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Spatial distribution of hospitalizations for tuberculosis and their relationship with the indicators of social inequity in the municipality of Natal/RN

Grant number: 13/17057-5
Support type:Scholarships in Brazil - Doctorate
Effective date (Start): January 01, 2014
Effective date (End): August 08, 2016
Field of knowledge:Health Sciences - Nursing - Public Health Nursing
Principal researcher:Ricardo Alexandre Arcêncio
Grantee:Maria Concebida da Cunha Garcia
Home Institution: Escola de Enfermagem de Ribeirão Preto (EERP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil


The development, evolution and progression of tuberculosis (TB) cases admissions were described in the scientific literature as a clear marker of social inequities to access the health services, from the characteristics of supply and health services, territorial conditions, households and social opportunities of the population. There is a considerable number of studies that proposed to measure the relation of TB hospitalizations with the supply and use of health services. However, there are still few researches that verify the connection between this indicator and social inequity, in the territories. The social inequity is assumed, in the research, as an unequal distribution of income and assets (material and non-material), of a society. Thus, the study aims to analyze the spatial distribution of TB hospitalizations according to the census tracts and their link with indicators of social inequity, in the municipality of Natal - RN. This is an ecological study whose hospitalization data is going to be obtained from the Hospital Information System of the Unified Health System (SIH/SUS). The period corresponding to the selection of TB admissions will be from 2008 to 2012. The authors shall use, as the analysis unit, the census tracts defined by the 2010 Census, from the Brazilian Institute of Geography and Statistics (IBGE). Synthetic indicators of social inequity will be constructed based on the variables of IBGE, by considering the multivariate statistical techniques of grouping analysis and the technique of principal components analysis, using the software Statistica ® version 10.0. In order to analyze the spatial distribution of TB hospitalizations, data geocoding will be held in the cartographic base with the subsequent obtaining of admissions per year and census tracts. It will be used the software ArcGIS 10.1. In the spatial analysis, it will be used the multiple linear regression with the existence analysis of spatial dependence by applying Moran's global I test. It is also planned to apply the scan statistics and discrete model of Poisson for agglomerates detection, and the performance of relative risk maps to compare the results. The census tracts will be ranked according to the scores obtained in the analyses previously established, and they will be classified as areas with or without problems of social inequity. The health systems exploited by this study may contribute to reducing the differences in exposure and vulnerability to TB and to provide health equity, through intersectoral action. (AU)

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