil.
Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil / Pontifical Catholic University of Rio de Janeiro. Tecgraf Institute. Rio de Janeiro, RJ, Brazil.
D'Or Institute of Research and Education. Rio de Janeiro, RJ, Brazil / Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. Rio de Janeiro, RJ, Brazil.
Associação Redes de Desenvolvimento da Maré. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.
Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil / Pontifical Catholic University of Rio de Janeiro. Tecgraf Institute. Rio de Janeiro, RJ, Brazil.
Barcelona Institute for Global Health. Barcelona, Spain / University of São Paulo Hospital of Clinics. São Paulo, SP, Brazil.
Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil / Pontifical Catholic University of Rio de Janeiro. Tecgraf Institute. Rio de Janeiro, RJ, Brazil.
D'Or Institute of Research and Education. Rio de Janeiro, RJ, Brazil / Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. Rio de Janeiro, RJ, Brazil.
Abstract
Introduction: Few community-based interventions addressing the transmission control and clinical management of COVID-19 cases have been reported, especially in poor urban communities from low-income and middle-income countries. Here, we analyse the impact of a multicomponent intervention that combines community engagement, mobile surveillance, massive testing and telehealth on COVID-19 cases detection and mortality rates in a large vulnerable community (Complexo da Maré) in Rio de Janeiro, Brazil. Methods: We performed a difference-in-differences (DID) analysis to estimate the impact of the multicomponent intervention in Maré, before (March-August 2020) and after the intervention (September 2020 to April 2021), compared with equivalent local vulnerable communities. We applied a negative binomial regression model to estimate the intervention effect in weekly cases and mortality rates in Maré. Results: Before the intervention, Maré presented lower rates of reported COVID-19 cases compared with the control group (1373 vs 1579 cases/100 000 population), comparable mortality rates (309 vs 287 deaths/100 000 population) and higher case fatality rates (13.7% vs 12.2%). After the intervention, Maré displayed a 154% (95% CI 138.6% to 170.4%) relative increase in reported case rates. Relative changes in reported death rates were -60% (95% CI -69.0% to -47.9%) in Maré and -28% (95% CI -42.0% to -9.8%) in the control group. The case fatality rate was reduced by 77% (95% CI -93.1% to -21.1%) in Maré and 52% (95% CI -81.8% to -29.4%) in the control group. The DID showed a reduction of 46% (95% CI 17% to 65%) of weekly reported deaths and an increased 23% (95% CI 5% to 44%) of reported cases in Maré after intervention onset. Conclusion: An integrated intervention combining communication, surveillance and telehealth, with a strong community engagement component, could reduce COVID-19 mortality and increase case detection in a large vulnerable community in Rio de Janeiro. These findings show that investment in community-based interventions may reduce mortality and improve pandemic control in poor communities from low-income and middle-income countries.
Keywords
COVID-19Control Strategies
Infections
Diseases
Disorders
Injuries
Intervention Study
Public Health
Publisher
BMJ Publishing Group Ltd
Citation
BATISTA-DA-SILVA, Amanda de Araujo et al. Effectiveness of a multicomponent intervention to face the COVID-19 pandemic in Rio de Janeiro's favelas: difference-in-differences analysis. BMJ Global Health, v. 8, n. 5, p. 1-12, May 2023.DOI
10.1136/bmjgh-2022-009997ISSN
2059-7908Notes
Collaborators Comitê Gestor (steering committee) Conexão Saúde is composed of Luna Arouca (Redes da Maré), Valcler Rangel Fernandes (FIOCRUZ), Sabine Zink Bolonhini (SAS Brasil), Eduardo Pádua (União Rio), Andre Lima (Conselho Comunitario de Manguinhos) and Fernando Bozza (FIOCRUZ and Dados do Bem).Ethics approval This study involves human participants and was approved by National Research Ethics Committee (IRB/CONEP) (CAAE - 44180921.5.0000.5249 and 44180821.1.0000.5249).
Share